Medical-Surgical Nursing Past Paper PDF

1. To measure the required length on nasogastric tube, measure from the patient’s: A. Ear to xiphisternum C. Nose to xiphisternum B. Nose to ear to xiphisternum D. Angle of the jaw to xiphisternum 2. The contents aspirated after insertion of the nasogas...

1. To measure the required length on nasogastric tube, measure from the patient’s: A. Ear to xiphisternum C. Nose to xiphisternum B. Nose to ear to xiphisternum D. Angle of the jaw to xiphisternum 2. The contents aspirated after insertion of the nasogastric tube should be of: A. Low ph C. Variable ph B. High ph D. None of the above 3. Prior to inserting a nasogastric tube, you should: A. Measure the required length C. Lubricate the tube B. Gain the patient’s consent D. All of the above 4. A nurse has identified that the patient has overflow incontinence. What is a major factor that contributes to this clinical manifestation? A. Coughing C. Prostate enlargement B. Mobility deficits D. Urinary tract infection 5. A patient’s urine is cloudy. Is amber. And has an unpleasant odor. What problem may this information indicate that requires the nurse to make a focused assessment? A. Urinary retention C. Ketone bodies in the urine B. Urinary tract infection D. High urinary calcium level 6. A nurse is caring for a debilitated female patient with nocturia. Which nursing intervention is the priority when planning to meet this patient’s needs? A. encouraging the use of bladder training exercises B. providing assistance with toileting every four hours C. positioning a bedside commode near the bed D. teaching the avoidance of fluids after 5pm 7. A practitioner orders a urine specimen for culture and sensitivity via a straight catheter for a patient. What should the nurse do when collecting this urine specimen? A. use a sterile specimen container B. collect urine from the catheter port C. inflate the balloon with 10ml of sterile water D. have the patient void before collecting the specimen 8. A client who has an indwelling catheter reports I need to urinate. Which of the following interventions should the nurse perform? A. Check to see whether the catheter is patent B. Reassure the client that it is not possible for her to urinate C. Re-catheterize the bladder with a larger gauge catheter D. Collect a urine specimen for analysis 9. Which of the following statements is true regarding the internal structures of the breast? The breast is made up of: A. Primarily muscle with very little fibrous tissue. B. Fibrous, glandular, and adipose tissues. C. Primarily milk ducts, known as lactiferous ducts. D. Glandular tissue, which supports the breast by attaching to the chest wall. 10. In performing a breast examination, the nurse knows that examining the upper outer quadrant of the breast is especially important. The reason for this is that the upper outer quadrant i A. The largest quadrant of the breast. B. The location of most breast tumors. C. Where most of the suspensory ligaments attach. D. More prone to injury and calcifications than other locations in the breast. 11. In performing an assessment of a woman’s axillary lymph system, the nurse should assess which of these nodes? A. Central, axillary, lateral, and sternal B. Pectoral, lateral, anterior, and sternal C. Central, lateral, pectoral, and subscapular D. Lateral, pectoral, axillary, and suprascapular 12. During a health history interview, a female patient states that she has noticed a few drops of clear discharge from her right nipple. What should the nurse do next? A. Immediately contact the physician to report the discharge. B. Ask her if she is possibly pregnant. C. Ask the patient some additional questions about the medications she is taking. D. Immediately obtain a sample for culture and sensitivity testing. 13. During a physical examination, a 45-year-old woman states that she has had a crusty, itchy rash on her breast for approximately 2 weeks. In trying to find the cause of the rash, which question would be important for the nurse to ask? A. “Is the rash raised and red?” B. “Does it appear to be cyclic?” C. “Where did the rash first appear—on the nipple, the areola, or the surrounding skin?” D. “What was she doing when she first noticed the rash, and do her actions make it worse?” 14. Which statements should the nurse include when providing client education regarding testicular self-examination? Select all that apply. a. "The testicle should feel smooth, rounded, and firm." b. "Apply gentle pressure with your thumb, index, and middle fingers. Your testicle should hurt when you feel it." c. "The best time to perform the exam is in the shower or bath." d. "If your testicle has any lumps or is enlarged, call your healthcare provider." e. "It is normal to feel the epididymis on top of and behind each testicle." 15. A teenage boy reports sudden, severe pain in the testicles with no precipitating event. The nurse notes edema of the testicles. The nurse is concerned that this teen may be experiencing: a. testicular tumor b. scrotal hernia c. scrotal edema d. torsion of the spermatic cord 16. Which statements should the nurse include when providing client education regarding testicular self-examination? Select all that apply. a. "The testicle should feel smooth, rounded, and firm." b. "Apply gentle pressure with your thumb, index, and middle fingers. Your testicle should hurt when you feel it." c. "The best time to perform the exam is in the shower or bath." d. "If your testicle has any lumps or is enlarged, call your healthcare provider." e. "It is normal to feel the epididymis on top of and behind each testicle." 17. The following are metabolic changes in pregnancy that affect diabetes mellitus, except? A. Increased renal threshold for sugar, increased Glomerular Filtration Rate is link to GLYCOSURIA. B. Increase insulin antagonistic hormones: cortisol, estrogen, progesterone and human placental lactogen C. Vomiting decreases CHO intake link to metabolic acidosis D. Excess glucose crosses placenta is link to LGA 18. The following are the fetal complications of gestational diabetes, except? A. Increase renal threshold for sugar, increased glomerular filtration rate is link to glycosuria B. Hyperbilirubinemia C. Spontaneous Abortion or Fetal Anomalies D. Neonatal Hyperglycemia 19. The following conditions are at risk of developing deep vein thrombosis (DVT) in pregnancy. Select all that apply. A. Spontaneous Miscarriage B. Gestational Diabetes Mellitus C. Gestational Hypertension D. Antiphospolipid Antibodies (aPLA) / Antophospolipid Syndrome 20. A woman with heart disease ask you what she should avoid during her pregnancy. Which of the following following is correct? A. Excessive weight gain C. Edema and anemia B. Infection D. All of the above 21. Which of the following is the risk factor for cardiac disease in pregnancy, except? A. Rheumatic fever C. Pulmonary Disease B. Hypertension D. Heart Surgery 22. Which of the following is the effects of pregnancy on Heart Disease? A. Cardiac output increase 50% C. Blood volume peaks at 24-28 weeks B. Heart must contract harder and faster D. All of the above 23. Which of the following class of heart disease does the client has? A. Class I C. Class III B. Class II D. Class Iv 24. The nurse is correct when she told the patient that the most dangerous stage of a pregnant client with heart disease is on what period of pregnancy? A. 6-12 weeks C. 28-32 weeks B. 12-24 weeks D. 34-40 weeks 25. How often should the Nitroglycerin taken? A. Every 5 minutes up to 3 tables, if the chest pain is not relieved after 15 minutes, go to ER. B. Every 5 minutes up to 4 tables, if the chest pain is not relieved after 20 minutes, go to ER. C. Every 5 minutes up to 3 tables, if the chest pain is not relieved after 15 minutes, take 1 more tablet then go to ER immediately. D. Every 10 minutes up to 3 tables, if the chest pain is not relieved after 30 minutes, go to ER. 26. What are the side effects of Nitroglycerin? A. Hypotension C. Stinging sensation under the tongue B. Headache D. All of the above 27. If an Rh- negative female delivered and Rh positive child, then what would happen to the pregnant female? A. They would never be able to have children again, B. They would become sensitized to the Rh-positive antigen, unless they were treated with RhoGAM. C. They would need an immediate blood transfusion. D. They would be diagnosed with erythroblastosis fetalis. 