Acumen Pediatric Nursing Growth and Development Screening Exam

Acumen
International Review Center

Screening Exam
c. Placing a colorful toy within the infant’s
PEDIATRIC NURSING line
of vision
GROWTH & DEVELOPMENT d. Turning the infant’s head from side at
regular
1. Growth and development of an individual can intervals
be described as follows, except: 8. Another mother tells you that at some times her
a. They proceed from the head to feet baby seem cross-eyed. She asks you “why is
b. They occur uniformly in every individual this?” your best response would be:
c. They progress from simple to complex a. “This is normal during the first few months
d. They are interrelated to one another of life.”
2. When can an infant start to say mama & dada? b.“If no one is cross-eye in your family there is
a. 3-4months no
b. 5-6 months need to worry.”
c. 8-9 months c. “If no one is cross-eye in your family there is
d. 11-12 months no
3.The nurse knows that the birth weight usually need to worry.”
triples at age: d.“This is a congenital defect I’ll inform the
a. 6 months doctor.”
b. 12 months 9.In differentiating physiologic jaundice, which
c. 1 ½ year of the following facts is most important?
d. 2 years a. Mother is 37 years old
4.The nurse knows which of the following is a b. Infant is a term newborn
normal assessment for an 8-month old infant? c. Unconjugated bilirubin level is 6 mg/dl
a. infant able to roll over on third day
b. infant crawls d. Appears at 22 hours after birth
c. infant able to stand alone 10. Which of the following would the nurse
d. infant able to walks with support expect to find in a newborn with birth asphyxia?
5.The nurse is assessing an 11-month old infant. a. hyperoxemia
Which of the following is a normal assessment? b. hypocarbia
a. tonic-neck reflex c. Acidosis
b. babinski reflex d. Ketosis
c. moro reflex
d. rooting reflex NEUROLOGIC & ENDOCRINOLOGIC
NURSING
NEONATAL CARE
11. A nurse witnesses a two-year-old child
6.The nurse is performing a newborn assessment, experiencing a generalized seizure while being
which of the following is considered normal? evaluated in the emergency department for a high
a. presence of 2 veins and 1 artery fever. Which of the following actions would a
b. presence of tuft of hair at the lumbar of nurse take first?
baby’s back a. Protect the child from physical injury
c. swelling of labia majora b. Administer an antipyretic medication
d. presence of ortolani’s click rectally
7.To help meet the developmental needs of a 3- c. Apply cool compresses to the axilla and
day old infant, which of these measures is groin
essential to include in the infant’ care plan d. Reassure the parents that this is a common
a. Giving pacifier whenever the infant starts occurrence
to 12. Which of the following statements, if made by the
cry parent of an 18-month-old child who has experienced two
b. Stroking and talking to the infant episodes of febrile seizures, is accurate?
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Screening Exam
a. “My child will have to take anti-seizure b. Obstruction of blood from the right
medicine.” ventricle
b. “I made an appointment to see a genetic c. Obstruction of blood from the left ventricle
counselor.” d. A single vessel arising from both ventricles
c. “My child will probably outgrow these
seizures.”
d. “I’ve made arrangements to have oxygen
equipment at home.”
13. Susan, an eight-year-old child has cerebral palsy, a 18.Which of the following are defects associated
tracheostomy, and is oxygen (O2) dependent. During with tetralogy of Fallot?
an initial visit to the home, the nurse would include a. Coarctation of the aorta, aortic valve
which of the following questions in an environmental stenosis, mitral valve stenosis, and patent
safety assessment? ductus arteriosus
a. “Are there drafts or air leaks in the home?” b. Ventricular septal defect, overriding aorta,
b. “Are there other children in the home?” pulmonic stenosis, and right ventricular
c. “Does anyone smoke in the home?” hypertrophy
d. “Are the pets in the home?” c. Tricuspid valve atresia, atrial septal defect,
14. Which of the following definitions most ventricular septal defect, and hypoplastic
accurately describes meningocele? right ventricle
a. Complete exposure of the spinal cord & d. Aorta exists from the right ventricle,
meanings pulmonary artery exists from the left
b. Herniation of spinal cord and meninges ventricle, and two non-communicating
into a sac circulations
c. Sac formation containing meninges and 19.Chris, 2 mos, is suspected of having coarctation
spinal fluid of the aorta. The cardinal sign of this defect is:
d. Spinal cord tumor containing nerve roots a. Clubbing of the digits and circumoral
15. The nurse is performing an admission assessment cyanosis
on a 6-month-old infant with a diagnosis of b. Pedal edema and portal congestion
hydrocephalus. The nurse assesses for the major c. Systolic ejection murmur
symptom associated with hydrocephalus when the d. Upper extremity hypertention
nurse: 20.A 10 – year old child is admitted with
a. Test the urine protein rheumatic fever. In addition to carditis, the nurse
b. Takes the apical should assess the child for the presence of
c. Palpates the anterior fontanel a. Arthritis
d. Takes the BP b. Bronchitis
c. Malabsorption
CARDIOVASCULAR NURSING d. Oliguria
16. Which of the following disorders leads to RESPIRATORY NURSING

cyanosis from deoxygenated blood entering the
systemic arterial circulation? 21. Which of the following manifestations in a six-
a. Patent ductus arteriosus week-old Little Benilda who was born prematurely
b. Tetralogy of Fallot would lead a nurse to suspect that Little Benilda
c. Coarctation of the aorta may have apnea?
d. Aortic stenosis a. Intermittent episodes of acrocyanosis for
17.When developing a teaching plan for the periods of 10 minutes
parents of a child with pulmonic stenosis, the b. Random episodes of breath holding during
nurse would keep in mind that this disorder periods of stress
involves which of the following? c. Transient episodes of mottling with
a. Return of blood to the heart without entry environmental temperature changes
into the left atrium d. A lapse of spontaneous breathing for 20 or
more seconds
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Screening Exam
22.When caring for preterm infants with six years ago. She has now been admitted to the
respiratory distress, the nurse should keep: hospital for an emergency appendectomy.
a. Them prone to prevent aspiration Which operative procedure should the nurse
b. Them in a high-humidity environment withhold?
c. Their caloric intake low to decreases a. Administering a cleansing enema
metabolic rate b. Starting an IV
d. Their oxygen concentration low to prevent c. Keeping her NPO
eye damage d. Obtaining a blood sample for a CBC
23.The nurse is caring for an 8-month old infant 29.A nurse would assess a three-year-old child
because of Pneumonia. Nurse is alert to look for who has Hirschsprung’s diseases (HD) for
early signs of respiratory distress which includes: which of the following manifestations?
a. nasal flaring and substernal retractions a. Prolapsed rectum and mucous stools
b. drooling and wheezing b. Tight rectal sphincter and watery stools
c. poor skin turgor and sunken eyeballs c. Periumbilical pain and clay-colored stools
d. clubbing and cyanosis d. Abdominal distention and ribbon-like
24. A young child is placed on droplet stools
precautions. The nurse is caring for which of the 30.A child admitted for intussusceptions is
following clients? scheduled for Barium enema. The father asks the
a. A child with cystic fibrosis. nurse regarding the purpose of the procedure. The
B .A child with tonsillitis. nurse is correct to say that it will:
c. A child with bronchitis. a. Increase the peristalsis of bowel
d. A child with pertussis. b.Will reduce the intussusceptions
25. The nurse is assessing an infant who had a c. Aids in visualization of other bowel
repair of a cleft lip and palate. The respiratory obstruction
assessment reveals that the infant has upper d.Helps in evacuation of fecal material in the
airway congestion and slightly labored bowel
respirations. Which of the following nursing
actions would be MOST appropriate? GENITOURINARY NURSING
a Elevate the head of the bed.
b. Suction the infant's mouth and nose. 31. A baby boy has been circumcised. Which of
c. Position the infant on one side. the following interventions is part of the initial
d. Administer oxygen until breathing is easier. care of a circumcised neonate?
a. Apply alcohol to the site.
b. Change the diaper as needed.
GASTROINESTINAL NURSING c. Keep the neonate in supine position.
d. Apply petroleum gauze to the site for 24
26. Which of the following if done by the nurse hours
would be appropriate in feeding a post- 32. Which of the following responses would be the
palatoplasty patient? earliest indication that a child who has acute
a. feed using a nipple with large hole glomerulonephritis is responding positively to
b. give water before feeding treatment?
c. use a rubber-tip syringe when feeding a. Decrease in appetite
d. allow the patient to drink from a cup b. Decrease in blood pressure
27.When assessing a 2-month old infant suspected c. Increase in urinary output
of having pyloric stenosis, the nurse would expect d. Increase in energy level
which of the following findings? 33 .Tyrone, age 4 years, has just been diagnosed as
a. absence of bowel sounds having nephrotic syndrome. His potential for
b. ribbon-like stools impairment of skin integrity is related to:
c. decrease appetite a. Joint inflammation
d. visible peristalsis b. Muscle cramps
28. Janie, age 9, has celiac disease, which has been c. Edema
in good control since it was diagnosed d. Generalized body rash
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Screening Exam
34.Walter is 20 months old and admitted to the d. Obtain blood specimens for analysis.
hospital with the diagnosis of cryptorchidism. 39. A 15-year old client has been placed in a
Surgical correction is performed at this time to Milwaukee brace. Which one of the following
prevent: statements from the client indicates the need for
a. Difficulty urinating additional teaching?
b. Sterility a. “I will only have to wear this for 6
c. Herniation months.”
