Comminicable Disease FC Exam PDF

COMMUNICABLE DISEASES Final Coaching Exam – Prof. Daclis 1. The nurse is to explain to a client and his family about transmission based precautions. It was verbalized by the client that he felt “unclean and disliked” as a result of the perception that he was highly com...

COMMUNICABLE DISEASES Final Coaching Exam – Prof. Daclis 1. The nurse is to explain to a client and his family about transmission based precautions. It was verbalized by the client that he felt “unclean and disliked” as a result of the perception that he was highly communicable. The nurse’s MOST appropriate instructions would include: 1. Protective equipment used by the staff are to protect the client. 2. Precautions are temporary and continuously evaluated ✓ 3. Proper hand hygiene before and after visiting the client is very effective in preventing infection ✓ 4. Patient care items like glasses, pitchers, basin must always be in clean condition to prevent spread of infection ✓ A. 2, 3, 4 B. 1, 2, 3 C. 1, 3, 4 D. 1, 2, 4 Standard Precaution Transmission-based Precaution - Applicable to all patients - Highly contagious - HIV - AIDs with Pneumocystis Pneumonia - Chicken pox (Crust all lesions) - Chickenpox Period of Communicability “POC” COVID-19: 10 days Mild: 10 days after the start of signs and symptoms Severe: 20 days after the start of signs and symptoms Quarantine for exposed individuals Covid – 14 days 2. Lace administered as prescribed antivenom and tetanus toxoid to a client admitted with history of snake bite. If you were the newly hired nurse, which of the following will you consider INCORRECT A. Tetanus toxoid enhance effect of antivenom. ✖ B. Amount of antivenom is dependent on the severity of reaction than weight of the client. ✓ C. Complications induced may be prevented by the tetanus toxoid. ✓ D. Antivenom is an antidote for snake bite. ✓ Situation: Worthy, 4 years old is positive for Bacterial Meningitis.  MENINGITIS Causative Agent: ○ Bacteria Neisseria Meningitidis Hib (Haemophilus influenzae type B) E. Coli ○ Virus Paramyxovirus Mode of Transmission: Droplet Signs and Symptoms ○ ↑ ICP Infant: high pitched cry adult (Cushing’s Triad) ○ Signs of Meningeal irritation Brudzinski Sign → “Batok” Flex the head, umaangat ang paa (both) / nagfe-flex ang knee Kernig Sign → “Knee” Extend the knee, there is pain in the hamstring muscle Diagnostic Test ○ Lumbar Puncture Bacteria Virus Color Cloudy Clear WBC Increased Slightly increased Protein (CHON) Increased Increased Glucose Decreased Normal (bacteria will it the glucose) 3. From the history obtained from the mother, which of the following could be the possible method by which the infection was transmitted to the patient? A. Drinking water in the community was contaminated. B. Contact with respiratory secretions of an infected person C. Hands of caregiver was contaminated with local discharges D. Eating utensils of the child were contaminated 4. The physician prescribed lumbar tap. When the nurse reads the laboratory results, which of the following reflects positive results indicative of Bacterial Meningitis? A. Decreased white blood cells, decreased proteins, high glucose B. Normal white blood cells, increased proteins, high glucose C. Increased white blood cells, increased proteins, low glucose D. Increased white blood cells, decreased proteins, low glucose 5. Assessment findings reveal positive Brudzinski sign, When the nurse flexed the child’s neck forward, which of the following behavior indicated a positive Brudzinski’s sign: A. Hip flexed and knee Extended B. Knee extended and ankle flexed C. Leg extended with resistance D. Hip, knee and ankle flexed 6. In the nursing care plan prepared by the nurse, “Pain related to meningeal irritation” is a priority nursing diagnosis. Which of the following should the nurse avoid to do to prevent pain when positioning the patient? A. Extend leg → Kernig’s Sign B. Flex the neck forward C. Hyperextend the neck D. Flex the hip 7.The nurse understands that this leucocytes is related to