Foundation of Professional Nursing s

1. While caring for an 8 year old child with a broken wrist, the nurse notices red, raised streaks on the child’s back. The child’s
father enters the room and the child becomes quiet and distant, leaning away from the father as he approaches. What is the best
nursing action?
a. Chart the child was probably beaten by the father
b. Notify the supervisor to report possible child abuse
c. Disregard suspicious and care for the immediate needs of the child
d. No action is required; there is no actual proof of child abuse.
Rationale: any suspected child abuse should be reported to the appropriate agencies.
2. A nurse manager has been notified to obtain a bed for a client. Of the following clients, which one would the nurse anticipate
being able to discharge?
a. A client who had myocardial infarction 2 days ago. His vital signs are:
BP: 130/88mmHg
PR: 84 BPM and irregular
RR: 28 BPM, minimal
b. A client who underwent an abdominal aneurysm resection 3 days ago. His vital sign are BP130/88 mmHG, PR: 88 BPM RR
22 BPM and oral temperature 101 F. he is beginning oral intake without problems
c. A client who has a subdural hematoma. He is lethargic; PR is 60 BPM, RR 28 BPM temperature is 99 F
d. A client who had abdominal surgery for a bowel obstruction 4 days ago. He has bowel sounds, is taking fluids orally, has an
abdominal penrose drain and is continuing to experience abdominal pain.
Rationale: D represents the most stable clients could be discharge. Clients in A and C are showing signs of being unstable with
their diagnosis. The client B is stable but because of the extensiveness of his surgery and because he had surgery only 3 days
ago, he is a likely candidate to move than the client in option D.
3. Delegation is the process of transferring work to subordinates. A nurse-manager can appropriately delegate which tasl?
a. Scheduling staff assignment for the next month
b. Terminating a nursing assistant for insubordination
c. Deciding on salary increases for licensed practical nurses after they complete orientation
d. Telling the staff nurse to initiate disciplinary action against one of her peers.
Rationale: Scheduling may be safely and appropriately delegated to staff, which doesn’t have the power and authority to take
such actions.

4. The nurse is planning assignments. Which task can be safely delegated to a nursing assistant?
a. Obtain a stool specimen from a client with diarrhea
b. Assist a client with a colostomy in practicing his first colostomy irrigation
c. Obtain a dietary history from a client with peptic ulcer disease
d. Evaluate the voiding pattern from a client who had a urinary retention catheter
Rationale: the assignment in A has the most specific guidelines for performance. The other procedures require assessment and
judgement and should not be assigned to a nursing assistant.
5. A staff nurse on a busy pediatric unit is an excellent role model for her colleagues. She encourages
them to participate in the unit’s decision-making process and helps them improve their clinical skills.This nurse is functioning
effectively in which role?
a. Manager b. Autocrat c. Leader d. Authority
Answer: C
Rationale: A leader doesn’t have formal power and authority but influences the success
of a unit by being an excellent role model and by guiding, encouraging, and facilitating
professional growth and development.

6. A nurse-manager on an oncology unit has been informed that she must determine which nursing
care delivery system is the best for efficient client care, client satisfaction, and cost reduction. Knowing that 2 or 3 registered
nurses, 4 licensed practical nurses, and 5 nursing assistants are generally on duty on each shift and that the clients can be grouped
fairly easily by geographic location and client care needs, the nurse-manager and her staff appropriately decide
to implement which nursing care delivery system?
a. Functional nursing c. Team Nursing
b. Case management d. Primary Nursing
Answer: C
Rationale: Team nursing is efficient and cost less to implement than primary or case management systems. Because the staff
members know each other well, they can function effectively as a team. Although functional nursing is the most cost effective,
care is commonly fragmented and client satisfaction decreased. Case management and primary nursing require more registered
nurses than are available.

7. The charge nurse is planning assignments for the nursing staff. One of the staff nurses is pregnant.
Which client would not be appropriate to assign to this nurse?
a. Child with brain tumor being treated with radiation
b. Infant with respiratory syncytial virus receiving ribavirin
c. Toddler who is HIV+ and has an opportunistic respiratory tract infection
d. Child with leukemia who is receiving Oncovin (Vincristine) and Zyloprim
(allopurinol)
Answer: B
Rationale: Involves contact with a medication that is teratogenic and is classified as Pregnancy Risk category X. The other
clients do not pose a risk to the pregnant nurse.