d. Peritonitis b. “I should inspect my skin daily”
35. Sally, 17 years old is admitted to the hospital c. “The brace will be worn day and night”
with a diagnosis of acute renal failure. Nursing d. “I can take it off when I shower”
interventions for acute renal failure should 40. Ethel. Age 14, is in a hip spica cast. To turn her
include all of the following, except: correctly, the nurse should:
a. administering oxygen a. Use the cross bar
b. encouraging coughing and deep breathing b. Turn her upper body first, then turn the
exercises lower body
c. placing her in Semi-fowler’s position c. Log-roll body
d. replacing fluids d. Tell her to pull on the trapeze and sit up
to help in turning
MUSCULOSKELETAL/INTEGUMENTARY
NURSING HEMATOLOGIC & ONCOLOGIC NURSING
36.A routine physical examination on 2 day-old 41. A four-year-old child who has multiple
Melissa uncovered evidence of congenital traumas is brought to the emergency department
dislocation of the right-side hip. When assessing in hypovolemic shock. The child’s blood type is
Melissa, a sign of one sided hip displacement is: known to be A-positive. The blood bank sends
a. An usually narrow perineum O-negative blood for replacement therapy. The
b. Pain where her leg is abducted nurse should administer the O-negative blood
c. Symmetrical skin folds near her buttocks because:
and thigh a. individuals with any blood type can
d. Asymmetrical skin folds over her receive O-negative blood
buttocks b. severe volume depletion is an indication
37.Prior to surgery for correction of congenital hip to administer whichever blood is
dysplasia in a four-month-old-infant, which of available in an emergency
the following homecare instructions would a c. a child this age has not yet developed
nurse include in the teaching plan for the infant’s antibodies against O-negative blood.
family? d. Any blood type can be given in an
a. “Apply double diapers when changing emergency if resuscitative drugs are
the infant.” available.
b. “Perform passive range-of-motion on the 42. A nurse should expect a six-month-old infant
lower extremities.” who has iron deficiency anemia to have which of
c. Support the legs in a adducted position the following findings?
with pillows during sleep.” a. Weight for length at the 25th percentile
d. “Avoid placing the infant in an upright b. Pale, chubby appearance
position.” c. History of a fractured clavicle at birth
38 A 4-year-old girl is brought to the hospital for d. Delayed eruption of primary teeth
treatment of second- and third-degree burns 43. Marie Rose, a very studious student often stay
sustained in a house fire. An intravenous infusion late at night studying. Right now she is
is started in the patient's left forearm. The nurse complaining of easy fatigability and dizziness.
knows that the primary purpose of the IV is to She was brought by her mother to the family
a. Provide a route for pain medications. physician with tentative diagnosis of Anemia.
b. Maintain fluid balance. What blood examination would be requested?
c. Prevent gastrointestinal upset. a. Platelet count
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Screening Exam
b. Hemoglobin count d. Share the information with the Pediatric
c. Hematocrit count Social Worker
d. White Blood cell count 49. To help a mother anticipate the safety needs of
her nine-year-old son who is learning to ride a
bicycle, the nurse would teach that
a. a helmet will reduce his risk of head
44.Anton, age 10, has hemophilia A and admitted injury
to the hospital for hemarthrosis of the right knee. b. the child must never ride without a friend
He is in great deal of pain. Which of the following c. a formal course of instruction is needed
interventions would aggravate his condition? d. the child must ride on the sidewalk
a. Applying ice bag to the affected knee 50. When assessing the knowledge of an
b. Administering aspirin for the pain relief adolescent regarding safety, the nurse should
c. Elevating the leg above the level of heart consider the leading cause of death in this age
d. Keeping the right leg immobilized group, which is
45.Which of the following test is most helpful in a. motor vehicle accidents
diagnosing hemophilia? b. suicide
a. Bleeding time c. poisoning
b. Partial thromboplastin time d. drug overdose
c. Platelet court
d. Complete blood count (CBC) MATERNITY NURSING
ABUSE & POISONING ANATOMY & PHYSIOLOGY/MENSTRUATION
46.Jimmy Jose, 2 years old, is brought to the 51.The hypothalamus begins menstrual cycle
pediatric clinic with an upper respiratory with the production of which hormone?
infection. After assessing Jimmy, the nurse a. FSH
informs the physician that she suspects this child b. GnRH
may be a victim of child abuse. Physical signs that c. Estrogen
almost always indicate child abuse are: d. Progesterone
a. Diaper rash 52.The hormone that is secreted by the corpus
b. Bruises on the lower legs luteum and prepares the endometrium for
c. Asymmetrical burns on the legs implantation is:
d. Welts or bruises in various stage of a. Estrogen
healing b. luteinizing hormone
47. A nurse conducts a community education c. Progesterone
program on child abuse. A primary preventive d. Prostaglandin
strategy for child abuse would be that the parents: 53.A new mother is going to breast feed her baby.
a. finish high school What is the best indication that the let-down
b. move in with family reflex has been achieved in a nursing mother?
c. visit a safe house a. Increased prolactin levels
d. attend a parenting class b. Milk dripping from the opposite breast
48. A two-year-old is admitted to the pediatric c. Progressive weight gain in the infant
unit with numerous bruises, a fractured left d. Relief of breast engorgement
humerus, and several lacerations with 54.The pituitary hormone that stimulates the
unexplained origin. The nurse would identify secretion of milk from the mammary glands is:
which of the following as a priority nursing a. Prolactin
action? b. Oxytocin
a. Report the findings to the DSWD c. Estrogen
b. Share this information only with other d. Progesterone
health care professionals. 55.At 38 weeks gestation an amniocentesis is done
c. Document this information in the chart. to determine fetal maturity. The proper L/S ratio
for lung maturity is:
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Screening Exam
a. 1:1 61.A 28 year old woman comes to take prenatal
b. 1:2 clinic because she thinks she might be pregnant.
c. 2:1 She tells the nurse that her menstrual periods are
d. 1.5:1 irregular but, since her last menses seven weeks
ago, she noticed some physiologic changes in her
body. Which findings should the nurse expect
when assessing the woman for a probable sign of
CHILD BEARING CYCLE pregnancy?
a. Morning sickness
56.A 37-year old pregnant mother on underwent b. Urinary frequency
Amniocentesis. How will the nurse ensure that c. A positive pregnancy test
the mother is not having a complication? d. Auscultation of fetal heart sounds.
a. assess fetal heart rate using a stetoscope 62.A positive early diagnosis of pregnancy is
b. assess maternal vital signs based on the presence of:
c. maintain adequate fluid intake a. Quickening
d. give O2 at 3-4 liters/minute b. Chadwick’s sign
57.The nurse knows that an Alpha-feto Protein c. A feel heart rate
Test is used in pregnancy in order to screen for : d. Chorionic gonadotropin
a. diabetes mellitus 63.In a client’s 10th week of pregnancy, the presumptive
b. pregnancy-induced hypertension signs of pregnancy that might be assessed by the nurse
c. neural tube defects include:
d. congenital heart disease a. Fatigue, abnormal enlargement, and HCG in her
58.A Gravida 2 Para 1 mother says that during her urine
first pregnancy, she occasionally drinks alcohol b. Abdominal enlargement, urinary frequency, and
and yet her daughter is normal. What is an nausea
appropriate response by the nurse? c. Nausea and vomiting, urinary frequency, and
a. “it’s all right to take alcohol but make sure nausea
to take it in moderation” d. Breast changes, abdominal enlargement, and
b. “alcohol consumption anytime during urinary frequency
pregnancy puts the baby at risk” 64.A client at 10 weeks gestation tells the nurse
c. “alcohol helps in digestion, you can have it that she voids often, without dysuria, and would
anytime you want” like to know what to do. The nurse is aware that
d. “ alcohol is safe if taken occasionally” this client will have to:
59. 15-year old primigravida needs more of the a. Decrease her fluid intake during the day
following nutrients compared to a 27-year old b. Contact her physician as soon as possible
primigravida? c. Maintain increased fluid intake during the day
a. calcium d. Try to resist the urge to void as long as possible
b. iron 65. During initial assessment, a 24-year old woman tells
c. vitamin c the nurse that she is pregnant because she feels the baby
d. glucose is moving or “fluttering around”. The nurse recognizes
60. Ricky F., 28 years old, has had diabetes this as:
mellitus since she was an adolescent. She is 8 a. presumptive sign
weeks pregnant. Hyperglycemia during Vicky’s b. probable sign
first trimester will have what effect on the fetus? c. positive sign
a. Hyperinsulinemia d. possible sign
b. Excessive fetal size
c. Malformed organs ANTEPARTAL PERIOD
d. Abnormal positioning
66.Between 12 and 24 weeks gestation, applicable
CHANGES IN PREGNANCY prenatal teaching for a pregnant client should
include information about:
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Screening Exam
a. Preparation for the baby, travel to the hospital, c. cervix is fully dilated
signs of labor d. at the onset of labor
b. Growth of the fetus, personal hygiene, and
nutritional guidance
c. Growth of the fetus, interventions for nausea and
vomiting, expectations for care 73. Nursing assessment: active labor, breech
d. Danger signs of preeclampsia, relaxationpresentation, ruptured membranes, a change in
breathing techniques, and signs of labor location of fetal heart sounds.Nurse evaluates this as:
67.The nurse explains to a pregnant couple that in a. a fetus in distress
childbirth classes the emphasis is on: b. a normal assessment
a. Birth is a family experience c. a sign labor is progressing
b. Labor without using analgesics d. indicative of cesarean section
c. Nutrition, relaxation, and breathing 74.The woman pregnant for the first time comes
d. Education, breathing, and exercise to the hospital in labor. Which of the following
68..Rose is in prenatal clinic and tells the nurse symptoms is indicative of true labor?
that her last menstrual period was July 18th. The a. pain in the back
nurse uses Nagele’s rule to calculate the due date b. irregular contractions
ad being about: c. walking doesn’t increase the pain
a. April 8th d. no change in intensity of contractions
b. April 15th 75.A patient in labor was placed on external fetal
c. April 25nd monitor and the nurse was assigned to monitor
d. April 29th the fetal heart beat. The nurse knows that a sign
69. A pregnant client who has one living child of uteroplacental insufficiency would be:
resulting from a full-term pregnancy has also had a. decrease of fetal heart rate at start of
two spontaneous abortions. She is recorded as contractions
being: b. increase of fetal heart rate at acme of
a. Gravida IV, para I contraction
b.Gravida I, para IV c. decrease of fetal heart rate at end of
c. Gravida II, para III contraction
d.Gravida III, para II d. increase of fetal heart rate before peak of
70.Folic acid supplements are prescribed for a contraction
prenatal client. The nurse is aware that that
these are necessary to prevent: POSTPARTUM PERIOD
a. Pernicious anemia
b. Anaphylactic shock 76.A woman suffers from vaginal and cervical
c. Neural tube defects laceration during delivery. The nurse is correct in
d. Erythroblastosis fetalis concluding that the trauma is due to:
a. placenta previa
LABOR & DELIVERY b. abruptio placentae
c. precipitate labor
71.The woman who is dilated at 7 cm is beginning d. incompetent cervix
to bear down and push. The nurse discourages 77.On the second day postpartum, the nurse asks
pushing at this point in the labor process because the new mother to describe her vaginal bleeding.