phagocytosis? A. neutrophils. → most abundant white blood cells (first WBC that goes to injury site) B. eosinophils. → increases during allergic reaction, and if parasitic C. basophils. → more of releasing histamine D. monocytes. → Transforms to become phagocytes Phagocytosis → engulfing 8. When discarding used needles and syringes after injection to the patient, which of the following is appropriate nursing action? A. Remove needle from syringe and discard them in separate containers. B. Recap needle, then discard the needle still attached to the syringe into a container. → Do not RECAP C. Discard the uncapped needle and syringe into a container in the nurse station D. Discard the uncapped needle and syring into a container in the patient’s room SHARPS → Puncture Resistant Container (PRC) → Every patient should have own PRC and meron din dapat sa nurse station MEDICAL WASTES COLOR CODING BLACK Non-biodegradable (di nabubulok) GREEN Biodegradable (nabubulok) YELLOW Infectious Waste ORANGE Radioactive RED Sharps 9. The nurse caring for an immunosuppressed patient is diligent about protecting the patient from infection. When visitors come in, in addition to having them put on isolation garb, the nurse would prohibit them bringing: A. a battery-operated DVD player. B. baked broccoli with beans C. potted plants. → Anything that is fresh is contraindicated D. boxed candy. 10.The patient with the diagnosis of Clostridium difficile infection asks what has caused the diarrhea. The nurse responds that it is caused by: A. protozoal infection. B. fecal–oral contamination. C. inflammatory response. D. long-term antibiotic therapy. Clostridium difficile Caused by antibiotic therapy ○ Tetracycline ○ Amoxicillin DOC: ○ Metronidazole ○ Vancomycin Transmission based precaution: ○ Contact Precaution 11.The nurse would anticipate a caesarean birth for a client who has which infection present at the onset of labor? A. Herpes-simplex virus type 2 → Caused by warts B. Human papilloma virus C. Herpes simplex type 1 D. Toxoplasmosis → Transplacental Herpes Simplex Virus Herpes Simplex type 1 → Oral herpes Herpes Simplex type 2 → Genital Herpes Treatment: Acyclovir (Zovirax) *For lifetime ang HSV *Hindi kailangan CS lahat, basta walang lesions *Can recurr due to stress, sunlight 12.Surgical asepsis is observed when: a. inserting an intravenous catheter b. disposing of syringe and needles in puncture proof containers – clean c. washing hands before changing wound dressing - clean  d. placing dirty soiled linen in moisture resistant bags - clean Medical Asepsis Surgical Asepsis Clean technique Sterile Technique ex. Removal of Wound dressing ex. Wound dressing 13.A client with viral infection, will most likely manifest which of the following during the illness stage of the infection? a. Client was exposed to the infection 2 days ago but without any symptoms b. Oral temperature shows fever c. Acute symptoms are no longer visible d. Client “feels sick” but can do normal activities 14.Which action by a new nurse signifies an understanding about infection control? A. The nurse touches the the inside portion of the gloves only when wearing gloves. ✕ → Skin to skin, glove to glove B. The nurse washes gloved hands before removing. ✕ C. The nurse uses her bare hands to change the dressing ✕ D. The nurse applies standard precaution to all types of patients. 15.Several clients are admitted to an adult medical unit. The nurse would ensure airborne precautions for a client with which medical condition? A. Autoimmune deficiency syndrome (AIDS) with cytomegalovirus (CMV) B. A positive purified protein derivative with an abnormal chest x-ray – Airborne C. A tentative diagnosis of viral pneumonia with productive brown sputum - Droplet D. Advanced carcinoma of the lung with hemoptysis 16.The nurse is assigned to a client newly diagnosed with active tuberculosis. Which of these protocols would be a priority for the nurse to implement? A. Have the client cough into a tissue and dispose in a separate bag B. Instruct the client to cover the mouth with a tissue when coughing C. Reinforce for all to wash their hands before and after entering the room D. Place client in a negative pressure private room and have all who enter the room use masks with shields → isolate the patient Protect the public → greatest good to the greates number Situation: Khaki is a regular recipient of isoniazid tablets. His children are Boknoy, 2 y/o and Lenlen, 4y/o. You followed-up Mang Khaki for failing to get his tablets. 