28. Mother Rh blood typer incompatibility problems can occur if the mother is _____ and her fetus ____. A. Rh positive, Rh negative C. Rh negative, Rh positive B. Rh positive, Rh negative D. Rh negative, Rh negative 29. A 39 years old at 37 weeks’ gestation is admitted to the hospital with complaint of vaginal bleeding following the use of cocaine 1 hour earlier, which complication is most likely causing the clients complaints of vaginal bleeding. A. Placenta previa C. Ectopic pregnancy B. Abruptio placentae D. Spontaneous abortion 30. A 25-year old female is about to deliver a baby. The patient is HIV positive and has been taking antiretroviral therapy during the pregnancy. What steps can be taken to help prevent transmitting the virus to the baby after birth? A. Substitute formula for breastfeeding B. Administer antiretroviral treatment to the newborn for 2 weeks after birth C. Avoid kissing and hugging the newborn. D. Stop taking antiretroviral therapy for 2 months postpartum. 31. The nurse is providing instructions to a pregnant client with human immunodeficiency virus (HIV) infection regarding care to the newborn after delivery. The client asks the nurse about the feeding options that are available. Which response should the nurse make to the client? A. "You will need to bottle-feed your newborn." B. "You will need to feed your newborn by nasogastric tube feeding." C. "You will be able to breast-feed for 6 months and then will need to switch to bottle-feeding." D. "You will be able to breast-feed for 9 months and then will need to switch to bottle-feeding 32. The nurse is assessing a newborn who was born to a mother who is addicted to drugs. Which findings should the nurse expect to note during the assessment of this newborn? Select all that apply. A. Lethargy D. constant crying B. Sleepiness E. difficult to comfort C. Irritability F. cuddles when being held 33. The nurse is creating a plan of care for a newborn diagnosed with fetal alcohol syndrome. The nurse should include which priority intervention in the plan of care? A. allow the newborn to establish own sleep-rest pattern B. maintain the newborn in a brightly lit area of the nursery C. encourage frequent handling of the newborn by staff and parents D. monitor the newborn's response to feedings and weight gain pattern 34. The nurse creates a plan of care for a woman with HIV infection and her newborn. The nurse should include which intervention in the plan of care? A. monitoring the newborn's vital signs routinely B. maintaining standard precautions at all times while caring for the newborn C. initiating referral to evaluate for blindness, deafness, learning problems, or behavioral problems D. instructing the breastfeeding mother regarding the treatment of the nipples with nystatin ointment 35. Which of the following is TRUE about Complete Mole? A. All trophoblastic villi swell & become cystic; embryo dies early B. Chromosomes are normal, 44xy or 44xx but are contributed by only by the father or an empty ovum was fertilized C. the chromosome material from the sperm was duplicated D. May lead to choriocarcinoma E. All of the above 36. A case of 25 y/o (G2002) pregnant came in for enlarging abdominal mass. Pregnancy test was done reveal positive, no other associated symptoms, thus sought consult at her physician, diagnostic and laboratory was done, reveals PARTIAL MOLE. Which of the following is CORRECT about Partial Mole? A. Some of the villi form normally B. Syncytiotrophoblast layer is swollen & misshapen C. It has 69 chromosomes (3 chromosomes instead of 2 for every pair) resulting from 2 sperms fertilizing an ovum D. A, B, and C E. None of the Above  37. A case of 35 y/o (G3003) pregnant came in for enlarging abdominal mass. Pregnancy test was done reveal positive, no other associated symptoms, thus sought consult at her physician. What disease is abnormal proliferation and then degeneration of the trophoblastic villi? As the cells degenerate, they become filled with fluid and appear as clear fluid-filled, grape-size vesicles. A. Gestational Trophoblastic disease C. Complete Mole B. Partial Mole D. Ectopic Pregnancy SITUATION: A case of a 30 y/o (G3Po) 20 weeks pregnant came in your clinic due to vaginal spotting and watery discharge for 3 days. LMP was December 15, 2022. EDC was September 21, 2023. No associated symptoms of fever, cough, dysuria, rhinorrhea. Patient has history of miscarriage 2x already. Patient denies as sexually active and her husband was loyal as claimed. Thus sought consult at your clinic. Ultrasound was done reveal short cervix. Your patient was diagnosed with incompetent cervix. 38. Which of the following is TRUE statement about the case above? 1. cervix that dilates prematurely and cannot hold a fetus until term 2. weeks 12 to 14, purse-string sutures are placed in the cervix by the vaginal route under regional anesthesia (CERVICAL CERCLAGE). 3. After extraction, chest xray, pelvic examination, serum test for ß subunit of Hcg 4. Cervical insufficiency is responsible for only 20-30% of all preterm births, compared with 60- 70% with spontaneous preterm labor and 25-30% with PROM. A. 1,2 C. 2,3 B. 1, 2, 3 D. 1 39. Which of the associated factors that contribute to incompetent cervix? A. Age D. A & B B. Trauma of the cervix E. None of the above C. UTI 40. Which of the following are TRUE about Iron Deficiency Anemia in Pregnancy? A. Most common type, develops in the 2nd & 3rd trimester when the Fe requirements increase to compensate for the expanding blood volume B. Pregnancy requires an additional 300–650 mg of iron. Of this, 500–1000 mg is transferred to the fetus. C. Increased resistance to infection and no associated with prematurity and LBW infant. D. Normal Hemoglobin Level 41. A case of 20 y/o femal (G1P1), a worker came in for profuse vaginal bleeding for 3 days. No associated symptoms of fever and dysuria. Patient denies of multiple sexual contact. The doctor requested for pregnancy test, complete blood count, and urinalysis. The result was CBC reveals low hemoglobin of 10g/100 ml urinalysis reveals normal range. Pregnancy test reveals negative. Which of the following is a risk factor for the patient anemia? 1. Poor nutrition 2. Excess alcohol consumption 3. Hypotension 4. Ectopic Pregnancy A. 1, 2, 3,4 C. 2, 3 B. None of the above D. 1, 2 42. A case of 25 y/o female came in for painful vaginal spotting associated with pelvic pain, radiating to the shoulder, dizziness and stabbing abdominal pain for 2 days. No associated symptoms of dysuria and fever. No medication take, thus sought consult at her doctor. The physician order pregnancy test, and ultrasound and urinalysis. Lab test reveals positive pregnancy diagnosed the patient with ectopic pregnancy. Which of the following is the COMPLICATIONS of the disease? A. Hemorrhage C. Peritonitis B. Shock D. All of the above. 43. Which of the following drug of choice for unruptured ectopic pregnancy? A. Acetaminophen C. Erythromycin B. Methotrexate D. Metronidazole 44. Bleeding and slight cramping occur with the cervix closed and membrane intact: A. Inevitable miscarriage C. Habitual Miscarriage B. Missed miscarriage D. Threatened Miscarriage 45. A client in the first trimester of the pregnancy arrives at a health care clinic and reports that she has been experiencing vaginal bleeding. A threatened abortion is suspected, and the nurse instruct the client regarding management of care. Which statement, if made by the client, indicates need for further education? A. "I will avoid sexual intercourse until the bleeding has stopped and for 2 weeks following the last episode of bleeding." B. "I will count the number of perineal pads used on a daily basis and note the amount and color of blood on the pad." C. "I will maintain strict bed rest throughout the remainder of the pregnancy." D. "I will watch to see if I pass any tissue." 46. A type of spontaneous abortion occurring with 3 consecutive pregnancies. This condition is a result of weakened cervix that dilates in the 2nd trimester, and expels the fetus. A. Incomplete miscarriage B. Habitual abortion B. Imminent miscarriage C. Threatened miscarriage 47. Linda rushed in to the ED with complains of bleeding, cramping and part of the conceptus is expelled but the rest are retained. Cervical dilation was also noted. As a nurse, you are aware that these are the presenting symptoms of what type of spontaneous abortion? A. Complete miscarriage B. Incomplete Miscarriage B. Missed miscarriage C. Inevitable miscarriage 48. Below are complication of miscarriage, except: A. Infection B. Hemorrhage B. Isoimmunization D. Hydatidiform mole 49. Which of the following is a management of Isoimmunization A. RHOGAM or RhIg administration to all women with Rh (-) blood B. Combination if penicillin, gentamicin, and clindamycin C. Dilatation and curettage D. Blood replacement 50. Symptoms of inevitable miscarriage include the following, except: A. Uterine Contraction C. Vaginal bleeding B. Cervical dilation & rupture of membranes D. No cervical dilation 51. You are a nurse in the OB ward of Destiny’s Child Sanitarium, one of your patients with a history of recent miscarriage presents fever higher than 38°C and foul-smelling vaginal discharge. You are aware that this indicate what kind of miscarriage complication? A. Septic abortion C. Obstetric fistula B. Infection D. Asherman syndrome 52. A 28-year old female, who is 33 weeks pregnant with her second child, has uncontrolled hypertension. What risk factor below found in the patient’s health history places her at risk for abruptio placenta? A. Childhood polio C. Pre-eclampsia B. Cesarean section D. Her age 53. A nurse in the postpartum unit is caring for a client who has just delivered a newborn infant following a pregnancy with placenta previa. The nurse reviews the plan of care and prepares to monitor the client for which of the following risks associate with placenta previa? A. Disseminated Intravascular Coagulation C. Infection B. Chronic Hypertension D. Hemorrhage 54. You’re performing a head-to-toe assessment on a patient admitted with abruption placenta. Which of the following assessment findings would you immediately report to the physician? A. Oozing around the IV site C. Hard abdomen B. Tender Uterus D. Vaginal bleeding 55. Which statement is TRUE regarding abruption placenta? A. This condition occur due to an abnormal attachment of the placenta in the uterus near or over the cervical opening. B. Nursing intervention for this condition includes measuring the fundal height. C. A marginal abruption placenta occurs when the placenta is located near the edge of the cervical opening. D. Fetal distress is not common in this condition as it is in placenta previa. 