a. pushing does not aid in delivery The nurse should expect her to say that it is:
b. pushing should always be avoided a. Red and moderate
c. pushing should begin at full dilatation b. Pinkish with clots
d. pushing should begin at 8 cm dilatation c. Scant and brownish
72.A gravida III para II is in labor and d. Thin and whitish
progressing rapidly. When should she be moved 78.Jane S., is a gravida 1, in the active phase of
into the delivery room? stage 1 labor. The fetal position is LOA. When
a. cervix is dilated 2-4 cm Jane’s membranes rupture, the nurse should
b. cervix is dilated 7-8 cm expect to see:
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Screening Exam
a. A large amount of bloody fluid a. board-like abdomen
b. A moderate amount of clear to straw b. painless vaginal bleeding
colored fluid c. dark red bleeding
c. A small amount of greenish fluid d. fetal bradycardia
d. A small segment of the umbilical cord 85. The nurse is aware that a common nursing
79.Who among the pregnant clients are at risk for diagnosis for clients following an abdominal
post partum hemorrhage? hysterectomy is:
a. Client with Diabetes Mellitus a. Sexual dysfunction
b. Client who have just delivered twins b. Reflex incontinence
c. Client who had previous abortion c. Risk for disuse syndrome
d. Client who is Rh negative d. Altered growth and development
80.What is the assessment finding in a post
partum patient with vaginal hematoma? FERTILITY & INFERTILITY
a. pulling sensation in vaginal opening
b. itchiness in vaginal opening 86.When obtaining the health history from a client
c. pain in vaginal opening who is seeking contraceptives information, the
d. burning sensation on urination nurse should consider that oral contraceptives
are contraindicated for a client who:
MEDICAL DISORDERS IN PREGNANCY a. Is older than 30 years
b. Smokes a pack of cigarettes per day
81.Most appropriate nursing diagnosis for a client c. Has a history of borderline hypertension
with ruptured ectopic pregnancy would be: d. Has had at least one multiple pregnancy
a. Risk for infection 87.A client is taking oral contraceptives. The nurse should
b. Fluid volume excess inform the client to stop taking the contraceptive and
c. Decreased cardiac output report to the physician immediately if she experiences:
d. Altered health maintenance a. Vertigo and nausea
82.A client with mild preeclampsia is told that she b. Weight loss and breast pain
must remain on bed rest at home. The client starts c. Hypo tension and Amenorrhea
to cry and tells the nurse that she has two small d. Headaches and visual disturbances
children at home who need her. The nurse’s best 88.When teaching about normal childbearing and
response would be: contraceptive options, the nurse explains that
a. “You’ll need someone to care for the children. fertilization of the ovum by the sperm occurs
b. “You are worried about how you will be when:
able to mange.” a. The male sperm count is high
c. “You can get a neighbor to help out, and b. The ovum reaches the endometrium of the uterus
your husband can do the housework c. The sperm successfully penetrates the wall of the
in the evening.” ovum
d. “You’ll be able to fix light meals, and the d. The sperm prevents the ovum from moving along
children can go to nursery school a few the tube
hours each day.” 89.A couple have been married for 5 years and
83. A client with preeclampsia who is would like to start a family. When talking with
receiving magnesium sulfate (MgSO4) is showing them regarding the timing and frequency of their
signs of magnesium toxicity. The nurse is sexual intercourse, the husband says, “Well, I
aware that these signs can be reversed guess we are going to have to jump into bed three
by the administration of: or four times a day, every day until it works.” The
a. Calcium gluconate (Kalcinate) nurse’s best response would be to:
b. Edentate disodium (Disodium EDTA) a. Tell them to continue relations as usual until the
c. Hydralazine hydrochloride (Apresoline) tests are completed
d. Sodium polystyrene suffocate (Kayexalate) b. Instruct them on the frequently and timing of
84.The nurse knows that sign/symptom of a intercourse for conception
patient with placenta previa includes, which of
the following?
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Screening Exam
c. Discourage this behavior because sperm
production decreases with frequent
intercourse 94.A client with a large fetus is to have a
d. Agree that the frequency of intercourse must pudendal block during the second stage of labor.
increase, but three of four times daily isThe nurse plans to instruct the client that once the
excessive block is working she:
90.After 5 years of unprotected intercourse, a a. Will not feel an episiotomies
childless couple comes to the infertility clinic. b.May lose the ability to push
The husband tells the nurse that his parents have c. May lose bladder sensation
promised to make a down payment on a house for d.Will no longer feel contractions
them if his wife gets pregnant this year. The 95.After a hysterosalpingo-oophorectomy a client
nurse’s best response to this comment would be: wants to know if it would be wise for her to take
a. “How do the two of you fell about having a baby?” hormones right away to prevent symptoms of
b. “You’re lucky; I wish someone would give me a menopause. The most appropriate response by
down payment for a house” the nurse would be:
c. “Five years without a pregnancy is a long time. Do a. “It is best to wait; you may not have not
you think there is something wrong with both of have any symptoms at all.”
you? b. “You have to wait until symptoms are
d. “You know, you don’t have to worry about severe; otherwise, hormones will have no
satisfying your parents. Having a child should be a effect.”
decision you make” c. “Isn’t it comforting to know that
hormones are available if you should
OBSTETRIC SURGERY really need them?”
d. “This is something you should discuss
91.Mary had a midline episiotomy performed at with your physician to know how you
delivery. The primary purpose of the episiotomy feel and what your concerns are.”
is to:
a. Allow forceps to be applied MENOPAUSE
b. Enlarge the vaginal opening
c. Eliminate the possibility of lacerations 96.Mrs. Jane M, is 64 years old, postmenopausal,
d. Eliminate the need for cesarean birth and takes calcium supplements on a daily basis.
92.During delivery, a mediolateral episiotomy is She can reduce the danger of renal calculi by the
performed and Ms. Brown delivers a 7 lb and 8 oz simple action of
girl. To detect postpartum complications in Ms. a. Chewing her calcium tablets rather than
Brown as soon as possible, the nurse should be swallowing them whole
expecting the following except: b. Swallowing her calcium tablets with
a. A foul lochial odor cranberry juice
b. Discomfort while sitting c. Eliminating other sources of calcium from
c. Ecchymosis and edema of the perineum her diet
d. Separation of the episiotomy wound edges d. Drinking 2-3 quarts of water daily
93.A client in the active phase of labor has just 97.Mrs. Frances D, 57 years old and having a
been given continuous epidural anesthesia. routine physical exam. Which of the following
Which assessment findings indicates to the nurse assessments would yield critical information as to
that the client is experiencing a common side her postmenopausal status?
effect of type of anesthesia? a. Asking about weight loss of more than 5 lb
a. Blood pressure of 70/50 in the last year
b. Uterine pain b. Asking about her nightly sleep patterns
c. Fetal heart rate of 140 c. Asking about her cultural background
d. Euphoria d. Asking her last pregnancy
98.The nurse knows that sign/symptom of
menopause includes the following:
a. hot flashes
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b. weight loss 104. A client with Myasthenia Gravis asks the
c. diarrhea nurse why the disease has occured? The nurse
d. diabetes bases the reply on the knowledge that there is a :
99. The nurse knows that the primary purpose of a. a genetic defect in productionof
estrogen replacement therapy following surgical acetylcholine
menopause is to prevent: b. a reduced amount of neurotransmitter
a. arthritis Acetylcholine
b. pregnancy c. a decreased number of functioning
c. breast cancer Acetylcholinereceptor sites
d. vasomotor instability d. an inhibition of the enzyme AchE leaving
100. A bone mineral analysis reveals that Mrs. the end plates folded
Green who is postmenopausal has severe 105. Following a spinal cord injury, the
osteoporosis. Which of the following instructions physician indicates that the client is
should the nurse give to Mrs. Green’s family to paraplegic.The family asks the nurse what this
ensure a safe environment for Mrs. Green? means.The nurse explains that:
a. “Disinfect the bathroom weekly.” a. upper extremities are paralyzed
b. “Carpet floor surfaces.” b. lower extremities are paralyzed
c. “Install handrails on stairways.” c. one side of the body is paralyzed
d. “Keep the lights dim.” d. both lower and upper extremity are
paralyzed
MEDICAL SURGICAL NURSING
NEUROLOGIC NURSING CARDIOVASCULAR NURSING
101. The nurse is assessing the optic nerve of a 106. The nurse is performing physical assessment
client. Which of following is a correct method to of a patient with suspected valvular
evaluate cranial nerve (CN) II, the optic nerve? problem. The nurse is properly assessing
a. Inspect the pupils for reaction. the Mitral Valve by placing her stethoscope
b. Test extraocular movements. over:
c. Use of the Snellen chart. a. 2nd ICS right parasternal border
d. Test for a corneal reflex. b. 2nd ICS left parasternal border
102. The nurse is caring for an adult client who c. 4th ICS left parasternal border
was admitted unconscious. The initial assessment d. 5th ICS left midclavicular line
utilized is the Glasgow Coma Scale. The nurse 107. Chito Miguel,64-years old is complaining of
knows that GCS is a systematic neurologic chest pain To assess his condition, whether
assessment tool that evaluates all of the following he is suffering from MI or angina. Which of
except: the following would you expect to find in
a. eye opening the assessment?
b. motor response a. characteristics of chest pain
c. pupillary reaction b. blood pressure reading
d. verbal performance c. duration of chest pain
103. When comparing a cerebrovascular accident d. frequency of chest pain
(CVA) to a transient ischemic attack (TIA), the 108. Which sign would the nurse monitor closely
nurse understands that a TIA is if a patient takes nitroglycerine?
a. Permanent with long-term focal deficits. a. tachycardia
b. Intermittent with spontaneous resolution of b. hypotension
the neurologic deficit. c. toxicity
c. Intermittent with permanent motor and d. hypertension
sensory deficits. 109. Mrs. H is admitted to the Coronary Care Unit
d. Permanent with no long-term neurologic to rule out a myocardial infaction. She tells the
deficits. nurse that she is sure that it is just angina and
cannot understand the difference between angina
& infarct pain. Which response is most
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appropriate for the nurse to make to Ms. H. b. fluctuations in the water seal chamber
statement? c. intermittent bubbling when the suction is
a. anginal pain produces clenching of the turned on
fist over the chest while acute MI pain d. vesicular breath sounds throughout the
does not lung fields
b. anginal pain requires morphine for relief 115. M r Fernandez was confined due to
c. anginal pain radiates to the left arm while pneumonia. After your physical assessment to Mr
acute MI does not Fernandez, which of the following signifies that
d. anginal pain usually lasts only 3-5 minutes he is having pneumonia?