17. You explained the importance of early diagnosis/ treatment and convinced her to go to the health center for: A. bronchoscopy B. chest x-ray C. direct sputum smear microscopy  D. tuberculin test Tuberculosis Diagnostic test Primary diagnostic test in Ph: Sputum; 1. Direct sputum smear microscopy (DSSM) → 2 sputum specimen (5ml) Best time: Early morning No to toothbrush and mouthwash before obtaining Gargle with water only Inhale exhale, then dura ng phlegm 2. Purified Protein Derivative (PPD) / Mantoux test Would not confirm TB, but will check exposure to TB Skin test → ID Site: inner surface of the forearm 0.1 ml / 5 unit purified protein ang iinject Interpretation after 48 - 72 hours 3. X-ray (+) Lesions 4. Xpert MTB 1 ml of sputum can also detect rifampicin resistance Results Interpretation T (+) for MTB RR (+), Rifampicin Resistance TI (+) MTB, RR (indeterminate → not sure) N (-) MTB 18 Case finding is essential for the control of TB. However, this is useful only when followed by: A. home visits B. regular-check up C. drug compliance → Direct Observed Treatment Short course chemotherapy (DOTS) Regimen D. chest and x-ray Direct Observed Treatment Short course chemotherapy (DOTS) - Nurse / midwife mismo magbibigay ng drug - araw araw pupunta patient to inom ng gamot - Mixed - to prevent resistance 19.Primary diagnostic tool in NTP case finding: A. direct sputum smear microscopy B. chest x-ray C. sputum culture D. tuberculin testing 20. Which of the following TB patients are eligible for short course chemotherapy?  A. cavitary cases and non-cavitary cases of PTB on chest x-ray B. all newly discovered and reconfirmed sputum positive cases C. for advanced cases D. all of the above 21. If the patient is considered as relapse in the treatment. He will fall on what category of the short course chemotherapy? A. category I B. category IIa C. category II D. category IV CATEGORIZATION OF SHORT COURSE CHEMOTHERAPY CATEGORY Intensive Maintenance DURATION (continuation) Category I Positive sputum 2 months RIPE 4 months RI 6 months Immunocompromised Extrapulmonary TB (TB outside the lungs) Category Ia Extrapulmonary TB (na 2 months RIPE 10 months RI 12 months mahirap gamutin); Tb of the; Bone Joints Meninges Category II Treatment Failure 2 months RIPES 5 months RIE 8 months Relapse 1 month RIPE Category IIa Treatment Failure 2 months RIPES 9 months RIE 12 months Relapse 1 month RIPE & Extrapulmonary TB: Bone Joints Meninges Category IV Chronic REFER → culture and sensitivity 22. In providing follow-up instruction to Mark who received mantoux test in the physician’s office on Tuesday. The nurse tells the patient to return to have the results (reading) on which of the following days? A. Saturday B. Tuesday C. Friday → 48- 72 HOURS D. Sunday 23. What is the rationale that supports multi-drug treatment for clients with tuberculosis? A. multiple drugs potentiate the drug actions B. multiple drugs reduce undesirable side-effects C. multiple drugs allow reduced dosages to be given  D. multiple drugs reduce development of resistant strains of bacteria 24. A 24 year old male bar tender comes to the clinic for physical exam and asks to be tested for AIDS. The nurse explains that the initial screening for AIDS will be done via the: A. western blot test B. polymerase chain reaction C. CD4 T cell count D. ELISA/EIA HIV / AIDS Causative Agent: Retrovirus HIV - 1: Most common HIV virus HIV - 2: African American Diagnostic Test: 1. Serological Test : check for presence of antibodies e.g; EIA / ELISA: (+) Ab ○ if (+) for ELISA → Presumptive lang because marami pwedeng sakit na pwede mag positive sa