Nursing Practice II- Community Health Nursing And care Of The Mother And Child (Practice Mode)
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May arrives at the health care clinic and tells the nurse that her last menstrual period was 9 weeks ago. She also tells the nurse that a home pregnancy test was positive but she began to have mild cramps and is now having moderate vaginal bleeding. During the physical examination of the client, the nurse notes that May has a dilated cervix. The nurse determines that May is experiencing which type of abortion?
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Inevitable
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Incomplete
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Threatened
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Septic
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Mark the letter of the letter of choice then click on the next button. Answer will be revealed after each question. No time limit to finish the exam. Good luck!
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- 2.
Nurse Reese is reviewing the record of a pregnant client for her first prenatal visit. Which of the following data, if noted on the client’s record, would alert the nurse that the client is at risk for a spontaneous abortion?
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Age 36 years
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History of syphilis
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History of genital herpes
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History of diabetes mellitus
Correct Answer
A. History of syphilisExplanation
Maternal infections such as syphilis, toxoplasmosis, and rubella are causes of spontaneous abortion.Rate this question:
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- 3.
Nurse Hazel is preparing to care for a client who is newly admitted to the hospital with a possible diagnosis of ectopic pregnancy. Nurse Hazel develops a plan of care for the client and determines that which of the following nursing actions is the priority?
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Monitoring weight
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Assessing for edema
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Monitoring apical pulse
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Monitoring temperature
Correct Answer
A. Monitoring apical pulseExplanation
Nursing care for the client with a possible ectopic pregnancy is focused on preventing or identifying hypovolemic shock and controlling pain. An elevated pulse rate is an indicator of shock.Rate this question:
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- 4.
Nurse Oliver is teaching a diabetic pregnant client about nutrition and insulin needs during pregnancy. The nurse determines that the client understands dietary and insulin needs if the client states that the second half of pregnancy require:
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Decreased caloric intake
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Increased caloric intake
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Decreased Insulin
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Increase Insulin
Correct Answer
A. Increased caloric intakeExplanation
Glucose crosses the placenta, but insulin does not. High fetal demands for glucose, combined with the insulin resistance caused by hormonal changes in the last half of pregnancy can result in elevation of maternal blood glucose levels. This increases the mother’s demand for insulin and is referred to as the diabetogenic effect of pregnancy.Rate this question:
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- 5.
Nurse Michelle is assessing a 24 year old client with a diagnosis of hydatidiform mole. She is aware that one of the following is unassociated with this condition?
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Excessive fetal activity.
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Larger than normal uterus for gestational age.
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Vaginal bleeding
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Elevated levels of human chorionic gonadotropin.
Correct Answer
A. Excessive fetal activity.Explanation
The most common signs and symptoms of hydatidiform mole includes elevated levels of human chorionic gonadotropin, vaginal bleeding, larger than normal uterus for gestational age, failure to detect fetal heart activity even with sensitive instruments, excessive nausea and vomiting, and early development of pregnancy-induced hypertension. Fetal activity would not be noted.Rate this question:
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- 6.
A pregnant client is receiving magnesium sulfate for severe pregnancy induced hypertension (PIH). The clinical findings that would warrant use of the antidote , calcium gluconate is:
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Urinary output 90 cc in 2 hours.
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Absent patellar reflexes.
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Rapid respiratory rate above 40/min.
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Rapid rise in blood pressure.
Correct Answer
A. Absent patellar reflexes.Explanation
Absence of patellar reflexes is an indicator of hypermagnesemia, which requires administration of calcium gluconate.Rate this question:
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- 7.
During vaginal examination of Janah who is in labor, the presenting part is at station plus two. Nurse, correctly interprets it as:
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Presenting part is 2 cm above the plane of the ischial spines.
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Biparietal diameter is at the level of the ischial spines.
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Presenting part in 2 cm below the plane of the ischial spines.
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Biparietal diameter is 2 cm above the ischial spines.
Correct Answer
A. Presenting part in 2 cm below the plane of the ischial spines.Explanation
Fetus at station plus two indicates that the presenting part is 2 cm below the plane of the ischial spines.Rate this question:
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- 8.