56. A maternity nurse is preparing for the admission of a client in the 3rd trimester of pregnancy that is experiencing vaginal bleeding and has a suspected diagnosis of placenta previa. The nurse reviews the physician’s orders and would question which order? A. Obtain equipment for a manual pelvic examination. B. Obtain equipment for external electronic fetal heart monitorin. C. Prepare the client for an ultrasound. D. Prepare to draw a Hgb and Hct blood sample. 57. Alma, a pregnant woman with partial placenta previa. In explaining the diagnosis, the nurse tells the client that the usual management for partial placenta previa is which of the following? A. Immediate C-section C. Labor induction with oxytocin B. Platelet infusion D. Activity limited to bed rest 58. Maureen in her third trimester arrives at the emergency room with painless vaginal bleeding. Which of the following conditions is suspected? A. Premature labor C. Abruptio Placenta B. Placenta previa D. Sexually transmitted disease 59. A patient who is 25 weeks pregnant has partial placenta previa. As the nurse you’re education the patient about the condition and self-care. Which statement by the patient requires you to re-educate the patient? A. “I will avoid sexual intercourse and douching throughout the rest of the pregnancy.” B. “I will have another ultrasound at 32 weeks to re-assess the placenta’s location” C. “I may start to experience dark red bleeding with pain.” D. “My uterus should be soft and non-tender.” 60. A nurse is assessing a pregnant client in the 2nd trimester of pregnancy who was admitted to the maternity unit with a suspected diagnosis of abruptio placenta. Which of the following assessment findings would the nurse expect to note if this condition is present? A. Absence of abdominal pain C. A soft abdomen B. Painless, bright red vaginal bleeding D. Uterine tenderness/pain 61. What is the best and safest way to confirm placenta previa? A. Ultrasound C. MRI B. Clotting studies D. X-ray 62. A nurse in the newborn nursery suspects that a new admission 42 weeks’ gestation, was exposed to meconium in utero. What would lead the nurse to suspect this? A. The baby’s anterior fontanel is sunken. C. The baby is desquamating. B. The baby is bradycardic. D. The baby’s umbilical cord is green. 63. An 18-hour-old baby with an elevated bilirubin level is placed under the bili lights. Which of the following is an expected nursing action in these circumstances? A. Rotate the baby from front to back every 2 hours B. Give the baby oral rehydration C. Administer IV fluids via pump per Dr. orders D. Apply restraints to keep the baby under the light 64. A baby with hemolytic jaundice is being treated with fluorescent phototherapy. To provide safe newborn care, which of the following actions should the nurse perform? A. Turn the lights off for ten minutes every hour B. Tightly swaddle the baby in a baby blanket C. Clothe the baby in a shirt and diaper only D. Cover the baby’s eyes with eye pads 65. A neonate is in the warming crib for poor thermoregulation. Which of the following sites is appropriate for the placement of the skin thermal sensor? A. Forehead C. Xiphoid process. B. Abdominal wall. D. Great toe. 66. A baby is in the NICU whose mother was addicted to heroin during the pregnancy. Which of the following nursing actions would be appropriate? A. Place the baby prone in the crib. B. Tightly swaddle the baby. C. Provide needed stimulation to the baby. D. Feed the baby half-strength formula. 67. A 1,000-gram neonate is being admitted to the neonatal intensive care unit. The surfactant Survanta (beractant) has just been prescribed to prevent respiratory distress syndrome. Which of the following actions should the nurse take while administering this medication? A. Administer the reconstituted liquid via an oral syringe B. Assist the neonatologist during the intubation procedure. C. Inject the medication deep into the vastus lateralis muscle. D. Flush the intravenous line with normal saline solution 68. Based on maternal history of alcohol addiction, a baby in the neonatal nursery is being monitored for signs of fetal alcohol syndrome (FAS). The nurse should assess this baby for which of the following? A. Ambiguous genitalia. C. Poor suck reflex B. Absent Moro reflex. D. Webbed neck. 69. A baby was born 24 hours ago to a mother who received no prenatal care. The infant has tremors, sneezes excessively, constantly mouths for food, and has a shrill, highpitched cry. The baby's serum glucose levels are normal. For which of the following should the nurse request an order from the pediatrician? A. Urine drug toxicology test. B. Oxygen saturation and blood gas assessments. C. Biophysical profile test. D. Chest and abdominal ultrasound evaluations. 70. A macrosomic infant of a non-insulin dependent diabetic mother has been admitted to the neonatal nursery. The baby's glucose level on admission to the nursery is 25 mg/dL and after a feeding of mother's expressed breast milk is 35 mg/dL. Which of the following actions should the nurse take at this time? A. Nothing, because the glucose level is normal for an infant of a diabetic mother. B. Administer intravenous glucagon slowly over five minutes. C. Feed the baby a bottle of dextrose and water and reassess the glucose level. D. Notify the neonatologist of the abnormal glucose levels. 71. Monochorionic twins, whose gestation was complicated by twin-to-twin transfusion, are admitted to the neonatal intensive care unit. Which of the following characteristic findings would the nurse expect to see in the smaller twin? A. Pallor. C. Jaundice. B. Opisthotonus D.Hydrocephalus. 72. Which of the following is the primary predisposing factor related to mastitis? A Breast injury caused by overdistention, stasis, and cracking of the nipples B Epidemic infection from nosocomial sources localizing in the lactiferous glands and ducts C Temporary urinary retention due to decreased perception of the urge to avoid D Endemic infection occurring randomly and localizing in the periglandular connective tissue 73. The nurse is preparing a list of self-care instructions for a postpartum client who was diagnosed with mastitis. Which instructions should be included on the list? Select all that apply. A. Wear a supportive bra. B. Rest during the acute phase. C. Maintain a fluid intake of at least 3000 mL/day. D. Continue to breast-feed if the breasts are not too sore. E. Take the prescribed antibiotics until the soreness subsides. F. Avoid decompression of the breasts by breast-feeding or breast pump. 74. A PP client is being treated for DVT. The nurse understands that the client’s response to treatment will be evaluated by regularly assessing the client for: A. Dysuria, ecchymosis, and vertigo B. Epistaxis, hematuria, and dysuria C. Hematuria, ecchymosis, and epistaxis D. Hematuria, ecchymosis, and vertigo 75. A nurse is caring for a PP client with a diagnosis of DVT who is receiving a continuous intravenous infusion of heparin sodium. Which of the following laboratory results will the nurse specifically review to determine if an effective and appropriate dose of the heparin is being delivered? A. Prothrombin time B. Internationalized normalized ratio C. Activated partial thromboplastin time D. Platelet count 76. Which statement regarding postpartum depression (PPD) is essential for the nurse to be aware of when attempting to formulate a plan of care? A) PPD symptoms are consistently severe. B) This syndrome affects only new mothers. C) PPD can easily go undetected. D) Only mental health professionals should teach new parents about this condition. 