EIA Western Blot ○ Specific Ab ○ Confirmatory for HIV Window period: - you have the virus but you still don’t have the antibodies because the immune system haven’t produced yet - after 2 weeks - 3 months, maximum of 6 months → the body will produce antibodies 2. Virological Test: check for the viral particle - have shorter window period e.g; RT PCR - confirmatory P24 Antigen - part of the virus Viral load - check the amount of virus in the blood 25.When educating a female with gonorrhea, the nurse should emphasize that for women gonorrhea. A. is often marked by symptoms of dysuria or vaginal bleeding  B. does not lead to serious complication C. can be treated but not cured D. may not cause symptoms Gonorrhea - Gonorrhea - “tulo” - Chlamydia pag meron kang gonorrhea, matik na may chlamydia Male Female S/Sx: S/sx - Dysuria - 80% asymptomatic - burning sensation upon - nakakahawa urination - Pus discharge Management: Ceftriaxone (Rocephin) → pampatay kay Gonorrhea + Azithromycin (for 3 days) → Pamatay sa Chlamydia 26.Which of the following groups has experienced the greatest rise in the incidence of STD over the past two decades A. teenagers B. divorced people C. young adults D. older adults 27.A female client with gonorrhea informs the nurse that she has had sexual intercourse with her bf and asks the nurse. “ would he have any symptoms?” the nurse responds that in men the symptoms of gonorrhea include: A. impotence B. scrotal swelling C. urinary distention D. dysuria 28.The following are nursing interventions for patient with chickenpox, except: A. give ASA for fever B. TSB C. calamine lotion D. hypoallergenic diet  Measles German Measles Chicken Pox - Rubeola / Tigdas - Rubella /Tigdas hangin - Varicella / Bulutong tubig 7 day fever 3 day fever Serious infection Mild infection Teratogenic Airborne Droplet Droplet Airborne N95 Surgical Mask Contact Direct / indirect Contact PRODROMAL Rashes pattern: Confluent Centrifugal Flu-like s/sx rashes (rashes appear - start from the katawan Rashes started from the together) and pattern goes face Maculopapular rashes outward pattern: going down → (pale-red pinkish) Macule - nakakahawa Cephalocaudal Forchheimer's Spots – Papule - nakakahawa Maculopapular rashes rashes on soft palate Vesicles - (Reddish) Unique/ pathognomonic nakakahawa Koplik’s spots sign: Crust/ scabs - Lymphadenopathy - Non-infectious pag tuyo (kulani) - located na POST- occipital - sa may batok POST auricular - sa may tenga Management: Supportive Fever: Paracetamol ○ No aspirin - BATA, viral, bawal aspirin → can cause Reye’s syndrome ○ Reye Syndrome → damage to brain and liver Chicken pox: avoid spicy, salty, acidic and crunchy foods ○ Hypoallergenic diet lang To remember: measles is 1 word → 1 L - rubeoLa German measles 2 word → 2 L - rubeLLa Measles – 7 worlds – 7 day fever Measles → nag start sa Mukha German Measles → start sa mukha din 29. Annie is diagnosed with chickenpox. Her mother asks how she might have gotten the disease. What is the most appropriate reply? A. “ Chickenpox is an expected childhood illness that everyone gets.” B. “ It is transmitted from direct contact, droplet spread.” C. “ It is inherited and transmitted through the genes.” - x D. “ It is possibly a side effect of recent vaccinations.” - x 30. The virus of the chickenpox is found in the: A. contents of the vesicles (yes) and the crust (no) B. discharges of respiratory tract C. both D. neither 31.Characteristics of rashes of Herpes zoster: A. unilateral ✓ B. vesiculopustular rashes ✓ C. never cross the midline ✓ D. AOTA (all of the above) Chickenpox → Herpes Zoster (shingles) causative agent: varicella zoster virus Herpes Zoster (shingles) - reactivation of chickenpox later in life - cluster of vesicles - unilateral - painful (grows in nerve roots) - never cross the midline - transmit through Contact 32.Most common virus that causes diarrhea: A. giardia lambiasis B. rotavirus – may vaccine na po C. adenovirus D. norovirus 33.A serious, often fatal form of gastroenteritis usually eating canned and processed food: A. botulism → descending paralysis B. salmonellosis C. cholera D. typhoid fever Situation: Richard, a 22 yrs old male, was referred to the public health nurse by one of the midwives in the community. He is sick of typhoid fever. The PHN plans for a home visit. 