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Strategi Pertama: Persiapkan Diri Anda

Kandidat yang berhak untuk mengikuti ujian kompetensi adalah mereka yang telah lulus pendidikan
keperawatan, baik pendidikan diploma keperawatan maupun sarjana keperawatan (plus ners). Tujuan
utama dari ujian kompetensi adalah untuk menguji pengetahuan dan tingkah laku kandidat dan
menetapkan bahwa kandidat tersebut memiliki kompetensi yang diperlukan.
Pastikan bahwa Anda telah melakukan persiapan yang diperlukan untuk mengikutiujian kompetensi ini.
Setidaknya Anda harus sudah familiar dengan format dan tipe soal yang akan diujikan nanti. Oleh karena
itu berlatih secara rutin akan membuat kemungkinan Anda lulus lebih tinggi.
Berdasarkan informasi yang berkembang bahwa ujian kompetensi ini terdiri dari 120 soal pilihan ganda
dan wajib diselesaikan selama 2 jam. Berarti setiap soal hanya diberikan waktu 1 menit untuk memilih
satu jawaban yang paling tepat.
Di awal ujian kompetensi, Anda akan diberikan satu set soal ujian kompetensi bersama dengan lembar
jawaban. Anda wajib mengisi semua informasi yang diperlukan dalam lembar jawaban secara akurat.
Setelah itu, Anda baru diperbolehkan untuk membulatkan jawaban yang paling tepat dalam lembar
jawaban yang telah diberikan dengan menggunakan pensil 2B. Pastikan bahwa jawaban yang Anda
berikan cukup tebal dan bulatan telah terisi dengan sempurna.
Lembar jawaban ini akan dikoreksi oleh alat yang sesuai, oleh karenanya Anda perlu untuk
memperhatikan hal-hal berikut ini:
o Apabila Anda ingin merubah jawaban yang diberikan, pastikan bahwa jawaban yang telah diberikan
sebelumnya telah Anda hapus dengan bersih,
o Jangan berikan tanda apapun di lembar jawaban menggunakan pulpen atau pensil, kecuali pada
tempat yang diperbolehkan,
o Anda tidak perlu merubah apapun bagian sebelah kiri dari lembar jawapan yang tampak berbayang,
biarkan saja apa adanya,
o Jangan melipat lembar jawaban Anda agar alat korektor lembar jawaban dapat membaca lembar
jawapan Anda dengan sempurna.
o Akhirnya, jangan lupa selama ujian kompetensi, perhatikan jumlah halaman dari set soal yang
diberikan, pastikan bahwa Anda tidak tertinggal satu halamanpun untuk menjawab soal tersebut.
Strategi 2: Fahami Soal Ujian
Pembuat soal pada umumnya akan secara general mengambil bahan untuk diujikan yang biasanya akan
tampak asing bagi peserta ujian kompetensi. Anda tidak mungkin berharap bahwa semua topik
Keperawatan Medikal Bedah yang Anda kuasai yang akan dikeluarkan. Namun, apabila ternyata soal
ujian kompetensi yang keluar sesuai dengan prediksi Anda, berarti Anda sedang beruntung. Tapi jangan
harap keberuntungan Anda tersebut akan 100% terjadi.
Setiap studi kasus dan skenario biasanya berbeda. Coba dan fahami semua bahan yang diujikan, sambil
Anda memilah jawaban-jawaban yang mengelirukan. Studi kasus juga biasanya akan diambil dari
pengalaman nyata yang terjadi di rumah sakit atau layanan kesehatan lain. Oleh karena itu, pasangan
jawaban yang akan Anda temui dalam soal ujian kadang terlihat diluar konteks dan kerapkali dimulai dari
pertengahan proses pengobatan. Selama ujian, Anda tidak akan mendapati soal yang menjelaskan topik
secara umum (berbeda dengan yang Anda biasa jumpai di buku), melainkan Anda akan langsung dibawa
ketengah-tengah jenis soal ujian yang baru dan tidak Anda kuasai.
Strategi 3: Belajarlah mengikuti Irama Anda
Tidak perlu ngoyo semasa anda mempersiapkan diri untuk menghadapi uji kompetensi. Tiap orang
mempunyai learning style yang beragam. Jika anda senang belajar bersendirian, lakukanlah. Namun jika
anda lebih menyukai belajar dalam diskusi berkelompok carilah rekan yang mempunyai learning
style yang sama.
Strategi 4: Jangan Ingin Terlalu Sempurna
Pepatah mengatakan no body is perfect. Setiap orang pasti memiliki kelemahan. Namun, kelemahan yang
kita miliki bisa kita tutupi dengan giat belajar dan berlatih. Orang barat sering mengatakan practice
makes perfect semakin sering belajar atau berlatih maka kepandaian atau kemampuan kita kian
sempurna.
Strategi 5: Kesalahan yang Biasa Terjadi
Seorang mahasiswa ataupun calon peserta uji kompetensi biasanya malas dan sering menunda-nunda
aktivitas untuk belajar. Sebagaimana saat kuliah dahulu, masih sering menganggap sistem kebut semalam
masih ampuh untuk dijalankan dalam menghadapi uji kompetensi, ini adalah kesalahan yang fatal.
Perlu difahami bahwa kejayaan seseorang adalah berkat usaha gigih yang dilakukannya secara sedikit
demi sedikit namun berkesinambungan. Bukan hasil keberuntungan karena soal uji kompetensi yang
keluar hasil belajar dengan sistem kebut semalam.
Strategi 6: Perbanyak Informasi Tambahan
Banyaklah bergaul dengan kawan-kawan anda yang sedang menghadapi problemyang sama. Saling
berkomunikasi untuk bertukar fikiran dan sharing resource yang dimiliki. Yakin anda akan banyak
mendapatkan pencerahan jika dibandingkan dengan duduk melamun sendirian di kamar karena berfikir
masalah anda tidak ada yang membantu.
Anda juga bisa mengunjungi berbagai laman web yang menyediakan berbagai soal untuk uji kompetensi
secara gratis, baca dan pelajari dengan baik, insha Allah anda akan banyak mendapatkan informasi
tambahan yang tidak sedikit disana.
Strategi 7: Jawaban yang Mencolok biasanya Salah
Setiap uji apapun, biasanya kita temukan jawaban-jawaban yang lain dari pilihan yang ada, misalnya
jawaban yang karakternya paling panjang sendiri, jawapan yang sangat bertolak belakang maupun
jawapan yang tidak rasional. Biasanya jawaban yang mencolok seperti itu salah. Pilihlah alternatif
jawaban lain yang berbeda dan yang menurut anda paling benar.
Strategi 8: Trik Jawaban
Ketika menjawab soal uji kompetensi, pandai-pandailah anda memilah dan memilih. Gunakan analisa
anda dari hasil-hasil pembelajaran yang telah anda lalui. Setiap pilihan jawaban kaitkan dengan memori
anda, kemudian pilihlah satu jawaban yang paling tepat.
Selain itu berbeda dengan penerimaan mahasiswa di perguruan tinggi negeri dimana jawaban salah akan
dikurangi beberapa point, pada uji kompetensi jawaban salah tidak akan dikurangi point. Jadi jawablah
semua soal dengan yakin. Jangan biarkan ada soal yang dibiarkan kosong dan tidak terisi karena hal
tersebut berarti mengurangi kesempatan anda untuk lulus ujian.
Strategi 9: I dea yang Pertama Muncul Biasanya Betul
Saat membaca soal uji kompetensi biasanya akan muncul ide-ide secara sekelebat tentang jawaban dari
soal yang sedang kita hadapi. Perhatikan baik-baik dan koneksikan dengan memori anda, karena biasanya
ide yang pertama muncul adalah jawaban yang betul.
Strategi 10: Rileks
Soal uji kompetensi tidak akan menelan anda. Oleh karenanya berusahalah untuk rileks. Anda yang harus
bisa menaklukkan serangkaian soal-soal tersebut, bukan sebaliknya. Jika stress sudah anda rasakan,
istirahat sejenak, tarik nafas dalam dan hembuskan perlahan sehingga perasaan anda lega. Ulang berkali-
kali selama anda mengikuti uji kompetensi agar tetap rileks.
Strategi 11: Dapatkan Gambaran dari yang Tidak Anda Ketahui
Anda mendapati soal uji kompetensi yang benar-benar baru dan belum pernah membaca atau
mempelajarinya, tenang. Jangan stress. Gunakan fikiran anda untuk membayangkan soalan tersebut dan
dapatkan gambaran yang rasional darinya, setelah itu carilah jawaban yang menurut anda sesuai dengan
gambaran yang telah anda dapatkan tersebut.
Strategi 12: Optimalkan Ilmu yang telah Dipelajari
Disaat Anda menemukan soal ujian yang memiliki jawaban yang berlawanan, jawaban yang tepat
biasanya ada di salah satu pilihan jawaban tersebut.
Contoh:
A. Calcium is the primary mineral linked to osteoporosis treatment.
B. Potassium is the primary mineral linked to osteoporosis treatment.
Kedua pilihan jawaban diatas saling berlawanan, ini mengindikasikan bahwa salah satu pilihan jawaban
adalah benar.
Strategi 13: Tidak perlu jadi Genius untuk Lulus Ujian Kompetensi
Anda tidak harus menjadi Einstein atau mengetahui semua topik yang dipelajari selama di bangku kuliah
untuk lulus ujian kompetensi. Bahkan, kerapkali soal yang dikeluarkan tidak pernah Anda dengar dan
mengaburkan. Jika Anda harus mengetahui semua topik secara detail, malah Anda akan pusing sendiri.
Jadi, kuasailah topik-topik penting yang Anda anggap perlu Anda fahami.
Jika tulisan ini dirasakan bermanfaat bagi anda, harap tinggalkan tulisan anda di kolom komentar
dibawah ya. Terima kasih.
Disarikan dari sumber rujukan berikut ini:
1. Murray, Timothy Neil, et. all. (2010). Licensing Exam Review Guide for Nurses. Selangor: Oxford
University Press.
2. Lagerquist, Sally Lambert (Ed). (2006). NCLEX-RN Success. 2nd Edition. Philadelphia: F.A. Davis
Company


















Questions
1. Which is the primary goal of community health nursing?
A. To support and supplement the efforts of the medical profession in the promotion of health
and prevention of
B. To enhance the capacity of individuals, families and communities to cope with their health
needs
C. To increase the productivity of the people by providing them with services that will increase
their level of health
D. To contribute to national development through promotion of family welfare, focusing
particularly on mothers and children
2. CHN is a community-based practice. Which best explains this statement?
A. The service is provided in the natural environment of people
B. The nurse has to conduct community diagnosis to determine nursing needs and problems
C. The service are based on the available resources within the community
D. Priority setting is based on the magnitude of the health problems identified
3. Population- focused nursing practice requires which of the following processes?
A. Community organizing .
B. Nursing, process
C. Community diagnosis
D. Epidemiologic process
4. RA 1054 is also known as the Occupational Health Act. Aside from the number of
employees, what other factor must be considered in determining the occupational health
privileges to which the workers will be entitled?
A. Type of occupation,: agriculture, commercial, industrial
B. Location of the workplace in relation to health facilities
C. Classification of the business enterprise based on net profit
D. Sex and age composition of employees
5. A business firm must employ an occupational health nurse when it has at least how
many employees.
A. 21
B. 101
C. 201
D. 301
6. When the occupational health nurse employs ergonomic principles, she is performing
which of her roles?
A. Health care provider
B. Health educator
C. Health care coordinator
D. Environment manager
7. A garment factory does not have an occupational nurse. Who shall provide the
occupational health needs of the factory workers?
A. Occupational health nurse at the Provincial Health Office
B. Physician employed by the factory
C. Public Health nurse of the RHU of their municipality
D. Rural Sanitary inspector of the RHU in their municipality
8. Public health services are given free of charge. Is this statement true or false?
A. The statement is true; it is the responsibility of government to provide haste services
B. The statement is false; people pay indirectly for public health services
C. The statement may be true or false; depending on the Specific service required
D. The statement may be true or false; depending on policies of the government concerned.
9. According to C.E. Winslow, which of the following is the goal of Public Health?
A. For people to attain their birthrights and longevity
B. For promotion of health and prevention and diseases
C. For people to have access to basic health services
D. For people to be organized in their health efforts
10. We say that a Filipino has attained longevity when he is able to reach the average life
span of Filipinos. What other statistic may be used to determine attainment of longevity?
A. Age-specific mortality rate
B. Proportionate mortality rate
C. Swaroops index
D. Case fatality rate
11. Which of the following is the most prominent feature of public health nursing?
A. It involves providing home care to sick people who are not confined in the hospital
B. Services are provided free of charge to people within the catchment area
C. The public health nurse functions as part of a team providing a public health nursing service
D. Public health nursing focuses on preventive, not curative services
12. According to Margaret Shetland, the philosophy of public health nursing is based on
which of the following?
A. Health and longevity as birthrights
B. The mandate of the state to protect the birthrights of its citizens
C. Public health nursing as a specialized field of nursing
D. The worth and dignity of man
13. Which of the following is the mission of the Department of Health?
A. Health for all Filipinos
B. Ensure the accessibility and quality of health
C. Improve the general health status of the population
D. Health in the hands of the Filipino people by the year 2020
14. Region IV Hospital is classified as what level of facility?
A. Primary
B. Secondary
C. Intermediate
D. Tertiary
15. What is true of primary facilities?
A. They are usually government-run
B. Their services are provided on an out-patient basis
C. They are training facilities for health professionals
D. A community hospital is an example of this level of health facilities
16. Which is an example of the school nurses health care provider function?
A. Requesting for BCG from the RHU for school entrance immunization
B. Conducting random classroom inspection during measles epidemic
C. Taking remedial action on an accident hazard in the school playground
D. Observing places in the school where pupils spend their free times
17. When the nurse determines whether resources were maximized in implementing
Ligtas Tigdas, she is evaluating:
A. Effectiveness
B. Efficiency
C. Adequacy
D. Appropriateness
18. You are a new B.S.N. graduate. You want to become a Public Health Nurse. Where will
you apply?
A. Department of Health
B. Provincial Health Office
C. Regional Health Office
D. Rural Health Unit
19. RA 7160 mandates devolution of basic services from the national government to local
government units. Which of the following is the major goal of devolution?
A. To strengthen local government units
B. To allow greater autonomy to local government units.
C. To empower the people and promote their self-reliance
D. To make basic services more accessible to the people
20. Who is the Chairman of the Municipal Health Board?
A. Mayor
B. Municipal Health Officer
C. Public Health Nurse
D. Any qualified physician
21. Which level of health facility is the usual point of entry of a client into the health care
delivery system?
A. Primary
B. Secondary
C. Intermediate
D. Tertiary
22. The public health nurse is the supervisor of rural health midwives. Which of the
following is a supervisory function of the pubic health nurse?
A. Referring cases or patients to the midwife
B. Providing technical guidance to the midwife
C. Proving nursing care to cases referred by the midwife
D. Formulating and implementing training programs for midwives
23. One of the participants in a hilot training class asked you to whom she should refer a
patient in labor who develops a complication. You will answer, to the;
A. Public health nurse
B. Rural health midwife
C. Municipal health officer
D. Any of these health professionals
24. You are the public health nurse in a municipality with a total population of about
20,000. There are3 health midwives among the RHU personnel. How many more midwife
items will the RHU need?
A. 1
B. 2
C. 3
D. 4
25. If the RHU needs additional midwife items, you will submit the request for additional
midwife items for approval to the:
A. Rural Health Unit
B. District Health Office
C. Provincial Health Office
D. Municipal Health Board
26. As an epidemiologist, the nurse is responsible for reporting cases or notifiable
diseases. What law mandates reporting cases of notifiable diseases?
A. Act 3573
B. RA.3753
C. RA 1054
D. RA 1082
27. According to Freeman and Heinrich, community health nursing is a developmental
service. Which of the following best illustrates this statement?
A. The community health nurse continuously develops himself personally and professionally
B. Health education and community organizing are necessary in providing community health
services
C. Community health nursing in intended primarily for health promotion and prevention and
treatment of disease.
D. The goal of community health nursing is to provide nursing services to people in their own
place of .residence
28. Which disease was declared through Presidential Proclamation No. 4 as a target for,
eradication in the Philippines?
A. Pioliomyelitis
B. Measles
C. Rabies
D. Neonatal Tetanus
29. The public health nurse is responsible for presenting the municipal health statistics
using graphs and tables. To compare the frequency of the leading causes of mortality in
the municipality, which graph will you prepare?
A. Line
B. Bar
C. Pie
D. Scatter diagram
30. Which step in community organizing involves training of potential leaders in the
community?
A. Integration
B. Community organization
C. Community study
D. Core group formation
31. In which step are plans formulated for solving community problems?
A. Mobilization
B. Community organization
C. Follow-up/extension
D. Core group formation
32. The public health nurse takes an active role in community participation. What is the
primary goal of community organizing?
A. To educate the people regarding community health problems
B. To mobilize the people to resolve community health problems
C. To maximize the communitys resources in dealing with health problems
33. An indicator of success in community organizing is when people are able to:
A. Participate in community activities for the solution of a community problem
B. Implement activities for the solution of the community problem
C. Plan activities for the solution of the community problem
D. Identify the health problem as a common concern
34. Tertiary prevention is needed in which stage of the natural history of disease?
A. Pre-pathogenesis
B. Pathogenesis
C. Predromal
D. Terminal
35. Isolation of a child with measles belongs to what level of prevention?
A. Primary
B. Secondary
C. Intermediate
D. Tertiary
36. On the other hand, Operation Timbang is_____ prevention?
A. Primary
B. Secondary
C. Intermediate
D. Tertiary
37. Which type of family-nurse contact will provide you with the best opportunity to
observe family dynamics?
A. Clinic consultation
B. Group conferences
C. Home visit
D. Written communication
38. The typology of family nursing problems is used in the statement of nursing
diagnosis in the care of families. The youngest child of the delos Reyes family has been
diagnosed as mentally retarded. This is classified as:
A. Health threat
B. Health deficit
C. Foreseeable crisis
D. Stress point
39. The delos Reyes couple have 6-year old child entering school for the first time. The
delos Reyes family has a:
A. Health threat
B. Health deficit
C. Foreseeable crisis
D. Stress point
40. Which of the following is an advantage of a home visit?
A. It allows the nurse to provide nursing care to a greater number of people
B. It provides an opportunity to do first hand appraisal of the home situation
C. It allows sharing of experience among people with similar health problems
D. It develops the familys initiative in providing for health needs of its members
41. Which is CONTRARY to the principles in planning a home visit?
A. A home visit should have a purpose of objective
B. The plan should revolve around the family health .needs
C. A home visit should be conducted in the manner prescribed by RHU
D. Planning of continuing care should involve a responsible-family member
42. The PHN bag is an important tool in providing nursing care during a home visit. The
most important principle in bag technique states that it;
A. Should save time and effort
B. Should minimize if not totally prevent the spread of infection
C. Should not overshadow concern for the patient and his family
D. May be done in variety of ways depending on the home situation, etc.
43. To maintain the cleanliness of the bag and its contents, which of the following must
the nurse do?
A. Wash his/her hands before and after providing nursing care to the family members
B. In the care of family members, as much as possible, use only articles taken from the bag
C. Put on an apron to protect her uniform and fold it with the right side out before putting it back
into the bag.
D. At the end of the visit, fold the lining on which the bag was placed, ensuring that the
contaminated side is on the outside.
44. The public health conducts a study on the factors contributing to the high morality
rate due to heart diseases in the municipality where she works. Which branch of
epidemiology does the nurse practice in this situation?