A pregnant client is receiving oxytocin (Pitocin) for induction of labor. A condition that warrant the nurse in-charge to discontinue I.V. infusion of Pitocin is:
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Contractions every 1 ½ minutes lasting 70-80 seconds.
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Maternal temperature 101.2
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Early decelerations in the fetal heart rate.
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Fetal heart rate baseline 140-160 bpm.
Correct Answer
A. Contractions every 1 ½ minutes lasting 70-80 seconds.Explanation
Contractions every 1 ½ minutes lasting 70-80 seconds, is indicative of hyperstimulation of the uterus, which could result in injury to the mother and the fetus if Pitocin is not discontinued.Rate this question:
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- 9.
Calcium gluconate is being administered to a client with pregnancy induced hypertension (PIH). A nursing action that must be initiated as the plan of care throughout injection of the drug is:
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Ventilator assistance
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CVP readings
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EKG tracings
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Continuous CPR
Correct Answer
A. EKG tracingsExplanation
A potential side effect of calcium gluconate administration is cardiac arrest. Continuous monitoring of cardiac activity (EKG) throught administration of calcium gluconate is an essential part of care.Rate this question:
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- 10.
A trial for vaginal delivery after an earlier caesareans, would likely to be given to a gravida, who had:
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First low transverse cesarean was for active herpes type 2 infections; vaginal culture at 39 weeks pregnancy was positive.
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First and second caesareans were for cephalopelvic disproportion.
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First caesarean through a classic incision as a result of severe fetal distress.
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First low transverse caesarean was for breech position. Fetus in this pregnancy is in a vertex presentation.
Correct Answer
A. First low transverse caesarean was for breech position. Fetus in this pregnancy is in a vertex presentation.Explanation
This type of client has no obstetrical indication for a caesarean section as she did with her first caesarean delivery.Rate this question:
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- 11.
Nurse Ryan is aware that the best initial approach when trying to take a crying toddler’s temperature is:
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Talk to the mother first and then to the toddler.
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Bring extra help so it can be done quickly.
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Encourage the mother to hold the child.
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Ignore the crying and screaming.
Correct Answer
A. Talk to the mother first and then to the toddler.Explanation
When dealing with a crying toddler, the best approach is to talk to the mother and ignore the toddler first. This approach helps the toddler get used to the nurse before she attempts any procedures. It also gives the toddler an opportunity to see that the mother trusts the nurse.Rate this question:
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- 12.
Baby Tina a 3 month old infant just had a cleft lip and palate repair. What should the nurse do to prevent trauma to operative site?
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Avoid touching the suture line, even when cleaning.
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Place the baby in prone position.
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Give the baby a pacifier.
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Place the infant’s arms in soft elbow restraints.
Correct Answer
A. Place the infant’s arms in soft elbow restraints.Explanation
Soft restraints from the upper arm to the wrist prevent the infant from touching her lip but allow him to hold a favorite item such as a blanket. Because they could damage the operative site, such as objects as pacifiers, suction catheters, and small spoons shouldn’t be placed in a baby’s mouth after cleft repair. A baby in a prone position may rub her face on the sheets and traumatize the operative site. The suture line should be cleaned gently to prevent infection, which could interfere with healing and damage the cosmetic appearance of the repair.Rate this question:
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- 13.
Which action should nurse Marian include in the care plan for a 2 month old with heart failure?
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Feed the infant when he cries.
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Allow the infant to rest before feeding.
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Bathe the infant and administer medications before feeding.
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Weigh and bathe the infant before feeding.
Correct Answer
A. Allow the infant to rest before feeding.Explanation
Because feeding requires so much energy, an infant with heart failure should rest before feeding.Rate this question:
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- 14.
Nurse Hazel is teaching a mother who plans to discontinue breast feeding after 5 months. The nurse should advise her to include which foods in her infant’s diet?
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Skim milk and baby food.
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Whole milk and baby food.
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Iron-rich formula only.
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Iron-rich formula and baby food.
Correct Answer
A. Iron-rich formula only.Explanation
The infants at age 5 months should receive iron-rich formula and that they shouldn’t receive solid food, even baby food until age 6 months.Rate this question:
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- 15.