34. The typical symptoms that the PHN expects to see in Richard is/are the following: A. headache, diarrhea and abdominal pain B. maculopapular rashes and koplik spots C. general malaise and difficulty in swallowing D. ladderlike progression of fever with rose spots on the trunk  Typhoid fever caused by bacteria causative agent: Salmonella typhi source: feces, urine S/sx: Fever: High fever ○ Ladder-like fever GI s/sx bacteria ng typhoid may endotoxin delikado sa typhoid is yung toxin “lason” Rose spots tachycardia / bradycardia ○ if toxins attack the heart → tachycardia ○ if body has fever → bradycardia constipation / diarrhea Management → bacteria Chloramphenicol (Chloromycetin) 35. A nurse is knowledgeable when he states that the other name for pertussis is: A. La Grippe B. Whooping cough → 10 - 15 x C. Hansen’s disease D. Consumption 36. A pregnant client at 16 weeks’ gestation has a blood sample for rubella antibody screening drawn. The test results reveal a low titer. When discussing the results with the client, what is an appropriate nursing action? A. Arrange for the client to have a measles-mumps-rubella (MMR) immunization. - x B. Explain to the client that the results are what is expected. C. Counsel client regarding potential birth defects. D. Instruct the client to receive the rubella immunization immediately after delivery. → after vaccine, no pregnancy for 1-3 months 37. Malaria is produced by an intraerythrocytic parasite by the genus Plasmodium. In humans, malaria is caused by four plasmodia. Which among the following choices produces most severe disease and is common in the Philippines? A. P. falciparum B. P. vivax C. P. ovale D. P. malariae 38.One of the most specific sign of filariasis is enlargement and thickening of the skin of the lower and/or upper extremeties, scrotum, and breast known as: A. Orchitis B. Hydrocele  C. Lymphedema D. Elephantiasis Elephantiasis causative agent: Wuchereria bancrofti MOT: Aedes Poecilus 39.A 32-year old 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 his history, which disease condition will you suspect? A. Hepatittis A B. Hepatitis B C. Tetanus D. Leptospirosis 40.You are the PHN in the city health center. A client underwent screening for AIDS using ELISA. His result was positive. What is the best course of action that you may take? A. Get a thorough history of the client, focusing on the practice of high risk behaviors. B. Ask the client to be accompanied by a significant person before revealing the result. C. Refer the client to the physician since he is the best person to reveal the result to the client. D. Refer the client for a supplementary test, such as Western blot, since the ELISA result may be false. 41. Antiretroviral agents, such as AZT, are used in the management of AIDS. Which of the following is NOT an action expected of these drugs. (-) A. They prolong the life of the client with AIDS. (+) B. They reduce the risk of opportunistic infections (+) C. They shorten the period of communicability of the disease. (+) D. They are able to bring about a cure of the disease condition. (-) 42. Post-exposure treatment is given to persons who are exposed to rabies. It consist of the following: A. local wound treatment - wash wound with soap and water B. passive immunization C. active immunization ( vaccination ) D. all of the above Local wound treatment - wash wound with soap and water Passive immunization - HRIG, ERIG – antibodies – based on the body weight of the patient, injected on the wound site Active immunization - Vero rabies - 5 doses  - ID / IM - Day 0, 3, 7, 14, 28 43.The nurse is assessing a patient with typhoid fever. She has documented an erythematous macules on the patient’s trunk. She documents this as: A. Bitot’s spot B. Cullen sign C. Rose spots D. Forscheimer spot 44.A school