110. Oxygen is ordered for a patient diagnosed a. chest auscultation reveals bronchial breath
with Acute Myocardial Infarction. Administering sounds
oxygen to this client is related to which of the b. equal chest wall expansion occurs during
following client problems? inspiration
a. anxiety c. tactile fremitus is decreased over the
b. chest pains affected area
c. alteration in myocardial perfusion d. percussion is clear over areas of
d. alteration in rate rhythm and conduction pneumonia
RESPIRATORY NURSING ENDOCRINOLOGIC NURSING
111. What clinical manifestations would the nurse 116. A newly diagnosed patient with diabetes
expect in a patient with PTB? mellitus was admitted to your unit. She wanted to
a. hemoptysis and weight gain know as much as possible about the disease. The
b. dry cough and blood streaked sputum following are characteristics of NIDDM, except:
c. productive cough and afternoon fever a. commonly occurs after age of 40
d. night sweats and urticaria b. there is absolute deficiency of insulin
112. Category 3 of pulmonary tuberculosis is c. related to obesity
prescribed to: d. ketosis resistant
a. new PTB patients whose tuberculin skin 117. Ms. Angie Lu is admitted in the hospital
test is positive because of easy fatiguability for the past few
b. new PTB patients whose chest x-ray months. After a series of examinations, a
revealed minimal PTB diagnosis of hyperthyroidism was confirmed.
c. previously treated patients who are on An assessment was made, the least symptom that
relapse she would experience is:
d. previously treated patients who are a. tremors of the hands
failures b. hyperactivity
113. Mr Tatad was diagnosed with COPD, c. palpitations
Emphysema. The doctor’s order states: ”Do not d. drowsiness
give oxygen” The basis for this order is that 118. A patient was diagnosed with Addison’s
administration of oxygen at this point may Disease and was admitted due to weakness and
produce: dehydration. Your initial assessment confirms the
a. bronchial spasm nursing diagnosis of Fluid volume deficit which
b. pulmonary hypertension is related to:
c. overdistention of emphysematous alveoli a. mineralocorticoid deficit
d. respiratory arrest b. glucocorticoid excess
c. glucocorticoid deficit
114. Bert has a chest tube inserted and connected d. melanocyte-stimulating hormone excess
to a water seal drainage.The nurse determines 119.The nurse is performing physical assessment
that the system is functioning correctly when of a patient diagnosed with Cushing’s Disease.
which of the following is observed? The nurse expects to find which of the following?
a. continuous bubbling in the water seal a. dry, flaky skin
chamber b. fine hand tremors
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c. facial hair seconds, and thirst. The nurse assessing the
d. decreased breath sounds patient should be aware that these signs and
120. Initial action of the nurse for a patient with symptoms are indicative of
diagnosis of Diabetes Insipidus? a. gall bladder inflammation
a. obtain random blood sugar b. intra-abdominal hemorrhage
b. check urine specific gravity c. septicemia
c. strain all urine for stones d. cardiogenic shock
d. get specimen for fasting blood sugar
determination GENITOURINARY NURSING
GASTROINTESTINAL NURSING 126. A follow-up home visit conducted on an

elderly Mrs. White after a recent hospitalization.
121. The nurse should be aware that the correct Mrs. White reports nocturia. Which of the
order for physical assessment of the abdomen is following patient instructions by the nurse would
a. Inspect, auscultate, percuss and palpate most effectively address Mrs. White’s nocturia?
b. Inspect, palpate, auscultate and percuss a. “Avoid liquids after 5 pm.”
c. Inspect, percuss, palpate and auscultate b. “Keep a low-wattage light on in the
d. Inspect, palpate, percuss and auscultate hallway.”
122. Which of the following instructions should a c. “Wear a disposable undergarment at
nurse include in the discharge teaching for a bedtime.”
patient who has been diagnosed with hepatitis B? d. “Obtain a bedside commode.”
a. “Avoid alcoholic beverages.” 127. The nurse caring for a patient with renal
b. “Consume a diet low in fat.” disease should be aware that one of the most
c. “Stay in a darkened room.” common factors contributing to renal failure is
d. “Take acetaminophen (Tylenol) for a. diabetes mellitus.
headache.” b. alcohol abuse.
123. To which of the following nursing diagnoses c. morbid obesity.
should a nurse give priority in the care of a d. bile stones
patient who has cirrhosis of the liver and an 128. Which of the following dietary changes
elevated serum ammonia level? would a nurse implement with a patient who is in
a. Risk for infection the acute stage of nephritic syndrome?
b. Colonic constipation a. Increase iron
c. Altered thought processes b. Increase calcium
d. Ineffective thermoregulation c. Decrease sodium
124. A 73-year-old with a history of hepatitis B is d. Increase protein
being discharged for the outpatient center after an 129. A patient admitted to the hospital with a
abdominal paracentesis. The patient asks if she diagnosis of chronic renal failure should be
can take aspirin for nay discomfort. The nurse’s assessed for which of the following
response should be based on which of the manifestations?
following statements? a. Hypotension
a. Enteric-coated aspirin would decrease b. Fatigue
gastric distress c. Flushed skin
b. Aspirin is contraindicated d. Painful urination
c. Acetaminophen provides more effective 130. A client who is receiving a blood transfusion
pain control experiences a hemolytic reaction. The nurse
d. Pain medication should not be necessary would anticipate which of the following
following the procedure assessment findings?
125. A patient arrives at the emergency a. Hypotension, backache, low back pain, fever.
department with a history of a fall and a b. Wet breath sounds, severe shortness of breath.
complaint of abdominal pain. Assessment c. Chills and fever occurring about an hour after
findings are blood pressure 101/68, pulse 116 and the infusion started.
regular, respiration 24, capillary refill four d. Urticaria, itching, respiratory distress
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accompanied by formation of large calcium
MUSCULOSKELETAL-INTEGUMENTARY deposits, which cause swelling and joint
NURSING pain.
135. Compartment syndrome occurs under which
131. A client uses a cane for assistance in walking. of the following conditions?
Which of the following statement is true about a. increase in scar tissue
cane or other assistive devices? b. increase in bone mass
a. a walker is a better choice than a cane c. decrease in bone mass
b. the cane should be used on the affected d. hemorrhage into the muscle
side
c. the cane should be used on the unaffected INFECTIOUS NURSING
side
d. a client with osteoarthritis should be 136. The nurse provides discharge instructions to
encouraged to ambulate without the cane Ms. Red with hepatitis B. Which of the following
132. The nurse is providing health teaching to Ms. statements, if made by Ms. Red, would indicate
Cruz, 36 years old who is visiting who has been the need for further instruction?
hospitalized for repair of fractured hip. The a. “I can never donate blood.”
physician told her that her mother has severe b. “I can never have unprotected sex.”
osteoporosis and that this was a contributing c. “I cannot share needles.”
factor to present problem. Ms Cruz has many d. “I should avoid drugs and alcohol
questions for the nurse regarding her risk for 137 The mother of a child with chickenpox asks
developing osteoporosis. Which statement by Ms. the physician's office nurse why her child will not
Cruz indicates that she does fully understand the come down with chickenpox again if exposed to
relationship between exercise and maintenance of the virus at school at a later date. The nurse's
bone mass? response should be based on the information that
a. I will begin jogging a. Natural passive immunity occurs because the
b. I will begin jumping rope child receives antibodies from outside the
c. I will begin swimming body.
d. I will begin walking b. Artificial active immunity occurs because the
133. Health teaching the nurse will provide to a child receives specific antigens against the
patient diagnosed with osteoarthritis. chickenpox virus.
a. perform weight bearing exercises daily to c. Natural active immunity occurs because the
stimulate bone formation child's body actively makes antibodies
b. avoid foods such as sardines and organ against the chickenpox virus.
meats d. Artificial passive immunity occurs because of
c. weight reduction the inflammatory process of chickenpox.
d. report side effects such as skin rashes with 138. A 28-year-old client is admitted to the
gold therapy hospital unit with hepatitis A. The nurse knows
134. A 55-year-old complains of a sudden onset of that the client's overall care during hospitalization
pain the ankle, which is swollen, red and should include which of the following?
extremely sensitive to pressure. A diagnosis of a. Protective isolation.
acute gout is made. The client asks the nurse b. Airborne precautions.
about gout. The nurse teaches him that gout is: c. Standard precautions.
a. A metabolic disorder that results in d. Droplet precautions.
elevated serum uric acid levels 139. Which of the following laboratory values
b. An infection of the synovial membrane by would the nurse expect to be elevated in Ms.
microorganism, resulting in Purple with a parasitic infection who recently
inflammation immigrated to the United States?
c. A disease of cartilage resulting in a. White blood cell count
destruction of the cartilage and the b. Reticulocyte count
underlying bone, causing severe pain c. Eosinophils count
d. Inflammation of the bursal sac d. Sedimentation rate
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140. The nurse is caring for clients in the student decreased appetite and a significant weight loss
health center. A client confides to the nurse that in the past three weeks. Which of the following
the client's boyfriend informed her that he tested actions should the nurse take first?
positive for hepatitis B. Which of the following a. Recommend multiple small feedings of
responses by the nurse is BEST? high-protein foods
a.” That must have been a real shock to you." b. Plan to include the majority of calories for
b. "You should be tested for hepatitis B." the day at breakfast
c. "You'll receive the hepatitis B immune globulin c. Apply the standard care plan for altered
(HBIG)." nutrition: less than body requirements
d. "Have you had unprotected sex with your d. Collect additional information to
boyfriend?" determine potential causes of the weight
loss
FLUIDS & ELECTROLYTES 147. A client had surgery for cancer of the colon,
and a colostomy was performed. Prior to
141. The major role in maintaining fluid balance discharge, the client states that he will no longer
in the body is performed by the: be able to swim. The nurse's response would be
a. Liver based on which of the following?
b. Heart a. Swimming is not recommended; the client
c. Lungs should begin looking for other areas of
d. Kidneys interest.