A. Descriptive
B. Analytical
C. Therapeutic
D. Evaluation
45. Which of the following is a function of epidemiology?
A. Identifying the disease condition based on manifestations presented by a client
B. Determining factors that contributed to the occurrence of pneumonia in a 3 year old
C. Determining the efficacy of the antibiotic used in the treatment of the 3 year old client with
pneumonia
D. Evaluating the effectiveness of the implementation of the Integrated Management of
Childhood Illness
46. Which of the following is an epidemiologic function of the nurse during an epidemic?
A Conducting assessment of suspected cases to detect the communicable diseases
B. Monitoring the condition of the cases affected by the communicable disease
C. Participating in the investigation to determine the source of epidemic
D. Teaching the community on preventive measures against the disease
47. The primary purpose of conducting an epidemiologic investigation is to;
A. Delineate the etiology of the epidemic
B. Encourage cooperation and support of the community
C. Identify groups who are at risk of contracting the disease
D. Identify geographical location of cases of the disease in the community
48. Which is a characteristic of person-to-person propagated epidemic?
A. There are more cases of the disease than expected
B. The disease must necessarily be transmitted through a vector
C. The spread of the disease can be attributed to a common vehicle
D. There is gradual build up of cases before we epidemic becomes easily noticeable
49. In the investigation of an epidemic, you compare the present frequency of the disease
with the usual frequency at this time of the year in this community. This is done during
which stage of the investigation?
A. Establishing the epidemic
B. Testing the hypothesis
C. Formulation of the hypothesis
D. Appraisal of facts
50. The number of cases of Dengue fever usually increases towards the end of the rainy
season. This pattern of occurrence of Dengue fever is best described as;
A. Epidemic occurrence
B. Cyclical variation
C. Sporadic occurrence
D. Secular occurrence
51. In the year 1980, the World Health Organization declared the Philippines, together
with some other countries in the Western Pacific Region, free of which disease?
A. Pneumonic plaque
B. Poliomyelitis
C. Small pox
D. Anthrax
52. In the census of the Philippines in 1995, there were about 35,299,000 males and about
34,968,000 females. What is the sex ratio?
A. 99.06:100
B. 100.94:100
C. 50.23%
D. 49.76%
53. Primary health care is a total approach to community development. Which of the
following is an indicator of success in the use of the primary health care approach?
A. Health services are provided free of charge to individuals and families
B. Local officials are empowered as the major decision makers in matters of health
C. Health workers are able too provide care based on identified health needs of the people
D. Health programs are sustained according to the level of development of the community
54. Sputum examination is the major screening tool for pulmonary tuberculosis. Clients
would sometimes get false negative results in this exam. This means that the test is not
perfect in terms of which characteristic of a diagnostic examination?
A. Effectiveness
B. Efficacy
C. Specificity
D. Sensitivity
55. Use of appropriate technology requires knowledge of indigenous technology. Which
medical herb is given for fever, headache and cough?
A. Sambong
B. Tsaang gubat
C. Akapulko
D. Lagundi
56. What law created the Philippine institute of Traditional and Alternative Health Care?
A. RA 8483
B. RA4823
C. RA 2483
D. RA 3482
57. In traditional Chinese medicine, the yielding, negative and feminine force is termed:
A. Yin
B. Yang
C. Qi
D. Chai
58. What is the legal basis of Primary Health Care approach in the Philippines?
A. Alma Ata Declaration of PHC
B. Letter of Instruction No 949
C. Presidential Decree No. 147
D. Presidential Decree 996
59. Which of the following demonstrates inter-sectoral linkages?
A. Two-way referral system
B. Team approach
C. Endorsement done by a midwife to another midwife
D. Cooperation between PHN and public school teacher
60. The municipality assigned to you has a population of about 20/000. Estimate the
number of 1-4 year old children who be given Retinol capsule 200.000 every 6 months.
A. 1,500
B. 1,800
C. 2,000
D. 2,300
61. Estimate the number of pregnant women who will be given tetanus toxoid during an
immunization outreach activity in a barangay with a population of about 1,500.
A. 265
B. 300
C. 375
D. 400
62. To describe the sex composition of the population, which demographic tool may be
used?
A. Sex ratio
B. Sex proportion
C. Population pyramid
D. Any of these maybe used
63. Which of the following is a natality rate?
A. Crude birth rate
B. Neonatal mortality rate
C. Infant mortality rate
D. General fertility rate
64. You are computing the crude rate of your municipality, with a total population o about
18,000 for last year. There were 94 deaths. Among those who died, 20 died because of
diseases of the heart and 32 were aged 50 years or older. What is the crude death rate?
A. 4.1/1000
B. 5.2/1000
C. 6.3/1000
D. 7.3/1000
65. Knowing that malnutrition is a frequent community health problem, you decided to
conduct nutritional assessment. What population is particularly susceptible to protein
energy malnutrition (PEM)?
A. Pregnant women and the elderly
B. Under 5 year old children
C. 1-4 year old children
D. School age children
66. Which statistic can give the most accurate reflection of the health status of a
community?
A. 1-4 year old age-specific mortality rate
B. Infant mortality rate
C. Swaroops index
D. Crude death rate
67. In the past year, Barangay A had an average population of 1655. 46 babies were born
in that year, 2 of whom died less than 4 weeks after they were born. They were 4
recorded stillbirths. What is the neonatal mortality rate?
A. 27.8/1000
B. 43.5/1000
C. 86.9/1000
D. 130.4/1000
68. Which statistic best reflects the nutritional status of a population?
A. 1-4 year old age-specific mortality rate
B. Proportionate mortality rate
C. Infant mortality rate
D. Swaroops index
69. What numerator is used in computing general fertility rate?
A. Estimated midyear population
B. Number of registered live births
C. Number of pregnancies in the year
D. Number of females of reproductive age
70. You will gather data for nutritional assessment of a purok. You will gather information
only from families with members who belong to the target population for PEM. What
method of delta gathering is best for this purpose?
A. Census
B. Survey
C. Record Review
D. Review of civil registry
71. In the conduct of a census, the method of population assignment based on the actual
physical location of the people is termed;
A. De jure
B. De locus
C. De facto
D. De novo
72. The Field Health Services and information System (FHSIS) is the recording and
reporting system in public health) care in the Philippines. The monthly field health
service activity report is a form used in which of the components of the FHSIS?
A. Tally report
B. Output report
C. Target/client list
D. Individual health record
73. To monitor clients registered in long-term regimens, such as the Multi-Drug Therapy,
which component will be most useful?
A. Tally report
B. Output report
C. Target/client list
D. Individual health record
74. Civil registries are important sources of data. Which law requires registration of
births within 30 days from the occurrence of the birth?
A. PD 651
B. Act 3573
C. RA 3753
D. RA 3375
75. Which of the following professionals can sign the birth certificate?
A. Public health nurse
B. Rural health midwife
C. Municipal health officer
D. Any of these health professionals
76. Which criterion in priority setting of health problems is used only in community
health care?
A. Modifiability of the problem
B. Nature of the problem presented
C. Magnitude of the health problem
D. Preventive potential of the health problem
77. The Sentrong Sigla Movement has been launched to improve health service delivery.
Which of the following is/are true of this movement?
A. This is a project spearheaded by local government units
B. It is a basis for increasing funding from local government units
C. It encourages health centers to focus on disease prevention and control
D. Its main strategy is certification of health centers able to comply with standards
78. Which of the following women should be considered as special targets for family
planning?
A. Those who have two children or more
B. Those with medical conditions such as anemia
C. Those younger than 20 years and older than 35 years
D. Those who just had a delivery within the past 15 months
79. Freedom of choice in one of the policies of the Family Planning Program of the
Philippines. Which of the following illustrates this principle?
A. Information dissemination about the need for family planning
B. Support of research and development in family planning methods
C. Adequate information for couples regarding the different methods
D. Encouragement of couples to take family planning as a joint responsibility
80. A woman, 6 months pregnant, came to the center for consultation. Which of the
following substances is contraindicated?
A. Tetanus toxoid
B. Retinol 200,000 IU
C. Ferrous sulfate 200mg
D. Potassium iodate 200 mg, capsule
81. During prenatal consultation, a client asked you if she can have her delivery at home.
After history taking and physical examination, you advised her against a home delivery.
Which of the following findings disqualifies her for a home delivery?
A. Her OB score is G5P3
B. She has some palmar pallor
C. Her blood pressure is 130/80
D. Her baby is in cephalic presentation
82. Inadequate intake by the pregnant woman of which vitamin may cause neural tube
defects?
A. Niacin
B. Riboflavin
C. Folic Acid
D. Thiamine
83. You are in a clients home to attend to a delivery. Which of the following will you do
first?
A. Set up a sterile area
B. Put on a clean gown and apron
C. Cleanse the clients vulva with soap and water
D. Note the interval, duration and intensity of labor and contractions
84. In preparing a primigravida for breastfeeding, which of the following will you do?
A. Tell her that lactation begins within a day after delivery
B. Teach her nipple stretching exercises if her nipples are everted
C. Instruct her to wash her nipples before and after each breastfeeding
D. Explain to her that putting the baby to breast will lessen blood loss after delivery
85. A primigravida is instructed to offer her breast to the baby for the first time within 30
minutes after delivery. What is the purpose of offering the breast this early?
A. To initiate the occurrence of milk letdown
B. To stimulate milk production by the mammary acini
C. To make sure that the baby is able to get the colustrum
D. To allow the woman to practice breastfeeding in the presence of the health worker
86. In a mothers class, you discuss proper breastfeeding technique. Which of these is a
sign that the baby has lactated on the breast property?
A. The baby takes shallow, rapid sucks
B. The mother does not feel nipple pain
C. The babys mouth is only partly open
D. Only the mothers nipple is inside the babys mouth
87. You explain to a breastfeeding mother that breastmilk is sufficient for all of the babys
nutrient needs only up to:
A. 3 months
B. 6 months
C. 1 year
D. 2 years
88. What is given to a woman within a month after the delivery of a baby?
A. Malunggay capsule
B. Ferrous sutfate l00mg O.D.
C. Retinol 200.000 IU 1 capsule
D. Potassium Iodate 200 mg, 1 capsule
89. Which biological used in EPI is stored in the freezer?
A. DPT
B. Tetanus toxoid
C. Measles vaccine
D. Hepatitis B vaccine
90. Unused BCG should be discarded how many hours after reconstitution?
A. 2
B. 4
C. 6
D. At the end of the day
91. In immunity school entrants with BCG, you not obliged to secure parental consent.
This is because of which legal document?
A. PD 996
B. RA 7864
C. Presidential Proclamation No. 6
D. Presidential Proclamation No. 46
92. Which immunization produces a permanent scar?
A. DPT
B. BCG
C. Measles vaccination
D. Hepatitis B vaccination
93. A 4 week old baby was brought to the health center for his first immunization. Which
can be given to him?
A. DPT1
B. OPV1
C. Infant BCG
D. Hepatitis B Vaccin
94. You will not give DPT 2 if the mother says that the infant had?
A. Seizures a day after DPT1
B. Fever for 3 days after DPT1
C. Abscess formation after DPT1
D. Local tenderness for 3 days after DPT1
95. A 2-month old infant was brought to the health center for immunization. During
assessment, the infants temperature registered at 38.1 C. Which is the best course of
action that you will take?
A. Go on with the infants immunization
B. Give paracetamol and wait for his fever to subside
C. Refer the infant to the physician for further assessment
D. Advise the infants mother to bring him back for immunization when he is well
96. A pregnant woman had just received her 4th dose of tetanus toxoid. Subsequently,
her baby will have protection against tetanus for how long?
A. 1 year
B. 3 years
C. 10 years
D. Lifetime
97. A 4-month old infant was brought to the health center of cough. Her respiratory rate
is 42/minute. Using the IMCI guidelines of assessment, her breathing is considered;
A. Fast
B. Slow
C. Normal
D. Insignificant
98. Which of the following signs will indicate that a young child is suffering from severe
pneumonia?
A. Dyspnea
B. Wheezing
C. Fast breathing
D. Chest indrawing
99. Using IMCI guidelines, you classify a child as having severe pneumonia. What is the
best management for the child?
A. Prescribe antibiotic
B. Refer him urgently to the hospital
C. Instruct the mother to increase fluid intake
D. Instruct the mother to continue breastfeeding
100. A 5-month old infant was brought by his mother to the health center because of
diarrhea occurring 4 to 5 times a day. His skin goes back slowly after a skin pinch and
his eyes are sunken. Using the IMCI guidelines, you will classify this infant in which
category?
A. No signs of dehydration
B. Some dehydration
C. Severe dehydration
D. The data is insufficient
101. Based on the assessment, you classified a 3-month old infant with the chief
complaint of diarrhea in the category of SOME DEHYDRATION. Based on the IMCI
management guidelines, which of the following will you do?
A. Bring the infant to the nearest facility where IV fluids can be given
B. Supervise the mother in giving 200 to 400 ml of Oresol in 4 hours
C. Give the infants mother instructions on home management
D. Keep the infant in your health center for close observation
102. A mother is using Oresol in the management of diarrhea of her 3-year old child. She
asked you what to do if her child vomits. You will tell her to:
A. Bring the child to the nearest hospital for further assessment
B. Bring the child to the health center for IV therapy
C. Bring the child to the health center for assessment by the physician
D. Let the child rest for 10 minutes then continue giving Oresol more slowly
103. A 1 1/2 year old child was classified as having 3rd degree of protein energy
malnutrition, kwashjorkor. Which of the following signs will be most apparent in this
child?
A. Voracious appetite
B. Wasting
C. Apathy
D. Edema
104. Assessment of a 2-year old child revealed baggy pants. Using the IMCI guidelines,
how will you manage this child?
A. Refer the child urgently to a hospital for confinement
B. Coordinate with the social worker to enroll the child in a feeding program
C. Make a teaching plan for the mother, focusing on the menu planning for her child
D. Assess and treat the child for health problems like infections and intestinal parasitism
105. During the physical examination of a young child, what is the earliest sign of
xerophthalmia that may observe?
A. Keratomalacia
B. Corneal opacity
C. Night blindness
D. Conjunctival xerosis
106. To prevent xerophthalmia, young children are given Retinol capsule every 6 months.
What is the dose given to preschoolers?
A. 10, 000 IU
B. 20, 000 IU
C. 100, 000 IU
D. 200, 000 IU
107. The major sign of iron deficiency anemia is pallor. What part is best examined for
pallor?
A. Palms
B. Nailbeds
C. Around the lips
D. Lower conjunctival sac
108. Food fortification is one of the strategies to prevent micronutrient deficiency
conditions. RA 8976 mandates fortification of certain food items. Which of the following
is among these food items?
A. Sugar
B. Bread
C. Margarine
D. Filled milk
109. What is the best course of action when there is a measles epidemic in a nearby
municipality?
A. Give measles vaccine to babies aged 6 to 3 months
B. Give babies aged 6 to 11 months one dose of 100,000 IU of Retinol
C. Instruct mother to keep their babies at home to prevent disease transmission
D. Instruct mothers to feed their babies adequately to enhance their babies resistance
110. A mother brought her daughter, 4 years old, to the RHU because of cough and
colds. Following the IMCI assessment guide, which of the following is a danger sign that
indicates the need for urgent referral to a hospital?
A. Inability to drink
B. High grade fever
C. Signs of severe dehydration
D. Cough for more than 30 days
111. Management of a child with measles includes the administration of which of the
following?
A. Gentian violet on mouth lesions
B. Antibiotic to prevent pneumonia
C. Tetracycline eye ointment for corneal opacity
D. Retinol capsule regardless of when the last dose was given
112. A mother brought her 10 month old infant for consultation because of fever which
started 4 days prior to consultation. To determine malaria risk, what will you do?
A. Do a tourniquet test
B. Ask where the family resides
C. Get a specimen for blood smear
D. Ask if the fever is present everyday
113. The following are strategies implemented by the DOH to prevent mosquito-borne
diseases. Which of these is most effective in the control of Dengue fever?
A. Stream seeding with larva-eating fish
B. Destroying breeding places of mosquitoes
C. Chemoprophylaxis of non-immune persons going to endemic areas
D. Teaching people in endemic areas to use chemically treated mosquito nets
114. Secondary prevention for malaria includes?
A. Planting of neem or eucalyptus trees
B. Residual spraying of insecticides at night
C. Determining whether a place is endemic or not
D. Growing larva-eating fish in mosquito breeding places
115. Scotch tape swab is done to check for which intestinal parasite?
A. Ascaris
B. Pinworm
C. Hookworm
D. Schistosoma
116. Which of the following signs indicates the need for sputum examination for AFB?
A. Hematemesis
B. Fever for 1 week
C. Cough for 3 weeks
D. Chest pain for 1 week
117. Which clients are considered targets for DOTS category?
A. Sputum negative cavitary cases
B. Clients returning after default
C. Relapses and failures of previous PTB treatment regimens
D. Clients diagnosed for the first time through a positive sputum exam
118. To improve compliance to treatment, what innovation is being implemented in
DOTS?
A. Having the health worker follow up the client at home
B. Having the health worker or a responsible family member monitor drug intake
C. Having the patient come to the health center every month to get his medications
D. Having a target list to check on whether the patient has collected his monthly supply of drugs
119. Diagnosis of leprosy is highly dependent on recognition of symptoms. Which of the
following is an early sign of leprosy?
A. Macular lesions
B. Inability to close eyelids
C. Thickened painful nerves
D. Sinking of the nose bridge
120. Which of the following clients should be classified as a case of mutibacillary
leprosy?
A. 3 skin lesions, negative slit skin smear
B. 3 skin lesions, positive slit skin smear
C. 5 skin lesions, negative slit skin smear
D. 5 skin lesions, positive slit skin smear
121. In the Philippines, which condition is the most frequent cause of death associated
by schistosomiasis?
A. Liver cancer
B. Liver cirrhosis
C. Bladder cancer
D. Intestinal perforation
122. What is the most effective way of controlling schistosomiasis in an endemic area?
A. Use of molluscicides
B. Building of foot bridges
C. Proper use of sanitary toilets
D. Use of protective footwear, such as rubber boots
123. When residents obtain water from an artesian well in the neighborhood, the level of
this approved type of water facility is:
A. I
B. II
C. III
D. IV
124. For prevention of Hepatitis A, you decided to conduct health education activities.
Which of the following is Irrelevant?
A. Use of sterile syringes and needles
B. Safe food preparation and food handling by vendors
C. Proper disposal of human excreta and personal hygiene
D. Immediate reporting of water pipe leaks and illegal water connections
125. Which biological used in EPI should not be stored in the freezer?
A. DPT
B. OPV
C. Measles vaccine
D. MMR
126. You will conduct outreach immunization in a barangay with a population of about
1500. Estimate the number of infants in the barangay.
A. 45
B. 50
C. 55
D. 60
127. In IMCI, severe conditions generally require urgent referral to a hospital. Which of
the following severe conditions Does not always require urgent referral to hospital?
A. Mastoiditis
B. Severe dehydration
C. Severe pneumonia
D. Severe febrile disease.
128. A client was diagnosed as having Dengue Fever. You will say that there is slow
capillary refill when the color of the nailbed that you pressed does not return within how
many seconds?
A. 3
B. 5
C. 8
D. 10
129. A 3-year old child was brought by his mother to the health center because of fever of
4-day duration. The child had a positive tourniquet test result. In the absence of other
signs, which of the most appropriate measure that the PHN may carry out to prevent
Dengue shock syndrome?