8. A nurse-manager appropriately behaves as an autocrat in which situation?

a. Planning vacation time for staff
b. Directing staff activities if a client has a cardiac arrest
c. Evaluating a new medication administration process
d. Identifying the strengths and weaknesses of a client education video
Answer: B
Rationale: In a crisis situation, the nurse- manager should take command for the benefit of the client. Planning vacation time and
evaluating procedures and client resources require staff input characteristic of a democratic or participative manager.

9. There are phases in the change process to be considered, the first one should be:
a. Refreezing b. Unfreezing c. Changing d. Resisting
Answer: B
Rationale: In the change process the first step is unfreezing followed by moving and refreezing.

10. Form of communication that travels from staff and lower middle level management personnel and continues up the
organizational hierarchy is:
a. Downward b. Upward c. Matrix d. Grapevine
Answer: B
Rationale: Upward communication emanates from subordinates and goes upward.

11. What is a key component in a quality assurance program?

a. Patient satisfaction questionnaire
b. Determination of criteria to meet standards
c. Case management for continuity of care
d. An acuity system for client classification
Answer: B
Rationale: In a quality assurance program, there must be standards from which to measure progress. Criteria are established to
obtain objective measurement.

12. Which of the following tools can be most helpful in the evaluation of staff performance?
a. Performance assessment c. Performance audit
b. Performance standard d. Performance appraisal
Answer: D
Rationale: Performance appraisal is a control process in which employee’s performance is evaluated against standards. It is the
most valuable tool in controlling human resources and productivity.

13. A storm has prevented most of the staff members from getting to work on a busy medical-surgical unit. One registered nurse,
2 licensed practical nurses, and 3 nursing assistants have been able to work. The nurse-manager must decide which nursing care
delivery system should implemented for the best possible client care during this staffing crisis. The nurse-manager directs the
staff to implement which delivery system?
a. Team nursing c. Functional nursing
b. Primary nursing d. Case management
Answer: C
Rationale: Functional nursing best uses the skills in a timely manner during this crisis. This delivery system requires the least
staff and delegates tasks to those who can best perform them.

14. The nurse-manager of a 20-bed coronary care unit isn’t on duty when a staff nurse makes a serious medication error. The
client, who received an overdose of medication, nearly dies. Which statement accurately reflects the accountability of the nurse-
manager?
a. The nursing supervisor on duty will call the nurse-manager at home and apprise her of the problem
b. Because the nurse-manager is off duty, she isn’t accountable for incidents that occur in her absence. Therefore, the nurse
manager won’t be notified
c. The nurse-manager will be informed of the incident when returning to work on
Monday because the nurse-manager was officially off duty when the incident took place
d. Although the nurse-manager is off duty, the nursing supervisor believes that
the manager has no responsibility for what happened during the manager’s absence
Answer: A
Rationale: The nurse-manager is accountable for what happens on the unit 24 hours per day, 7 days per week. If a serious
problem occurs, the nurse-manager should be notified as soon as possible. The other choices don’t accurately reflect the
accountability of the nurse-manager’s position.

15. The selection of a nursing care delivery system is critical to the success of a nursing area. Which factor is essential in the
evaluation of a nursing care delivery system?
a. Determining how planned absences, such as vacation time, will be scheduled so that all staff are treated fairly
b. Identifying who will be responsible for making client care decisions
c. Deciding what type of dress code will be implemented
d. Identifying salary ranges for various types of staff
Answer: B
Rationale: Determining who has responsibility for making decision regarding client care is an essential element of all client care
delivery systems. Dress code, salary, and scheduling planned staff absences are important to any organization but aren’t actually
determined by nursing care delivery system.

16. The nurse –manager in the office of a group of surgeons has received complaints from discharged clients about inadequate
instructions for performing home care. Knowing the importance of good, timely client education, the nurse should take which
steps?
a. Contact the nurses who work in the facility and tell them that client education should be implemented as soon as the clients are
admitted to either the hospital or the outpatient surgical center
b. Review and revise the way client education is conducted in the surgeons’
c. Because no serious damage was done to any of the clients, the nurse-manager can safely ignore their complaints
d. Work with the surgeons’ and nursing staff in the hospital and outpatient surgical center to evaluate current client education
practices and revise as needed
Answer: D
Rationale: Client education is the responsibility of all nurses providing care to the client, and the nurse must work together to
establish the best methods. The most appropriate response is to contact the nurse manager, not the nursing staff, at the facility.
Evaluating client education in one setting only doesn’t consider the entire process and the staff providing it. No complaint should
be ignored; patient education is an important nursing responsibility.