Mommy Linda is playing with her infant, who is sitting securely alone on the floor of the clinic. The mother hides a toy behind her back and the infant looks for it. The nurse is aware that estimated age of the infant would be:
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6 months
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4 months
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8 months
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10 months
Correct Answer
A. 10 monthsExplanation
A 10 month old infant can sit alone and understands object permanence, so he would look for the hidden toy. At age 4 to 6 months, infants can’t sit securely alone. At age 8 months, infants can sit securely alone but cannot understand the permanence of objects.Rate this question:
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- 16.
Which of the following is the most prominent feature of public health nursing?
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It involves providing home care to sick people who are not confined in the hospital.
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Services are provided free of charge to people within the catchments area.
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The public health nurse functions as part of a team providing a public health nursing services.
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Public health nursing focuses on preventive, not curative, services.
Correct Answer
A. Public health nursing focuses on preventive, not curative, services.Explanation
The catchments area in PHN consists of a residential community, many of whom are well individuals who have greater need for preventive rather than curative services.Rate this question:
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- 17.
When the nurse determines whether resources were maximized in implementing Ligtas Tigdas, she is evaluating
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Effectiveness
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Efficiency
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Adequacy
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Appropriateness
Correct Answer
A. EfficiencyExplanation
Efficiency is determining whether the goals were attained at the least possible cost.Rate this question:
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- 18.
Vangie is a new B.S.N. graduate. She wants to become a Public Health Nurse. Where should she apply?
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Department of Health
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Provincial Health Office
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Regional Health Office
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Rural Health Unit
Correct Answer
A. Rural Health UnitExplanation
R.A. 7160 devolved basic health services to local government units (LGU’s ). The public health nurse is an employee of the LGU.Rate this question:
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- 19.
Tony is aware the Chairman of the Municipal Health Board is:
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Mayor
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Municipal Health Officer
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Public Health Nurse
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Any qualified physician
Correct Answer
A. MayorExplanation
The local executive serves as the chairman of the Municipal Health Board.Rate this question:
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- 20.
Myra is the public health nurse in a municipality with a total population of about 20,000. There are 3 rural health midwives among the RHU personnel. How many more midwife items will the RHU need?
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1
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2
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3
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The RHU does not need any more midwife item.
Correct Answer
A. 1Explanation
Each rural health midwife is given a population assignment of about 5,000.Rate this question:
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- 21.
According to Freeman and Heinrich, community health nursing is a developmental service. Which of the following best illustrates this statement?
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The community health nurse continuously develops himself personally and professionally.
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Health education and community organizing are necessary in providing community health services.
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Community health nursing is intended primarily for health promotion and prevention and treatment of disease.
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The goal of community health nursing is to provide nursing services to people in their own places of residence.
Correct Answer
A. Health education and community organizing are necessary in providing community health services.Explanation
The community health nurse develops the health capability of people through health education and community organizing activities.Rate this question:
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- 22.
Nurse Tina is aware that the disease declared through Presidential Proclamation No. 4 as a target for eradication in the Philippines is?
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Poliomyelitis
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Measles
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Rabies
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Neonatal tetanus
Correct Answer
A. MeaslesExplanation
Presidential Proclamation No. 4 is on the Ligtas Tigdas Program.Rate this question:
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- 23.
May knows that the step in community organizing that involves training of potential leaders in the community is:
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Integration
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Community organization
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Community study
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Core group formation
Correct Answer
A. Core group formationExplanation
In core group formation, the nurse is able to transfer the technology of community organizing to the potential or informal community leaders through a training program.Rate this question:
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- 24.
Beth a public health nurse takes an active role in community participation. What is the primary goal of community organizing?
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To educate the people regarding community health problems
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To mobilize the people to resolve community health problems
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To maximize the community’s resources in dealing with health problems.
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To maximize the community’s resources in dealing with health problems.
Correct Answer
A. To maximize the community’s resources in dealing with health problems.Explanation
Community organizing is a developmental service, with the goal of developing the people’s self-reliance in dealing with community health problems. A, B and C are objectives of contributory objectives to this goal.Rate this question:
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- 25.
Tertiary prevention is needed in which stage of the natural history of disease?