A. Insert an NGT and give fluids per NGT
B. Instruct the mother to give the child Oresol
C. Start the patient on IV Stat
D. Refer the client to the physician for appropriate management
130. The pathognomonic sign of measles is Kopliks spot. You may see Kopliks spot by
inspecting the:
A. Nasal Mucosa
B. Buccal mucosa
C. Skin on the abdomen
D. Skin on the antecubital surface
131. Among the following diseases, which is airborne?
A. Viral conjunctivitis
B. Acute poliomyelitis
C. Diphtheria
D. Measles
132. Among children aged 2 months to 3 years, the most prevalent form of meningitis is
caused by which microorganism?
A. Hemophilus Influenzae
B. Morbillivirus
C. Streptococcus Pneumoniae
D. Neisseria meningitides
133. Human beings are the major reservoir of malaria. Which of the following strategies
in malaria control is based on this fact?
A. Stream seeding
B. Stream clearing
C. Destruction of breeding places
D. Zooprophylaxis
134. The use of larvivorous fish in malaria control is the basis for which strategy of
malaria control?
A. Stream seeding
B. Stream clearing
C. Destruction of breeding places
D. Zooprophylaxis .
135. Mosquito-borne diseases are prevented mostly with the use of mosquito control
measures. Which of the following is NOT appropriate for malaria control?
A. Use of chemically treated mosquito nets
B. Seeding of breeding places with larva-eating fish
C. Destruction of breeding places of the mosquito vector
D. Use of mosquito-repelling soaps, such as those with basil or citronella
136. A 4-year old client was brought to the health center with chief complaint of severe
diarrhea and the passage of rice water. The client is most probably suffering from
which condition?
A. Giardiasis
B. Cholera
C. Amebiasis
D. Dysentery
137. In the Philippines, which specie of schistosoma is endemic in certain regions?
A. S. mansoni
B. S. japonicum
C. S. malayensis
D. S. haematobium
138. 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 this history/ which disease condition will you suspect?
A. Hepatitis A
B. Hepatitis B
C. Tetanus
D. Leptospirosis
139. MWSS provides water to Manila and other cities in Metro Manila. This is an example
of which level of water facility?
A. I
B. II
C. III
D. IV
140. 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 behavior
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
maybe false
141. Which is the BEST control measure for AIDS?
A. Being faithful to a single sexual partner
B. Using a condom during each sexual contact
C. Avoiding sexual contact with commercial sex workers
D. Making sure that ones sexual partner does not have signs of AIDS
142. The most frequent causes of death among clients with AIDS are opportunistic
diseases. Which of the following opportunistic infections is characterized by
tonsilllopharyngitis?
A. Respiratory candidiasis
B. Infectious mononucleosis
C. Cytomegalovirus disease
D. Pneumocystis carinii pneumonia
143. To determine the possible sources of sexually transmitted infections, which is the
BEST method that may be undertaken by the public health nurse?
A. Contact tracing
B. Community survey
C. Mass screening tests
D. Interview suspects
144. 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
145. A barangay had an outbreak of German measles. To prevent congenital rubella, what
is the BEST advice that you can give to women in the first trimester of pregnancy in the
barangay?
a. Advice them on the sign of German Measles
b. Avoid crowded places, such as markets and moviehouses
c. Consult at the health center where rubella vaccine may be given
d. Consult a physician who may give them rubella immunoglobulin
Answers and Rationale
Gauge your performance by counter-checking your answers to those below. If you have
disputes or further questions, please direct them to the comments section.
1. Answer: (B) To enhance the capacity of individuals, families and communities to cope with
their health needs.
To contribute to national development through promotion of family welfare, focusing particularly
on mothers and children.
2. Answer: (B) The nurse has to conduct community diagnosis to determine nursing needs and
problems.
Community-based practice means providing care to people in their own natural environments:
the home, school and workplace, for example.
3. Answer: (C) Community diagnosis
Population-focused nursing care means providing care based on the greater need of the
majority of the population. The greater need is identified through community diagnosis.
4. Answer: (B) Location of the workplace in relation to health facilities
Based on R.A. 1054, an occupational nurse must be employed when there are 30 to 100
employees and the workplace is more than 1 km. away from the nearest health center.
5. Answer: (B) 101
6. Answer: (D) Environmental manager
Ergonomics is improving efficiency of workers by improving the workers environment through
appropriately designed furniture, for example.
7. Answer: (C) Public health nurse of the RHU of their municipality
8. Answer: (B) The statement is false; people pay indirectly for public health services.
Community health services, including public health services, are prepaid paid services, through
taxation, for example.
9. Answer: (A) For people to attain their birthrights of health and longevity
According to Winslow, all public health efforts are for people to realize their birthrights of health
and longevity.
10. Answer: (C) Swaroops index
Swaroops index is the percentage of the deaths aged 50 years or older. Its inverse represents
the percentage of untimely deaths (those who died younger than 50 years).
11. Answer: (D) Public health nursing focuses on preventive, not curative, services.
The catchment area in PHN consists of a residential community, many of whom are well
individuals who have greater need for preventive rather than curative services.
12. Answer: (D) The worth and dignity of man
This is a direct quote from Dr. Margaret Shetlands statements on Public Health Nursing.
13. Answer: (B) Ensure the accessibility and quality of health care
14. Answer: (D) Tertiary
Regional hospitals are tertiary facilities because they serve as training hospitals for the region.
15. Answer: (B) Their services are provided on an out-patient basis.
Primary facilities government and non-government facilities that provide basic out-patient
services.
16. Answer: (B) Conducting random classroom inspection during a measles epidemic
Random classroom inspection is assessment of pupils/students and teachers for signs of a
health problem prevalent in the community.
17. Answer: (B) Efficiency
Efficiency is determining whether the goals were attained at the least possible cost.
18. Answer: (D) Rural Health Unit
R.A. 7160 devolved basic health services to local government units (LGUs). The public health
nurse is an employee of the LGU.
19. Answer: (C) To empower the people and promote their self-reliance
People empowerment is the basic motivation behind devolution of basic services to LGUs.
20. Answer: (A) Mayor
The local executive serves as the chairman of the Municipal Health Board.
21. Answer: (A) Primary
The entry of a person into the health care delivery system is usually through a consultation in
out-patient services.
22. Answer: (B) Providing technical guidance to the midwife
The nurse provides technical guidance to the midwife in the care of clients, particularly in the
implementation of management guidelines, as in Integrated Management of Childhood Illness.
23. Answer: (C) Municipal Health Officer
A public health nurse and rural health midwife can provide care during normal childbirth. A
physician should attend to a woman with a complication during labor.
24. Answer: (A) 1
Each rural health midwife is given a population assignment of about 5,000.
25. Answer: (D) Municipal Health Board
As mandated by R.A. 7160, basic health services have been devolved from the national
government to local government units.
26. Answer: (A) Act 3573
Act 3573, the Law on Reporting of Communicable Diseases, enacted in 1929, mandated the
reporting of diseases listed in the law to the nearest health station.
27. Answer: (B) Health education and community organizing are necessary in providing
community health services.
The community health nurse develops the health capability of people through health education
and community organizing activities.
28. Answer: (B) Measles
Presidential Proclamation No. 4 is on the Ligtas Tigdas Program.
29. Answer: (B) Bar
A bar graph is used to present comparison of values, a line graph for trends over time or age, a
pie graph for population composition or distribution, and a scatter diagram for correlation of two
variables.
30. Answer: (D) Core group formation
In core group formation, the nurse is able to transfer the technology of community organizing to
the potential or informal community leaders through a training program.
31. Answer: (B) Community organization
Community organization is the step when community assemblies take place. During the
community assembly, the people may opt to formalize the community organization and make
plans for community action to resolve a community health problem.
32. Answer: (D) To maximize the communitys resources in dealing with health problems
Community organizing is a developmental service, with the goal of developing the peoples self-
reliance in dealing with community health problems. A, B and C are objectives of contributory
objectives to this goal.
33. Answer: (A) Participate in community activities for the solution of a community problem
Participation in community activities in resolving a community problem may be in any of the
processes mentioned in the other choices.
34. Answer: (D) Terminal
Tertiary prevention involves rehabilitation, prevention of permanent disability and disability
limitation appropriate for convalescents, the disabled, complicated cases and the terminally ill
(those in the terminal stage of a disease)
35. Answer: (A) Primary
The purpose of isolating a client with a communicable disease is to protect those who are not
sick (specific disease prevention).
36. Answer: (B) Secondary
Operation Timbang is done to identify members of the susceptible population who are
malnourished. Its purpose is early diagnosis and, subsequently, prompt treatment.
37. Answer: (C) Home visit
Dynamics of family relationships can best be observed in the familys natural environment,
which is the home.
38. Answer: (B) Health deficit
Failure of a family member to develop according to what is expected, as in mental retardation, is
a health deficit.
39. Answer: (C) Foreseeable crisis
Entry of the 6-year old into school is an anticipated period of unusual demand on the family.
40. Answer: (B) It provides an opportunity to do first hand appraisal of the home situation.
Choice A is not correct since a home visit requires that the nurse spend so much time with the
family. Choice C is an advantage of a group conference, while choice D is true of a clinic
consultation.
41. Answer: (C) A home visit should be conducted in the manner prescribed by the RHU.
The home visit plan should be flexible and practical, depending on factors, such as the familys
needs and the resources available to the nurse and the family.
42. Answer: (B) Should minimize if not totally prevent the spread of infection.
Bag technique is performed before and after handling a client in the home to prevent
transmission of infection to and from the client.
43. Answer: (A) Wash his/her hands before and after providing nursing care to the family
members.
Choice B goes against the idea of utilizing the familys resources, which is encouraged in CHN.
Choices C and D goes against the principle of asepsis of confining the contaminated surface of
objects.
44. Answer: (B) Analytical
Analytical epidemiology is the study of factors or determinants affecting the patterns of
occurrence and distribution of disease in a community.
45. Answer: (D) Evaluating the effectiveness of the implementation of the Integrated
Management of Childhood Illness
Epidemiology is used in the assessment of a community or evaluation of interventions in
community health practice.
46. Answer: (C) Participating in the investigation to determine the source of the epidemic
Epidemiology is the study of patterns of occurrence and distribution of disease in the
community, as well as the factors that affect disease patterns. The purpose of an epidemiologic
investigation is to identify the source of an epidemic, i.e., what brought about the epidemic.
47. Answer: (A) Delineate the etiology of the epidemic
Delineating the etiology of an epidemic is identifying its source.
48. Answer: (D) There is a gradual build up of cases before the epidemic becomes easily
noticeable.
A gradual or insidious onset of the epidemic is usually observable in person-to-person
propagated epidemics.
49. Answer: (A) Establishing the epidemic
Establishing the epidemic is determining whether there is an epidemic or not. This is done by
comparing the present number of cases with the usual number of cases of the disease at the
same time of the year, as well as establishing the relatedness of the cases of the disease.
50. Answer: (B) Cyclical variation
A cyclical variation is a periodic fluctuation in the number of cases of a disease in the
community.
51. Answer: (C) Smallpox
The last documented case of Smallpox was in 1977 at Somalia.
52. Answer: (B) 100.94:100
Sex ratio is the number of males for every 100 females in the population.
53. Answer: (D) Health programs are sustained according to the level of development of the
community.
Primary health care is essential health care that can be sustained in all stages of development
of the community.
54. Answer: (D) Sensitivity
Sensitivity is the capacity of a diagnostic examination to detect cases of the disease. If a test is
100% sensitive, all the cases tested will have a positive result, i.e., there will be no false
negative results.
55. Answer: (D) Lagundi
Sambong is used as a diuretic. Tsaang gubat is used to relieve diarrhea. Akapulko is used for
its antifungal property.
56. Answer: (A) R.A. 8423 or AN ACT CREATING THE PHILIPPINE INSTITUTE OF
TRADITIONAL AND ALTERNATIVE HEALTH CARE (PITAHC) TO ACCELERATE THE
DEVELOPMENT OF TRADITIONAL AND ALTERNATIVE HEALTH CARE IN THE
PHILIPPINES, PROVIDING FOR A TRADITIONAL AND ALTERNATIVE HEALTH CARE
DEVELOPMENT FUND AND FOR OTHER PURPOSES signed to a law on December 9, 1997.
57. Answer: (A) Yin
Yang is the male dominating, positive and masculine force.
58. Answer: (B) Letter of Instruction No. 949
Letter of Instruction 949 was issued by then President Ferdinand Marcos, directing the formerly
called Ministry of Health, now the Department of Health, to utilize Primary Health Care approach
in planning and implementing health programs.
59. Answer: (D) Cooperation between the PHN and public school teacher
Intersectoral linkages refer to working relationships between the health sector and other sectors
involved in community development.
60. Answer: (D) 2,300
Based on the Philippine population composition, to estimate the number of 1-4 year old
children, multiply total population by 11.5%.
61. Answer: (A) 265
To estimate the number of pregnant women, multiply the total population by 3.5%.
62. Answer: (D) Any of these may be used.
Sex ratio and sex proportion are used to determine the sex composition of a population. A
population pyramid is used to present the composition of a population by age and sex.
63. Answer: (A) Crude birth rate
Natality means birth. A natality rate is a birth rate.
64. Answer: (B) 5.2/1,000
To compute crude death rate divide total number of deaths (94) by total population (18,000) and
multiply by 1,000.
65. Answer: (C) 1-4 year old children
Preschoolers are the most susceptible to PEM because they have generally been weaned.
Also, this is the population who, unable to feed themselves, are often the victims of poor
intrafamilial food distribution.
66. Answer: (C) Swaroops index
Swaroops index is the proportion of deaths aged 50 years and above. The higher the
Swaroops index of a population, the greater the proportion of the deaths who were able to
reach the age of at least 50 years, i.e., more people grew old before they died.
67. Answer: (B) 43.5/1,000
To compute for neonatal mortality rate, divide the number of babies who died before reaching
the age of 28 days by the total number of live births, then multiply by 1,000.
68. Answer: (A) 1-4 year old age-specific mortality rate
Since preschoolers are the most susceptible to the effects of malnutrition, a population with
poor nutritional status will most likely have a high 1-4 year old age-specific mortality rate, also
known as child mortality rate.
69. Answer: (B) Number of registered live births
To compute for general or total fertility rate, divide the number of registered live births by the
number of females of reproductive age (15-45 years), then multiply by 1,000.
70. Answer: (B) Survey
A survey, also called sample survey, is data gathering about a sample of the population.
71. Answer: (C) De facto
The other method of population assignment, de jure, is based on the usual place of residence of
the people.
72. Answer: (A) Tally report
A tally report is prepared monthly or quarterly by the RHU personnel and transmitted to the
Provincial Health Office.
73. Answer: (C) Target/client list
The MDT Client List is a record of clients enrolled in MDT and other relevant data, such as
dates when clients collected their monthly supply of drugs.
74. Answer: (A) P.D. 651
P.D. 651 amended R.A. 3753, requiring the registry of births within 30 days from their
occurrence.
75. Answer: (D) Any of these health professionals
R.A. 3753 states that any birth attendant may sign the certificate of live birth.
76. Answer: (C) Magnitude of the health problem
Magnitude of the problem refers to the percentage of the population affected by a health
problem. The other choices are criteria considered in both family and community health care.
77. Answer: (D) Its main strategy is certification of health centers able to comply with standards.
Sentrong Sigla Movement is a joint project of the DOH and local government units. Its main
strategy is certification of health centers that are able to comply with standards set by the DOH.
78. Answer: (D) Those who just had a delivery within the past 15 months
The ideal birth spacing is at least two years. 15 months plus 9 months of pregnancy = 2 years.
79. Answer: (C) Adequate information for couples regarding the different methods
To enable the couple to choose freely among different methods of family planning, they must be
given full information regarding the different methods that are available to them, considering the
availability of quality services that can support their choice.
80. Answer: (B) Retinol 200,000 IU
Retinol 200,000 IU is a form of megadose Vitamin A. This may have a teratogenic effect.
81. Answer: (A) Her OB score is G5P3.
Only women with less than 5 pregnancies are qualified for a home delivery. It is also advisable
for a primigravida to have delivery at a childbirth facility.
82. Answer: (C) Folic acid
It is estimated that the incidence of neural tube defects can be reduced drastically if pregnant
women have an adequate intake of folic acid.
83. Answer: (D) Note the interval, duration and intensity of labor contractions.
Assessment of the woman should be done first to determine whether she is having true labor
and, if so, what stage of labor she is in.
84. Answer: (D) Explain to her that putting the baby to breast will lessen blood loss after
delivery.
Suckling of the nipple stimulates the release of oxytocin by the posterior pituitary gland, which
causes uterine contraction. Lactation begins 1 to 3 days after delivery. Nipple stretching
exercises are done when the nipples are flat or inverted. Frequent washing dries up the nipples,
making them prone to the formation of fissures.
85. Answer: (B) To stimulate milk production by the mammary acini
Suckling of the nipple stimulates prolactin reflex (the release of prolactin by the anterior pituitary
gland), which initiates lactation.
86. Answer: (B) The mother does not feel nipple pain.
When the baby has properly latched on to the breast, he takes deep, slow sucks; his mouth is
wide open; and much of the areola is inside his mouth. And, youre right! The mother does not
feel nipple pain.
87. Answer: (B) 6 months
After 6 months, the babys nutrient needs, especially the babys iron requirement, can no longer
be provided by mothers milk alone.
88. Answer: (C) Retinol 200,000 I.U., 1 capsule
A capsule of Retinol 200,000 IU is given within 1 month after delivery. Potassium iodate is given
during pregnancy; malunggay capsule is not routinely administered after delivery; and ferrous
sulfate is taken for two months after delivery.
89. Answer: (C) Measles vaccine
Among the biologicals used in the Expanded Program on Immunization, measles vaccine and
OPV are highly sensitive to heat, requiring storage in the freezer.
90. Answer: (B) 4
While the unused portion of other biologicals in EPI may be given until the end of the day, only
BCG is discarded 4 hours after reconstitution. This is why BCG immunization is scheduled only
in the morning.
91. Answer: (A) P.D. 996
Presidential Decree 996, enacted in 1976, made immunization in the EPI compulsory for
children under 8 years of age. Hepatitis B vaccination was made compulsory for the same age
group by R.A. 7846.
92. Answer: (B) BCG
BCG causes the formation of a superficial abscess, which begins 2 weeks after immunization.
The abscess heals without treatment, with the formation of a permanent scar.
93. Answer: (C) Infant BCG
Infant BCG may be given at birth. All the other immunizations mentioned can be given at 6
weeks of age.
94. Answer: (A) Seizures a day after DPT 1.
Seizures within 3 days after administration of DPT is an indication of hypersensitivity to
pertussis vaccine, a component of DPT. This is considered a specific contraindication to
subsequent doses of DPT.
95. Answer: (A) Go on with the infants immunizations.
In the EPI, fever up to 38.5C is not a contraindication to immunization. Mild acute respiratory
tract infection, simple diarrhea and malnutrition are not contraindications either.
96. Answer: (A) 1 year
The baby will have passive natural immunity by placental transfer of antibodies. The mother will
have active artificial immunity lasting for about 10 years. 5 doses will give the mother lifetime
protection.
97. Answer: (C) Normal
In IMCI, a respiratory rate of 50/minute or more is fast breathing for an infant aged 2 to 12
months.
98. Answer: (D) Chest indrawing
In IMCI, chest indrawing is used as the positive sign of dyspnea, indicating severe pneumonia.
99. Answer: (B) Refer him urgently to the hospital.
Severe pneumonia requires urgent referral to a hospital. Answers A, C and D are done for a
client classified as having pneumonia.
100. Answer: (B) Some dehydration
Using the assessment guidelines of IMCI, a child (2 months to 5 years old) with diarrhea is
classified as having SOME DEHYDRATION if he shows 2 or more of the following signs:
restless or irritable, sunken eyes, the skin goes back slow after a skin pinch.