17. When the team approach is utilized in a management situation the subordinates should be aware that they should receive
order from only one person. This principle is:
a. Unity of command c. Centralization
b. Chain of command d. Channel of communication
Answer: A
Rationale: Unity of command is represented by the vertical solid line between positions on an organizational chart. It indicates
one person has one boss

18. Which of the following would the nurse identify as an indication that the client understands the informed consent document?
a. The client states that the physician has explained the procedure to him
b. The nurse finds the informed consent form already signed
c. The client can give return verbal explanation of the informed consent document
d. The client states that his wife read it and said it was okay
Answer: C
Rationale: The client needs to show an understanding of the informed consent document by giving an explanation in his own
words

19. The nurse enters data on a chart and discovers she has written on the wrong chart.
How this error is best corrected?
a. White out the wrong information and write over it
b. Recopy the page with error so chart will be neat
c. Draw a straight line through the error, initial and date
d. Obliterate the error so it will not be confusing
Answer: C
Rationale: Errors in charting should never be obliterated, recopied, or covered with correction fluid. When the erroneous
information is not legible, it raises questions as to what the person was trying to cover up.
20. Performance improvement is an important component of continuous quality improvement. Which action should an effective
nurse- manager take when conducting performance evaluations?
a. Conduct performance evaluation in a group setting so input from peers and subordinates is considered when evaluating a staff
member’s effectiveness.
b. Provide feedback on strengths as well as areas for improvement and clarify what the staff member is expected to accomplish
before the next performance evaluation
c. Document areas for improvement in writing. Areas of strength don’t need to documented because these areas are
complementary and don’t describe actions the staff member must take to improve
d. Delegate responsibility for conducting performance evaluations to primary nurses whenever possible to help them grow
professionally.
Answer: B
Rationale: An effective performance evaluation provides recognition of strengths, identifies areas for improvement, and clarifies
performance expectations. Performance evaluation should be done in private, not in front of others. All components of a
performance evaluation should be documented in writing. Although input from staff members can be useful in preparing
performance evaluations, delegating all responsibility to others is inappropriate. The nurse- manager is responsible for the
performance of the staff.

21. The correct sequence of steps in the research process is:

1. Selection and development of the tools/ techniques for collecting data
2. Formulation of hypothesis
3. Determining the research design or the approach suitable for the study
4. Formulation of the problem
a. 1, 2, 3, 4 b. 4, 1, 2, 3 c. 4, 2, 3, 1 d. 1, 3, 4, 2
Answer: C
Rationale: The major steps in the research process listed in chronological order as follows: Formulation of the problem,
formulation of the hypothesis, determining the research design or the approach suitable for the study, selection and development
of the tools/techniques for collecting data.

22. When selecting your study sample. Which of the following activities should you do first?
a. specify the sampling frame
b. identify the target population
c. specify the criteria for selection of subjects
d. identify the available population
Answer: B
Rationale: In selecting study sample the researcher must first identify the target population. He/she must identify the common
characteristics of the population.
23. You decided to use convenience sampling. This is an example of convenience sampling:
a. selection with consent c. availability of subjects
b. simple selection d. first come, first selected basis
Answer: C
Rationale: In convenience sampling data are collected from anyone most conveniently available such as people on a street.

24. You decided to use Prospective Longitudinal Sampling. Which of the following is an example of this?
a. Growth of newborn 2 years ago to the present
b. Mastectomy patients are studied from operation to 3 years after discharge
c. Asking high school students their choices of career after graduation
d. Asking mothers their past experiences in giving birth
Answer: B
Rationale: In longitudinal sampling a given group of subjects are studied for an extended period of time, which can be
retrospective (past) or prospective (future)

25. A type of sampling that starts with one participant or member of the population and uses that member’s contacts to identify
other potential participants for the study is:
a. cluster sampling c. snowball sampling
b. convenience sampling d. purposive sampling
Answer: C
Rationale: Snowball sampling involves subjects suggesting or referring other subjects who meet the researcher’s eligibility
criteria.