77. Which of the following interventions would be helpful to a breastfeeding mother who is experiencing engorged breasts? A. Applying ice B. Applying a breast binder C. Teaching how to express her breasts in a warm shower D. Administering bromocriptine (Parlodel) 78. A PP nurse is assessing a mother who delivered a healthy newborn infant by C-section. The nurse is assessing for signs and symptoms of superficial venous thrombosis. Which of the following signs or symptoms would the nurse note if superficial venous thrombosis were present? A. Paleness of the calf area B. Enlarged, hardened veins C. Coolness of the calf area D. Palpable dorsalis pedis pulses 79. As part of the postpartum assessment, the nurse examines the breasts of a primiparous breastfeeding woman who is one day postpartum. An expected finding would be: A. Soft, non-tender; colostrum is present B. Leakage of milk at let down C. Swollen, warm, and tender upon palpation D. A few blisters and a bruise on each areola 80. When making a visit to the home of a postpartum woman 1 week after birth, the nurse should recognize that the woman would characteristically: A) Express a strong need to review events and her behavior during the process of labor and birth. B) Exhibit a reduced attention span, limiting readiness to learn. C) Vacillate between the desire to have her own nurturing needs met and the need to take charge of her own care and that of her newborn. D) Have reestablished her role as a spouse/partner. 81. Infants who fall below the 10th percentile of weight for their age A. Small for gestational age C. Low birth weight infants B. Large for gestational age D. Appropriate for gestational age 82. It is the destruction of brain cells by invasion of direct bilirubin in the blood from excessive hemolysis. A. Vernic Caseosa C. Low birth weight infants B. Kernicterus D. Patent Ductus 83. The weight of these infants whose birth weight’s fall between the 10th and 90th percentiles of weight for their age regardless of gestational age: A. Appropriate for Gestational Age (AGA) B. Small for Gestational Age (SGA) C. Large for Gestational Age (LGA) D. Very-Low Birth Weight (VLBW) 84. While doing an assessment, you noticed that a 13-week pregnant mother has pale, cold clammy skin, lethargic and anorexic. Blood test shows low reticulocyte count immaturity. There is a hematopoietic system + RBS hemolysis due to low levels of Vitamin E which protects RBCs against oxidation. Which of the following interventions used to manage the problem EXCEPT: A. Avoid excessive drawing of blood. B. Stress the importance of administering Vitamin E. C. Remind the mother not to do blood transfusion. D. Drinking Iron provided by a preterm formula. 85. What is the cause of hyaline-like (fibrous) membrane formed from a exudates of the infant’s blood? A. Severe Acidosis C. Low body temperature B. Lack of surfactant D. Bradycardia 86. It is an eye infection that occurs at birth or within the 1st month A. Ophthalmia Neonatorum C. Stye B. Optic Degeneration D. Blepharitis 87. All except ONE is the therapeutic management in caring a high risk newborn with generalized herpes virus infection: A. Acyclovir (Zovirax) (inhibits DNA synthesis) is given B. CS birth is advised C. infected infants must be separated from other infants D. women with herpes lesions on their face should not hold or feed their infants until the lesions have crusted over E. Eyes are irrigated with sterile saline solution to clear the discharge 88. It is an abnormal formation of the white matter of the brain caused by an ischemic episode that interferes with circulation to a portion of the brain. A. Periventricular Leukomalacia C. Hemolytic Disease of the Newborn B. Hyperbilirubinemia D. Rh Incompatibility 89. What do you call an elevated level of bilirubin in the blood resulting from RBC hemolysis? A. Periventricular Leukomalacia C. Hemolytic Disease of the Newborn B. Hyperbilirubinemia D. Rh Incompatibility 90. In Caudal Regression Syndrome, all except one are the signs to watch out: A. Lethargic & limp due to hyperglycemia B. High fetal insulin blocks cortisol release blocking formation of lecithin preventing lung maturity C. grunting, cyanosis in room air, tachypnea, nasal flaring, retractions & shock D. Cushingoid appearance (fat & puffy) 91. Nurse Kelly is teaching the parents of a young child how to handle poisoning. If the child ingests poison, what should the parents do first? A. Administer ipecac syrup B. Call an ambulance immediately C. Call the poison control center D. Punish the child for being bad 92. Nurse Betina should begin screening for lead poisoning when a child reaches which age? A. 6 months B. 12 months C. 18 months D. 24 months 93. A kindergarten student is frequently violent toward other children. A school nurse notices bruises and burns on the childs face and arms. What other symptom should indicate to the nurse that the child might have been physically abused? A. The child shrinks at the approach of adults. B. The child begs or steals food or money. C. The child is frequently absent from school. D. The child is delayed in physical and emotional development. 94. A nursing instructor is developing a lesson plan to teach about domestic violence. Which information should be included? A. Power and control are central to the dynamic of domestic violence. B. Poor communication and social isolation are central to the dynamic of domestic violence. C. Erratic relationships and vulnerability are central to the dynamic of domestic violence. D. Emotional injury and learned helplessness are central to the dynamic of domestic violence. 95. The nurse analyzes the laboratory values of a child with leukemia who is receiving chemotherapy. The nurse notes that the platelet count is 20,000/ul. Based on the laboratry result, which intervention will the nurse document in the plan of care? A. Mointor closely for signs of infection B. Mointor the temperature every 4hours C. Initate prptective isolation precautions D. Use soft small toothbrush for mouth care 96. "A client with acute leukemia is admitted to the oncology unit. Which of the following would be most important for the nurse to inquire? a. "Have you noticed a change in sleeping habits recently?" b. ""Have you had a respiratory infection in the last 6 months?"" c. "Have you lost weight recently?" d. "Have you noticed changes in your alertness?" 97. Situation: Stacy is diagnosed with acute lymphoid leukemia (ALL) and beginning chemotherapy. Stacy is discharged from the hospital following her chemotherapy treatments. Which statement of Stacy’s mother indicated that she understands when she will contact the physician? A. “I should contact the physician if Stacy has difficulty in sleeping”. B. “I will call my doctor if Stacy has persistent vomiting and diarrhea”. C. “My physician should be called if Stacy is irritable and unhappy”. D. “Should Stacy have continued hair loss, I need to call the doctor”.  98. "David, age 15 months, is recovering from surgery to remove Wilms' tumor. Which findings best indicates that the child is free from pain? a. Decreased appetite b. Increased heart rate c. Decreased urine output d. Increased interest in play 99. Child is diagnosed with Wilms' tumor. In planning teaching interventions, what key point should the nurse emphasize to the parents? A. Do not put pressure on the abdomen. B. Frequent visits from friends and family will improve morale. C. Appropriate protective equipment should be worn for contact sports. D. Encourage the child to remain active." E. 100. A child is diagnosed with Wilms' tumor. During assessment, the nurse in charge expects to detect: a. Gross hematuria b. Dysuria c. Nausea and vomiting d. An abdominal mass MCN 2 RLE 1. The nurse is evaluating an 8-year-old child who demonstrates the following behaviors: daydreaming, poor school performance, constant fidgeting, interrupting others, and mood swings. The child's speech development is age-appropriate. Which disorder would the nurse suspect? a. Autism b. Depression c. Mental retardation d. Attention deficit hyperactivity disorder (ADHD) 2. The family of a child who is experiencing attention deficit hyperactivity disorder tells the nurse that they are having difficulty dealing with the child's behavior at home. The nurse teaches the family which of the following techniques to help manage the child at home? a. Punish unwanted behaviors. b. Have routines for eating, sleeping, and recreation. c. Invite the neighborhood children over to play. d. Put the child in the yard to exercise and run to tire the child. 