101. Answer: (B) Supervise the mother in giving 200 to 400 ml. of Oresol in 4 hours.
In the IMCI management guidelines, SOME DEHYDRATION is treated with the administration
of Oresol within a period of 4 hours. The amount of Oresol is best computed on the basis of the
childs weight (75 ml/kg body weight). If the weight is unknown, the amount of Oresol is based
on the childs age.
102. Answer: (D) Let the child rest for 10 minutes then continue giving Oresol more slowly.
If the child vomits persistently, that is, he vomits everything that he takes in, he has to be
referred urgently to a hospital. Otherwise, vomiting is managed by letting the child rest for 10
minutes and then continuing with Oresol administration. Teach the mother to give Oresol more
slowly.
103. Answer: (D) Edema
Edema, a major sign of kwashiorkor, is caused by decreased colloidal osmotic pressure of the
blood brought about by hypoalbuminemia. Decreased blood albumin level is due a protein-
deficient diet.
104. Answer: (A) Refer the child urgently to a hospital for confinement.
Baggy pants is a sign of severe marasmus. The best management is urgent referral to a
hospital.
105. Answer: (D) Conjunctival xerosis
The earliest sign of Vitamin A deficiency (xerophthalmia) is night blindness. However, this is a
functional change, which is not observable during physical examination.The earliest visible
lesion is conjunctival xerosis or dullness of the conjunctiva due to inadequate tear production.
106. Answer: (D) 200,000 IU
Preschoolers are given Retinol 200,000 IU every 6 months. 100,000 IU is given once to infants
aged 6 to 12 months. The dose for pregnant women is 10,000 IU.
107. Answer: (A) Palms
The anatomic characteristics of the palms allow a reliable and convenient basis for examination
for pallor.
108. Answer: (A) Sugar
R.A. 8976 mandates fortification of rice, wheat flour, sugar and cooking oil with Vitamin A, iron
and/or iodine.
109. Answer: (A) Give measles vaccine to babies aged 6 to 8 months.
Ordinarily, measles vaccine is given at 9 months of age. During an impending epidemic,
however, one dose may be given to babies aged 6 to 8 months. The mother is instructed that
the baby needs another dose when the baby is 9 months old.
110. Answer: (A) Inability to drink
A sick child aged 2 months to 5 years must be referred urgently to a hospital if he/she has one
or more of the following signs: not able to feed or drink, vomits everything, convulsions,
abnormally sleepy or difficult to awaken.
111. Answer: (D) Retinol capsule regardless of when the last dose was given
An infant 6 to 12 months classified as a case of measles is given Retinol 100,000 IU; a child is
given 200,000 IU regardless of when the last dose was given.
112. Answer: (B) Ask where the family resides.
Because malaria is endemic, the first question to determine malaria risk is where the clients
family resides. If the area of residence is not a known endemic area, ask if the child had
traveled within the past 6 months, where he/she was brought and whether he/she stayed
overnight in that area.
113. Answer: (B) Destroying breeding places of mosquitoes
Aedes aegypti, the vector of Dengue fever, breeds in stagnant, clear water. Its feeding time is
usually during the daytime. It has a cyclical pattern of occurrence, unlike malaria which is
endemic in certain parts of the country.
114. Answer: (C) Determining whether a place is endemic or not
This is diagnostic and therefore secondary level prevention. The other choices are for primary
prevention.
115. Answer: (B) Pinworm
Pinworm ova are deposited around the anal orifice.
116. Answer: (C) Cough for 3 weeks
A client is considered a PTB suspect when he has cough for 2 weeks or more, plus one or more
of the following signs: fever for 1 month or more; chest pain lasting for 2 weeks or more not
attributed to other conditions; progressive, unexplained weight loss; night sweats; and
hemoptysis.
117. Answer: (D) Clients diagnosed for the first time through a positive sputum exam
Category I is for new clients diagnosed by sputum examination and clients diagnosed to have a
serious form of extrapulmonary tuberculosis, such as TB osteomyelitis.
118. Answer: (B) Having the health worker or a responsible family member monitor drug intake
Directly Observed Treatment Short Course is so-called because a treatment partner, preferably
a health worker accessible to the client, monitors the clients compliance to the treatment.
119. Answer: (C) Thickened painful nerves
The lesion of leprosy is not macular. It is characterized by a change in skin color (either reddish
or whitish) and loss of sensation, sweating and hair growth over the lesion. Inability to close the
eyelids (lagophthalmos) and sinking of the nosebridge are late symptoms.
120. Answer: (D) 5 skin lesions, positive slit skin smear
A multibacillary leprosy case is one who has a positive slit skin smear and at least 5 skin
lesions.
121. Answer: (B) Liver cirrhosis
The etiologic agent of schistosomiasis in the Philippines is Schistosoma japonicum, which
affects the small intestine and the liver. Liver damage is a consequence of fibrotic reactions to
schistosoma eggs in the liver.
122. Answer: (C) Proper use of sanitary toilets
The ova of the parasite get out of the human body together with feces. Cutting the cycle at this
stage is the most effective way of preventing the spread of the disease to susceptible hosts.
123. Answer: (B) II
A communal faucet or water standpost is classified as Level II.
124. Answer: (A) Use of sterile syringes and needles
Hepatitis A is transmitted through the fecal oral route. Hepatitis B is transmitted through infected
body secretions like blood and semen.
125. Answer: (A) DPT
DPT is sensitive to freezing. The appropriate storage temperature of DPT is 2 to 8C only. OPV
and measles vaccine are highly sensitive to heat and require freezing. MMR is not an
immunization in the Expanded Program on Immunization.
126. Answer: (A) 45
To estimate the number of infants, multiply total population by 3%.
127. Answer: (B) Severe dehydration
The order of priority in the management of severe dehydration is as follows: intravenous fluid
therapy, referral to a facility where IV fluids can be initiated within 30 minutes,
Oresol/nasogastric tube, Oresol/orem. When the foregoing measures are not possible or
effective, tehn urgent referral to the hospital is done.
128. Answer: (A) 3
Adequate blood supply to the area allows the return of the color of the nailbed within 3 seconds.
129. Answer: (B) Instruct the mother to give the child Oresol.
Since the child does not manifest any other danger sign, maintenance of fluid balance and
replacement of fluid loss may be done by giving the client Oresol.
130. Answer: (B) Buccal mucosa
Kopliks spot may be seen on the mucosa of the mouth or the throat.
131. Answer: (D) Measles
Viral conjunctivitis is transmitted by direct or indirect contact with discharges from infected eyes.
Acute poliomyelitis is spread through the fecal-oral route and contact with throat secretions,
whereas diphtheria is through direct and indirect contact with respiratory secretions.
132. Answer: (A) Hemophilus influenzae
Hemophilus meningitis is unusual over the age of 5 years. In developing countries, the peak
incidence is in children less than 6 months of age. Morbillivirus is the etiology of measles.
Streptococcus pneumoniae and Neisseria meningitidis may cause meningitis, but age
distribution is not specific in young children.
133. Answer: (D) Zooprophylaxis
Zooprophylaxis is done by putting animals like cattle or dogs close to windows or doorways just
before nightfall. The Anopheles mosquito takes his blood meal from the animal and goes back
to its breeding place, thereby preventing infection of humans.
134. Answer: (A) Stream seeding
Stream seeding is done by putting tilapia fry in streams or other bodies of water identified as
breeding places of the Anopheles mosquito.
135. Answer: (C) Destruction of breeding places of the mosquito vector
Anopheles mosquitoes breed in slow-moving, clear water, such as mountain streams.
136. Answer: (B) Cholera
Passage of profuse watery stools is the major symptom of cholera. Both amebic and bacillary
dysentery are characterized by the presence of blood and/or mucus in the stools. Giardiasis is
characterized by fat malabsorption and, therefore, steatorrhea.
137. Answer: (B) S. japonicum
S. mansoni is found mostly in Africa and South America; S. haematobium in Africa and the
Middle East; and S. malayensis only in peninsular Malaysia.
138. Answer: (D) Leptospirosis
Leptospirosis is transmitted through contact with the skin or mucous membrane with water or
moist soil contaminated with urine of infected animals, like rats.
139. Answer: (C) III
Waterworks systems, such as MWSS, are classified as level III.
140. Answer: (D) Refer the client for a supplementary test, such as Western blot, since the
ELISA result may be false.
A client having a reactive ELISA result must undergo a more specific test, such as Western blot.
A negative supplementary test result means that the ELISA result was false and that, most
probably, the client is not infected.
141. Answer: (A) Being faithful to a single sexual partner
Sexual fidelity rules out the possibility of getting the disease by sexual contact with another
infected person. Transmission occurs mostly through sexual intercourse and exposure to blood
or tissues.
142. Answer: (B) Infectious mononucleosis
Cytomegalovirus disease is an acute viral disease characterized by fever, sore throat and
lymphadenopathy.
143. Answer: (A) Contact tracing
Contact tracing is the most practical and reliable method of finding possible sources of person-
to-person transmitted infections, such as sexually transmitted diseases.
144. Answer: (D) They are able to bring about a cure of the disease condition.
There is no known treatment for AIDS. Antiretroviral agents reduce the risk of opportunistic
infections and prolong life, but does not cure the underlying immunodeficiency.
145. Answer: (D) Consult a physician who may give them rubella immunoglobulin.
Rubella vaccine is made up of attenuated German measles viruses. This is contraindicated in
pregnancy. Immune globulin, a specific prophylactic against German measles, may be given to
pregnant women




















KMB
1. A pregnant woman who is at term is admitted to the birthing unit in active labor. The client
has only progressed from 2cm to 3 cm in 8 hours. She is diagnosed with hypotonic dystocia and
the physician ordered Oxytocin (Pitocin) to augment her contractions. Which of the following is
the most important aspect of nursing intervention at this time?
A. Timing and recording length of contractions.
B. Monitoring.
C. Preparing for an emergency cesarean birth.
D. Checking the perineum for bulging.
2. A client who hallucinates is not in touch with reality. It is important for the nurse to:
A. Isolate the client from other patients.
B. Maintain a safe environment.
C. Orient the client to time, place, and person.
D. Establish a trusting relationship.
3. The nurse is caring to a child client who has had a tonsillectomy. The child complains of
having dryness of the throat. Which of the following would the nurse give to the child?
A. Cola with ice
B. Yellow noncitrus Jello
C. Cool cherry Kool-Aid
D. A glass of milk
4. The physician ordered Phenylephrine (Neo-Synephrine) nasal spray to a 13-year-old client.
The nurse caring to the client provides instructions that the nasal spray must be used exactly as
directed to prevent the development of:
A. Increased nasal congestion.
B. Nasal polyps.
C. Bleeding tendencies.
D. Tinnitus and diplopia.
5. A client with tuberculosis is to be admitted in the hospital. The nurse who will be assigned to
care for the client must institute appropriate precautions. The nurse should:
A. Place the client in a private room.
B. Wear an N 95 respirator when caring for the client.
C. Put on a gown every time when entering the room.
D. Don a surgical mask with a face shield when entering the room.
6. Which of the following is the most frequent cause of noncompliance to the medical treatment
of open-angle glaucoma?
A. The frequent nausea and vomiting accompanying use of miotic drug.
B. Loss of mobility due to severe driving restrictions.
C. Decreased light and near-vision accommodation due to miotic effects of pilocarpine.
D. The painful and insidious progression of this type of glaucoma.
7. In the morning shift, the nurse is making rounds in the nursing care units. The nurse enters in
a clients room and notes that the clients tube has become disconnected from the Pleurovac.
What would be the initial nursing action?
A. Apply pressure directly over the incision site.
B. Clamp the chest tube near the incision site.
C. Clamp the chest tube closer to the drainage system.
D. Reconnect the chest tube to the Pleurovac.
8. Which of the following complications during a breech birth the nurse needs to be alarmed?
A. Abruption placenta.
B. Caput succedaneum.
C. Pathological hyperbilirubinemia.
D. Umbilical cord prolapse.
9. The nurse is caring to a client diagnosed with severe depression. Which of the following
nursing approach is important in depression?
A. Protect the client against harm to others.
B. Provide the client with motor outlets for aggressive, hostile feelings.
C. Reduce interpersonal contacts.
D. Deemphasizing preoccupation with elimination, nourishment, and sleep.
10. A 3-month-old client is in the pediatric unit. During assessment, the nurse is suspecting that
the baby may have hypothyroidism when mother states that her baby does not:
A. Sit up.
B. Pick up and hold a rattle.
C. Roll over.
D. Hold the head up.
11. The physician calls the nursing unit to leave an order. The senior nurse had conversation
with the other staff. The newly hired nurse answers the phone so that the senior nurses may
continue their conversation. The new nurse does not knowthe physician or the client to whom
the order pertains. The nurse should:
A. Ask the physician to call back after the nurse has read the hospital policy manual.
B. Take the telephone order.
C. Refuse to take the telephone order.
D. Ask the charge nurse or one of the other senior staff nurses to take the telephone order.
12. The staff nurse on the labor and delivery unit is assigned to care to a primigravida in
transition complicated by hypertension. A new pregnant woman in active labor is admitted in the
same unit. The nurse manager assigned the same nurse to the second client. The nurse feels
that the client with hypertension requires one-to-one care. What would be the initial actionof the
nurse?
A. Accept the new assignment and complete an incident report describing a shortage of nursing
staff.
B. Report the incident to the nursing supervisor and request to be floated.
C. Report the nursing assessment of the client in transitional labor to the nurse manager and
discuss misgivings about the new assignment.
D. Accept the new assignment and provide the best care.
13. A newborn infant with Down syndrome is to be discharged today. The nurse is preparing to
give the discharge teaching regarding the proper care at home. The nurse would anticipate that
the mother is probably at the:
A. 40 years of age.
B. 20 years of age.
C. 35 years of age.
D. 20 years of age.
14. The emergency department has shortage of staff. The nurse manager informs the staff
nurse in the critical care unit that she has to float to the emergency department. What should
the staff nurse expect under these conditions?
A. The float staff nurse will be informed of the situation before the shift begins.
B. The staff nurse will be able to negotiate the assignments in the emergency department.
C. Cross training will be available for the staff nurse.
D. Client assignments will be equally divided among the nurses.
15. The nurse is assigned to care for a child client admitted in the pediatrics unit. The client is
receiving digoxin. Which of the following questions will be asked by the nurse to the parents of
the child in order to assess the clients risk for digoxin toxicity?
A. Has he been exposed to any childhood communicable diseases in the past 2-3 weeks?
B. Has he been taking diuretics at home?
C. Do any of his brothers and sisters have history of cardiac problems?
D. Has he been going to school regularly?
16. The nurse noticed that the signed consent form has an error. The form states, Amputation
of the right leg instead of the left leg that is to be amputated. The nurse has administered
already the preoperative medications. What should the nurse do?
A. Call the physician to reschedule the surgery.
B. Call the nearest relative to come in to sign a new form.
C. Cross out the error and initial the form.
D. Have the client sign another form.
17. The nurse in the nursing care unit checks the fluctuation in the water-seal compartment of a
closed chest drainage system. The fluctuation has stopped, the nurse would:
A. Vigorously strip the tube to dislodge a clot.
B. Raise the apparatus above the chest to move fluid.
C. Increase wall suction above 20 cm H2O pressure.
D. Ask the client to cough and take a deep breath.
18. The pediatric nurse in the neonatal unit was informed that the baby that is brought to the
mother in the hospital room is wrong. The nurse determines that two babies were placed in the
wrong cribs. The most appropriate nursing action would be to:
A. Determine who is responsible for the mistake and terminate his or her employment.
B. Record the event in an incident/variance report and notify the nursing supervisor.
C. Reassure both mothers, report to the charge nurse, and do not record.
D. Record detailed notes of the event on the mothers medical record.
19. Before the administration of digoxin, the nurse completes an assessment to a toddler client
for signs and symptoms of digoxin toxicity. Which of the following is the earliest and most
significant sign of digoxin toxicity?
A. Tinnitus
B. Nausea and vomiting
C. Vision problem
D. Slowing in the heart rate
20. Which of the following treatment modality is appropriate for a client with paranoid tendency?
A. Activity therapy.
B. Individual therapy.
C. Group therapy.
D. Family therapy.
21. The client with rheumatoid arthritis is for discharge. In preparing the client for discharge on
prednisone therapy, the nurse should advise the client to:
A. Wear sunglasses if exposed to bright light for an extended period of time.
B. Take oral preparations of prednisone before meals.
C. Have periodic complete blood counts while on the medication.
D. Never stop or change the amount of the medication without medical advice.
22. A pregnant client tells the nurse that she is worried about having urinary frequency. What
will be the most appropriate nursing response?
A. Try using Kegel (perineal) exercises and limiting fluids before bedtime. If you have
frequency associated with fever, pain on voiding, or blood in the urine, call your doctor/nurse-
midwife.
B. Placental progesterone causes irritability of the bladder sphincter. Your symptoms will go
away after the baby comes.
C. Pregnant women urinate frequently to get rid of fetal wastes. Limit fluids to 1L/daily.
D. Frequency is due to bladder irritation from concentrate urine and is normal in pregnancy.
Increase your daily fluid intake to 3L.
23. Which of the following will help the nurse determine that the expression of hostility is useful?
A. Expression of anger dissipates the energy.
B. Energy from anger is used to accomplish what needs to be done.
C. Expression intimidates others.
D. Degree of hostility is less than the provocation.
24. The nurse is providing an orientation regarding case management to the nursing students.
Which characteristics should the nurse include in the discussion in understanding case
management?
A. Main objective is a written plan that combines discipline-specific processes used to measure
outcomes of care.
B. Main purpose is to identify expected client, family and staff performance against the timeline
for clients with the same diagnosis.
C. Main focus is comprehensive coordination of client care, avoid unnecessary duplication of
services, improve resource utilization and decrease cost.
D. Primary goal is to understand why predicted outcomes have not been met and the correction
of identified problems.
25. The physician orders a dose of IV phenytoin to a child client. In preparing in the
administration of the drug, which nursing action is not correct?
A. Infuse the phenytoin into a smaller vein to prevent purple glove syndrome.
B. Check the phenytoin solution to be sure it is clear or light yellow in color, never cloudy.
C. Plan to give phenytoin over 30-60 minutes, using an in-line filter.
D. Flush the IV tubing with normal saline before starting phenytoin.
26. The pregnant woman visits the clinic for check up. Which assessment findings will help the
nurse determine that the client is in 8-week gestation?
A. Leopold maneuvers.
B. Fundal height.
C. Positive radioimmunoassay test (RIA test).
D. Auscultation of fetal heart tones.
27. Which of the following nursing intervention is essential for the client who had
pneumonectomy?
A. Medicate for pain only when needed.
B. Connect the chest tube to water-seal drainage.
C. Notify the physician if the chest drainage exceeds 100mL/hr.
D. Encourage deep breathing and coughing.
28. The nurse is providing a health teaching to a group of parents regarding Chlamydia
trachomatis. The nurse is correct in the statement, Chlamydia trachomatis is not only an
intracellular bacterium that causes neonatal conjunctivitis, but it also can cause:
A. Discoloration of baby and adult teeth.
B. Pneumonia in the newborn.
C. Snuffles and rhagades in the newborn.
D. Central hearing defects in infancy.
29. The nurse is assigned to care to a 17-year-old male client with a history of substance abuse.
The client asks the nurse, Have you ever tried or used drugs? The most correct response of
the nurse would be:
A. Yes, once I tried grass.
B. No, I dont think so.
C. Why do you want to know that?
D. How will my answer help you?
30. Which of the following describes a health care team with the principles of participative
leadership?