26. A patient refuses to take his antibiotics because he believes that it’s not giving him any good. Which of the following actions
of the nurse is MOST appropriate?
a. Explains to the patient that he needs the medications for his recovery and clarify any misconceptions
b. Writes in the chart that the patient refuses to take his medication
c. Refer to the attending physician about his refusal
d. Ask the patient to sign the waiver of responsibility
Answer: A
Rationale: The nurse must explain all the appropriate measures that have to be done to the patient. If after the explanation, he
still refuses to sign the consent form he should be made to fill out the release form to protect the hospital/personnel from any
liability that may result from his refusal.

27. When conflict arises regarding management of patient care, which of the following should be upheld?
a. Physician’s orders c. Patient’s rights
b. Preference of the family d. Institutional Policy
Answer: C
Rationale: when conflict arises regarding management of patient care, the patients’ right are upheld.

28. The most common major risk to safety of unconscious patient in the hospital is:
a. carbon dioxide poisoning
b. any poisoning
c. falls
d. insect bites
Answer: C
Rationale: The most common risk for unconscious patients is falls. For the protection of patient, padded side rails are provided
and raised at all times.

29. Devolution of the Health department of care is implemented in order to:

a. bring services near to the people c. become self reliant
b. empower local politician d. stop funding for national funds
Answer: A
Rationale: Local Government Code transfers responsibility for delivery of basic services and facilities of the national
government to local government units to bring services near to the people.

30. Which of the following is your vital role in cancer care?

a. arrange for spiritual consultation
b. allow patient to get angry
c. maintain dignity of patient
d. control shame and guilt
Answer: C
Rationale: The primary responsibility of the nurse to the patient is to give him/her the kind of care his/her needs regardless of
his/her status.

31. If the died without a will, the succession is called:

a. holographic will
b. testate
c. heir
d. intestate
Answer: D
Rationale: a person who dies leaving a will is said to have died testate, while one who dies without a will is said to have died
intestate.

32. This is treated as the most important attribute of a true Professional Nurse
a. competence and independent approach
b. professional accountability
c. self autonomy
d. responsibility
Answer: A
Rationale: Nurses must acquire and develop the necessary competence.

33. The board may allow licensed nurses from foreign countries or state to practice nursing in the Philippines through special and
temporary permit if they belong to the following categories EXCEPT:
a. internationally-well specialist or outstanding experts in any branch of specialty of nursing
b. nurses on medical mission whose services shall be free in a particular hospital, center or clinic
c. employed by schools, colleges of nursing as exchange professors in a branch or specialty of nursing
d. Balikbayan nurses who wants to practice nursing in order to earn credits for continuing professional education
Answer: B
Rationale: A special/temporary permit may be issued by the Board to the following
persons: Licensed nurses from foreign countries/states whose service are either for a fee or free; Licensed nurses from foreign
countries/states on medical mission whose services shall be free in a particular hospital; and Licensed nurses from foreign
countries/states employed by schools/colleges of nursing as exchange professors in a branch of specialty or training

34. The following are grounds for the suspension and revocation of certificates of registration/professional license or
special/temporary permit; which one is NOT included?
a. use of fictitious date in obtaining a professional license
b. Commission of a serious negligence
c. Unprofessional or unethical conduct
d. Not a member of the accredited professional organization
Answer: D
Rationale: The Nursing Board of the PRC shall have the power to revoke or suspend the certificate of registration of a nurse
upon any of the ff. grounds: unprofessional and unethical conduct; gross incompetence or serious ignorance and the use of fraud,
deceit, or false statements in obtaining a certificate of registration

35. Nursing is considered as rewarding and fulfilling career. Nursing is best described as a profession that;
a. concerned with patients
b. concerned with proper organization of the ward
c. assist the people towards self care
d. helps to prevent disease and promote wellness
Answer: D
Rationale: As independent practitioners, nurses are primarily responsible for the promotion of health and prevention of illness.

36. Which of the following are grounds for removal of suspension of the Board Members?
1. Unprofessional, immoral or dishonorable conduct
2. Continued neglect of duty
3. Commission or toleration of irregularities in the licensure examination
4. Gross incompetence or serious ignorance
a. 1,2,4 b. 2,3,4 c. 1,3,4 d. 1,2,3
Answer: D
Rationale: The President may remove or suspend any member of the Board after having been given the opportunity to defend
himself/herself in a proper administrative investigation, on the following grounds: continued neglect of duty or incompetence;
commission or toleration of irregularities in the licensure examination and unprofessional, immoral or dishonourable conduct.

