Jun 27, 2010

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

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

PART 2 Board Exam test questions 51 - 100

Situation 7: The infant and child mortality rate in the low to middle income countries is ten times higher than industrialized countries. In response to this the WHO and UNICEF launched protocol Integrated Management of Childhood Illness to reduce the morbidity and mortality against childhood illnesses.

51. If a child with diarrhea registers two signs in the yellow row in the IMCCI char, we can classify the patient as:
A. Moderate dehydration
B. Some dehydration
C. Severe dehydration
D. No dehydration

52. Celeste has had diarrhea for 8 days. There is no blood in the stool, he is irritable, his eyes are sunken, the nurse offers fluid to Celeste and he drinks eagerly. When the nurse pinched the abdomen it goes back slowly. How will you classify Celeste’s Illness?
A. Moderate dehydration
B. Some dehydration
C. Severe dehydration
D. No dehydration

53. A child who is 7 weeks has had diarrhea for 14 days but has no sign of dehydration is classified as?
A. Persistent diarrhea
B. Severe dysentery
C. Dysentery
D. Severe Persistent diarrhea

54. 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. Forced fluids
B. When to return
C. Give Vitamin A supplement
D. Feeding more

55. Fever as used in IMCI includes:
A. Axillary temperature of 37.5 or higher
B.  Rectal temperature of 38 or higher
C. Feeling hot to touch
D. All of the above
E. A and C only

Situation: Prevention of Dengue is an important nursing responsibility and controlling it’s spread is priority once outbreak has been observed.

56.  An important role of the community health nurse in the prevention and control of Dengue H-fever includes:
A. Advising the elimination of vectors by keeping water containers covered
B. Conducting strong health education drives/campaign directed toward proper garbage disposal
C. Explaining to the individuals, families, groups and community the nature of the disease and its causation.
D. Practicing residual spraying with insectesides

57. Community health nurses should be alert in observing a Dengue suspect. The following is NOT an indicator for hospitalization of H-fever suspects?
A. Marked anorexia, abdominal pain and vomiting
B. Increasing hematocrit count
C. Cough of 30 days
D. Persistent headache

58. The community health nurses primary concern in the immediate control of hemmorrhage among patients with dengue is:
A. Advising low fiber and non-fat diet
B. Providing warmth through light weight covers
C. Observing closely the patient for vital signs leading to shock
D. Keeping the patient at rest.

59. Which of these signs may NOT be REGARDED as a truly positive signs indicative of Dengue H-fever?
A. Prolonged Bleeding Time
B. Appearance of at least 20 petechiae within 1 cm square
C. Steadily increasing hematocrit count
D. Fall in the platelet count

60. Which of the following is the most important treatment of patients with Dengue H-fever?
A. Give aspirin for fever
B. Replacement of body fluids
C. Avoid unnecessary movement
D. Ice cap over abdomen in case of melena

Situation 9: Health education and Health Promotion is an important part of nursing responsibility in the community. Immunization is a form of health promotion that aims at preventingthe common childhood illnesses.

61. In correcting misconception and myths about certain diseases and their management, the health worker should first:
A. Identify the myths and misconceptions prevailing in the community
B. Identify the source of these myths and misconceptions
C. Explain how and why these myths came about
D. Select the appropriate IEC strategies to correct them.

62. How many percent of measles are prevented by immunization at 9 months age?
A. 80 %
B. 90%
C. 99 %
D. 95 %

63. After TT3 vaccination a mother is said to be protected to tetanus by around?
A. 80 %
B. 85 %
C. 99 %
D. 90 %

64. If ever convulsion occurs after administering DPT, what should nurse best suggest to the mother?
A. Do not continue DPT vaccination anymore
B. Advise mother to come back aster 1 week
C. Give DT instead of DPT
D. Give pertussis of the DPT and remove DT

65. These vaccines are given 3 doses at one month intervals:
C. OPV, Hep. B, DPT
D. Measles, OPV, DPT

Situation 10: With the increasing documented cases of CANCER the best alternative to treatment still remains to be PREVENTION. The following conditions apply.

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

67. In the prevention and control of cancer, which of the following activity is the most important function of the community health nurse?
A. Conduct community assemblies
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.