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Pre-pathogenesis
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Pathogenesis
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Prodromal
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Terminal
Correct Answer
A. TerminalExplanation
Tertiary prevention involves rehabilitation, prevention of permanent disability and disability limitation appropriate for convalescents, the disabled, complicated cases and the terminally ill (those in the terminal stage of a disease).Rate this question:
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- 26.
The nurse is caring for a primigravid client in the labor and delivery area. Which condition would place the client at risk for disseminated intravascular coagulation (DIC)?
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Intrauterine fetal death.
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Placenta accreta.
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Dysfunctional labor.
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Premature rupture of the membranes.
Correct Answer
A. Intrauterine fetal death.Explanation
Intrauterine fetal death, abruptio placentae, septic shock, and amniotic fluid embolism may trigger normal clotting mechanisms; if clotting factors are depleted, DIC may occur. Placenta accreta, dysfunctional labor, and premature rupture of the membranes aren't associated with DIC.Rate this question:
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- 27.
A fullterm client is in labor. Nurse Betty is aware that the fetal heart rate would be:
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80 to 100 beats/minute
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100 to 120 beats/minute
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120 to 160 beats/minute
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160 to 180 beats/minute
Correct Answer
A. 120 to 160 beats/minuteExplanation
A rate of 120 to 160 beats/minute in the fetal heart appropriate for filling the heart with blood and pumping it out to the system.Rate this question:
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- 28.
The skin in the diaper area of a 7 month old infant is excoriated and red. Nurse Hazel should instruct the mother to:
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Change the diaper more often.
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Apply talc powder with diaper changes.
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Wash the area vigorously with each diaper change.
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Decrease the infant’s fluid intake to decrease saturating diapers.
Correct Answer
A. Change the diaper more often.Explanation
Decreasing the amount of time the skin comes contact with wet soiled diapers will help heal the irritation.Rate this question:
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- 29.
Nurse Carla knows that the common cardiac anomalies in children with Down Syndrome (tri-somy 21) is:
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Atrial septal defect
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Pulmonic stenosis
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Ventricular septal defect
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Endocardial cushion defect
Correct Answer
A. Endocardial cushion defectExplanation
Endocardial cushion defects are seen most in children with Down syndrome, asplenia, or polysplenia.Rate this question:
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- 30.
Malou was diagnosed with severe preeclampsia is now receiving I.V. magnesium sulfate. The adverse effects associated with magnesium sulfate is:
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Anemia
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Decreased urine output
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Hyperreflexia
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Increased respiratory rate
Correct Answer
A. Decreased urine outputExplanation
Decreased urine output may occur in clients receiving I.V. magnesium and should be monitored closely to keep urine output at greater than 30 ml/hour, because magnesium is excreted through the kidneys and can easily accumulate to toxic levels.Rate this question:
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- 31.
A 23 year old client is having her menstrual period every 2 weeks that last for 1 week. This type of menstrual pattern is bets defined by:
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Menorrhagia
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Metrorrhagia
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Dyspareunia
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Amenorrhea
Correct Answer
A. MenorrhagiaExplanation
Menorrhagia is an excessive menstrual period.Rate this question:
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- 32.
Jannah is admitted to the labor and delivery unit. The critical laboratory result for this client would be:
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Oxygen saturation
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Iron binding capacity
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Blood typing
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Serum Calcium
Correct Answer
A. Blood typingExplanation
Blood type would be a critical value to have because the risk of blood loss is always a potential complication during the labor and delivery process. Approximately 40% of a woman’s cardiac output is delivered to the uterus, therefore, blood loss can occur quite rapidly in the event of uncontrolled bleeding.Rate this question:
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- 33.
Nurse Gina is aware that the most common condition found during the second-trimester of pregnancy is:
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Metabolic alkalosis
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Respiratory acidosis
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Mastitis
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Physiologic anemia
Correct Answer
A. Physiologic anemiaExplanation
Hemoglobin values and hematocrit decrease during pregnancy as the increase in plasma volume exceeds the increase in red blood cell production.Rate this question:
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- 34.
Nurse Lynette is working in the triage area of an emergency department. She sees that several pediatric clients arrive simultaneously. The client who needs to be treated first is:
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A crying 5 year old child with a laceration on his scalp.