A. Each member of the team can independently make decisions regarding the clients care
without necessarily consulting the other members.
B. The physician makes most of the decisions regarding the clients care.
C. The team uses the expertise of its members to influence the decisions regarding the clients
care.
D. Nurses decide nursing care; physicians decide medical and other treatment for the client.
31. A nurse is giving a health teaching to a woman who wants to breastfeed her newborn baby.
Which hormone, normally secreted during the postpartum period, influences both the milk
ejection reflex and uterine involution?
A. Oxytocin.
B. Estrogen.
C. Progesterone.
D. Relaxin.
32. One staff nurse is assigned to a group of 5 patients for the 12-hour shift. The nurse is
responsible for the overall planning, giving and evaluating care during the entire shift. After the
shift, same responsibility will be endorsed to the next nurse in charge. This describes nursing
care delivered via the:
A. Primary nursing method.
B. Case method.
C. Functional method.
D. Team method.
33. The ambulance team calls the emergency department that they are going to bring a client
who sustained burns in a house fire. While waiting for the ambulance, the nurse will anticipate
emergency care to include assessment for:
A. Gas exchange impairment.
B. Hypoglycemia.
C. Hyperthermia.
D. Fluid volume excess.
34. Most couples are using natural family planning methods. Most accidental pregnancies in
couples preferred to use this method have been related to unprotected intercourse before
ovulation. Which of the following factor explains why pregnancy may be achieved by
unprotected intercourse during the preovulatory period?
A. Ovum viability.
B. Tubal motility.
C. Spermatozoal viability.
D. Secretory endometrium.
35. An older adult client wakes up at 2 oclock in the morning and comes to the nurses station
saying, I am having difficulty in sleeping. What is the best nursing response to the client?
A. Ill give you a sleeping pill to help you get more sleep now.
B. Perhaps youd like to sit here at the nurses station for a while.
C. Would you like me to show you where the bathroom is?
D. What woke you up?
36. The nurse is taking care of a multipara who is at 42 weeks of gestation and in active labor,
her membranes ruptured spontaneously 2 hours ago. While auscultating for the point of
maximum intensity of fetal heart tones before applying an external fetal monitor, the nurse
counts 100 beats per minute. The immediate nursing action is to:
A. Start oxygen by mask to reduce fetal distress.
B. Examine the woman for signs of a prolapsed cord.
C. Turn the woman on her left side to increase placental perfusion.
D. Take the womans radial pulse while still auscultating the FHR.
37. The nurse must instruct a client with glaucoma to avoid taking over-the-counter medications
like:
A. Antihistamines.
B. NSAIDs.
C. Antacids.
D. Salicylates.
38. A male client is brought to the emergency department due to motor vehicle accident. While
monitoring the client, the nurse suspects increasing intracranial pressure when:
A. Client is oriented when aroused from sleep, and goes back to sleep immediately.
B. Blood pressure is decreased from 160/90 to 110/70.
C. Client refuses dinner because of anorexia.
D. Pulse is increased from 88-96 with occasional skipped beat.
39. The nurse is conducting a lecture to a class of nursing students about advance directives to
preoperative clients. Which of the following statement by the nurse js correct?
A. The spouse, but not the rest of the family, may override the advance directive.
B. An advance directive is required for a do not resuscitate order.
C. A durable power of attorney, a form of advance directive, may only be held by a blood
relative.
D. The advance directive may be enforced even in the face of opposition by the spouse.
40. A client diagnosed with schizophrenia is shouting and banging on the door leading to the
outside, saying, I need to go to an appointment. What is the appropriate nursing intervention?
A. Tell the client that he cannot bang on the door.
B. Ignore this behavior.
C. Escort the client going back into the room.
D. Ask the client to move away from the door.
41. Which of the following action is an accurate tracheal suctioning technique?
A. 25 seconds of continuous suction during catheter insertion.
B. 20 seconds of continuous suction during catheter insertion.
C. 10 seconds of intermittent suction during catheter withdrawal.
D. 15 seconds of intermittent suction during catheter withdrawal.
42. The clients jaw and cheekbone is sutured and wired. The nurse anticipates that the most
important thing that must be ready at the bedside is:
A. Suture set.
B. Tracheostomy set.
C. Suction equipment.
D. Wire cutters.
43. A mother is in the third stage of labor. Which of the following signs will help the nurse
determine the signs of placental separation?
A. The uterus becomes globular.
B. The umbilical cord is shortened.
C. The fundus appears at the introitus.
D. Mucoid discharge is increased.
44. After therapy with the thrombolytic alteplase (t-PA. , what observation will the nurse report to
the physician?
A. 3+ peripheral pulses.
B. Change in level of consciousness and headache.
C. Occasional dysrhythmias.
D. Heart rate of 100/bpm.
45. A client who undergone left nephrectomy has a large flank incision. Which of the following
nursing action will facilitate deep breathing and coughing?
A. Push fluid administration to loosen respiratory secretions.
B. Have the client lie on the unaffected side.
C. Maintain the client in high Fowlers position.
D. Coordinate breathing and coughing exercise with administration of analgesics.
46. The community nurse is teaching the group of mothers about the cervical mucus method of
natural family planning. Which characteristics are typical of the cervical mucus during the
fertile period of the menstrual cycle?
A. Absence of ferning.
B. Thin, clear, good spinnbarkeit.
C. Thick, cloudy.
D. Yellow and sticky.
47. A client with ruptured appendix had surgery an hour ago and is transferred to the nursing
care unit. The nurse placed the client in a semi-Fowlers position primarily to:
A. Facilitate movement and reduce complications from immobility.
B. Fully aerate the lungs.
C. Splint the wound.
D. Promote drainage and prevent subdiaphragmatic abscesses.
48. Which of the following will best describe a management function?
A. Writing a letter to the editor of a nursing journal.
B. Negotiating labor contracts.
C. Directing and evaluating nursing staff members.
D. Explaining medication side effects to a client.
49. The parents of an infant client ask the nurse to teach them how to administer Cortisporin
eye drops. The nurse is correct in advising the parents to place the drops:
A. In the middle of the lower conjunctival sac of the infants eye.
B. Directly onto the infants sclera.
C. In the outer canthus of the infants eye.
D. In the inner canthus of the infants eye.
50. The nurse is assessing on the client who is admitted due to vehicle accident. Which of the
following findings will help the nurse that there is internal bleeding?
A. Frank blood on the clothing.
B. Thirst and restlessness.
C. Abdominal pain.
D. Confusion and altered of consciousness.
51. The nurse is completing an assessment to a newborn baby boy. The nurse observes that
the skin of the newborn is dry and flaking and there are several areas of an apparent macular
rash. The nurse charts this as:
A. Icterus neonatorum
B. Multiple hemangiomas
C. Erythema toxicum
D. Milia
52. The client is brought to the emergency department because of serious vehicle accident.
After an hour, the client has been declared brain dead. The nurse who has been with the client
must now talk to the family about organ donation. Which of the following consideration is
necessary?
A. Include as many family members as possible.
B. Take the family to the chapel.
C. Discuss life support systems.
D. Clarify the familys understanding of brain death.
53. The nurse is teaching exercises that are good for pregnant women increasing tone and
fitness and decreasing lower backache. Which of the following should the nurse exclude in the
exercise program?
A. Stand with legs apart and touch hands to floor three times per day.
B. Ten minutes of walking per day with an emphasis on good posture.
C. Ten minutes of swimming or leg kicking in pool per day.
D. Pelvic rock exercise and squats three times a day.
54. A client with obsessive-compulsive behavior is admitted in the psychiatric unit. The nurse
taking care of the client knows that the primary treatment goal is to:
A. Provide distraction.
B. Support but limit the behavior.
C. Prohibit the behavior.
D. Point out the behavior.
55. After ileostomy, the nurse expects that the drainage appliance will be applied to the stoma:
A. When the client is able to begin self-care procedures.
B. 24 hours later, when the swelling subsided.
C. In the operating room after the ileostomy procedure.
D. After the ileostomy begins to function.
56. A female client who has a 28-day menstrual cycle asks the community health nurse when
she get pregnant during her cycle. What will be the best nursing response?
A. It is impossible to determine the fertile period reliably. So it is best to assume that a woman is
always fertile.
B. In a 28-day cycle, ovulation occurs at or about day 14. The egg lives for about 24 hours and
the sperm live for about 72 hours. The fertile period would be approximately between day 11
and day 15.
C. In a 28- day cycle, ovulation occurs at or about day 14. The egg lives for about 72 hours and
the sperm live for about 24 hours. The fertile period would be approximately between day 13
and 17.
D. In a 28-day cycle, ovulation occurs 8 days before the next period or at about day 20. The
fertile period is between day 20 and the beginning of the next period.
57. Which of the following statement describes the role of a nurse as a client advocate?
A. A nurse may override clients wishes for their own good.
B. A nurse has the moral obligation to prevent harm and do well for clients.
C. A nurse helps clients gain greater independence and self-determination.
D. A nurse measures the risk and benefits of various health situations while factoring in cost.
58. A community health nurse is providing a health teaching to a woman infected with herpes
simplex 2. Which of the following health teaching must the nurse include to reduce the chances
of transmission of herpes simplex 2?
A. Abstain from intercourse until lesions heal.
B. Therapy is curative.
C. Penicillin is the drug of choice for treatment.
D. The organism is associated with later development of hydatidiform mole.
59. The nurse in the psychiatric ward informed the male client that he will be attending the 9:00
AM group therapy sessions. The client tells the nurse that he must wash his hands from 9:00 to
9:30 AM each day and therefore he cannot attend. Which concept does the nursing staff need
to keep in mind in planning nursing intervention for this client?
A. Depression underlines ritualistic behavior.
B. Fear and tensions are often expressed in disguised form through symbolic processes.
C. Ritualistic behavior makes others uncomfortable.
D. Unmet needs are discharged through ritualistic behavior.
10. The nurse assesses the health condition of the female client. The client tells the nurse that
she discovered a lump in the breast last year and hesitated to seek medical advice. The nurse
understands that, women who tend to delay seeking medical advice after discovering the
disease are displaying what common defense mechanism?
A. Intellectualization.
B. Suppression.
C. Repression.
D. Denial.
61. Which of the following situations cannot be delegated by the registered nurse to the nursing
assistant?
A. A postoperative client who is stable needs to ambulate.
B. Client in soft restraint who is very agitated and crying.
C. A confused elderly woman who needs assistance with eating.
D. Routine temperature check that must be done for a client at end of shift.
62. In the admission care unit, which of the following client would the nurse give immediate
attention?
A. A client who is 3 days postoperative with left calf pain.
B. A client who is postoperative hip pinning who is complaining of pain.
C. New admitted client with chest pain.
D. A client with diabetes who has a glucoscan reading of 180.
63. A couple seeks medical advice in the community health care unit. A couple has been unable
to conceive; the man is being evaluated for possible problems. The physician ordered semen
analysis. Which of the following instructions is correct regarding collection of a sperm
specimen?
A. Collect a specimen at the clinic, place in iced container, and give to laboratory personnel
immediately.
B. Collect specimen after 48-72 hours of abstinence and bring to clinic within 2 hours.
C. Collect specimen in the morning after 24 hours of abstinence and bring to clinic immediately.
D. Collect specimen at night, refrigerate, and bring to clinic the next morning.
64. The physician ordered Betamethasone to a pregnant woman at 34 weeks of gestation with
sign of preterm labor. The nurse expects that the drug will:
A. Treat infection.
B. Suppress labor contraction.
C. Stimulate the production of surfactant.
D. Reduce the risk of hypertension.
65. A tracheostomy cuff is to be deflated, which of the following nursing intervention should be
implemented before starting the procedures?
A. Suction the trachea and mouth.
B. Have the obdurator available.
C. Encourage deep breathing and coughing.
D. Do a pulse oximetry reading.
66. A client is diagnosed with Tuberculosis and respiratory isolation is initiated. This means that:
A. Gloves are worn when handling the clients tissue, excretions, and linen.
B. Both client and attending nurse must wear masks at all times.
C. Nurse and visitors must wear masks until chemotherapy is begun. Client is instructed in
cough and tissue techniques.
D. Full isolation; that is, caps and gowns are required during the period of contagion.
67. A client with lung cancer is admitted in the nursing care unit. The husband wants to know
the condition of his wife. How should the nurse respond to the husband?
A. Find out what information he already has.
B. Suggest that he discuss it with his wife.
C. Refer him to the doctor.
D. Refer him to the nurse in charge.
68. A hospitalized client cannot find his handkerchief and accuses other cient in the room and
the nurse of stealing them. Which is the most therapeutic approach to this client?
A. Divert the clients attention.
B. Listen without reinforcing the clients belief.
C. Inject humor to defuse the intensity.
D. Logically point out that the client is jumping to conclusions.
69. After a cystectomy and formation of an ileal conduit, the nurse provides instruction regarding
prevention of leakage of the pouch and backflow of the urine. The nurse is correct to include in
the instruction to empty the urine pouch:
A. Every 3-4 hours.
B. Every hour.
C. Twice a day.
D. Once before bedtime.
70. Which telephone call from a students mother should the school nurse take care of at once?
A. A telephone call notifying the school nurse that the child pediatrician has informed the
mother that the child will need cardiac repair surgery within the next few weeks.
B. A telephone call notifying the school nurse that the childs pediatrician has informed the
mother that the child has head lice.
C. A telephone call notifying the school nurse that a child has a temperature of 102F and a
rash covering the trunk and upper extremities of the body.
D. A telephone call notifying the school nurse that a child underwent an emergency
appendectomy during the previous night.
71. Which of the following signs and symptoms that require immediate attention and may
indicate most serious complications during pregnancy?
A. Severe abdominal pain or fluid discharge from the vagina.
B. Excessive saliva, bumps around the areolae, and increased vaginal mucus.
C. Fatigue, nausea, and urinary frequency at any time during pregnancy.
D. Ankle edema, enlarging varicosities, and heartburn.
72. The nurse is assessing the newborn boy. Apgar scores are 7 and 9. The newborn becomes
slightly cyanotic. What is the initial nursing action?
A. Elevate his head to promote gravity drainage of secretions.
B. Wrap him in another blanket, to reduce heat loss.
C. Stimulate him to cry,, to increase oxygenation.
D. Aspirate his mouth and nose with bulb syringe.
73. The nurse is formulating a plan of care to a client with a somatoform disorder. The nurse
needs to have knowledge of which psychodynamic principle?
A. The symptoms of a somatoform disorder are an attempt to adjust to painful life situations or
to cope with conflicting sexual, aggressive, or dependent feelings.
B. The major fundamental mechanism is regression.
C. The clients symptoms are imaginary and the suffering is faked.
D. An extensive, prolonged study of the symptoms will be reassuring to the client, who seeks
sympathy, attention and love.
74. An infant is brought to the health care clinic for three immunizations at the same time. The
nurse knows that hepatitis B, DPT, and Haemophilus influenzae type B immunizations should:
A. Be drawn in the same syringe and given in one injection.
B. Be mixed and inject in the same sites.
C. Not be mixed and the nurse must give three injections in three sites.
D. Be mixed and the nurse must give the injection in three sites.
75. A female client with cancer has radium implants. The nurse wants to maintain the implants
in the correct position. The nurse should position the client:
A. Flat in bed.
B. On the side only.
C. With the foot of the bed elevated.
D. With the head elevated 45-degrees (semi-Fowlers).
76. The nurse wants to know if the mother of a toddler understands the instructions regarding
the administration of syrup of ipecac. Which of the following statement will help the nurse to
know that the mother needs additional teaching?
A. Ill give the medicine if my child gets into some toilet bowl cleaner.
B. Ill give the medicine if my child gets into some aspirin.
C. Ill give the medicine if my child gets into some plant bulbs.
D. Ill give the medicine if my child gets into some vitamin pills.
77. To assess if the cranial nerve VII of the client was damaged, which changes would not be
expected?
A. Drooling and drooping of the mouth.
B. Inability to open eyelids on operative side.
C. Sagging of the face on the operative side.
D. Inability to close eyelid on operative side.
78. The community health nurse makes a home visit to a family. During the visit, the nurse
observes that the mother is beating her child. What is the priority nursing intervention in this
situation?
A. Assess the childs injuries.
B. Report the incident to protective agencies.
C. Refer the family to appropriate support group.
D. Assist the family to identify stressors and use of other coping mechanisms to prevent further
incidents.
79. The nurse in the neonatal care unit is supervising the actions of a certified nursing assistant
in giving care to the newborns. The nursing assistant mistakenly gives a formula feeding to a
newborn that is on water feeding only. The nurse is responsible for the mistake of the nursing
assistant:
A. Always, as a representative of the institution.
B. Always, because nurses who supervise less-trained individuals are responsible for their
mistakes.
C. If the nurse failed to determine whether the nursing assistant was competent to take care of
the client.
D. Only if the nurse agreed that the newborn could be fed formula.
80. The nurse is assigned to care for a client with urinary calculi. Fluid intake of 2L/day is
encouraged to the client. the primary reason for this is to:
A. Reduce the size of existing stones.
B. Prevent crystalline irritation to the ureter.
C. Reduce the size of existing stones
D. Increase the hydrostatic pressure in the urinary tract.
81. The nurse is counseling a couple in their mid 30s who have been unable to conceive for
about 6 months. They are concerned that one or both of them may be infertile. What is the best
advice the nurse could give to the couple?
A. it is no unusual to take 6-12 months to get pregnant, especially when the partners are in
their mid-30s. Eat well, exercise, and avoid stress.
B. Start planning adoption. Many couples get pregnant when they are trying to adopt.
C. Consult a fertility specialist and start testing before you get any older.
D. Have sex as often as you can, especially around the time of ovulation, to increase your
chances of pregnancy.
82. The nurse is caring for a cient who Is a retired nurse. A 24-hour urine collection for
Creatinine clearance is to be done. The client tells the nurse, I cant remember what this test is
for. The best response by the nurse is:
A. It provides a way to see if you are passing any protein in your urine.
B. It tells how well the kidneys filter wastes from the blood.
C. It tells if your renal insufficiency has affected your heart.
D. The test measures the number of particles the kidney filters.
83. The nurse observes the female client in the psychiatric ward that she is having a hard time
sleeping at night. The nurse asks the client about it and the client says, I cant sleep at night
because of fear of dying. What is the best initial nursing response?
A. It must be frightening for you to feel that way. Tell me more about it.
B. Dont worry, you wont die. You are just here for some test.
C. Why are you afraid of dying?
D. Try to sleep. You need the rest before tomorrows test.
84. In the hospital lobby, the registered nurse overhears a two staff members discussing about
the health condition of her client. What would be the appropriate action for the registered nurse
to take?
A. Join in the conversation, giving her input about the case.
B. Ignore them, because they have the right to discuss anything they want to.
C. Tell them it is not appropriate to discuss such things.
D. Report this incident to the nursing supervisor.
85. The client has had a right-sided cerebrovascular accident. In transferring the client from the
wheelchair to bed, in what position should a client be placed to facilitate safe transfer?
A. Weakened (L) side of the cient next to bed.
B. Weakened (R) side of the client next to bed.
C. Weakened (L) side of the client away from bed.
D. Weakened (R) side of the cient away from bed.
86. The child client has undergone hip surgery and is in a spica cast. Which of the following toy
should be avoided to be in the childs bed?