142. A patient is experiencing diarrhea. The nurse b. Swimming is not restricted if the client wears a
expects which of the following laboratory values? watertight dressing over the stoma.
a. Metabolic Acidosis c. The client cannot go into water that is over the
b. Respiratory Acidosis stoma area; he can go into water only up to
c. Metabolic Alkalosis that area.
d. Respiratory Alkalosis d. There are no restrictions on the activity of a
143. The nurse is aware that fluid deficit can most client with a colostomy; all previous activities
accurately assessed by: may be resumed.
a. A change in body weight 148. A priority nursing intervention for the care of
b. The presence of dry skin a terminally ill with Mrs. Burgundy diagnosed
c. A decrease in blood pressure with metastatic cancer is
d. An altered general appearance a. Maintaining bowel function.
144. When teaching parents first aid for minor b. Alleviating and relieving pain.
burns, a nurse should instruct the parents to c. Preventing respiratory arrest.
a. cover the burned area with cotton gauze. d. managing chemotherapy.
b. apply ice directly to the burned area. 149. A staff nurse on an oncology unit tells the
c. coat the burned area lightly with nurse in charge that he does not want to care for
petroleum jelly. dying patients. The nurse in charge initially
d. immerse the burned area in cool water should
145. The nurse caring for an elderly trauma a. not assign the staff nurse to care for dying
patient should be aware that which of the patients
following measures should be used to accurately b. send the staff nurse to meet with the
determine fluid volume status? agency spiritual advisor
a. Urinary output determination c. ask the nurse to discuss the reason for his
b. Serial hemoglobin and hematocrit values statement
c. Invasive hemodynamic monitoring d. tell the staff nurse that he should request
d. Serial blood pressure reading a transfer to another unit
150. Which of the following physical assessment
ONCOLOGIC NURSING findings would require the nurse to refer a patient
for evaluation for breast cancer?
146. A home health nurse is visiting Mrs. Red a. Freely moveable breast lesions
with ovarian cancer. Mrs. Red has experienced
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b. Breast tenderness during or before 156. A classic full blown AIDS case is identified
menstruation by clinical manifestations such as:
c. Breast lesions with difficult-to-define a. persistent generalized
edges lymphadenopathy
d. Bilateral breast lesions b. fever, weight loss, night sweats
and diarrhea
COMMUNITY HEALTH NURSING c. tumors and opportunistic
infections
COMMUNICABLE DISEASES d. sudden loss of weight, fever,
general malaise accompanied by acute
151. Swabbing of nose and throat of diphtheria respiratory infection
clients must be avoided to prevent which 157. In giving Hepatitis B immunization, priority
outcome? is given by DOH to:
a. coughing a. at risk groups
b. bleeding b. infants 0-12 mos.
c. irritation c. pregnant women
d. membrane scale off d. aged
152. The ff. are signs and symptoms of 158. When hepatitis B client is cared by the family
schistosomiasis at home. Health teaching includes all, except:
1) low fever a. use separate dishes
2) diarrhea and dark tarry stool b. use separate thermometer
3) diarrhea and mucoid stool c. lye disinfection of feces
4) fever and chills d. meticulous handwashing
5) enlarged abdomen with 159. Narda, 2 years old, had measles last April 3,
abdominal pain weeks after her sister Kathy got sick of the same
a. 1,2,3 disease. Their brother Brien was exposed to
b. 1,3 measles but did not get sick. What type of
c. 3,4 immunity did Narda and Kathy get?
d. 1,2,5 a. artificially acquired active
153. The period of isolation for the child with b. naturally acquired passive
measles would last for: c. artificially acquired passive
a. 9 days after onset of rash and coryza d. naturally acquired active
b. 5 days after disappearance of rash 160. In view of Brien’s repeated exposure to his
c. 4 days before and 5 days after rash sisters with measles, he developed which type of
and coryza appears immunity?
d. 7 days before and after subsides a. artificially acquired active
154. The official term adopted in reference to the b. naturally acquired passive
virus which causes AIDS is: c. naturally acquired active
a. Human immunodeficiency Virus d. artificially acquired passive
b. Human lympotropic virus type III
c. Lympadenopathy-associated virus NONCOMMUNICABLE DISEASES
d. Human infectious virus 161. Results of the Nat’l Registration for Persons
155. The most common therapy in prevention of with Disabilities (PWD’s) reveal that most of
the multiplication of AIDS virus is by: them:
a. Azidothymidine or ribavirin a. belong to young age group
treatment b. belong to the elderly group
b. Replacement of destroyed immune c. belong to the productive age
cells, through bone marrow group
c. a & b d. belong to late old age group
d. none of the above
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162. What is the goal of the community-based a. participate in drug abuse
rehabilitation program? prevention education
a. Improvement of quality of life b. anticipatory guidance of
productivity of disabled vulnerable age groups
handicapped persons c. promotion of mental health
b. Reduce the prevalence of disability among families and the
through prevention, early detection, community through advocacy of
and provision of rehabilitation wholesome family living, sports
services at the community level and other participative activities
c. Provision of opportunities for d. recognition of mental health
manpower dev’t. hazards and how to minimize
d. Reduce the incidence of disability them
through prevention, early detection, 168. It refers to the burden of mental health
and provision of rehabilitation problems currently affecting the persons with
services at the community level mental disorders and is measured in terms of
163. Which is not an IEC program component of prevalence and other indicators such as the
the Community-based Rehabilitation Program? quality of life indicators and disability adjusted
a. provision for family counseling, life years.
organization of special events a. future burden
among persons with disability with b. defined burden
talents in different special events c. hidden burden
b. organization of advocacy d. present burden
c. creating a wide range of health 169. I t refers to the burden of mental health
promotion activities through face to problems resulting from the aging of the
face communication and tri-media population, increasing social problems and
campaign at all levels unrest inherited from the existing burden.
d. development and distribution of a. defined burden
information materials to target b. undefined burden
audience c. hidden burden
164. This act ensures the full participation of d. future burden
NGOs and other private sectors as supported by 170. It pertains to the portion of the burden
the nat’l. and local gov’t. agencies in endeavors relating to the impact of mental health problems
providing for the rehabilitation of the disabled. to persons other than the individual directly
a. RA 7772 affected, felt heavily by families and communities
b. RA 7727 both in human and economic loss.
c. RA7272 a. defined burden
d. RA 7277 b. undefined burden
165. Which nursing responsibility and function of c. hidden burden
the PHN is priority in terms of Drug Abuse? d. future burden
a. Case finding
b. Prevention
c. rehabilitation COMMUNITY ORGANIZING, HEALTH
d. management and treatment EDUCATION AND ENVIRONMENTAL
166. Which is not a nature of drug dependence? SANITATION
a. it is only psychological
b. is multi-faceted in nature
c. it encompasses sociological factors
d. apathy is considered a contributory
problem 171. Which of the ff. principles of Health
Education (HE) would you consider to be least in
167. What will be the nurse’s highest-priority- importance?
primary-prevention for substance abuse?
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a. Health education makes careful a. sets up action pattern to solve
evaluation of the planning, problems
organization and implementation of b. strong unity and coherence developed
all health education programs and among various organizational and
activities. leaders of the community
b. HE helps people attain health c. contributes to the establishment of an
through their own efforts. environment with different
c. Health education is a creative community resources
process d. people are given a chance to study
d. HE makes use of supplementary their problems, offer solutions and
aids and devices give a chance to plan an action
172. These are important motivating influences 177. What is the condition necessary for the
for initiating individual, family, and community success of a good organizational plan?
activities in solving health problems: a. when people who operate it will see
a. Learning about health results from a its values which are compatible
wide variety of contacts between personally and not antagonistic
members of the family, between professionally
pupils and teachers and among b. when people who operate it develop
community members a feeling of responsibility for making
b. The expressed needs and interest of the program successful
the people themselves c. when people are given a chance to
c. People’s attitudes, customs and plan an action
habits in relation to health and d. when major discussions are made by
everyday living the entire group
d. Economic and social conscience of 178. What is the 1st act of integrating yourself with
the country the people?
173. It is the sum of activities in which health a. making your courtesy call
agencies engage to influence the thinking, b. residing in your area of assignment
motivation, judgment and action of the people of c. arranging for 1st meeting with
the community: identified key leaders,
a. Community Organizing d. introducing yourself
b. Community Assembly 179. Which of the ff. is not a health education
c. Health Education teaching method?
d. Participatory Action Research a. interviewing
174. Which principle of health education would b. Nominal Group Therapy
you consider to be most important: c. Case Study
a. HE should be recognized as a basic d. Laboratory Training
function of all health workers 180. What factor, which may exercise a deleterious
b. HE is a cooperative effort effect on man’s health, well-being and survival, is
c. Health education involves considered to be a major environmental sanitation
motivation, experience and change program?
in conduct and thinking a. Water supply sanitation
d. Health education is learning b. Air pollution
175. A process by which people, health services c. Insect Vector and Rodent Control
and agencies of the community are brought d. Housing
together to learn about the common problems:
a. Program Formation
b. Community Assembly
c. Community Organization DOH PLANS, PROGRAMS AND PROJECTS
d. Immersion
176. What is the primary benefit of the answer in
# 175?
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181. The usual procedure of applying fluoride c. Give today, give tomorrow, give
solution to the teeth is to make applications after three days
about a week apart when the children are about: d. Give today, give the day after
a. 3,7,10,13 yrs. of age tomorrow, give after 1 week
b. 2,8,10,12 yrs. of age 189. How much Iron is given to prevent Iron
c. 2,8,10 yrs of age deficiency in a 9-mo. old infant?
d. 3,7,10 yrs. of age a. 0.5 mg daily
182. Using the above situation how many b. 0.6 mg daily
applications of fluoride solution will you make: c. 0.7 mg daily
a. 1 d. mg daily
b. 2 190. How much Iron is given for the treatment of
c. 3 Iron deficiency in children 0-59 mos.?