3. The nurse is teaching the family about reducing stimulation for their child who has been diagnosed with attention deficit hyperactivity disorder (ADHD). Which of the following activities will the nurse teach the family to limit? a. Eating with the family b. Watching television c. Playing with a sibling d. Reading books 4. A client is experiencing a severe panic attack. Which nursing intervention would meet this client's immediate need? A. Teach deep breathing relaxation exercises B. Place the client in a Trendelenburg position C. Stay with the client and offer reassurance of safety D. Administer the ordered PRN buspirone (BuSpar) 5. Which nursing diagnosis would best describe the problems evidenced by the following client symptoms: avoidance, poor concentration, nightmares, hypervigilance, exaggerated startle response, detachment, emotional numbing, and flashbacks? A. Ineffective coping B. Post-trauma syndrome C. Complicated grieving D. Panic anxiety 6. A newly admitted client is diagnosed with posttraumatic stress disorder. Which behavioral symptom would the nurse expect to assess? 1. Recurrent, distressing flashbacks. 2. Intense fear, helplessness, and horror. 3. Diminished participation in significant activities. 4. Detachment or estrangement from others. 7. A client diagnosed with generalized anxiety disorder complains of feeling out of control and states, "I just can't do this anymore." Which nursing action takes priority at this time? 1. Ask the client, "Are you thinking about harming yourself?" 2. Remove all potentially harmful objects from the milieu. 3. Place the client on a one-to-one observation status. 4. Encourage the client to verbalize feelings during the next group. 8. It is characterized by refusal to maintain a minimally usual body weight because of disturbance in perception of the size or appearance of the body. Thi refers to which eating disorder? A. Bulimia Nervosa C. Pica B. Anorexia Nervosa D. Avoidant 9. A nurse assesses a client suspected of having major depressive disorder. Which client symptom would eliminate this diagnosis? A. The client is disheveled and malodorous. B. The client refuses to interact with others. C. The client is unable to feel any pleasure. D. The client has maxed-out charge cards and exhibits promiscuous behaviors. 10. Which of the following statements of the mother demonstrates the major symptoms of schizophrenia of the child? A. Significant weight loss or gain C. Experience hallucinations B. Presence of mania D Anhedonia 11. A highly agitated client paces the unit and states, "I could buy and sell this place." The client's mood fluctuates from fits of laughter to outbursts of anger. Which is the most accurate documentation of this client's behavior? A. "Rates mood 8/10. Exhibiting looseness of association. Euphoric." B. "Mood euthymic. Exhibiting magical thinking. Restless." C. "Mood labile. Exhibiting delusions of reference. Hyperactive." D. "Agitated and pacing. Exhibiting grandiosity. Mood labile." 12. It is defined as repeated involuntary or intentional urination during the day or at night after an age at which a child attained or should have attained control over bladder function. A. Encopresis C. Diarrhea B. Enuresis D. UTI 13. A mother asked the nurse on what to do with his 3-year-old child who has not unable to defecated for 1 month. it was found out that his child is having encopresis, the management should be: A. Empty bowels with use of laxative B. Habit to evacuate their bowels about 2x a day C. High fiber diet D. All of the above 14. To prevent further urinary tract infections in a preschooler, what measures would you teach her mother? a. Encourage her to be more ambulatory to increase urine output. b. Teach her to take frequent tub baths to clean her perineal area. c. Suggest she drink less fluid daily to concentrate urine. d. Teach her to wipe her perineum front to back after voiding. 15. The child with nephrotic syndrome who has ascites and difficulty breathing is probably most comfortable sleeping in which position? A. Supine C. Prone B. Sim’s position D. Fowler’s 16. Which of the following is TRUE about nursing assessment of patient with bronchitis? A. Antibiotic will be prescribed if bacterial infection is suspected. B. The most common etiologic agent is the respiratory syncytial virus (rsv), although number of other viruses may also cause bronchitis. C. These symptoms may last for a week, although full recovery sometimes takes as long as 2 weeks. On auscultation, rhonchi and coarse crackles (the sound of rales) can be heard. D. Inflammation of the major bronchi and trachea. 17. A case of 7 years old male brought by mother came in the clinic for cough and fever for 3 days. The patient was diagnosed with bronchitis. Which of the following is true statement about the case? A. It is characterized by fever and cough, usually in conjunction with nasal congestion. B. On auscultation, rhonchi and coarse crackles (the sound of rales) can be heard. C. Nursing management include relieving respiratory symptoms, reducing fever, maintaining adequate hydration, and antibiotic will be prescribed if bacterial infection is suspected. D. A, B, C E. C only 18. Which of the following statement is TRUE? A. Pulmonary function studies or spirometry can be helpful in evaluating children for asthma. B. In children with asthma, the vital capacity (the air that they are able to exhale) may be low or the capacity may be normal but because of narrowed bronchioles as a result of bronchospasm, the expiratory rate will be abnormally long (more than 10 seconds rather than the normal 2 or 3 seconds). C. Often difficult to perform in young children because good understanding and effort is needed to effectively perform. D. All of the above E. None of the above 19. A case of 45 years old male came in for dyspnea and tachypnea for 7 days at the emergency room in your hospital. Patient is known asthmatic with poor compliance of inhaled medication. At the E.R. patient was intubated and given medication via IVTT route. Diagnosis of patient was STATUS ASTHMATICUS. Which of the following statement is TRUE? A. a mild and prolonged asthma attack that is not responsive to asthma therapy B. In severe attacks, endotracheal intubation and mechanical ventilation may be necessary maintain effective ventilation and perfusion. C. The heart rate and respiratory rate are decreased D. In this patient you here a loud wheezing initially. E. None of the above 20. A case of 7 years old male, came in your emergency due to productive cough and fever for 7 days. Chest X ray reveals infiltrates in the lower lobes of the lungs. Patient was diagnosed with PNEUMONIA. Which of the following nursing diagnosis is FALSE statement? A. Ineffective Airway Clearance. C. Ineffective Breathing Pattern. B. Impaired gas exchange D. Fluid Volume Excess  21. What type of acquired cardiac disease in children that is the leading cause of death? A. Kawasaki Disease C. Pericarditis B. Rhematoid Fever D. Myocarditis 22. What do you called a term in KAWASAKI HEART DISEASE when there is sudden involuntary movement of the limbs or a striking symptom that occurs in up to 10% of children and is exacerbated by stress? A. Erythema Marginatum B. Polyarthritis C. Sydenham Chorea D. Rheumatoid arthritis 23. A case of 9 years old female came in for chest pain and on and off fever for 7 days associated with knee pain and desquamation for sole and palms. Self-medication with Paracetamol 500mg/tab 1 tab every 4 hours with no relief thus sought consult at the hospital. History and Physical examination was done reveals polyarthritis, changes in hands and feet such as erythema, edema, peeling, diffuse maculopapular rash of the trunk and extremities, bilateral conjunctivitis without exudates, changes in lips and mouth such as strawberry tongue, dry, cracked lips, and cervical lymphadenopathy. Anti strepitolysin O was elevated. Patient was diagnosed with KAWASAKI DISEASE? Which of the nursing therapeutic management is CORRECT statement? 1. Provide hydration and give cold liquids for pain 2. Give Tepid Sponge Bath for pyrexia 3. Give Penicillin and aspirin twice a day 4. Prescribed Oral Corticosteroids A. 1,2,3,4 B. 1,2,3 C. 2,3 D. 1,2 24. What is the most common acyanotic cardiac defect found in children, either in isolation or combined with other defects, occurs when a portion of the ventricular septum does not completely close. A. Ventricular Septal Defect B. Patent Ductus Arteriosus C. Atrial Septial Defect D. Tetralogy of Fallot 25. A case of 9 years old female came in for high-spiking fevers for 7 days and toxic in appearance, with fatigue and dyspnea, auscultation reveals murmur, associated malaise, weight loss, arthralgias, fatigue and diaphoresis. Diagnostic and lab-test was done reveals infective endocarditis. Which of the following nursing intervention is the CORRECT? A. Refer to doctor for any unusualities C. Monitor intake and output B. A, C D. None of the above 26. A case of 9 years old female came in for high-spiking fevers for 7 days and toxic in appearance, with fatigue and dyspnea, auscultation reveals murmur, associated malaise, weight loss, arthralgias, fatigue and diaphoresis. Diagnostic and lab-test was done reveals infective endocarditis. Which of the following statements need further teaching? A. I don't care and I don't need any healthcare professional B. I will refer for any unusualities to you and the doctor. C. I will give her TSB if patient has temperature of more than 38 Celsius D. NONE OF THE ABOVE 27. Which of the following is TRUE statement of CYSTIC FIBROSIS? A. Abnormal chloride concentration in perspiration B. The disease is characterized by a thin mucus secretion, particularly in the pancreas and the lungs, as well as electrolyte abnormalities in urine gland secretions. C. Sweat testing detects abnormal salt and chlorine concentrations, content. D. This is not done by passing a nasogastric tube into the duodenum. 