nurse is working with a 12-year-old female student who has experienced early onset of puberty accompanied by increasing interest in sexual attractiveness. The nurse bases her work with this student on the knowledge that developmentally: A. The student is cognitively and socially unprepared for the risks associated with sexual activity B. Transmission of sexually transmitted disorders (STDs) is physiologically enhanced at the time of puberty C. Maturation of social skills precedes the physical changes of puberty D. Early adolescents are less impulsive and more wary of peer pressure than are older teens 45. A sputum specimen was collected from Mr. Ramos for culture and sensitivity. This study is to ascertain which of the following facts? A. The virulence of microorganism involved B. The antibiotics which would be most helpful C. The patients probably reaction to the causative microorganism D. The patient’s sensitivity to antibiotics 46.You are caring for a client who had a near-drowning incident in a lake. Which assessment will you perform to monitor for possible complications? A. Check the client’s blood glucose level before meals B. Assess the client’s bowel sounds three times daily C. Check the client’s skin for petechiae daily D. Assess the client’s temperature every 8 hours. 47. The effectiveness of nurse's teaching regarding take home prescribed antibiotic self-administration is indicated in which statement of the client? A. "I will see to it that the medication schedule is synchronized with my daily routine." B. "I have read the prescription and its specific instructions" C. "I fully understand the beneficial effects of the antibiotic" D. "I will report side effects immediately." 48.Where should you put Mr. Alejar, with Category II TB? A. In a room with positive air pressure and at least 3 air exchanges an hour B. In a room with positive air pressure and at least 6 air exchanges an hour C. In a room with negative air pressure and at least 3 air exchanges an hour  D. In a room with negative air pressure and at least 6 air exchanges an hour 49. A new technology adopted by the Philippines for a rapid diagnosis of TB in less than 2 hours? A. Chest X ray B. Sputum Microscopy C. Xpert-MTB/RIF → bago na D. Mantoux Test 50.Which of the following anti TB drugs would least likely allergic reaction? A. Rifampicin B. INH C. Pyrazinamide D. Streptomycin 51.Which of the following anti TB drugs is contraindicated to pregnant woman? A. Rifampicin → hepatotoxic B. INH → hepatotoxic C. Pyrazinamide D. Streptomycin → nephrotoxic, ototoxic 52. In removing protective devices, which should be the exact sequence? 1. Eye wear or goggles 2. Mask 3. Gloves 4. Gown A. 3, 4, 1, 2 B. 4,3,1,2 C. 1,3,4,2 D. 2,1,4,3 HAHAHA, wala sa choices, pero choose the best / near answer Donning (applying) Doffing (removing) - GOwn - GLOves - MAsk - GOggles - GOogles - GOwn  Donning (applying) Doffing (removing) - GLOves - MAsk Alphabetical order XD 53.Which new admission should the nurse plan to place in a private room with negative-pressure airflow? A. Client with rubella B. Client with strep throat C. Client with measles D. Client with TB of the bone E. Negative - Pressure → Airborne Measles Tb Varicella / chicken pox Covid - 19 ○ hospital - airborne Disseminated herpes zoster 54. A nursing instructor asks a nursing student to describe human immunoglobulin. The student correctly states that these types of vaccine are: → Passive A. Vaccine that have their virulence diminished so as to not produce a full blown clinical illness – Artificial active – Live-attenuated B. Vaccine that contains pathogens made inactive by either chemicals or heat - Artificial active - inactivagted C. Bacterial toxins that have been made inactive by either chemicals or heat - Artificial active - toxoid D. Vaccines collected from pooled blood of people and provide antibodies to variety of diseases - artificial passive – given post-exposure (within 72 hours) 55.While you are preparing to administer a tetanus toxoid vaccination for Carlo who had a punctured wound, he