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

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

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

Situation 11 – Two children were brought to you. One with chest indrawing and  the other had diarrhea. The following  questions apply:

71. Using Integrated Management and Childhood Illness (IMCI) approach, how would you classify the 1st child?
A. Brochopneumonia
B. No pneumonia: cough or cold
C. Severe pneumonia
D. Pneumonia

72. The 1st child who is 13 months has fast breathing using IMCI parameters he has:
A. 40 breaths per minute or more
B. 50 breaths per minute
C. 30 breaths per minute or more
D. 60 breaths per minute

73. Nina, the 2nd child has diarrhea for 5 days. There is no blood in the stool. She is irritable and her eyes are sunken. The nurse offered fluids and the child drinks eagerly. How would you classify Nina’s illness?
A. Some dehydration
B. Dysentery
C. Severe dehydration
D. No dehydration
74. Nina’s treatment should include the following EXCEPT:
A. Reassess the child and classify him for dehydration
B. For infants under 6 months old who are not breastfed, give 100-200 ml clean water as well during this period.
C. Give in the health center the recommended amount of ORS for 4 hours.
D. Do not give any other foods to the child for home treatment

75. While on treatment, Nina 18 months old weighed 18 kgs and her temperature registered at 37 degrees C. Her mother says she developed cough 3 days ago. Nina has no general danger signs. She has 45 breaths/minute, no chest indrawing, no stridor. How would you classify Nina’s manifestation.
A. No pneumonia
B. Severe pneumonia
C. Pneumonia
D. Bronchopneumonia

76. 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

77. 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

78. 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

79. 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

80. 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

81. 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

82. 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

83. 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

84. 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

85. 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 12: The following questions refer to common clinical encounters experienced by an entry level nurse.

86. A female client asks the nurse about the use of cervical cap. Which statement is correct regarding the use of the cervical cap?
A. It may affect Pap smear results
B. It does not need to be fitted by the physician
C. It does not require the use of spermicide
D. It must be removed within 24 hours

87. The major components of the communication process are?
A. Verbal, written, and nonverbal
B. Speaker, Listener and reply
C. Facial expression, tone of voice and gestures
D. Message, sender, channel, Receiver and Feedback

88. The extent of burns in children are normally assessed and expressed in terms of:
A. The amount of body surface that is unburned
B. Percentages of total body surface area (TBSA)
C. How deep the deepest burns are
D. The severity of the burns on a 1 to 5 burn scale

89. The school nurse notices a child who is wearing old, dirty, poor-fitting clothes; is
always hungry; has no lunch money; and is always tired. When the nurse asks the boy his
tiredness, he talks of playing outside until midnight. The nurse will suspect that this child
A. Being raised by a parent of low intelligence (IQ)
B. An orphan
C. A victim of child neglect
D. The victim of poverty

90. Which of the following indicates the type(s) of acute renal failure?
A. Four types: hemorrhagic with and without clotting, and non hemorrhagic with and without clotting
B. One type: Acute
C. Three types: Prerenal, intrarenal, postrenal
D. Two types: Acute and subacute

Situation 13: Mike 16 y/o has been diagnose to have AIDS, he worked as entertainer in a cruise ship:

91. Which method of transmission is common to contract AIDS:
A. Syringe and needles
B. Body fluids
C. Sexual contact
D. Transfusion

92. Causative organism in AIDS is one of the following:
A. Fungus
B. Bacteria
C. Retrovirus
D. Parasites

93. You are assigned in a private room of Mike. Which procedure should be of outmost importance:
A. Alcohol wash
B. Universal precaution
C. Washing isolation
D. Gloving technique

94. What primary health teaching would you give to Mike?
A. Daily exercise
B. Prevent infection
C. Reversal Isolation
D. Proper nutrition

95. Exercise precaution must be taken to protect health worker dealing with the AIDS patients, which among these must be done as priority?
A. Boil used syringed and needles
B. Use gloves when handling specimen
C. Label personal belonging
D. Avoid accidental wound

Situation 14: Michelle is a 6 year old preschooler. She was reported by her sister to have measles but she was at home because of fever, upper respiratory problem and white sports in her mouth.

96. Rubeola is an Arabic term meaning Red, the rash appears on the skin in invasive stage prior to eruption. As a nurse, your physical examination must determine complication especially:
A. Otitis media
B. Bronchial pneumonia
C. Inflammatory conjunctiva
D. Membranous laryngitis

97. To render comfort measure is one of the priorities, which includes care of the skin, eyes, ears, mouth and nose. To clean the mouth, your antiseptic is in some form of which one below?
A. Water
B. Sulfur
C. Alkaline
D. Salt

98. As a public health nurse, you teach mother and family members the prevention of complication of measles. Which of the following should be closely watched?
A. Temperature fails to drop
B. Inflammation of the conjunctiva
C. Inflammation of the nasopharynx
D. Ulcerative stomatitis

99. Source of infection of measles is secretion of nose and throat of infection person. Filterable of measles is transmitted by:
A. Water supply
B. Droplet
C. Food ingestion
D. Sexual contact

100. Method of prevention is to avoid exposure to an infection person. Nursing responsibility for rehabilitation of patient includes the provision of:
A. Terminal disinfection
B. Injection of gamma globulin
C. Immunization
D. Comfort measures

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