A. A toy gun.
B. A stuffed animal.
C. A ball.
D. Legos.
87. The LPN/LVN asks the registered nurse why oxytocin (Pitocin), 10 units (IV or IM) must be
given to a client after birth fo the fetus. The nurse is correct to explain that oxytocin:
A. Minimizes discomfort from afterpains.
B. Suppresses lactation.
C. Promotes lactation.
D. Maintains uterine tone.
88. The nurse in the nursing care unit is aware that one of the medical staff displays unlikely
behaviors like confusion, agitation, lethargy and unkempt appearance. This behavior has been
reported to the nurse manager several times, but no changes observed. The nurse should:
A. Continue to report observations of unusual behavior until the problem is resolved.
B. Consider that the obligation to protect the patient from harm has been met by the prior
reports and do nothing further.
C. Discuss the situation with friends who are also nurses to get ideas .
D. Approach the partner of this medical staff member with these concerns.
89. The physician ordered tetracycline PO qid to a child client who weights 20kg. The
recommended PO tetracycline dose is 25-50 mg/kg/day. What is the maximum single dose that
can be safely administered to this child?
A. 1 g
B. 500 mg
C. 250 mg
D. 125 mg
90. The nurse is completing an obstetric history of a woman in labor. Which event in the
obstetric history will help the nurse suspects dysfunctional labor in the current pregnancy?
A. Total time of ruptured membranes was 24 hours with the second birth.
B. First labor lasting 24 hours.
C. Uterine fibroid noted at time of cesarean delivery.
D. Second birth by cesarean for face presentation.
91. The nurse is planning to talk to the client with an antisocial personality disorder. What would
be the most therapeutic approach?
A. Provide external controls.
B. Reinforce the clients self-concept.
C. Give the client opportunities to test reality.
D. Gratify the clients inner needs.
92. The nurse is teaching a group of women about fertility awareness, the nurse should
emphasize that basal body temperature:
A. Can be done with a mercury thermometer but no a digital one.
B. The average temperature taken each morning.
C. Should be recorded each morning before any activity.
D. Has a lower degree of accuracy in predicting ovulation than the cervical mucus test.
93. The nursing applicant has given the chance to ask questions during a job interview at a local
hospital. What should be the most important question to ask that can increase chances of
securing a job offer?
A. Begin with questions about client care assignments, advancement opportunities, and
continuing education.
B. Decline to ask questions, because that is the responsibility of the interviewer.
C. Ask as many questions about the facility as possible.
D. Clarify information regarding salary, benefits, and working hours first, because this will help in
deciding whether or not to take the job.
94. The nurse advised the pregnant woman that smoking and alcohol should be avoided during
pregnancy. The nurse takes into account that the developing fetus is most vulnerable to
environment teratogens that cause malformation during:
A. The entire pregnancy.
B. The third trimester.
C. The first trimester.
D. The second trimester.
95. A male client tells the nurse that there is a big bug in his bed. The most therapeutic nursing
response would be:
A. Silence.
B. Wheres the bug? Ill kill it for you.
C. I dont see a bug in your bed, but you seem afraid.
D. You must be seeing things.
96. A pregnant client in late pregnancy is complaining of groin pain that seems worse on the
right side. Which of the following is the most likely cause of it?
A. Beginning of labor.
B. Bladder infection.
C. Constipation.
D. Tension on the round ligament.
97. The nurse is conducting a lecture to a group of volunteer nurses. The nurse is correct in
imparting the idea that the Good Samaritan law protects the nurse from a suit for malpractice
when:
A. The nurse stops to render emergency aid and leaves before the ambulance arrives.
B. The nurse acts in an emergency at his or her place of employment.
C. The nurse refuses to stop for an emergency outside of the scope of employment.
D. The nurse is grossly negligent at the scene of an emergency.
98. A woman is hospitalized with mild preeclampsia. The nurse is formulating a plan of care for
this client, which nursing care is least likely to be done?
A. Deep-tendon reflexes once per shift.
B. Vital signs and FHR and rhythm q4h while awake.
C. Absolute bed rest.
D. Daily weight.
99. While feeding a newborn with an unrepaired cardiac defect, the nurse keeps on assessing
the condition of the client. The nurse notes that the newborns respiration is 72 breaths per
minute. What would be the initial nursing action?
A. Burp the newborn.
B. Stop the feeding.
C. Continue the feeding.
D. Notify the physician.
100. A client who undergone appendectomy 3 days ago is scheduled for discharge today. The
nurse notes that the client is restless, picking at bedclothes and saying, I am late on my
appointment, and calling the nurse by the wrong name. The nurse suspects:
A. Panic reaction.
B. Medication overdose.
C. Toxic reaction to an antibiotic.
D. Delirium tremens.
Answers & Rationale
1. A. The oxytocic effect of Pitocin increases the intensity and durations of contractions;
prolonged contractions will jeopardize the safetyof the fetus and necessitate discontinuing the
drug.
2. B. It is of paramount importance to prevent the client from hurting himself or herself or others.
3. B. After tonsillectomy, clear, cool liquids should be given. Citrus, carbonated, and hot or cold
liquids should be avoided because they may irritate the throat. Red liquids should be avoided
because they give the appearance of blood if the child vomits. Milk and milk products including
pudding are avoided because they coat the throat, cause the child to clear the throat, and
increase the risk of bleeding.
4. A. Phenylephrine, with frequent and continued use, can cause rebound congestion of
mucous membranes.
5. B. The N 95 respirator is a high-particulate filtration mask that meets the CDC performance
criteria for a tuberculosis respirator.
6. C. The most frequent cause of noncompliance to the treatment of chronic, or open-angle
glaucoma is the miotic effects of pilocarpine. Pupillary constriction impedes normal
accommodation, making night driving difficult and hazardous, reducing the clients ability to read
for extended periods and making participation in games with fast-moving objects impossible.
7. B. This stops the sucking of air through the tube and prevents the entry of contaminants. In
addition, clamping near the chest wall provides for some stability and may prevent the clamp
from pulling on the chest tube.
8. D. Because umbilical cords insertion site is born before the fetal head, the cord may be
compressed by the after-coming head in a breech birth.
9. B. It is important to externalize the anger away from self.
10. D. Development normally proceeds cephalocaudally; so the first major developmental
milestone that the infant achieves is the ability to hold the head up within the first 8-12 weeks of
life. In hypothyroidism, the infants muscle tone would be poor and the infant would not be able
to achieve this milestone.
11. D. Get a senior nurse who know s the policies, the client, and the doctor. Generally
speaking, a nurse should not accept telephone orders. However, if it is necessary to take one,
follow the hospitals policy regarding telephone orders. Failure to followhospital policy could be
considered negligence. In this case, the nurse was new and did not know the hospitals policy
concerning telephone orders. The nurse was also unfamiliar with the doctor and the client.
Therefore the nurse should not take the order unless A. no one else is available and B. it is an
emergency situation.
12. C. The nurse is obligated to inform the nurse manager about changes in the condition of the
client, which may change the decision made by the nurse manager.
13. A. Perinatal risk factors for the development of Down syndrome include advanced maternal
age, especially with the first pregnancy.
14. B. Assignments should be based on scope of practice and expertise.
15. B. The child who is concurrently taking digoxin and diuretics is at increased risk for digoxin
toxicity due to the loss of potassium. The child and parents should be taught what foods are
high in potassium, and the child should be encouraged to eat a high-potassium diet. In addition,
the childs serum potassium level should be carefully monitored.
16. A. The responsible for an accurate informed consent is the physician. An exception to this
answer would be a life-threatening emergency, but there are no data to support another
response.
17. D. Asking the client to cough and take a deep breath will help determine if the chest tube is
kinked or if the lungs has reexpanded.
18. B. Every event that exposes a client to harm should be recorded in an incident report, as
well as reported to the appropriate supervisors in order to resolve the current problems and
permit the institution to prevent the problem from happening again.
19. D. One of the earliest signs of digoxin toxicity is Bradycardia. For a toddler, any heart rate
that falls below the norm of about 100-120 bpm would indicate Bradycardia and would
necessitate holding the medication and notifying the physician.
20. B. This option is least threatening.
21. D. In preparing the client for discharge that is receiving prednisone, the nurse should
caution the client to (A. take oral preparations after meals; (B. remember that routine checks of
vital signs, weight, and lab studies are critical; (C. NEVER STOP OR CHANGE THE AMOUNT
OF MEDICATION WITHOUT MEDICAL ADVICE; (D. store the medication in a light-resistant
container.
22. A. Progesterone also reduces smooth muscle motility in the urinary tract and predisposes
the pregnant woman to urinary tract infections. Women should contact their doctors if they
exhibit signs of infection. Kegel exercise will help strengthen the perineal muscles; limiting fluids
at bedtime reduces the possibility of being awakened by the necessity of voiding.
23. B. This is the proper use of anger.
24. C. There are several models of case management, but the commonality is comprehensive
coordination of care to better predict needs of high-risk clients, decrease exacerbations and
continually monitor progress overtime.
25. A. Phenytoin should be infused or injected into larger veins to avoid the discoloration know
as purple glove syndrome; infusing into a smaller vein is not appropriate.
26. C. Serum radioimmunoassay (RIA. is accurate within 7days of conception. This test is
specific for HCG, and accuracy is not compromised by confusion with LH.
27. D. Surgery and anesthesia can increase mucus production. Deep breathing and coughing
are essential to prevent atelectasis and pneumonia in the clients only remaining lung.
28. B. Newborns can get pneumonia (tachypnea, mild hypoxia, cough, eosinophiliA. and
conjunctivitis from Chlamydia.
29. D. The client may perceive this as avoidance, but it is more important to redirect back to the
client, especially in light of the manipulative behavior of drug abusers and adolescents.
30. C. It describes a democratic process in which all members have input in the clients care.
31. A. Contraction of the milk ducts and let-down reflex occur under the stimulation of oxytocin
released by the posterior pituitary gland.
32. B. In case management, the nurse assumes total responsibility for meeting the needs of the
client during the entire time on duty.
33. A. Smoke inhalation affects gas exchange.
34. C. Sperm deposited during intercourse may remain viable for about 3 days. If ovulation
occurs during this period, conception may result.
35. B. This option shows acceptance (key concept) of this age-typical sleep pattern (that of
waking in the early morning).
36. D. Taking the mothers pulse while listening to the FHR will differentiate between the
maternal and fetal heart rates and rule out fetal Bradycardia.
37. A. Antihistamines cause pupil dilation and should be avoided with glaucoma.
38. A. This suggests that the level of consciousness is decreasing.
39. D. An advance directive is a form of informed consent, and only a competent adult or the
holder of a durable power of attorney has the right to consent or refuse treatment. If the spouse
does not hold the power of attorney, the decisions of the holder, even if opposed by the spouse,
are enforced.
40. C. Gentle but firm guidance and nonverbal direction is needed to intervene when a client
with schizophrenic symptoms is being disruptive.
41. C. Suctioning is only done for 10 seconds, intermittently, as the catheter is being withdrawn.
42. D. The priority for this client is being able to establish an airway.
43. A. Signs of placental separation include a change in the shape of the uterus from ovoid to
globular.
44. B. This could indicate intracranial bleeding. Alteplase is a thrombolytic enzyme that lyses
thrombi and emboli. Bleeding is an adverse effect. Monitor clotting times and signs of any
gastrointestinal or internal bleeding.
45. D. Because flank incision in nephrectomy is directly below the diaphragm, deep breathing is
painful. Additionally, there is a greater incisional pull each time the person moves than there is
with abdominal surgery. Incisional pain following nephrectomy generally requires analgesics
administration every 3-4 hours for 24-48 hours after surgery. Therefore, turning, coughing and
deep-breathing exercises should be planned to maximize the analgesic effects.
46. B. Under high estrogen levels, during the period surrounding ovulation, the cervical mucus
becomes thin, clear, and elastic (spinnbarkeit), facilitating sperm passage.
47. D. After surgery for a ruptured appendix, the client should be placed in a semi-Fowlers
position to promote drainage and to prevent possible complications.
48. C. Directing and evaluation of staff is a major responsibility of a nursing manager.
49. A. The recommended procedure for administering eyedrops to any client calls for the drops
to be placed in the middle of the lower conjunctival sac.
50. B. Thirst and restlessness indicate hypovolemia and hypoxemia. Internal bleeding is difficult
to recognized and evaluate because it is not apparent.
51. C. Erythema toxicum is the normal, nonpathological macular newborn rash.
52. D. The family needs to understand what brain death is before talking about organ donation.
They need time to accept the death of their family member. An environment conducive to
discussing an emotional issue is needed.
53. A. Bending from the waist in pregnancy tends to make backache worse.
54. B. Support and limit setting decrease anxiety and provide external control.
55. C. The stoma drainage bag is applied in the operating room. Drainage from the ileostomy
contains secretions that are rich in digestive enzymes and highly irritating to the skin. Protection
of the skin from the effects of these enzymes is begun at once. Skin exposed to these enzymes
even for a short time becomes reddened, painful and excoriated.
56. B. It is the most accurate statement of physiological facts for a 28-day menstrual cycle:
ovulation at day 14, egg life span 24 hours, sperm life span of 72 hours. Fertilization could occur
from sperm deposited before ovulation.
57. C. An advocate role encourage freedom of choice, includes speaking out for the client, and
supports the clients best interests.
58. A. Abstinence will eliminate any unnecessary pain during intercourse and will reduce the
possibility of transmitting infection to ones sexual partner.
59. B. Anxiety is generated by group therapy at 9:00 AM. The ritualistic behavioral defense of
hand washing decreases anxiety by avoiding group therapy.
60. D. Denial is a very strong defense mechanism used to allay the emotional effects of
discovering a potential threat. Although denial has been found to be an effective mechanism for
survival in some instances, such as during natural disasters, it may in greater pathology in a
woman with potential breast carcinoma.
61. B. The registered nurse cannot delegate the responsibility for assessment and evaluation of
clients. The status of the client in restraint requires further assessment to determine if there are
additional causes for the behavior.
62. C. The client with chest pain may be having a myocardial infarction, and immediate
assessment and intervention is a priority.
63. B. Is correct because semen analysis requires that a freshly masturbated specimen be
obtained after a rest (abstinence) period of 48-72 hours.
64. C. Betamethasone, a form of cortisone, acts on the fetal lungs to produce surfactant.
65. A. Secretions may have pooled above the tracheostomy cuff. If these are not suctioned
before deflation, the secretions may be aspirated.
66. C. Proper handling of sputum is essential to allay droplet transference of bacilli in the air.
Clients need to be taught to cover their nose and mouth with tissues when sneezing or
coughing. Chemotherapy generally renders the client noninfectious within days to a few weeks,
usually before cultures for tubercle bacilli are negative. Until chemical isolation is established,
many institutions require the client to wear a mask when visitors are in the room or when the
nurse is in attendance. Client should be in a well-ventilated room, without air recirculation, to
prevent air contamination.
67. A. It is best to establish baseline information first.
68. B. Listening is probably the most effective response of the four choices.
69. A. Urine flow is continuous. The pouch has an outlet valve for easy drainage every 3-4
hours. (the pouch should be changed every 3-5 days, or sooner if the adhesive is loose).
70. C. A high fever accompanied by a body rash could indicate that the child has a
communicable disease and would have exposed other students to the infection. The school
nurse would want to investigate this telephone call immediately so that plans could be instituted
to control the spread of such infection.
71. A. Severe abdominal pain may indicate complications of pregnancy such as abortion,
ectopic pregnancy, or abruption placenta; fluid discharge from the vagina may indicate
premature rupture of the membrane.
72. D. Gentle aspiration of mucus helps maintain a patent airway, required for effective gas
exchange.
73. A. Somatoform disorders provide a way of coping with conflicts.
74. C. Immunization should never be mixed together in a syringe, thus necessitating three
separate injections in three sites. Note: some manufacturers make a premixed combination of
immunization that is safe and effective.
75. A. Clients with radioactive implants should be positioned flat in bed to prevent dislodgement
of the vaginal packing. The client may roll to the side for meals but the upper body should not
be raised more than 20 degrees.
76. A. Syrup of ipecac is not administered when the ingested substances is corrosive in nature.
Toilet bowl cleaners, as a collective whole, are highly corrosive substances. If the ingested
substance burned the esophagus going down, it will burn the esophagus coming back up
when the child begins to vomit after administration of syrup of ipecac.
77. B. Inability to open eyelids on operative side is seen with cranial nerve III damage.
78. A. Assessment of physical injuries (like bruises, lacerations, bleeding and fractures) is the
first priority.
79. C. The nurse who is supervising others has a legal obligation to determine that they are
competent to perform the assignment, as well as legal obligation to provide adequate
supervision.
80. D. Increasing hydrostatic pressure in the urinary tract will facilitate passage of the calculi.
81. A. Infertility is not diagnosed until atleast 12months of unprotected intercourse has failed to
produce a pregnancy. Older couples will experience a longer time to get pregnant.
82. B. Determining how well the kidneys filter wastes states the purpose of a Creatinine
clearance test.
83. A. Acknowledging a feeling tone is the most therapeutic response and provides a broad
opening for the client to elaborate feelings.
84. C. The behavior should be stopped. The first is to remind the staff that confidentiality maybe
violated.
85. C. With a right-sided cerebrovascular accident the client would have left-sided hemiplegia or
weakness. The clients good side should be closest to the bed to facilitate the transfer.
86. D. Legos are small plastic building blocks that could easily slip under the childs cast and
lead to a break in skin integrity and even infection. Pencils, backscratchers, and marbles are
some other narrow or small items that could easily slip under the childs cast and lead to a
break in skin integrity and infection.
87. D. Oxytocin (Pitocin) is used to maintain uterine tone.
88. B. The submission of reports about incidents that expose clients to harm does not remove
the obligation to report ongoing behavior as long as the risk to the client continues.
89. C. The recommended dosage of tetracycline is 25-50mg/kg/day. If the child weighs 20kg
and the maximum dose is 50mg/kg, this would indicate a total daily dose of 1000mg of
tetracycline. In this case, the child is being given this medication four times a day. Therefore the
maximum single dose that can be given is 250mg (1000 mg of tetracycline divided by four
doses.)
90. C. An abnormality in the uterine muscle could reduce the effectiveness of uterine
contractions and lengthen the duration of subsequent labors.
91. A. Personality disorders stem from a weak superego, implying a lack of adequate controls.
92. C. The basal body temperature is the lowest body temperature of a healthy person that is
taken immediately after waking and before getting out of bed. The BBT usually varies from 36.2
C to 36.3C during menses and for about 5-7 days afterward. About the time of ovulation, a
slight drop in temperature may be seen, after ovulation in concert with the increasing
progesterone levels of the early luteal phase, the BBT rises 0.2-0.4 C. This elevation remains
until 2-3 days before menstruation, or if pregnancy has occurred.
93. A. This choice implies concern for client care and self-improvement.
94. C. The first trimester is the period of organogenesis, that is, cell differentiation into the
various organs, tissues, and structures.
95. C. This response does not contradict the clients perception, is honest, and shows empathy.
96. D. Tension on round ligament occurs because of the erect human posture and pressure
exerted by the growing fetus.
97. D. The Good Samaritan Law does not impose a duty to stop at the scene of an emergency
outside of the scope of employment, therefore nurses who do not stop are not liable for suit.
98. C. Although reducing environment stimuli and activity is necessary for a woman with mild
preeclampsia, she will most probably have bathroom privileges.
99. B. A normal respiratory rate for a newborn is 30-40 breaths per minute.
100. D. The behavior described is likely to be symptoms of delirium tremens, or alcohol
withdrawal (often unsuspected on a surgical unit.)