tells you that he had tetanus shot just 1 year ago. What will be your BEST response? A. “Antibody production slows down as you age. You need a booster.” B. “You probably do not need another vaccination now.” C. it won’t hurt to receive an extra dose of the toxoid.” D. “you need this vacation because the strain of tetanus changes every year. 56.What antibodies is transmitted through breastmilk? A. IgG - transplacental B. IgA - lahat ng gatas sa grocery store starts with letter A C. IgM D. IgD 57. What type of immunity is attained if a patient received Sinovac vaccine? → inactivated  A. Natural Passive Immunity B. Natural Active Immunity C. Artificial Passive Immunity D. Artificial Active Immunity SITUATION: - You are caring for Rolando, 58 years old, was admitted because of difficulty of swallowing and stiffening of the neck. He has a history of a wound laceration on his right hand sustained whiel gardening. Physician suspects Tetanus infection. 58.While you were preparing to administer oxygen inhalation, Rolando had seizures and assumed an opisthotonic position. Which of the ff. correctly describe the position? A. Head retracted, back arched and feet extended B. Neck, hip, knee flexed and feet plantar flexed C. Head flexed forward, jaw clenched, arms pronated and feet plantar flexed D. Head hyper extended hip flexed and feet extended opisthotonic position - arching of the back * best position – left side lying position 59.Taking into consideration the incubation period, which of the ff. data in Rolando’s’ health history will you consider relevant? A. positive for type 2 diabetes mellitus B. Immunization status uncertain, no booster dose administered C. Wound laceration, sustained a week ago, was treated at home D. Wound pain, unbearable and unrelieved by analgesic 60.To decrease stimuli that cause muscle spasms and seizures, which of the ff. nursing interventions is LEAST relevant for you to do? A. Maintain a quiet, well ventilated and darkened room (-) B. Administer sedatives as prescribed (-) C. Monitor for hazards of immobility D. Perform physical care during time of maximal sedation (-) 61. During a seizure, which of the ff. are you expected to do FIRST? A. Monitor vital signs especially the respiratory rate - x B. Place a padded tongue blade in the patient’s mouth - x C. Provide mechanical ventilation D. Turn patient to his side Situation: Patient with Rabies 62. Nursing care of clients diagnosed with rabies is provision of this comfortable environment which is: A. Adequately supplied with food and water B. Quiet and dark C. Provided with soft music  D. Accessible to medication 63. Nursing intervention for the patient would include: A. Covering the IV fluid bag with paper - hydrophobia B. Opening the windows in the room C. Bringing extra fan for the patient to avoid hyperthermia → aerophobia D. Avoiding dim light Situation: Patient with Dengue 64. 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 → can cause bleeding D. prevent low blood sugar 65. 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 drivers/campaign directed towards 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 insecticides 66. Community health nurses should be alert in observing a opisthotonic position. The following is NOT and indicator for hospitalization of H-fever suspects. A. Marked anorexia, abdominal pain and vomiting B. Increasing hematocrit count C. Fever for more than 2 days D. Persistent headache 67. The community health nurses primary concern in the immediate control of hemorrhage 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 68. 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 5 petechiae – 20 or more petechiae C. Steadily increasing hematocrit count D. Fall in the platelet count 69. 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 of patient D. Ice cap over the abdomen in case of melena Isotonic - first choice: LR - second choice: NSS 70.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. 71.