28. Which of the following NURSING ASSESSMENT is CORRECT? A. Auscultation reveals absent or decreased breath sounds on the affected side. B. Shift of the apical pulse (mediastinal shift) away from the site of the pneumothorax. C. Chest radiography will show a darkened area of the air-filled pleural space. D. All of the following 29. Which of the following THERAPEUTIC MANAGEMENT about Bronchopulmonary Dysplasia is INCORRECT? A. Mild need for increased oxygen, which gradually resolves over disease requiring chronic tracheostomy B. Mechanical ventilation during the first few years of life. C. Administration of a corticosteroid to reduce inflammation D. Bronchodilator by nebulizer can improve respiratory function. E. None of the above 30. Which of the following THERAPEUTIC MANAGEMENT about PNEUMONIA is TRUE? A. IV fluid therapy B. Antibiotics C. Antipyretics D. Oxygen saturation levels should be assessed frequently. E. All of the following 31. Which of the following heart disease is DEFECTS WITH OBSTRUCTION TO SYSTEMIC BLOOD FLOW? 1. Coartation of the Aorta 2. Hypoplastic Left Heart Syndrome 3. Ventricular Septal defect 4. Aortic Stenosis A. 1,2,3,4 C. 1,2,3 B. 1,2 D. 4 only 32.Which of the following heart disease is DEFECTS THAT INCREASES PULMONARY BLOOD FLOW? A. Patent ductus Arteriousus C. Transposition of Great Vessel B. Atrial Septal Defect D. All of the above 33. Which of the following TRUE about Ventricular Septal Defect? A. The most common defect found in children, either in isolation or combined with other defects. B. Occurs when a portion of the ventricular septum does not completely close. C. Holosystolic murmur noted at the left lower sternal border D. Symptoms associated with a VSD are similar to those found with a PDA or ASD and are determined by the size of the defect E. All of the above. 34. Which of the following is FALSE statement of Atrial Septal Defect? A. Management typically includes medications such as furosemide, digoxin, and an ACE inhibitor like captopril or enalapril. B. Secundum is located in the center of the atrial septum C. Primum- found low in the atrial septum near the IVC D. Sinus venosus-allow communication of one or more of the pulmonary veins with the right atrium. E. None of the above. 35. A female child, age 6, is brought to the health clinic for a routine checkup. To assess the child's vision, the nurse should ask A. "Do you have any problems seeing different colors? B. "Do you have trouble seeing at night? C. "Do you have problems with glare? D. "How are you doing in school?" 36. After explaining to the parents about their child's unique psychological needs related to a seizure disorder and possible stressors, which of the following interests uttered by them would indicate further teaching? A. Feeling different from peers B. Poor self-image C. Cognitive delays D. Dependency 37. Which of the following is the most common permanent disability in childhood? A. Scoliosis B. Muscular dystrophy C. Cerebral palsy D. Developmental dysplasia of the hip (DDH) 38. Mrs. Cooper is concerned about her 4-month-old son's unusual condition; which of the following statements made by her would indicate that the child may have cerebral palsy? A. He holds his left leg so stiff that I have a hard time putting on his diapers," B. My baby won't lift his head up and look at me; he's so floppy." C. My baby's left hip tilts when I pull him to standing position." D. "I'm very worried because my baby has not rolled all the way over yet." 39. A child diagnosed with meningitis is having a generalized tonic-clonic seizure. Which should the nurse do first? A. Administer blow-by oxygen and call for additional help B. Reassure the parents that seizures are common in children with meningitis C. Call a code and ask the parents to leave the room. D. Assess the child's temperature and blood pressure 40. A child with Reye syndrome is described in the nurse's notes as follows: 1200-comatose with sluggish pupils; when stimulated, demonstrates decerebrate posturing. 1400-unchanged except that now demonstrates decorticate posturing when stimulated. The nurse concludes that the child's condition is: A. Worsening and progressing to a more advanced stage of Reye syndrome B. Worsening, and the child may likely experience cardiac and respiratory failure. C. Improving and progressing to a less advanced stage of Reye syndrome D. Improving as the child's posturing reflexes are similar 41. The nurse is caring for a 1-year-old who has just been diagnosed with viral encephalitis. The parents ask if their child will be admitted to the hospital. Select the nurse's best response. A. "Your child will likely be sent home because encephalitis is usually caused by a virus and not bacteria." B. "Your child will likely be admitted to the pediatric floor for intravenous antibiotics and observation." C. "Your child will likely be admitted to the PICU for close monitoring and observation." D. "Your child will likely be sent home because she is only 1-year-old. We see fewer complications and a shorter disease process in the younger child." 42. The nurse answers a call bell and finds a frightened mother whose child, the patient, is having a seizure. Which of these actions should the nurse take? A. The nurse should insert a padded tongue blade in the patient's mouth to prevent the child from swallowing or choking on his tongue. B. The nurse should help the mother restrain the child to prevent him from injuring himself. C. The nurse should call the operator to page for seizure assistance. D. The nurse should clear the area and position the client safely. 43. A child with a seizure disorder has been having episodes during which she drops her pencil and simply appears to be daydreaming. This is most likely a/an A. Absence seizure B. Akinetic seizure C. Non-epileptic seizure D. Simple spasm seizure 44. A child with cerebral palsy (CP) has been fitted for braces and is beginning physical therapy to assist with ambulation. The parents ask why he needs the braces when he was crawling without any assistive devices. Select the nurse's best response A. "The CP has progressed, and he now needs more assistance to ambulate B. "As your child grows, different muscle groups may need more assistance. C. "Most children with CP need braces to help with ambulation." D. "We have found that when children with CP use braces, they are less likely to fall." 45. A preschooler has been having periods during which he suddenly falls and appears to be weak for a short time after the event. The preschool teacher asks what she should do. Select the nurse's best response A. "Have the parents follow up with his pediatrician as this is likely an atonic seizure." B. "Find out if there have been any new stressors in his life, as it could be attention-seeking behavior." C. "Have the parents follow up with his pediatrician as this is likely an absence seizure." D. The preschool years are a time of rapid growth, and many children appear clumsy. It would be best to watch him, and see if it continues. 46. The mother of an unconscious child has been calling her name repeatedly and gently shaking her shoulders in an attempt to wake her up. The nurse notes that the child is flexing her arms and wrists while bringing her arms closer to the mid line of her body. The child's mother asks, "What is going on?" Select the nurse's best response. A. "I think your daughter hears you, and she is attempting to reach out to you." B. "Your child is responding to you; please continue trying to stimulate her." C. "It appears that your child is having a seizure." D. Your child is demonstrating a reflex that indicates she is overwhelmed with the stimulation she is receiving." 47. The nurse is caring for a 2-month-old infant who is at risk for cerebral palsy (CP) due to extreme low birth weight and premature. His parents ask why a speech therapist is involved in his care. Select the nurse's best response A. "Your child is likely to have speech problems because of his early birth. Involving the speech therapist now will ensure vocalization at a developmentally appropriate age." B. "The speech therapist will help with tongue and jaw movements to assist with babbling." C. "The speech therapist will help with tongue and jaw movements to assist with feeding." D. "Many members of the health-care team are involved in your child's care so that we will know if there are any unmet needs. 