Jiwa
1. Marco approached Nurse Trisha asking for advice on how to deal with his alcohol
addiction. Nurse Trisha should tell the client that the only effective treatment for
alcoholism is:
A. Psychotherapy
B. Alcoholics anonymous (A.A.)
C. Total abstinence
D. Aversion Therapy
2.Nurse Hazel is caring for a male client who experience false sensory perceptions with
no basis in reality. This perception is known as:
A. Hallucinations
B. Delusions
C. Loose associations
D. Neologisms
3. Nurse Monet is caring for a female client who has suicidal tendency. When
accompanying the client to the restroom, Nurse Monet should
A. Give her privacy
B. Allow her to urinate
C. Open the window and allow her to get some fresh air
D. Observe her
4. Nurse Maureen is developing a plan of care for a female client with anorexia nervosa.
Which action should the nurse include in the plan?
A. Provide privacy during meals
B. Set-up a strict eating plan for the client
C. Encourage client to exercise to reduce anxiety
D. Restrict visits with the family
5. A client is experiencing anxiety attack. The most appropriate nursing intervention
should include?
A. Turning on the television
B. Leaving the client alone
C. Staying with the client and speaking in short sentences
D. Ask the client to play with other clients
6. A female client is admitted with a diagnosis of delusions of GRANDEUR. This
diagnosis reflects a belief that one is:
A. Being Killed
B. Highly famous and important
C. Responsible for evil world
D. Connected to client unrelated to oneself
7.A 20 year old client was diagnosed with dependent personality disorder. Which
behavior is not most likely to be evidence of ineffective individual coping?
A. Recurrent self-destructive behavior
B. Avoiding relationship
C. Showing interest in solitary activities
D. Inability to make choices and decision without advise
8. A male client is diagnosed with schizotypal personality disorder. Which signs would
this client exhibit during social situation?
A. Paranoid thoughts
B. Emotional affect
C. Independence need
D. Aggressive behavior
9. Nurse Claire is caring for a client diagnosed with bulimia. The most appropriate initial
goal for a client diagnosed with bulimia is?
A. Encourage to avoid foods
B. Identify anxiety causing situations
C. Eat only three meals a day
D. Avoid shopping plenty of groceries
10. Nurse Tony was caring for a 41 year old female client. Which behavior by the client
indicates adult cognitive development?
A. Generates new levels of awareness
B. Assumes responsibility for her actions
C. Has maximum ability to solve problems and learn new skills
D. Her perception are based on reality
11. A neuromuscular blocking agent is administered to a client before ECT therapy. The
Nurse should carefully observe the client for?
A. Respiratory difficulties
B. Nausea and vomiting
C. Dizziness
D. Seizures
12. A 75 year old client is admitted to the hospital with the diagnosis of dementia of the
Alzheimers type and depression. The symptom that is unrelated to depression would
be?
A. Apathetic response to the environment
B. I dont know answer to questions
C. Shallow of labile effect
D. Neglect of personal hygiene
13. Nurse Trish is working in a mental health facility; the nurse priority nursing
intervention for a newly admitted client with bulimia nervosa would be to?
A. Teach client to measure I & O
B. Involve client in planning daily meal
C. Observe client during meals
D. Monitor client continuously
14. Nurse Patricia is aware that the major health complication associated with intractable
anorexia nervosa would be?
A. Cardiac dysrhythmias resulting to cardiac arrest
B. Glucose intolerance resulting in protracted hypoglycemia
C. Endocrine imbalance causing cold amenorrhea
D. Decreased metabolism causing cold intolerance
15. Nurse Anna can minimize agitation in a disturbed client by?
A. Increasing stimulation
B. limiting unnecessary interaction
C. increasing appropriate sensory perception
D. ensuring constant client and staff contact
16. A 39 year old mother with obsessive-compulsive disorder has become immobilized
by her elaborate hand washing and walking rituals. Nurse Trish recognizes that the basis
of O.C. disorder is often:
A. Problems with being too conscientious
B. Problems with anger and remorse
C. Feelings of guilt and inadequacy
D. Feeling of unworthiness and hopelessness
17. Mario is complaining to other clients about not being allowed by staff to keep food in
his room. Which of the following interventions would be most appropriate?
A. Allowing a snack to be kept in his room
B. Reprimanding the client
C. Ignoring the clients behavior
D. Setting limits on the behavior
18. Conney with borderline personality disorder who is to be discharge soon threatens to
do something to herself if discharged. Which of the following actions by the nurse
would be most important?
A. Ask a family member to stay with the client at home temporarily
B. Discuss the meaning of the clients statement with her
C. Request an immediate extension for the client
D. Ignore the clients statement because its a sign of manipulation
19. Joey a client with antisocial personality disorder belches loudly. A staff member asks
Joey, Do you know why people find you repulsive? this statement most likely would
elicit which of the following client reaction?
A. Defensiveness
B. Embarrassment
C. Shame
D. Remorsefulness
20. Which of the following approaches would be most appropriate to use with a client
suffering from narcissistic personality disorder when discrepancies exist between what
the client states and what actually exist?
A. Rationalization
B. Supportive confrontation
C. Limit setting
D. Consistency
21. Cely is experiencing alcohol withdrawal exhibits tremors, diaphoresis and
hyperactivity. Blood pressure is 190/87 mmhg and pulse is 92 bpm. Which of the
medications would the nurse expect to administer?
A. Naloxone (Narcan)
B. Benzlropine (Cogentin)
C. Lorazepam (Ativan)
D. Haloperidol (Haldol)
22. Which of the following foods would the nurse Trish eliminate from the diet of a client
in alcohol withdrawal?
A. Milk
B. Orange Juice
C. Soda
D. Regular Coffee
23. Which of the following would Nurse Hazel expect to assess for a client who is
exhibiting late signs of heroin withdrawal?
A. Yawning & diaphoresis
B. Restlessness & Irritability
C. Constipation & steatorrhea
D. Vomiting and Diarrhea
24. To establish open and trusting relationship with a female client who has been
hospitalized with severe anxiety, the nurse in charge should?
A. Encourage the staff to have frequent interaction with the client
B. Share an activity with the client
C. Give client feedback about behavior
D. Respect clients need for personal space
25. Nurse Monette recognizes that the focus of environmental (MILIEU) therapy is to:
A. Manipulate the environment to bring about positive changes in behavior
B. Allow the clients freedom to determine whether or not they will be involved in activities
C. Role play life events to meet individual needs
D. Use natural remedies rather than drugs to control behavior
26. Nurse Trish would expect a child with a diagnosis of reactive attachment disorder to:
A. Have more positive relation with the father than the mother
B. Cling to mother & cry on separation
C. Be able to develop only superficial relation with the others
D. Have been physically abuse
27. When teaching parents about childhood depression Nurse Trina should say?
A. It may appear acting out behavior
B. Does not respond to conventional treatment
C. Is short in duration & resolves easily
D. Looks almost identical to adult depression
28. Nurse Perry is aware that language development in autistic child resembles:
A. Scanning speech
B. Speech lag
C. Shuttering
D. Echolalia
29. A 60 year old female client who lives alone tells the nurse at the community health
center I really dont need anyone to talk to. The TV is my best friend. The nurse
recognizes that the client is using the defense mechanism known as?
A. Displacement
B. Projection
C. Sublimation
D. Denial
30. When working with a male client suffering phobia about black cats, Nurse Trish
should anticipate that a problem for this client would be?
A. Anxiety when discussing phobia
B. Anger toward the feared object
C. Denying that the phobia exist
D. Distortion of reality when completing daily routines
31. Linda is pacing the floor and appears extremely anxious. The duty nurse approaches
in an attempt to alleviate Lindas anxiety. The most therapeutic question by the nurse
would be?
A. Would you like to watch TV?
B. Would you like me to talk with you?
C. Are you feeling upset now?
D. Ignore the client
32. Nurse Penny is aware that the symptoms that distinguish post traumatic stress
disorder from other anxiety disorder would be:
A. Avoidance of situation & certain activities that resemble the stress
B. Depression and a blunted affect when discussing the traumatic situation
C. Lack of interest in family & others
D. Re-experiencing the trauma in dreams or flashback
33. Nurse Benjie is communicating with a male client with substance-induced persisting
dementia; the client cannot remember facts and fills in the gaps with imaginary
information. Nurse Benjie is aware that this is typical of?
A. Flight of ideas
B. Associative looseness
C. Confabulation
D. Concretism
34. Nurse Joey is aware that the signs & symptoms that would be most specific for
diagnosis anorexia are?
A. Excessive weight loss, amenorrhea & abdominal distension
B. Slow pulse, 10% weight loss & alopecia
C. Compulsive behavior, excessive fears & nausea
D. Excessive activity, memory lapses & an increased pulse
35. A characteristic that would suggest to Nurse Anne that an adolescent may have
bulimia would be:
A. Frequent regurgitation & re-swallowing of food
B. Previous history of gastritis
C. Badly stained teeth
D. Positive body image
36. Nurse Monette is aware that extremely depressed clients seem to do best in settings
where they have:
A. Multiple stimuli
B. Routine Activities
C. Minimal decision making
D. Varied Activities
37. To further assess a clients suicidal potential. Nurse Katrina should be especially
alert to the client expression of:
A. Frustration & fear of death
B. Anger & resentment
C. Anxiety & loneliness
D. Helplessness & hopelessness
38. A nursing care plan for a male client with bipolar I disorder should include:
A. Providing a structured environment
B. Designing activities that will require the client to maintain contact with reality
C. Engaging the client in conversing about current affairs
D. Touching the client provide assurance
39. When planning care for a female client using ritualistic behavior, Nurse Gina must
recognize that the ritual:
A. Helps the client focus on the inability to deal with reality
B. Helps the client control the anxiety
C. Is under the clients conscious control
D. Is used by the client primarily for secondary gains
40. A 32 year old male graduate student, who has become increasingly withdrawn and
neglectful of his work and personal hygiene, is brought to the psychiatric hospital by his
parents. After detailed assessment, a diagnosis of schizophrenia is made. It is unlikely
that the client will demonstrate:
A. Low self esteem
B. Concrete thinking
C. Effective self boundaries
D. Weak ego
41. A 23 year old client has been admitted with a diagnosis of schizophrenia says to the
nurse Yes, its march, March is little woman. Thats literal you know. These statement
illustrate:
A. Neologisms
B. Echolalia
C. Flight of ideas
D. Loosening of association
42. A long term goal for a paranoid male client who has unjustifiably accused his wife of
having many extramarital affairs would be to help the client develop:
A. Insight into his behavior
B. Better self control
C. Feeling of self worth
D. Faith in his wife
43. A male client who is experiencing disordered thinking about food being poisoned is
admitted to the mental health unit. The nurse uses which communication technique to
encourage the client to eat dinner?
A. Focusing on self-disclosure of own food preference
B. Using open ended question and silence
C. Offering opinion about the need to eat
D. Verbalizing reasons that the client may not choose to eat
44. Nurse Nina is assigned to care for a client diagnosed with Catatonic Stupor. When
Nurse Nina enters the clients room, the client is found lying on the bed with a body
pulled into a fetal position. Nurse Nina should?
A. Ask the client direct questions to encourage talking
B. Rake the client into the dayroom to be with other clients
C. Sit beside the client in silence and occasionally ask open-ended question
D. Leave the client alone and continue with providing care to the other clients
45. Nurse Tina is caring for a client with delirium and states that look at the spiders on
the wall. What should the nurse respond to the client?
A. Youre having hallucination, there are no spiders in this room at all
B. I can see the spiders on the wall, but they are not going to hurt you
C. Would you like me to kill the spiders
D. I know you are frightened, but I do not see spiders on the wall
46. Nurse Jonel is providing information to a community group about violence in the
family. Which statement by a group member would indicate a need to provide additional
information?
A. Abuse occurs more in low-income families
B. Abuser Are often jealous or self-centered
C. Abuser use fear and intimidation
D. Abuser usually have poor self-esteem
47. During electroconvulsive therapy (ECT) the client receives oxygen by mask via
positive pressure ventilation. The nurse assisting with this procedure knows that
positive pressure ventilation is necessary because?
A. Anesthesia is administered during the procedure
B. Decrease oxygen to the brain increases confusion and disorientation
C. Grand mal seizure activity depresses respirations
D. Muscle relaxations given to prevent injury during seizure activity depress respirations.
48. When planning the discharge of a client with chronic anxiety, Nurse Chris evaluates
achievement of the discharge maintenance goals. Which goal would be most
appropriately having been included in the plan of care requiring evaluation?
A. The client eliminates all anxiety from daily situations
B. The client ignores feelings of anxiety
C. The client identifies anxiety producing situations
D. The client maintains contact with a crisis counselor
49. Nurse Tina is caring for a client with depression who has not responded to
antidepressant medication. The nurse anticipates that what treatment procedure may be
prescribed?
A. Neuroleptic medication
B. Short term seclusion
C. Psychosurgery
D. Electroconvulsive therapy
50. Mario is admitted to the emergency room with drug-included anxiety related to over
ingestion of prescribed antipsychotic medication. The most important piece of
information the nurse in charge should obtain initially is the:
A. Length of time on the med.
B. Name of the ingested medication & the amount ingested
C. Reason for the suicide attempt
D. Name of the nearest relative & their phone number
Answers & Rationale
Here are the answers and rationale for this exam. Counter check your answers to those below
and tell us your scores. If you have any disputes or need more clarification to a certain question,
please direct them to the comments section.
1. C. Total abstinence is the only effective treatment for alcoholism.
2. A. Hallucinations are visual, auditory, gustatory, tactile or olfactory perceptions that have no
basis in reality.
3. D. The Nurse has a responsibility to observe continuously the acutely suicidal client. The
Nurse should watch for clues, such as communicating suicidal thoughts, and messages;
hoarding medications and talking about death.
4. B. Establishing a consistent eating plan and monitoring clients weight are important to this
disorder.
5. C. Appropriate nursing interventions for an anxiety attack include using short sentences,
staying with the client, decreasing stimuli, remaining calm and medicating as needed.
6. B. Delusion of grandeur is a false belief that one is highly famous and important.
7. D. Individual with dependent personality disorder typically shows indecisiveness
submissiveness and clinging behavior so that others will make decisions with them.
8. A. Clients with schizotypal personality disorder experience excessive social anxiety that can
lead to paranoid thoughts.
9. B. Bulimia disorder generally is a maladaptive coping response to stress and underlying
issues. The client should identify anxiety causing situation that stimulate the bulimic behavior
and then learn new ways of coping with the anxiety.
10. A. An adult age 31 to 45 generates new level of awareness.
11. A. Neuromuscular Blocker, such as SUCCINYLCHOLINE (Anectine) produces respiratory
depression because it inhibits contractions of respiratory muscles.
12. C. With depression, there is little or no emotional involvement therefore little alteration in
affect.
13. D. These clients often hide food or force vomiting; therefore they must be carefully
monitored.
14. A. These clients have severely depleted levels of sodium and potassium because of their
starvation diet and energy expenditure, these electrolytes are necessary for cardiac functioning.
15. B. Limiting unnecessary interaction will decrease stimulation and agitation.
16. C. Ritualistic behavior seen in this disorder is aimed at controlling guilt and inadequacy by
maintaining an absolute set pattern of behavior.
17. D. The nurse needs to set limits in the clients manipulative behavior to help the client
control dysfunctional behavior. A consistent approach by the staff is necessary to decrease
manipulation.
18. B. Any suicidal statement must be assessed by the nurse. The nurse should discuss the
clients statement with her to determine its meaning in terms of suicide.
19. A. When the staff member ask the client if he wonders why others find him repulsive, the
client is likely to feel defensive because the question is belittling. The natural tendency is to
counterattack the threat to self image.
20. B. The nurse would specifically use supportive confrontation with the client to point out
discrepancies between what the client states and what actually exists to increase responsibility
for self.
21. C. The nurse would most likely administer benzodiazepine, such as lorazepan (ativan) to
the client who is experiencing symptom: The clients experiences symptoms of withdrawal
because of the rebound phenomenon when the sedation of the CNS from alcohol begins to
decrease.
22. D. Regular coffee contains caffeine which acts as psychomotor stimulants and leads to
feelings of anxiety and agitation. Serving coffee top the client may add to tremors or
wakefulness.
23. D. Vomiting and diarrhea are usually the late signs of heroin withdrawal, along with muscle
spasm, fever, nausea, repetitive, abdominal cramps and backache.
24. D. Moving to a clients personal space increases the feeling of threat, which increases
anxiety.
25. A. Environmental (MILIEU) therapy aims at having everything in the clients surrounding
area toward helping the client.
26. C. Children who have experienced attachment difficulties with primary caregiver are not able
to trust others and therefore relate superficially
27. A. Children have difficulty verbally expressing their feelings, acting out behavior, such as
temper tantrums, may indicate underlying depression.
28. D. The autistic child repeat sounds or words spoken by others.
29. D. The client statement is an example of the use of denial, a defense that blocks problem by
unconscious refusing to admit they exist.
30. A. Discussion of the feared object triggers an emotional response to the object.
31. B. The nurse presence may provide the client with support & feeling of control.
32. D. Experiencing the actual trauma in dreams or flashback is the major symptom that
distinguishes post traumatic stress disorder from other anxiety disorder.
33. C. Confabulation or the filling in of memory gaps with imaginary facts is a defense
mechanism used by people experiencing memory deficits.
34. A. These are the major signs of anorexia nervosa. Weight loss is excessive (15% of
expected weight).
35. C. Dental enamel erosion occurs from repeated self-induced vomiting.
36. B. Depression usually is both emotional & physical. A simple daily routine is the best, least
stressful and least anxiety producing.
37. D. The expression of these feeling may indicate that this client is unable to continue the
struggle of life.
38. A. Structure tends to decrease agitation and anxiety and to increase the clients feeling of
security.
39. B. The rituals used by a client with obsessive compulsive disorder help control the anxiety
level by maintaining a set pattern of action.
40. C. A person with this disorder would not have adequate self-boundaries.
41. D. Loose associations are thoughts that are presented without the logical connections
usually necessary for the listening to interpret the message.
42. C. Helping the client to develop feeling of self worth would reduce the clients need to use
pathologic defenses.
43. B. Open ended questions and silence are strategies used to encourage clients to discuss
their problem in descriptive manner.
44. C. Clients who are withdrawn may be immobile and mute, and require consistent, repeated
interventions. Communication with withdrawn clients requires much patience from the nurse.
The nurse facilitates communication with the client by sitting in silence, asking open-ended
question and pausing to provide opportunities for the client to respond.
45. D. When hallucination is present, the nurse should reinforce reality with the client.
46. A. Personal characteristics of abuser include low self-esteem, immaturity, dependence,
insecurity and jealousy.
47. D. A short acting skeletal muscle relaxant such as succinylcholine (Anectine) is
administered during this procedure to prevent injuries during seizure.
48. C. Recognizing situations that produce anxiety allows the client to prepare to cope with
anxiety or avoid specific stimulus.
49. D. Electroconvulsive therapy is an effective treatment for depression that has not responded
to medication.
50. B. In an emergency, lives saving facts are obtained first. The name and the amount of
medication ingested are of outmost important in treating this potentially life threatening situation.
1. Nurse Tony should first discuss terminating the nurse-client relationship with a client
during the:
a. Termination phase when discharge plans are being made.
b. Working phase when the client shows some progress.
c. Orientation phase when a contract is established.
d. Working phase when the client brings it up.