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 → 20 petechiae but 1 inch or 2.5 cm square C. Steadily increasing hematocrit count D. Fall in the platelet count 72.Which of the ff. Was MOST likely the description of Bobby's fever prior to onset of hematuria that supported the physician's diagnosis of DENGUE FEVER? A. intermittent fever for 4 days B. onset of fever was abrupt and remained elevated for 4 days – babagsak C. abrupt onset of fever and sudden drop on the 4th day D. gradual increase of body temperature and sudden drop on the 4th day  Dengue - Fever: Biphasic / Saddleback pattern - Delikado: pag bumaba ang fever → because mababa ang platelet 73. With proper medical care and early recognition, case-fatality rates are below 1%. On the other hand, special attention needs to be given to these warning signs as it could lead to severe dengue: Select all that apply 1. Severe abdominal pain 2. Persistent vomiting 3. Bleeding gums 4. Vomiting blood 5. Rapid breathing – indication of plasma leakage → pleural effusion 6. Fatigue/ restlessness 7. Hemoptysis - TB 8. Headache - di kasama sa listahan A.1,2,3,4,5,6 B.1,2,3,4,5,6,7 C.1,2,3,4,5,6,7,8 D.1,2,3,4,5,7 Case fatality rate: Dengue Fever : < 1% Severe Dengue: 44 % 74.The nurse understands that the cycle of transmission of the Dengue Fever virus begins during which of the ff. A. Infected mosquito bites an uninfected human B. Virus multiply in the midgut of the mosquito C. Mosquito feeds on an infected human D. Mosquito's saliva is invaded by the virus during subsequent biting of infected human 75. To prevent transmission of the virus to others. Which of the ff. Is MOST appropriate isolation measure the nurse should implement in the care of Bobby? A. screen the environment → to protect the mosquito B. blood and body secretion isolation C. use gown, gloves, and mask D. use strict universal isolation technique 76.The mother is preparing for their discharge. She tells the nurse that she is relieved that everything is fine and her daughter is now immune to dengue. The nurse replies based on the knowledge that: A. Immunity against one serotype can lead to immunity to other serotypes B. Immunity against one serotype does not make the individual immune to other serotypes C. Immunity against all dengue viruses is based on the individual’s immune response D. Cross-immunity to other viruses is possible only if infected with DEN-4 serotype 77. The mother of a child whose chickenpox rash first appeared 8 days ago asks the nurse when her child may return to school without being contagious. Which of the following is the nurse’s most appropriate response? A. “your child cannot return to school until all the lesions disappear.” B. “your child is contagious as long as your child is itching.” C. “the contagious state of chickenpox is generally 2 weeks.” D. “your child is not contagious and may return to school now.” Hindi na nakakahawa kapag tuyo na → usually 7 days 78.When planning the care of a client diagnosed with asymptomatic herpes simplex virus type 2 (Hsv-2), Which of the following should the nurse consider? A. there is no risk of transmitting the condition to anyone else B. after prescribed treatment, herpes simplex virus type 2 is cured C. an antibiotic is used successfully in the treatment D. the client is a carrier, and still able to transmit the disease 79. The nurse assesses what clinical manifestation to be the priority in a child with Enterobius (pinworm)? A. nocturnal anal itching B. weight loss C. chronic or relapsing diarrhea D. flatulence E. Diagnostic Test: Scotch tape test 80. The nurse assesses which of the following to be a clinical manifestation of human papillomavirus (HPV)?  A. soft papules in the anogenital area B. nocturnal anal itching C. erythematous and macular rash on the ankles and wrists D. painful raised vesicles - Herpes Zoster (shingles) 81. A client with neutropenia has an absolute neutrophil count of 900. What is the client’s risk of infection? A. Normal risk. B. Moderate risk. C. High risk. D. Extremely high risk. Neutrophils – most abundant Normal: 1,500 - 7,000 Mild - 1,000 - 1,500 Moderate - 500 - 1,000 Severe -