d. 4 a. 3-6 mg/kg body wt./day
183. What is the recommended amount of fluoride b. 3-8 mg/kg body wt./day
for water fluoridation? c. 8-12 mg/kg body wt./day
a. 1 part per million of fluoride d. 12-14 mg/kg body wt./day
b. 2 parts per million of fluoride
c. 1 part per 2 million of fluoride CONCEPTS, NURSE IN THE ORGANIZATION
d. 2 parts per million of fluoride AND EPIDEMIOLOGY
184. Studies show that a number of children with
new tooth decay is reduced about how many 191. Who among these nurses in the organization
percent on the average when the applications are have the longest requirement in the number of
made as recommended? years as a community health nurse?
a. 20 % a. Regional Training Nurse
b. 40 % b. Regional Nurse Supervisor
c. 50 % c. Nurse Program Supervisor
d. 90 % d. Regional Public Health Nurse
185. Which is a house-house campaign for Vit. A 192. What position of a nurse does not require at
supplementation? least 5 years experience in community health
a. Mop-up Operations nursing?
b. Araw ng Sangkap Pinoy a. Regional Training Nurse
c. National Immunization Days b. Chief Nurse in a Health Office
d. Outbreak Response c. Regional Nurse Supervisor
186. Within 1 mo. postpartum, how much Vit. A is d. City-level Nurse Supervisor
given to mothers? 193. Which among these nursing positions
a. 150,000 IU requires 3 years in a supervisory nurse position?
b. 400,000 IU a. Chief Nurse in Selected City
c. 100,000 IU Health Departments or Health
d. 200,000 IU Offices
187. Who receives 100,000 IU of Vit. A? b. Assistant Chief Nurse in Selected
a. 8-mo. old infant City Health Departments or
b. Preschoolers with high risk Health Offices
condition present c. Regional Public Health Nurse
c. 83-mo. old child d. Regional Nurse Supervisor
d. 1 mo. postpartum mother 194. Who does not belong to the group, in
188. What is the schedule for Treatment of Vit. A terms of the minimum required number of years
Deficiency? as a community health nurse?
a. Give today, give after 1 week, give a. Supervising Public Health Nurse
after two weeks b. Regional Training Nurse
b. Give today, give tomorrow, give c. Nurse Supervisor at the Provincial
after two weeks or City Level
d. Regional Public Health Nurse
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195. What is the minimum requirement in the Situation: In order to meet the nutritional needs
number of years (in community health nursing) for the patients, nurses must have a very good
for a Nurse VI or Nursing Program Supervisor? background of the digestive and metabolic
a. 5 processes of the body.
b. 6 201. Which of the following is a good source
c. 7 of Vitamin A?
d. 8 a. Eggs
196. How much is the difference in the required b. Liver
number of years in a supervisory position c. Fish
between that of the Chief Nurse and the Assistant d. Peanuts
Chief Nurse, both in Selected City Health 202. The ff. may be given to relieve nausea
Departments? and vomiting EXCEPT:
a. 1 yr. a. Dry toast
b. 24 mos. b. Milk
c. 3 yrs. c. Cold cola beverages
d. 4 yrs. d. Ice chips
197. He/she is also known as the Nurse VII: 203. Which of the following is the richest
a. Public Health Nurse source of Iron?
b. Regional Public Health Nurse a. mongo
c. Chief Nurse in Selected City b. ampalaya
Health Departments and Health c. malunggay leaves
Offices d. pechay
d. Nurse Program Supervisor 204. A full liquid diet is one that contains:
198. The only nurse in the organization whose a. clear liquids at body temperature
qualification is 6 years nursing experience: b. any liquid at body temperature
a. Nursing Program Supervisor c. only liquids that have residue
b. Chief Nurse in the Hospital d. only liquids that have no residue
c. Chief Nurse in Selected City 205. Which of the following foods should be
Health Departments and Health excluded from a low-residue diet?
Offices a. cooked vegetables
d. Regional Training Nurse b. whole grain products
199. If you are applying for Regional Training c. broiled foods
Nurse, you must meet the qualification of how d. white rice
many years experience in nursing education:
a. 2 yrs. POSITIONING
b. 3. yrs.
c. 5 yrs. 206. A nurse assists a physician in performing
d. 6 yrs. a liver biopsy. After the biopsy, the nurse
200. How many years experience as a community plans to place the client in which of the
health nurse is required of you to become a Nurse following positions?
Instructor II? a. Supine
a. 2 b. Prone
b. 3 c. Left-side lying position with a small
c. 5 pillow or folded towel under the
d. 6 puncture site
d. Right side lying position with a
small pillow or folded towel under
FUNDAMENTALS the puncture site
OF NURSING 207. A nurse is administering a cleansing
enema to the client with fecal impaction.
NUTRITION Before administering the enema, the nurse
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places the client in which of the following d. 60 watts
position? 213. A sitz bath is generally administered for
a. On the left side of the body, with a. 5-10 min
the head of the bed elevated 45 b. 15-20 min
degrees c. 30-40 min
b. On the right side of the body, d. an hour
with the head of the bed elevated 214. During a cooling sponge bath, cool, wet
45 degrees washcloths are placed in which areas of
c. Left Sim’s position the body to facilitate cooling
d. Right Sim’s position a. the forehead and the back of the
208. A client is being prepared for a neck
thoracentesis. A nurse assists the client to b. the inner elbows and knees
which of the following positions for the c. the axillae and the chest
procedure? d. the axillae and groin
a. Lying in bed on the affected side, 215. Which of the following is reaction
with the head of the bed elevated for experienced by a person whose body
45 degrees temperature rises after completion of
b. Lying in bed on the unaffected hypothermia blanket therapy?
side, with the head of the bed a. anaphylactic
elevated for 45 degrees b. recurrent
c. Prone with the head turned to the c. rebound
side and supported by pillow d. residual
d. Sim’s position with the head of the
bed flat NURSING DIAGNOSIS
209. A nurse is preparing to care for a client
who has had a supratentorial craniotomy. The 216. The nurse is caring for a patient who has
nurse plans to place the client in which undergone a laparoscopic
position? cholecystectomy. Which of the ff nursing
a. Prone diagnoses should be included in the plan
b. Supine of care?
c. Semi-Fowler’s a. Risk for Impaired Gas Exchange
d. Dorsal recumbent R/t shallow breathing secondary
210. The best position for tonsillectomy is: to right upper quadrant care
a. high fowlers b. Pain R/t pressure of the
b. semi fowlers insufflated carbon dioxide in the
c. right side lying diaphragm
d. prone c. Diarrhea R/t preoperative bowel
preparation
APPLYING HEAT & COLD d. Fluid Volume Deficit R/t NPO
status and nasogastric drainage
211. Which of the ff is the most important 217. The nurse is caring for a patient newly
nursing diagnosis to use when applying diagnosed with cancer. The patient
heat or cold to the patient? expresses fear of the treatment and
a. Ineffective Thermoregulation debilitation associated with the disease.
b. Ineffective Individual Coping Which of the ff nursing diagnosis should
c. Risk for Injury receive priority?
d. Hyperthermia a. Knowledge Deficit (cause,
212. The bulb in a heat cradle is generally no prognosis and type of malignancy
larger than and treatment method)
a. 15 watts b. Risk for Ineffective Individual
b. 25 watts Coping R/t dealing with the
c. 40 watts diagnosis and treatment
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Screening Exam
c. Risk for Body Image Disturbance d. tinea infection
R/t loss of health 222.Skin temperature is best assessed with
d. Risk for Altered Role the:
Performance R/t fatigue a. Fingertips
218. Bladder spasms are common problems ff b. Back of the hands
all types of prostate reconstruction. The c. Palm of the hands
appropriate Nursing Diagnosis related to d. tip of the fingers
this symptom would be: Eyes
a. pain 223.Cone receptors are mainly responsible for
b. anxiety sensing:
c. impaired gas exchange a. Light
d. Knowledge Deficit (bladder b. Color
irrigations) c. Shape
219. The nurse is caring for a patient who has d. light sensitivity
sustained burns to the arm and hand from 224.The red reflex seen during ah
the spilled hot grease. The burned area opthalmoscope examination is the result
appears red, wet, and glistening with of:
blisters present. Which of the ff nursing a. An increase in Intraocular
diagnoses would receive priority? Pressure
a. Pain R/t partial-thickness burn b. Incorrect adjustment of the
injury diopter
b. Body image disturbance R/t c. Light from the scope reflecting
disfiguring wound back from the choroids
c. Hyperthermia R/t full thickness d. retinal oxygenation coming from
burn injury the choroid
d. Fluid Volume Deficit R/t massive Ears
fluid shifts 225.Before inserting the otoscope into a
patient’s ear, the nurse should palpate the:
220. The nurse is caring for a patient with the a. Helix
ff symptoms secondary to pneumonia b. Tragus
increased respiratory rate. Fever, dry c. Lymph nodes
mucous membranes and cough productive d. tympanic membrane
of thick , tenacious sputum. Which of the 226.During an otoscopic examination the
ff nursing diagnoses is most appropriate? nurse should pull the superior posterior
a. High Risk for Fluid Volume auricle of a 4 year old patient’s ear:
Deficit R/t increase insensible a. Up and back
fluid loss b. Up and forward
b. Impaired Gas Exchange R/t c. Down and back
ventilation/ perfusion mismatch d. down and forward
c. Ineffective Breathing Pattern R/t Breast and Axillae
pleuritic chest pain 227.Most malignant breast cancer occurs in
d. Activity Intolerance R/t the region of the breast known as the:
hypoxemia a. Lower inner quadrant
b. Lower outer quadrant
FUNDAMENTAL PHYSICAL ASSESSMENT c. Upper outer quadrant
TECHNIQUES d. Upper inner quadrant
228.The tail of Spence is located:
Skin a. in the lower outer quadrant, close
221. A Wood’s slamp is used to identify: to the ribs
a Foliculitis b. in the upper inner quadrant, near
b. Skin exudates the sternum
c. Ringworm infestation
AP Page 21
Acumen
Screening Exam
c. in the upper outer quadrant b. 5-6 inches
toward the axillae c. 6-9 inches
d. in the lower inner quadrant d. 9-12 inches
toward the axillae
Gastro- Intestinal NURSING: AN ART & SCIENCE , MAN AND
229.When you percuss over the liver you HIS BASIC HUMAN NEEDS, CONCEPTS OF
should hear: HEALTH AN ILLNESS
a. dullness
b. resonance 236. The four concepts common to nursing
c. Tympany that appear in each of the current
d. borborygmi conceptual models are:
230.To test a patient for rebound tenderness a. Person, nursing, environment
position your hand at a: a. Person, health, nursing, support
a. 30 degree angle to the abdomen system
b. 45 to 60 degree angle to the b. Person, environment, health,
abdomen nursing
c. 90 degree angle to the abdomen c. Person, environment, psychology,
d. 45 degrees angle towards the nursing
stomach 237.The caregiver role of the nurse
emphasizes:
ELIMINATION a. Implementing nursing care
measures
231. The ff. are solutions used as non- a. Providing direct nursing care
retention enema EXCEPT: b. Recognition of needs of clients
a. Tap water c. Observation of the client’s
b. Carminative enema responses to illness
c. Normal saline solution 238.The nurse takes the patient’s advocate
d. Fleet enema role when she:
232. Which of the following is inappropriate a. Defends the rights of the patient
nursing action during rectal tube b. Intercedes on behalf of the patient
insertion to relieve flatulence? c. Refers the patient to other services
a. Insert rectal tube for 3-4 inches d. Works with the significant others
a. Use rectal tube size Fr. 22-30 239.The manager role of the nurse is best
b. Keep rectal tube in place for 45 demonstrated when she:
minutes a. Plans nursing care with the patient
c. Insert well-lubricated rectal tube a. Works together with the nursing
in rotating motion team
233. The height of solution for non-retention b. Initiates nursing action with co-
enema above the buttocks is: workers
a. 12 inches c. Speaks in behalf of her patient
b. 18 inches
c. 24 inches MAN AND HIS BASIC HUMAN NEEDS
d. 4 inches
234. The proper size of urethral catheter for a 240. The theory on man as a biopsychosocial
female patient is: and spiritual being by Sister Callista Roy
a. Fr. 12-14 conceptualizes the following except:
b. Fr. 16-18 a. Man, as a biologic being is like all
c. Fr. 8-10 other men
d. Fr. 22-24 b. Man as a psychologic being is like
235. The length of urethral catheter insertion no other man.
in male patient is: c. Man as a social being is like some
a. 3-4 inches other men
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Screening Exam
d. Man is a spiritual being only when b. It connotes, maximizing one’s
he professes that he believes in potential
God c. It is the ability to perform self-care
241. Mrs. Arania, diagnosed with cancer of the COMMUNICATION
breast, is scheduled to undergo chemotherapy. 246. Which communication skill is most
How should the nurse deal with the topic of effective in dealing with covert
hair loss with client? communication?
a. Discuss about hair loss as it a. Validation
occurs b. Listening
b. Provide reading material about c. Evaluation
chemotherapy d. Clarification
c. Acknowledge that hair loss may 247. Which of the following teaching methods
be a difficult side effect, and explore is most appropriate for teaching a diabetic
the client’s feelings about this client on self-injection of insulin?
d. Give the patient information a. Detailed explanation
about head scarf, hats and wigs b. Demonstration
242. Which of the following clients should be c. Use of pamphlets
attended to first by the nurse? d. Filmstrip
a. The client with cough and colds 248. When using printed material to teach
b. The client with pain on the chest diabetic patient about foot care, the nurse
c. The client with fever due to should:
infection a. Read the material to the patient
d. The client who is for discharge b. Allow the patient to read the
CONCEPTS OF HEALTH AN ILLNESS material
243. Which of the following behaviors is not c. Give the material to a family
expected when a client assumes the sick role? member to read to the patient
a. The client seeks for sick leave d. Read the material to evaluate its
b. The client consults the physician clarity, accuracy and effectiveness
because of headache and perceived
fever 249. A patient has Broca’s aphasia, what is the
c. The client takes the medication as lobe affected, and another name for Broca’s
prescribed by the physician aphasia?
d. The client ignores his dizziness, a. Temporal lobe: receptive aphasia
with the hope that it will be relieved b. Occipital Lobe: telegraphic
spontaneously. aphasia
244. Health promotion activities are directed to c. Frontal Lobe: Expressive aphasia
achieve the following: d. Frontal Lobe: Receptive aphasia
1. Increasing level of wellness 250. What is the best communication
2. Improving quality of life technique for a patient with Broca’s aphasia ?
3. Relying on healthcare personnel to a. magic slate
maintain health b. picture board
4. Promoting healthful lifestyle c. brail board
a. 1,2,4 d. sign language
a. 2,3,4
b. 1,2,3
c. 1,3,4
245. Which of the following statements is not PSYCHIATRIC NURSING
true about high-level wellness?
a. It is applicable only to healthy BASIC CONCEPTS
individuals
a. It is the ability to perform
activities of daily living
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Screening Exam
251. The DSM-IV is a tool utilized for c. Orienting her to the environment
diagnosis I mental health settings. This and unit personnel
multi-axial system includes: d. Reassuring her that staff will be
a. Nursing and medical diagnosis available if she becomes upset
b. Frameworks of specific theories Situation: Paranoid patients frequently use
c. Assessments for several areas of the defense mechanism of
functioning projection.
d. Specific critical pathways 256. On arrival for admission to a voluntary
252. The nurse meets with the client daily. unit, a female client loudly announces:
The client stays mostly in his room and “Everyone kneel, you are in the presence
speaks only when addressed, answering of the Queen of England.” This is:
briefly and abruptly while keeping his a. A delusion of self-belief
eyes on the floor. In this stage of their b. A delusion of self-appreciation
relationship, the nurse focuses on the c. A nihilistic delusion
client’s ability to d. A delusion of grandeur
a. make decisions 257. A client refuses to eat food sent up on
b. relate to other clients individual trays from the hospital kitchen.
c. function independently The client shouts, “You want to kill me.”
d. express himself verbally The client has lost 8 pounds in 4 days. In
253. The client has tearfully described her discussion of this problem, with the
negative feelings about herself to the nurse assigned staff member, which statement by
during their last three interactions. Which the nurse indicates an accurate
of the following goals would be most interpretation of this client’s needs?
appropriate for the nurse to include in the a. “The client is malnourished and
care of plan at this time? The client will may require tube feedings.”
a. Increase her self-esteem b. “The client is terrified. Ask the
b. Write her negative feelings in a kitchen to send foods that are not
daily journal easily contaminated such as
c. Verbalize her work-related baked potatoes
accomplishments. c. “Continue to observe the client.
d. Verbalize three things she likes When the client gets hungry
about herself enough, the client will eat.”
254. The most important assessment data for d. The client appears frightened.
the nurse to gather from the client in crisis Spend more time with the client,
would be: showing a warm affection.”
a. The client’s work habits 258. The nurse is discussing the orientation
b. Any significant physical health phase. The student nurse asks what the
data primary goal between the nurse and the
c. A past history of any emotional client is during this phase. The nurse
problems in the family should respond that the primary goal is to:
d. the specific circumstances a. Explain unit rules
surrounding the perceived crisis b. Establish a relationship
situation c. Establish trust and support
255. A female client is admitted for surgery. d. Formulate a mutual plan of action
Although not physically distressed, the
client appears apprehensive and alienated. 259. A nurse is talking with a client who is
A nursing action that may help the client to hearing voices. The nurse states, “The only
feel more at ease includes: voices I hear are yours and mine.” This is an
a. Telling her that everything is all example of:
right a. Restating
b. Giving her a copy of hospital b. Clarification
regulations c. Focusing
AP Page 24
Acumen
Screening Exam
d. Presenting reality following responses by the nurse would
260. The parents of a child who had open-heart be therapeutic?
surgery are informed that their child is in a. “We should cancel the procedure
the recovery room and is stable. The mother until you feel better.”
is crying. The nurse can best help allay the b. “Have you talked to your doctor
mother’s anxiety by: about your fears?”
a. Reassuring her that their child is c. “It’s normal to every patient who
doing well experienced dissatisfaction with
b. Allowing her to continue to this procedure.”
express her feelings d. “This procedure is the best
c. Bringing her and her husband to treatment for your condition.”
the recovery unit for several 264. During the admission procedure a client
minutes appears to be responding to voices. The
d. Encouraging them both to go have client cries out at intervals, “No, no, I
a cup of coffee and return in 2 hours didn’t kill him. You know the truth; tell
that policeman. Please help me!” The
THERAPEUTIC COMMUNICATION nurse should :
a. Sit there quietly and not respond at
261. A 24-year old man with a diagnosis of all to the client’s statements
chronic schizophrenia is admitted to the b. Respond to the client by asking,
psychiatric unit. He is talking loudly as “Whom are they saying you killed?”
the nurse approaches him. When asked c. Respond by saying, “I want to help
who he is talking to, he said, “I hear you and I realize you must be very
God’s voice.” Which of these responses frightened.”
by the nurse would be best? d. Saying. “Do not become so upset.
a. “It must make you think No one is talking to you; the
important to talk with God.” accusing voices are part of your
b. “I don’t hear a voice, but I know illness.
it’s real to you.” 265. A client on the unit believes another
c. “Why do you think you’re hearing client has stolen his watch, and they want
a voice?” to discuss this with the nurse. What is the
d. “What could be God’s reason for nurse’s best response?
talking to you?” a. “I’ll meet with each of you
262. A patient who has a borderline individually.”
personality disorder asks the nurse on a b. “Tell me what you believed
psychiatric unit if she may stay up happened.”
beyond the designated bedtime. When the c. “I’m sure no one here would do a
nurse says no, the patient says, “The thing like that.”
nurse on duty last night let me stay up d. “Be careful when you accuse
late.” Which of these responses by the someone.”
nurse would be therapeutic?
a. “You shouldn’t have been given
that privilege.” 266. During the nurse’ conversation with the
b. “Everyone is required to go to bed, client, the client states, “I have no reason
now.” to be sad. I have a great job and a
c. “You can stay up for one more wonderful wife and family.” Which of the
hour.” following comments are would be best for
d.“Direct his focus away from his the nurse to make at this time?
symptoms.” a. “Why do you think you’re
263. A patient tells a nurse, “I really don’t depressed?”
want to have these shock treatments but b. “Think about how fortunate you
my doctor insists.” Which of the are.”