48. The nurse is caring for a 3-year-old with an altered state of consciousness. The nurse determines that the child is oriented by asking the child to: A. Name the president of the United States. B. Identify her parents and state her own name. C. State her full name and phone number. D. Identify the current month but not the date. 49. What would be the most appropriate advice to give to the parent of a child with slight visual blurring after being hit in the face with a basketball? A. "Apply ice, observe for any further eye complaints, and bring him back if he has increased pain." B. "Take him to the emergency department to ensure that he does not have any internal eye damage." C. "Call your pediatrician if he starts vomiting, is hard to wake up, or has worsening of eye blurring D. "Observe for any further eye complaints, headaches, dizziness, or vomiting, and if worsening occurs, take him to your pediatrician." Situation: Nurse Ann is interviewing a 20-week AOG pregnant mother in the OPD for a routine check-up when the patient complains of always feeling cold, easily gets tired most of the time even for a very short walk, pale and is always dizzy. The patient brought the lab result and showed it to the Nurse reflecting the hematocrit value of 34%. The Nurse also notes the dietary lifestyle of the patient such as eating junk foods and small amounts of fruits and vegetables at least twice a week. For questions 50-52, kindly refer to the given situation stated above. 50. Based on the given scenario stated above, the Nurse understands that this situation shows which of the following? A. The patient is suffering from Vitamin K deficiency. B. During the 2nd trimester of pregnancy, Iron Deficiency Anemia is most common and therefore, the patient should see an OB-GYN for a medical advice such as iron supplementation. C. Hematocrit value is within normal limits, and there's no need to worry about it. D. The Nurse should advise the patient to take 2 tabs of Ferrous Sulfate, over the counter. 51. The Nurse assesses patient's risk for imbalanced nutrition due to the following factors except? A. Iron deficiency anemia B. Eating junk foods at least twice a week C. Regular check-up to OB-GYN D. Taking supplemental Iron and folic acid without prior prescription from the OB-GYN. 52. The Nurse evaluates patient's understanding of health teaching when she verbalizes which of the following? A. "I suffered from IDA, therefore I should take iron supplementation". B. "I need to eat green, leafy vegetables, beans and junk foods at least once a week to decreased fetal risk of having neural tube defect". C. "Fruits such as citrus and avocado are rich in Folic acid and these can decrease the chance of having fetal neural tube defects". D. "All the above" 53. Patient is experiencing extreme nausea and vomiting in the past week 12 of pregnancy and noted a noticeable weight loss and dehydration. The patient in this situation is experiencing which of the following? A. IDA B. Hyperemesis Gravidarum C. Vitamin B12 Deficiency D. Folic Acid Deficiency 54. Ultrasound of a pregnant woman reveals pregnancy in the fallopian tube and complains of a growing pain over the past few weeks. As a Nurse, you understand that this an abnormality in pregnancy which is referred to as which of the following? A. Placenta Previa B. Hyperemesis Gravidarum C. Abortion D. Ectopic Pregnancy 55. The following conditions are associated with molar pregnancy, Except: A. Pregnancy-induced hypertension B. Gestational Diabetes C. Thyrotoxicosis D. Hyperemesis gravidarum 56. A first-time expectant mother, experiences amenorrhea for almost 3 months, pregnancy test revealed positive for HCG, and her uterus expands faster than normal. She also experiences abdominal pain and morning sickness with marked nausea and vomiting due to high levels of HCG produced in the body. During ultrasound, there was no fetal heart sound heard and no fetal skeleton observed. This situation suggests that the patient experiences which of the following? A. Molar pregnancy B. Ectopic pregnancy C. Pre-eclampsia D. Abortion 57. One of the Therapeutic Management of H-mole are the following except? A. Monitor for signs of hemorrhage, PIH, or other complications such as HELLP B. Suction & curettage to evacuate the mole. C. Should not get pregnant within 1 year of diagnosis because signs of pregnancy can mask signs of choriocarcinoma D. Do nothing, because this is normal for a pregnant woman 58. The nurse is caring for a pediatric client who is scheduled for the surgical removal of a Wilms tumor. Which action is contraindicated in the client's care? A. Foley catheter placement C.Abdominal palpation B. Intravenous fluids D. Supine positioning 59. A Parent of a 10-year-old have just been informed that their child has stage III cancer. They ask the nurse what this means. What is the nurse's best response? A. "This means that the tumor has not extended into surrounding tissue" B. "This means there is some local spread, but complete surgical removal is possible" C. "The cancer cells have spread to the lymph nodes" D. "The cancer has spread to other organs" 60. What is the priority action the nurse should take when caring for a child newly diagnosed with Wilms tumor (nephroblastoma)? A. Obtain a catheterized urine specimen B. Protect the abdomen from manipulation C. Control acute pain D. Assess for constipation 61. What is a well-defined risk management technique that the nurse can teach children and parents to prevent cancer? A. Limit sun exposure throughout childhood and adolescence B. Incorporate more preservative-free foods into the diet C. Eliminate aerosol sprays from the living area D. Avoid artificial colors, flavors, and fragrances in foods, cosmetics, and household items. 62. A nurse is preparing a presentation for a parent group on childhood cancers. As part of the presentation, the nurse plans to discuss rhabdomyosarcoma. What are some common sites where rhabdomyosarcoma occurs? Select all that apply. A.. Gastrointestinal tract B. Head C. Neck D. Extremities E. Central Nervous System 63. A school-aged client came into the Emergency Room with a history of a systemic inflammatory disease that involves the heart and joints. Upon assessment you noted involuntary movement of limbs, emotional lability and slurred speech. Using the Jones Criteria, you know that this is: A. Polyarthritis C. Subcutaneous nodules B. Erythema marginatum D. Chorea 64. It is a tumor that arises from a bone cell, probably the osteoblast. This also frequently affects the metaphysis of long bones. A. Scoliosis B. Osteogenic Sarcoma C. Rheumatic Fever D. Juvenile Arthritis 65. Maria comes in the clinic with symptoms of watery, gray-white vaginal discharge and vulvar itching. She also informed you that she is pregnant and taking Erythromycin. As a nurse taking the information, you know that this is: A. Gardnerella vaginalis B. Chlamydia trachomatis C. Candida albicans D. Herpesvirus type II 66. You are giving discharge instructions to a mother whose child has scoliosis and with braces. Which following statements made by the mother needs further Instructions? A. The brace should be worn 23 hours a day. B. " The brace should have direct contact with the skin to promote fast recovery." C. "My child can take off the brace once she goes for a bathe or swim." D. The brace should be worn during exercise. 67. Stacy an 18-year-old female consulted in your clinic with complains of nausea and vomiting. Her BMI is less than 85% of her expected weight and body image is distorted. She also has amenorrhea. After the consult, you gave Stacy instructions to improve her weight. Which of the following statement would indicate that Stacy understood the health teachings you provided? A. "I will increase oral fluid intake." B. "I will do self-monitoring and attend trainings to know my normal nutritional needs." C. "I will maintain a weight which for me is normal." D. "I will not communicate with family and friends about my condition." 68. A 16-year-old male patient who is diagnosed with juvenile arthritis came in for follow up check-up. Upon assessment you note that the patient has slightly elevated body temperature. You know that this is a characteristic of: A. Polyarticular B. Pauclarticular C. Systemic Onset D. Both A & B 69. The school is planning to have a trip to the pool. A parent is to accompany the child. As a school nurse, you are doing health teaching measures to the parents. Which teaching should you emphasize? A. Follow safe water rules B. Diving is encouraged C. Encourage children to plan in the water D. Let children swim with minimal supervision. 