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A 4 year old child with a barking coughs and flushed appearance.
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A 3 year old child with Down syndrome who is pale and asleep in his mother’s arms.
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A 2 year old infant with stridorous breath sounds, sitting up in his mother’s arms and drooling.
Correct Answer
A. A 2 year old infant with stridorous breath sounds, sitting up in his mother’s arms and drooling.Explanation
The infant with the airway emergency should be treated first, because of the risk of epiglottitis.Rate this question:
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- 35.
Maureen in her third trimester arrives at the emergency room with painless vaginal bleeding. Which of the following conditions is suspected?
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Placenta previa
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Abruptio placentae
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Premature labor
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Sexually transmitted disease
Correct Answer
A. Placenta previaExplanation
Placenta previa with painless vaginal bleeding.Rate this question:
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- 36.
A young child named Richard is suspected of having pinworms. The community nurse collects a stool specimen to confirm the diagnosis. The nurse should schedule the collection of this specimen for:
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Just before bedtime
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After the child has been bathe
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Any time during the day
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Early in the morning
Correct Answer
A. Early in the morningExplanation
Based on the nurse’s knowledge of microbiology, the specimen should be collected early in the morning. The rationale for this timing is that, because the female worm lays eggs at night around the perineal area, the first bowel movement of the day will yield the best results. The specific type of stool specimen used in the diagnosis of pinworms is called the tape test.Rate this question:
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- 37.
In doing a child’s admission assessment, Nurse Betty should be alert to note which signs or symptoms of chronic lead poisoning?
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Irritability and seizures
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Dehydration and diarrhea
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Bradycardia and hypotension
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Petechiae and hematuria
Correct Answer
A. Irritability and seizuresExplanation
Lead poisoning primarily affects the CNS, causing increased intracranial pressure. This condition results in irritability and changes in level of consciousness, as well as seizure disorders, hyperactivity, and learning disabilities.Rate this question:
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- 38.
To evaluate a woman’s understanding about the use of diaphragm for family planning, Nurse Trish asks her to explain how she will use the appliance. Which response indicates a need for further health teaching?
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“I should check the diaphragm carefully for holes every time I use it”
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“I may need a different size of diaphragm if I gain or lose weight more than 20 pounds”
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“The diaphragm must be left in place for atleast 6 hours after intercourse”
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“I really need to use the diaphragm and jelly most during the middle of my menstrual cycle”.
Correct Answer
A. “I really need to use the diaphragm and jelly most during the middle of my menstrual cycle”.Explanation
The woman must understand that, although the “fertile” period is approximately mid-cycle, hormonal variations do occur and can result in early or late ovulation. To be effective, the diaphragm should be inserted before every intercourse.Rate this question:
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- 39.
Hypoxia is a common complication of laryngotracheobronchitis. Nurse Oliver should frequently assess a child with laryngotracheobronchitis for:
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Drooling
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Muffled voice
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Restlessness
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Low-grade fever
Correct Answer
A. RestlessnessExplanation
In a child, restlessness is the earliest sign of hypoxia. Late signs of hypoxia in a child are associated with a change in color, such as pallor or cyanosis.Rate this question:
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- 40.
How should Nurse Michelle guide a child who is blind to walk to the playroom?
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Without touching the child, talk continuously as the child walks down the hall.
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Walk one step ahead, with the child’s hand on the nurse’s elbow.
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Walk slightly behind, gently guiding the child forward.
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Walk next to the child, holding the child’s hand.
Correct Answer
A. Walk one step ahead, with the child’s hand on the nurse’s elbow.Explanation
This procedure is generally recommended to follow in guiding a person who is blind.Rate this question:
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- 41.
When assessing a newborn diagnosed with ductus arteriosus, Nurse Olivia should expect that the child most likely would have an:
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Loud, machinery-like murmur.
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Bluish color to the lips.
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Decreased BP reading in the upper extremities
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Increased BP reading in the upper extremities.
Correct Answer
A. Loud, machinery-like murmur.Explanation
A loud, machinery-like murmur is a characteristic finding associated with patent ductus arteriosus.Rate this question:
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- 42.