AP Page 25
Acumen
Screening Exam
c. “You have many positive 270. The client states, “I’m looking forward to
qualities.” going back to work, but I wonder if I’ll be
d. “Depression can be caused by a able to keep up with the demands of my
chemical imbalance in the brain.” job.” Which of the following statements
SITUATION: The client was admitted to the by the nurse would be most helpful?
psychiatric unit yesterday. The nurse observes a. “You’ll do well. You have an
that his head is bowed in a dejected manner, his excellent work record.”
facial expression is sad, and he isolates himself in b. “I wouldn’t worry about it. The main
his room. thing to remember is that you can
267. After a few minutes of conversation, the work.”
client wearily asks the nurse, “Why pick c. “You might need extra breaks at first
me to talk to when there are so many until you feel better.”
other people here?” Which reply by the d. “You sound concerned. I want to
nurse would be best?” hear more about how you are
a. “I’m assigned to care for you today, feeling.”
if you’ll let me.”
b. “You have a lot of potential, and I’d PSYCHIATRIC DISORDERS AND
like to help you.” CONDITIONS
c. “Why shouldn’t I want to talk to you,
as well as the others?” 271. The situation in which individuals have
d. “You’re wondering why I’m excessive worry or belief that they are
interested in you, and not in suffering from a physical illness despite
others?” lack of medical evidence is known as:
268. The client begins to attend group a. Pain disorder
sessions daily. She explains to the group b. Phobic disorder
how she lost her job. Which of the c. Somatoform disorder
following statements by a group member d. Dissociative disorder
would be most therapeutic for the client? 272. A newly admitted client states, “No one
a. “Tell us about what you did on your cares, everyone is against me.” This type
job?” of statement is consistent with what
b. “It must have been very upsetting disorder?
for you.” a. Paranoid personality disorder
c. With your skills, finding another b. Schizoid personality disorder
job would be easy.” c. Schizotypal personality disorder
d. “The company must have had some d. Antisocial personality disorder
reason for letting you go.
269. The client admits to having thoughts of 273. Your client states, “I work for the
suicide, he is lethargic, withdrawn and government, and I am so important in
irritable. In conversations with the nurse, my office that that the other people will
he stresses his faults. When he starts to not be able to work without me.” This is
point out the things he can’t do, which of characteristic of:
the following responses by the nurse a. A histrionic personality disorder
would provide best intervention? b. An antisocial personality disorder
a. “You can do anything you out your c. A narcissistic personality disorder
mind to.” d. A multiple personality disorder
b. “Try to think more positively about 274. An appropriate nursing diagnosis of a
yourself.” client with a major depression is:
c. “Let’s talk about your plans for the a. Alteration in activity
weekend.” b. Alteration in perceptions
d. “You were able to write a letter to c. Alteration in affect
your friend today.” d. Alteration in social activity
AP Page 26
Acumen
Screening Exam
275. A client is diagnosed with catatonic feel worthless and unloved. In view of
schizophrenia. Which is the highest the fact that the client had previously
priority nursing diagnosis? made a suicidal gesture, which of the
a. Noncompliance following interventions by the nurse
b. Impaired communication would be a priority at this time?
c. Ineffective coping a. Ask the client frankly if she has
d. Self-care deficit thought of or plans of committing
276. A disorder where an individual may suicide
manifest a personality that is opposite to a b.Avoid bringing up the subject of
previous identity is: suicide to prevent giving the
a. Psychogenic amnesia client ideas of self-harm
b. Somatoform disorder c. Outline some alternative measures to
c. La belle indifference suicide for the client to use during
d. Psychogenic fugue periods of sadness
277. Personality disorders, on the multi-axial d.Mention others the nurse has known
diagnosis, appear in: who have felt like the client
a. Axis I and attempted suicide, to draw
b.Axis II her out
c. Axis III
d.Axis IV PSYCHIATRIC DRUGS
278. For clients with paranoid disorders,
which would be an initial goal? 281. Based on the knowledge of electro-
a. The clients will diminish convulsive treatment, the nurse explains
suspicious behavior. to the student nurse that atropine is given
b. The clients will express thoughts before the treatment primarily to:
and feeling verbally. a. Minimize intestinal contractions
c. The clients will develop a sense of b. Decrease anxiety
trust of reality that is validated by c. Dry up body secretions
others d. Prevent aspiration
d. The clients will establish trusting 282. Lithium, the drug of choice for bipolar
relationships with staff disorders, has a narrow therapeutic range
279. Parents are at the clinic with a child of:
diagnosed with attention deficit a. 0.5 mEq/L to 1.5 mEq/L
hyperactivity disorder. Which group of b. 0.6 mEq/L to 1.0 mEq/L
characteristics would the nurse most c. 0.7 mEq/L to 1.3 mEq/L
likely observe in the waiting room of the d. 1.0 mEq/L to 2.o mEq/L
clinic? The child: 283. A client is receiving monoamine oxidase
a. Plays with 2 children in the waiting inhibitors (MAOIs) as part of the
room treatment. Which food would be most
b. Runs over and turns on the video important for the nurse to stress to avoid?
player without listening to a. Organ meats
parents’ directions b. Sardines
c. Constantly wiggles a leg when c. Shellfish
waiting to take a turn at the board d. Legumes
game 284. A patient receiving lithium carbonate
d. Puts the toy truck back into the complains of blurred vision and appears
playbox only after visiting with confused. The nurse also notices that the
three other children and their client is having difficulty maintaining
parents balance. Which of these nursing actions
280. The nurse is careful not to act rushed or are appropriate?
inpatient with the client and gradually
learn that the client is very down and
AP Page 27
Acumen
Screening Exam
a. Administer a PRN amitriptyline hydrochloride (Elavil) when
antiparkinsonism drug and hold the client demonstrates
all other drugs a. An elevated blood glucose level
b. Take the client’s vital signs and b.Insomnia
administer high-potassium foods c. Hypertension
c. Hold the client’s next dose of d.Urinary retention
medication and notify the 290. The client has been taking lithium
physician immediately carbonate (Lithane) for hyperactivity, as
d. Sit with client to talk and teach prescribed by his physician. While the
the side effects of lithium client is taking this drug, the nurse should
285. Many of the major tranquilizers display ensure that he has adequate intake of
untoward side effects. The one side effect a. Sodium
displaying irreversible, abnormal, b.Iron
involuntary movements of the tongue and c. Iodine
mouth is: d. Calcium
a. Akathisia
b. Tardive dyskinesia TREATMENT MODALITIES & THERAPIES
c. Agranulocytosis
d. Dystonia 291. What is the expected outcome when
286. Which classification of drugs may be working with a client who has
used in children to treat enuresis? experienced a crisis?
a. Tricyclic antidepressant a. Stabilization of moods with
b. Major tranquilizers medications and return to
c. Antianxiety agents previous levels of functioning
d. Hypnotic b. Recovery from the crisis and
287. A client has been medicated with return to pre-crisis levels of
trifluperazine HCl (Stelazine) for a functioning
prolonged period of time. How would the c. Recovery from the crisis with
nurse check for early signs of tardive intense out-client therapy
dyskinesia? d. Recovery from the crisis with total
a. Akathisia of the lower extremities adjustment at pre-crisis events
b. Cogwheel rigidity at the elbow 292.An actively psychotic client is being
c. Drying of the mucous membranes assessed by the nurse for a participation
d. Vermiform movements of the in a milieu group. Which is the most
tongue appropriate group for this client?
288. When the nurse checks the lithium level a. A highly structured task-oriented
of a client on the unit, it is 2.0 mEq/L. group
What would the interpretation/action by b. An activity group
the nurse be? c. A group is not appropriate
a. The level is within therapeutic d. A movement therapy group, after
range; do nothing. a short period of isolation
b. The level is below therapeutic Situation: Therapeutic interventions provide
range; call the physician. varied opportunities for the nurse.
c. The level is slightly elevated but 293. The role of the nurse in environmental
does not require any nursing therapy includes:
action. a. Coordinating team activities,
d. This level is high; the client maintaining the environment 24
should be assessed for hrs. a day
manifestation of toxicity. b. Referring others to work with
289. The nurse judges correctly that a client is families, observing in groups
experiencing an adverse effect from c. Coordinating medical care,
selecting programs
AP Page 28
Acumen
Screening Exam
d. Observing community meetings b. You may not experience memory
leading groups loss, but you still need ECT to get
294. The activity therapy the nurse would better.”
select to promote reminiscing in a group c. It may be best if you can’t
with age over 70 is: remember certain things.”
a. Poetry d. There is memory loss, but it will
b. Art return over a 2-3 week period
c. Movement 298. A therapist is leading in a client group.
d. Music Which is most important to the
295. The registered nurse is discussing with a development of the group process?
student the guidelines for the use of a. Planning
restraints. Which of the statements by the b. Goal setting
students indicates a need for clarification? c. Problem-solving
a. An adequate number of staff are d. Reality orientation
needed before restraints are 299. Therapeutic treatment of a female client
attempted. with ritualistic behavior should be
b. Being restrained may help the directed toward helping her to:
client gain physical control a. Redirect her energy into activities
c. A physician’s order is required to help others
initially, followed by frequent b. Learn that her behavior is not
renewal serving a realistic purpose
d. The use of restraints requires the c. Forget her fears by administering
supervision of a licensed and antianxiety medications
certified professional d. Understand her behavior is
296. A client seeks counseling from the caused by unconscious impulses
nurse for marital conflict that includes a that the fears
history of physical abuse. What would 300. A client is participating in a crafty
be the initial intervention in this client’s therapy session when suddenly he
plan of care? begins to shout at another client, “Stop
a. Assist the client in identifying aspects watching me. I know what you’re up to.
of the client’s life that are under I’ll get you…” What will be the best
the control of the client immediate action for the nurse to take?
b.Facilitate the client’s desire to gain a. Disband the group immediately
knowledge of the democratic b. Instruct the client to follow the
family process nurse to
c. Discuss issues of the use of her room
stereotypic gender role behavior c. Tell the client that no one is
and the effect of violence in the watching her
family d. Ask the other clients to stop looking
d.Explain theories of family violence so at this person
the client understands patterns in
the marital conflict
a. A client is to receive his first electro-
convulsive treatment (ECT). He states,
“I’m afraid because my roommate told
me I’ll forget everything and my
memory will never return.” What is the
best response?
a. Don’t worry about it. You will get
your memory back.”
AP Page 29

Acumen Pediatric Nursing Growth and Development Screening Exam

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