2. Malou is diagnosed with major depression spends majority of the day lying in bed with
the sheet pulled over his head. Which of the following approaches by the nurse would be
the most therapeutic?
a. Question the client until he responds
b. Initiate contact with the client frequently
c. Sit outside the clients room
d. Wait for the client to begin the conversation
3. Joe who is very depressed exhibits psychomotor retardation, a flat affect and apathy.
The nurse in charge observes Joe to be in need of grooming and hygiene. Which of the
following nursing actions would be most appropriate?
a. Waiting until the clients family can participate in the clients care
b. Asking the client if he is ready to take shower
c. Explaining the importance of hygiene to the client
d. Stating to the client that its time for him to take a shower
4. When teaching Mario with a typical depression about foods to avoid while taking
phenelzine(Nardil), which of the following would the nurse in charge include?
a. Roasted chicken
b. Fresh fish
c. Salami
d. Hamburger
5. When assessing a female client who is receiving tricyclic antidepressant therapy,
which of the following would alert the nurse to the possibility that the client is
experiencing anticholinergic effects?
a. Urine retention and blurred vision
b. Respiratory depression and convulsion
c. Delirium and Sedation
d. Tremors and cardiac arrhythmias
6. For a male client with dysthymic disorder, which of the following approaches would
the nurse expect to implement?
a. ECT
b. Psychotherapeutic approach
c. Psychoanalysis
d. Antidepressant therapy
7. Danny who is diagnosed with bipolar disorder and acute mania, states the nurse,
Where is my daughter? I love Louis. Rain, rain go away. Dogs eat dirt. The nurse
interprets these statements as indicating which of the following?
a. Echolalia
b. Neologism
c. Clang associations
d. Flight of ideas
8. Terry with mania is skipping up and down the hallway practically running into other
clients. Which of the following activities would the nurse in charge expect to include in
Terrys plan of care?
a. Watching TV
b. Cleaning dayroom tables
c. Leading group activity
d. Reading a book
9. When assessing a male client for suicidal risk, which of the following methods of
suicide would the nurse identify as most lethal?
a. Wrist cutting
b. Head banging
c. Use of gun
d. Aspirin overdose
10. Jun has been hospitalized for major depression and suicidal ideation. Which of the
following statements indicates to the nurse that the client is improving?
a. Im of no use to anyone anymore.
b. I know my kids dont need me anymore since theyre grown.
c. I couldnt kill myself because I dont want to go to hell.
d. I dont think about killing myself as much as I used to.
11. Which of the following activities would Nurse Trish recommend to the client who
becomes very anxious when thoughts of suicide occur?
a. Using exercise bicycle
b. Meditating
c. Watching TV
d. Reading comics
12. When developing the plan of care for a client receiving haloperidol, which of the
following medications would nurse Monet anticipate administering if the client developed
extra pyramidal side effects?
a. Olanzapine (Zyprexa)
b. Paroxetine (Paxil)
c. Benztropine mesylate (Cogentin)
d. Lorazepam (Ativan)
13. Jon a suspicious client states that I know you nurses are spraying my food with
poison as you take it out of the cart. Which of the following would be the best response
of the nurse?
a. Giving the client canned supplements until the delusion subsides
b. Asking what kind of poison the client suspects is being used
c. Serving foods that come in sealed packages
d. Allowing the client to be the first to open the cart and get a tray
14. A client is suffering from catatonic behaviors. Which of the following would the nurse
use to determine that the medication administered PRN have been most effective?
a. The client responds to verbal directions to eat
b. The client initiates simple activities without direction
c. The client walks with the nurse to her room
d. The client is able to move all extremities occasionally
15. Nurse Hazel invites new clients parents to attend the psycho educational program for
families of the chronically mentally ill. The program would be most likely to help the
family with which of the following issues?
a. Developing a support network with other families
b. Feeling more guilty about the clients illness
c. Recognizing the clients weakness
d. Managing their financial concern and problems
16. When planning care for Dory with schizotypal personality disorder, which of the
following would help the client become involved with others?
a. Attending an activity with the nurse
b. Leading a sing a long in the afternoon
c. Participating solely in group activities
d. Being involved with primarily one to one activities
17. Which statement about an individual with a personality disorder is true?
a. Psychotic behavior is common during acute episodes
b. Prognosis for recovery is good with therapeutic intervention
c. The individual typically remains in the mainstream of society, although he has problems in
social and occupational roles
d. The individual usually seeks treatment willingly for symptoms that are personally distressful.
18. Nurse John is talking with a client who has been diagnosed with antisocial
personality about how to socialize during activities without being seductive. Nurse John
would focus the discussion on which of the following areas?
a. Discussing his relationship with his mother
b. Asking him to explain reasons for his seductive behavior
c. Suggesting to apologize to others for his behavior
d. Explaining the negative reactions of others toward his behavior
19. Tina with a histrionic personality disorder is melodramatic and responds to others
and situations in an exaggerated manner. Nurse Trish would recommend which of the
following activities for Tina?
a. Baking class
b. Role playing
c. Scrap book making
d. Music group
20. Joy has entered the chemical dependency unit for treatment of alcohol dependency.
Which of the following clients possession will the nurse most likely place in a locked
area?
a. Toothpaste
b. Shampoo
c. Antiseptic wash
d. Moisturizer
21. Which of the following assessment would provide the best information about the
clients physiologic response and the effectiveness of the medication prescribed
specifically for alcohol withdrawal?
a. Sleeping pattern
b. Mental alertness
c. Nutritional status
d. Vital signs
22. After administering naloxone (Narcan), an opioid antagonist, Nurse Ronald should
monitor the female client carefully for which of the following?
a. Respiratory depression
b. Epilepsy
c. Kidney failure
d. Cerebral edema
23. Which of the following would nurse Ronald use as the best measure to determine a
clients progress in rehabilitation?
a. The way he gets along with his parents
b. The number of drug-free days he has
c. The kinds of friends he makes
d. The amount of responsibility his job entails
24. A female client is brought by ambulance to the hospital emergency room after taking
an overdose of barbiturates is comatose. Nurse Trish would be especially alert for which
of the following?
a. Epilepsy
b. Myocardial Infarction
c. Renal failure
d. Respiratory failure
25. Joey who has a chronic user of cocaine reports that he feels like he has cockroaches
crawling under his skin. His arms are red because of scratching. The nurse in charge
interprets these findings as possibly indicating which of the following?
a. Delusion
b. Formication
c. Flash back
d. Confusion
26. Jose is diagnosed with amphetamine psychosis and was admitted in the emergency
room. Nurse Ronald would most likely prepare to administer which of the following
medication?
a. Librium
b. Valium
c. Ativan
d. Haldol
27. Which of the following liquids would nurse Leng administer to a female client who is
intoxicated with phencyclidine (PCP) to hasten excretion of the chemical?
a. Shake
b. Tea
c. Cranberry Juice
d. Grape juice
28. When developing a plan of care for a female client with acute stress disorder who lost
her sister in a car accident. Which of the following would the nurse expect to initiate?
a. Facilitating progressive review of the accident and its consequences
b. Postponing discussion of the accident until the client brings it up
c. Telling the client to avoid details of the accident
d. Helping the client to evaluate her sisters behavior
29. The nursing assistant tells nurse Ronald that the client is not in the dining room for
lunch. Nurse Ronald would direct the nursing assistant to do which of the following?
a. Tell the client hell need to wait until supper to eat if he misses lunch
b. Invite the client to lunch and accompany him to the dining room
c. Inform the client that he has 10 minutes to get to the dining room for lunch
d. Take the client a lunch tray and let the client eat in his room
30. The initial nursing intervention for the significant-others during shock phase of a
grief reaction should be focused on:
a. Presenting full reality of the loss of the individuals
b. Directing the individuals activities at this time
c. Staying with the individuals involved
d. Mobilizing the individuals support system
31. Joys stream of consciousness is occupied exclusively with thoughts of her fathers
death. Nurse Ronald should plan to help Joy through this stage of grieving, which is
known as:
a. Shock and disbelief
b. Developing awareness
c. Resolving the loss
d. Restitution
32. When taking a health history from a female client who has a moderate level of
cognitive impairment due to dementia, the nurse would expect to note the presence of:
a. Accentuated premorbid traits
b. Enhance intelligence
c. Increased inhibitions
d. Hyper vigilance
33. What is the priority care for a client with a dementia resulting from AIDS?
a. Planning for remotivational therapy
b. Arranging for long term custodial care
c. Providing basic intellectual stimulation
d. Assessing pain frequently
34. Jerome who has eating disorder often exhibits similar symptoms. Nurse Lhey would
expect an adolescent client with anorexia to exhibit:
a. Affective instability
b. Dishered, unkempt physical appearance
c. Depersonalization and derealization
d. Repetitive motor mechanisms
35. The primary nursing diagnosis for a female client with a medical diagnosis of major
depression would be:
a. Situational low self-esteem related to altered role
b. Powerlessness related to the loss of idealized self
c. Spiritual distress related to depression
d. Impaired verbal communication related to depression
36. When developing an initial nursing care plan for a male client with a Bipolar I disorder
(manic episode) nurse Ron should plan to?
a. Isolate his gym time
b. Encourage his active participation in unit programs
c. Provide foods, fluids and rest
d. Encourage his participation in programs
37. Grace is exhibiting withdrawn patterns of behavior. Nurse Johnny is aware that this
type of behavior eventually produces feeling of:
a. Repression
b. Loneliness
c. Anger
d. Paranoia
38. One morning a female client on the inpatient psychiatric service complains to nurse
Hazel that she has been waiting for over an hour for someone to accompany her to
activities. Nurse Hazel replies to the client Were doing the best we can. There are a lot
of other people on the unit who needs attention too. This statement shows that the
nurses use of:
a. Defensive behavior
b. Reality reinforcement
c. Limit-setting behavior
d. Impulse control
39. A nursing diagnosis for a male client with a diagnosed multiple personality disorder
is chronic low self-esteem probably related to childhood abuse. The most appropriate
short term client outcome would be:
a. Verbalizing the need for anxiety medications
b. Recognizing each existing personality
c. Engaging in object-oriented activities
d. Eliminating defense mechanisms and phobia
40. A 25 year old male is admitted to a mental health facility because of inappropriate
behavior. The client has been hearing voices, responding to imaginary companions and
withdrawing to his room for several days at a time. Nurse Monette understands that the
withdrawal is a defense against the clients fear of:
a. Phobia
b. Powerlessness
c. Punishment
d. Rejection
41. When asking the parents about the onset of problems in young client with the
diagnosis of schizophrenia, Nurse Linda would expect that they would relate the clients
difficulties began in:
a. Early childhood
b. Late childhood
c. Adolescence
d. Puberty
42. Jose who has been hospitalized with schizophrenia tells Nurse Ron, My heart has
stopped and my veins have turned to glass! Nurse Ron is aware that this is an example
of:
a. Somatic delusions
b. Depersonalization
c. Hypochondriasis
d. Echolalia
43. In recognizing common behaviors exhibited by male client who has a diagnosis of
schizophrenia, nurse Josie can anticipate:
a. Slumped posture, pessimistic out look and flight of ideas
b. Grandiosity, arrogance and distractibility
c. Withdrawal, regressed behavior and lack of social skills
d. Disorientation, forgetfulness and anxiety
44. One morning, nurse Diane finds a disturbed client curled up in the fetal position in
the corner of the dayroom. The most accurate initial evaluation of the behavior would be
that the client is:
a. Physically ill and experiencing abdominal discomfort
b. Tired and probably did not sleep well last night
c. Attempting to hide from the nurse
d. Feeling more anxious today
45. Nurse Bea notices a female client sitting alone in the corner smiling and talking to
herself. Realizing that the client is hallucinating. Nurse Bea should:
a. Invite the client to help decorate the dayroom
b. Leave the client alone until he stops talking
c. Ask the client why he is smiling and talking
d. Tell the client it is not good for him to talk to himself
46. When being admitted to a mental health facility, a young female adult tells Nurse
Mylene that the voices she hears frighten her. Nurse Mylene understands that the client
tends to hallucinate more vividly:
a. While watching TV
b. During meal time
c. During group activities
d. After going to bed
47. Nurse John recognizes that paranoid delusions usually are related to the defense
mechanism of:
a. Projection
b. Identification
c. Repression
d. Regression
48. When planning care for a male client using paranoid ideation, nurse Jasmin should
realize the importance of:
a. Giving the client difficult tasks to provide stimulation
b. Providing the client with activities in which success can be achieved
c. Removing stress so that the client can relax
d. Not placing any demands on the client
49. Nurse Gerry is aware that the defense mechanism commonly used by clients who are
alcoholics is:
a. Displacement
b. Denial
c. Projection
d. Compensation
50. Within a few hours of alcohol withdrawal, nurse John should assess the male client
for the presence of:
a. Disorientation, paranoia, tachycardia
b. Tremors, fever, profuse diaphoresis
c. Irritability, heightened alertness, jerky movements
d. Yawning, anxiety, convulsions
Answers and Rationale
Here are the answers and rationale for this exam. Counter check your answers to those below
and tell us your scores. If you have any disputes or need more clarification to a certain question,
please direct them to the comments section.
1. C. When the nurse and client agree to work together, a contract should be established, the
length of the relationship should be discussed in terms of its ultimate termination.
2. B. The nurse should initiate brief, frequent contacts throughout the day to let the client know
that he is important to the nurse. This will positively affect the clients self-esteem.
3. D. The client with depression is preoccupied, has decreased energy, and is unable to make
decisions. The nurse presents the situation, Its time for a shower, and assists the client
with personal hygiene to preserve his dignity and self-esteem.
4. C. Foods high in tyramine, those that are fermented, pickled, aged, or smoked must be
avoided because when they are ingested in combination with MAOIs a hypertensive crisis
will occur.
5. A. Anticholinergic effects, which result from blockage of the parasympathetic (craniosacral)
nervous system including urine retention, blurred vision, dry mouth & constipation.
6. B. Dysthymia is a less severe, chronic depression diagnosed when a client has had a
depressed mood for more days than not over a period of at least 2 years. Client with
dysthymic disorder benefit from psychotherapeutic approaches that assist the client in
reversing the negative self image, negative feelings about the future.
7. D. Flight of ideas is speech pattern of rapid transition from topic to topic, often without
finishing one idea. It is common in mania.
8. B. The client with mania is very active & needs to have this energy channeled in a
constructive task such as cleaning or tidying the room.
9. C. A crucial factor is determining the lethality of a method is the amount of time that occurs
between initiating the method & the delivery of the lethal impact of the method.
10. D. The statement I dont think about killing myself as much as I used to. Indicates a
lessening of suicidal ideation and improvement in the clients condition.
11. A. Using exercise bicycle is appropriate for the client who becomes very anxious when
thoughts of suicidal occur.
12. C. The drug of choice for a client experiencing extra pyramidal side effects from haloperidol
(Haldol) is benztropine mesylate (cogentin) because of its anti cholinergic properties.
13. D. Allowing the client to be the first to open the cart & take a tray presents the client with the
reality that the nurses are not touching the food & tray, thereby dispelling the delusion.
14. B. Although all the actions indicate improvement, the ability to initiate simple activities
without directions indicates the most improvement in the catatonic behaviors.
15. A. Psychoeducational groups for families develop a support network. They provide
education about the biochemical etiology of psychiatric disease to reduce, not increase
family guilt.
16. C. Attending activity with the nurse assists the client to become involved with others slowly.
The client with schizotypal personality disorder needs support, kindness & gentle
suggestion to improve social skills & interpersonal relationship.
17. C. An individual with personality disorder usually is not hospitalized unless a coexisting Axis
I psychiatric disorder is present. Generally, these individuals make marginal adjustments
and remain in society, although they typically experience relationship and occupational
problems related to their inflexible behaviors. Personality disorders are chronic lifelong
patterns of behavior; acute episodes do not occur. Psychotic behavior is usually not
common, although it can occur in either schizotypal personality disorder or borderline
personality disorder. Because these disorders are enduring and evasive and the individual
is inflexible, prognosis for recovery is unfavorable. Generally, the individual does not seek
treatment because he does not perceive problems with his own behavior. Distress can
occur based on other peoples reaction to the individuals behavior.
18. D. The nurse would explain the negative reactions of others towards the clients behaviors
to make the clients aware of the impact of his seductive behaviors on others.
19. B. The nurse would use role-playing to teach the client appropriate responses to others and
in various situations. This client dramatizes events, drawn attention to self, and is unaware
of and does not deal with feelings. The nurse works to help the client clarify true feelings &
learn to express them appropriately.
20. C. Antiseptic mouthwash often contains alcohol & should be kept in locked area, unless
labeling clearly indicates that the product does not contain alcohol.
21. D. Monitoring of vital signs provides the best information about the clients overall
physiologic status during alcohol withdrawal & the physiologic response to the medication
used.
22. A. After administering naloxone (Narcan) the nurse should monitor the clients respiratory
status carefully, because the drug is short acting & respiratory depression may recur after
its effects wear off.
23. B. The best measure to determine a clients progress in rehabilitation is the number of drug-
free days he has. The longer the client is free of drugs, the better the prognosis is.
24. D. Barbiturates are CNS depressants; the nurse would be especially alert for the possibility
of respiratory failure. Respiratory failure is the most likely cause of death from barbiturate
over dose.
25. B. The feeling of bugs crawling under the skin is termed as formication, and is associated
with cocaine use.
26. D. The nurse would prepare to administer an antipsychotic medication such as Haldol to a
client experiencing amphetamine psychosis to decrease agitation & psychotic symptoms,
including delusions, hallucinations & cognitive impairment.
27. C. An acid environment aids in the excretion of PCP. The nurse will definitely give the client
with PCP intoxication cranberry juice to acidify the urine to a ph of 5.5 & accelerate
excretion.
28. A. The nurse would facilitate progressive review of the accident and its consequence to help
the client integrate feelings & memories and to begin the grieving process.
29. B. The nurse instructs the nursing assistant to invite the client to lunch & accompany him to
the dinning room to decrease manipulation, secondary gain, dependency and reinforcement
of negative behavior while maintaining the clients worth.
30. C. This provides support until the individuals coping mechanisms and personal support
systems can be immobilized.
31. C. Resolving a loss is a slow, painful, continuous process until a mental image of the dead
person, almost devoid of negative or undesirable features emerges.
32. A. A moderate level of cognitive impairment due to dementia is characterized by increasing
dependence on environment & social structure and by increasing psychologic rigidity with
accentuated previous traits & behaviors.
33. C. This action maintains for as long as possible, the clients intellectual functions by
providing an opportunity to use them.
34. A. Individuals with anorexia often display irritability, hospitality, and a depressed mood.
35. D. Depressed clients demonstrate decreased communication because of lack of psychic or
physical energy.
36. C. The client in a manic episode of the illness often neglects basic needs, these needs are
a priority to ensure adequate nutrition, fluid, and rest.
37. B. The withdrawn pattern of behavior presents the individual from reaching out to others for
sharing the isolation produces feeling of loneliness.
38. A. The nurses response is not therapeutic because it does not recognize the clients needs
but tries to make the client feel guilty for being demanding.
39. B. The client must recognize the existence of the sub personalities so that interpretation can
occur.
40. D. An aloof, detached, withdrawn posture is a means of protecting the self by withdrawing
and maintaining a safe, emotional distance.
41. C. The usual age of onset of schizophrenia is adolescence or early childhood.
42. A. Somatic delusion is a fixed false belief about ones body.
43. C. These are the classic behaviors exhibited by clients with a diagnosis of schizophrenia.
44. D. The fetal position represents regressed behavior. Regression is a way of responding to
overwhelming anxiety.
45. B. This provides a stimulus that competes with and reduces hallucination.
46. D. Auditory hallucinations are most troublesome when environmental stimuli are diminished
and there are few competing distractions.
47. A. Projection is a mechanism in which inner thoughts and feelings are projected onto the
environment, seeming to come from outside the self rather than from within.
48. B. This will help the client develop self-esteem and reduce the use of paranoid ideation.
49. B. Denial is a method of resolving conflict or escaping unpleasant realities by ignoring their
existence.
50. C. Alcohol is a central nervous system depressant. These symptoms are the bodys
neurologic adaptation to the withdrawal of alcohol.