70. A 12-year-old female student came into the school clinic with complains of pain in the lower abdomen accompanied by an aching, pulling sensation of the vulva and inner thighs. What should you instruct the patient when taking analgesics? A. "You can take the medication anytime." B. "You take it with a full stomach." C. "You can take it without any food D. "You do not need medications." 71. A patient with systemic inflammatory disease that involves the heart and joints is for admission with macular rash which occurs primarily on the trunk and proximal limbs, associated with carditis. Based on your assessment you know that this is: SELECT ALL THAT APPLY: A. Chorea B. Polyarthritis C. Erythema marginatum D. Subcutaneous nodules 72. Your patient has symptoms of edema and reddening of vulva; milky-gray discharge, fishy odor. What is the most common therapy for this sexually transmitted infection? A. Clindamycin C. Oral analgesic B. Douching with weak vinegar D. Monistat 73. What is the inciting event in otitis externa? A. Reduction B. Deflation C. Inflammation D. Compression 74. What are agents frequently involved in externa otitis? A. Streptococcus and Staphylococcus B. Escherichia coli and Miconazole C. Clotrimazole and Ketoconazole D. Pseudomonas and Candida 75. What are the common causes of the Intellectual Disability? A. Very low birth weight and ADHD B. Autism Spectrum Disorder and Very low birth weight C. Brain malfuctions and ADHD D. Autism Spectrum Disorder and ADHD 76. A client diagnosed with Intellectual Disability is under the supervision of nurse Gea. The nurse is aware that the signs and symptoms of mild ID include which of the following? A. Few communication skills B. Lateness in walking C. Mental age of toddler D. Noticeable developmental delays 77. A nurse would question an order to irrigate the ear canal in which of the following circumstances? A. Ear pain B. Hearing loss C. Otitis media D. Perforated tympanic membrane 78. The key and should be done as soon as healthcare providers become aware of a delay in motor language, or social milestone: A. Late assessment B. Early assessment C. Thorough assessment D. Appropriate assessment 79. An older adult in the family practice clinic reports a decrease in hearing over a week. What action by the nurse is most appropriate? A. Assess for cerumen buildup. B. Facilitate audiological testing. C. Perform tuning fork tests. D. Review the medication list. 80. A client had a myringotomy. The nurse provides which discharge teaching? A. Buy dry shampoo to use for a week. B. Drink liquids through a straw C. Flying is not allowed for 1 month. D. Hot water showers will help the pain. 81. Classified were children demonstrate only minimal capacity for sensorimotor functioning and are non-verbal and non-symbolic in communication. A. Mild Intellectual Disabilities B. Moderate Intellectual Disabilities C. Severe Intellectual Disabilities D. Moderate Intellectual Disabilities 82. A nurse is teaching a client about ear hygiene and health. What client statement indicates a need for further teaching? A. A soft cotton swab is alright to clean my ears with. B. I make sure my ears are dry after I go. C. I use good earplugs when i practice with the band, D. Keeping my diabetes under control helps my ears. Situation: Lily is a patient in the Reproductive Health Unit (RHU) where you work. She is inquiring about pregnancy. 83. Lily tell you she is worried because she develops breasts later than most of her friends. Breast development is termed as: A. Adrenarche B. Thelarche C. Mamarch D. Menarche 84. Kevin, Lily's husband tells you that he is considering vasectomy after the birth of their new child Vasectomy involves the incision of which organ? A. The testes B. The epididymis C. The vas deferens D. The scrotum 85. On examination, Lily has been found of having a cystocele. A cystocele is: A. A sebaceous cyst arising from the vulvar fold B. Protrusion of intestines into the vagina C. Prolapse of the uterus into the vagina D. Herniation of the bladder into the vaginal wall 86. Lily typically has menstrual cycle of 34 days. She told you she had coitus on days: 8, 10, 15 and 20 of her menstrual cycle. Which is the day on which she is most likely to conceive? A. 8th day C. 10th day B. Day 15 D. Day 20 Situation: Nurse Angelie is a family planning and Infertility Nurse Specialist and currently attends to Family Planning Clients and Infertle Couples. The following conditions pertain to meeting the nursing needs of this particular population group. 87. Athena, 17 years old, asks you how a tubal ligation prevents pregnancy. Which would be the best answer? A. Prostaglandins released from the cut fallopian tubes can kill sperm. B. Sperm cannot enter the uterus because the cervical entrance is blocked. C. Sperm can no longer reach the ova, because the fallopian tubes are blocked. D. The ovary no longer releases ova as there is nowhere for them to go. 88. The Manzano's are a couple undergoing testing for infertility. Infertility is said A. A woman has a non-working uterus. B. A woman has no children. C. A couple has been trying to conceive for 1 year. D. A couple has wanted a child for 6 to 12 months. 89. Another client named Joan is diagnosed as having endometriosis. This condition interferes with fertility because: A. Endometrial implants can block the fallopian tubes. B. The uterine cervix becomes inflamed and swollen C. The ovaries stop producing adequate estrogen. D. Pressure on the pituitary leads to decreased FSH level. 90. Lilla is scheduled to have a hysterosalpingogram. Which of the following instructions would you give her regarding this procedure? A. She will not be able to conceive for 3 months after the procedure. B. The sonogram of the uterus will reveal any tumors present. C. Many women experience mild bleeding as an after effect. D. She may feel some cramping when the dye is inserted. 91. Joan's cousin on the other hand, knowing Nurse Angelie's specialization ask what artificial insemination by donor entails. Which would be your best answer if you were Nurse Angelie? A. Donor sperm are introduced vaginally into the uterus or cervix. B. Donor sperm are injected intra-abdominal y into each ovary. C. Artificial sperm are injected vaginally to test tubal patency. D. The husband's sperm is administered intravenously weekly. 92. Which of the following is the primary predisposing factor related to mastitis? A. Epidemic infection from nosocomial sources localizing in the lactiferous glands and ducts. B. Endemic infection occurring randomly and localizing in the periglandular connective tissue. C. Temporary urinary retention due to decreased perception of the urge to avoid. D. Breast injury caused by overdistention, stasis, and cracking of the nipples. 93. An appropriate nursing action to include in the care of an infant with congenital heart disease who has been admitted with heart failure is: A. Positioning flat on the back B. Encouraging nutritional fluids C. Offering small frequent feedings D. Measuring the head circumference 94. The assessment that would lead the nurse to suspect that a newborn infant has a ventricular septal defect is: A. A loud, harsh murmur with a systolic tremor. B. Cyanosis when crying. C. Blood pressure higher in the arms than in the legs. D. A machinery-like murmur. 95. The finding the nurse would expect when measuring blood pressure on all four extremities of a child with coarctation of the aorta is blood pressure that is: A. Higher on the right side. B. Higher on the left side. C. Lower in the arms than in the legs. D. Lower in the legs than in the arms. 96. The nurse caring for a child diagnosed with coarctation of the aorta is demonstrating signs of respiratory distress. The nurse suspects this is a sign of which of the following? A. Aspiration pneumonia B. Digoxin toxicity C. Systemic congestion D. Pulmonary congestion 97. An infant with a patent ductus arteriosus is admitted to the pediatric unit ward. The nurse anticipates which of the following medications will be given to the infant. A. Prednisone C. Penicillin B. Ibuprofen D. Albuterol 98. Which of the following disorders leads to cyanosis from deoxygenated blood entering the systematic arterial circulation? A. Aortic stenosis (AS) C. Patent ductus arteriosus (PDA) B. Coarctation of aorta D. Tetralogy of fallot 99. An infant with tetralogy of Fallot becomes cyanotic and dyspneic after a crying episode. To relieve the cyanosis and dyspnea, the nurse placed the infant in the: A. Orthopneic position B. Lateral Sims' position C. Knee-chest position D. Semi-Fowler's position 100. Upon performing an initial exam after the birth of an infant, the provider hears a murmur when auscultating the baby's heart. The provider suspects that the baby has an atrial septral defect. Which of the following tests would be performed to diagnose this condition? A. Echocardiogram B. Nuclear imaging C. Chemical stress test D. Isotope test