The reason nurse May keeps the neonate in a neutral thermal environment is that when a newborn becomes too cool, the neonate requires:
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Less oxygen, and the newborn’s metabolic rate increases.
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More oxygen, and the newborn’s metabolic rate decreases.
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More oxygen, and the newborn’s metabolic rate increases.
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Less oxygen, and the newborn’s metabolic rate decreases.
Correct Answer
A. More oxygen, and the newborn’s metabolic rate increases.Explanation
When cold, the infant requires more oxygen and there is an increase in metabolic rate. Non-shievering thermogenesis is a complex process that increases the metabolic rate and rate of oxygen consumption, therefore, the newborn increase heat production.Rate this question:
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- 43.
Before adding potassium to an infant’s I.V. line, Nurse Ron must be sure to assess whether this infant has:
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Stable blood pressure
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Patant fontanelles
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Moro’s reflex
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Voided
Correct Answer
A. VoidedExplanation
Before administering potassium I.V. to any client, the nurse must first check that the client’s kidneys are functioning and that the client is voiding. If the client is not voiding, the nurse should withhold the potassium and notify the physician.Rate this question:
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- 44.
Nurse Carla should know that the most common causative factor of dermatitis in infants and younger children is:
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Baby oil
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Baby lotion
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Laundry detergent
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Powder with cornstarch
Correct Answer
A. Laundry detergentExplanation
Eczema or dermatitis is an allergic skin reaction caused by an offending allergen. The topical allergen that is the most common causative factor is laundry detergent.Rate this question:
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- 45.
During tube feeding, how far above an infant’s stomach should the nurse hold the syringe with formula?
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6 inches
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12 inches
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18 inches
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24 inches
Correct Answer
A. 6 inchesExplanation
This distance allows for easy flow of the formula by gravity, but the flow will be slow enough not to overload the stomach too rapidly.Rate this question:
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- 46.
In a mothers’ class, Nurse Lhynnete discussed childhood diseases such as chicken pox. Which of the following statements about chicken pox is correct?
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The older one gets, the more susceptible he becomes to the complications of chicken pox.
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A single attack of chicken pox will prevent future episodes, including conditions such as shingles.
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To prevent an outbreak in the community, quarantine may be imposed by health authorities.
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Chicken pox vaccine is best given when there is an impending outbreak in the community.
Correct Answer
A. The older one gets, the more susceptible he becomes to the complications of chicken pox.Explanation
Chicken pox is usually more severe in adults than in children. Complications, such as pneumonia, are higher in incidence in adults.Rate this question:
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- 47.
Barangay Pinoy had an outbreak of German measles. To prevent congenital rubella, what is the BEST advice that you can give to women in the first trimester of pregnancy in the barangay Pinoy?
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Advice them on the signs of German measles.
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Avoid crowded places, such as markets and movie houses.
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Consult at the health center where rubella vaccine may be given.
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Consult a physician who may give them rubella immunoglobulin.
Correct Answer
A. Consult a physician who may give them rubella immunoglobulin.Explanation
Rubella vaccine is made up of attenuated German measles viruses. This is contraindicated in pregnancy. Immune globulin, a specific prophylactic against German measles, may be given to pregnant women.Rate this question:
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- 48.
Myrna a public health nurse knows that to determine possible sources of sexually transmitted infections, the BEST method that may be undertaken is:
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Contact tracing
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Community survey
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Mass screening tests
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Interview of suspects
Correct Answer
A. Contact tracingExplanation
Contact tracing is the most practical and reliable method of finding possible sources of person-to-person transmitted infections, such as sexually transmitted diseases.Rate this question:
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- 49.
A 33-year old female client came for consultation at the health center with the chief complaint of fever for a week. Accompanying symptoms were muscle pains and body malaise. A week after the start of fever, the client noted yellowish discoloration of his sclera. History showed that he waded in flood waters about 2 weeks before the onset of symptoms. Based on her history, which disease condition will you suspect?
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Hepatitis A
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Hepatitis B
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Tetanus
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Leptospirosis
Correct Answer
A. LeptospirosisExplanation
Leptospirosis is transmitted through contact with the skin or mucous membrane with water or moist soil contaminated with urine of infected animals, like rats.Rate this question:
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