37. The Board has the mandate to determine whether an applicant for the licensure examination is qualified to take the said
examination. Who among the following is NOT qualified under the provision of the law?
a. Nurse who finished BSN then proceeded to pursue a medical degree
b. Medical degree graduate who pursued nursing course for one year.
c. Midwife graduate who took up nursing following the AHSE program
d. BSN graduate of a ladderized BSN curriculum
Answer: B
Rationale: In order to be admitted to the examination for nurses an applicant must be a holder of a Bachelor’s Degree in Nursing
from a college or university that complies with the standards of nursing education duly recognized by the proper government
agency.
38. Which TWO of the following courses of action would an examinee that got a general average of 76.8% but a rating of 59% in
Curative-A need a take?
1 Repeat the whole examination all over again
2 Take only the subject where she got a rating below 60%
3 Enroll in a refresher course in the subject that she failed
4 Obtain a score of 75% in the repeated subjects
a. 1&2 b. 2&3 c. 1&3 d. 2&4
Answer: D
Rationale: An examinee who obtains an average rating of 75% or higher but gets a rating below 60% in any subject must take
the examination again but only in the subject or subjects where he/she is rated below 60%. In order to pass the succeeding
examination, an examinee must obtain a rating of at least 75 % in the subject or subjects repeated.

39. Which of the following considered quasi-judicial powers of the Board?

a. Conduct licensure examination
b. Recognize nursing specialty organization
c. Conduct hearing and investigations to resolve complaints against nurses
d. Promulgate a Code of Ethics for nurses
Answer: C
Rationale: Conducting hearings and investigations to resolve complaints against nurse practitioners for unethical and
unprofessional conduct and violations is a quasi-judicial power of the Board.

40. Some functions of the board are considered to be quasi-legislative. Which of the following functions belong to this category?
a. Ensure quality nursing education by examining prescribed facilities of colleges of nursing
b. Monitor and enforce quality standards of nursing education in the
Philippines
c. Prescribe, adopt and promulgate guidelines, regulations, measures and decisions as maybe necessary for the improvement of
the nursing practice.
d. Issue, suspend and revoke certificates of registration for the practice of nursing
Answer: C
Rationale: Prescribe, adopt, issue and promulgate guidelines, regulations, measures and decisions as may be necessary for the
improvement of the nursing practice and the advancement of the profession are considered as quasi-legislative power of the
Board.

41. Which of the following areas should be represented by the members of the Board?
1. Nursing education
2. Nursing practice
3. Community health Nursing
4. Maternal & Child health
Nursing
a. 1,2,3 b. 2,3,4 c. 1,3,4 d. 1,2,3,4
Answer: A
Rationale: The board created under Section 3, Article III of the said Nursing Act shall be composed of a Chairperson and 6
members, representing the 3 areas of nursing, namely, nursing education, nursing service, and community health nursing.

42. The following are qualifications of the Chairperson of the Board. Which one is NOT included?
a. A natural born citizen and resident of the Philippines
b. Member of good standing of the Philippine Nurses Ass.
c. Be a registered nurse and holder of a Master’s degree in Hospital
Administration
d. Have at least ten years of continuous practice of the profession prior to appointment
Answer: C
Rationale: The chairperson shall be a holder of a Master’s degree in Nursing.

43. Some patients have different health beliefs and practices, and Nesty is aware how these can be considered in the plan of care
she and her team will prepare for the patients. Which theory is appropriate for these groups of patients?
a. Transcultural theory c. Health System Theory
b. Adaptation Theory d. Self care Theory
Answer: A
Rationale: Transcultural theory is a humanistic and scientific mode of helping a client through specific cultural caring process
(cultural values, beliefs and practices) to improve or maintain a health condition.

Situation: The Board of Nursing has two vacant positions for members. The Philippine
Nurses Association (PNA) has launched its search for nominees.
44. The PNA after having deliberated whom to nominate to PRC must have at least how many candidates for the two positions?
a. two b. four c. Six d. Eight
Answer: C
Rationale: There shall be created a Professional Regulatory Board of Nursing, here in after referred to as the Board, to be
composed of a Chairperson and 6 members. They shall be appointed by the President of the Republic of the Philippines from
among
2 recommendees per vacancy, of the PRC, hereinafter referred to as the Commission, chosen and ranked from a list of 3
nominees, per vacancy.

45. After 2 years in hospital nursing, Nesty decided to change career military nursing.
She knows that the chief nurse in the military hospital is qualified if she has completed:
a. Master’s degree in nursing
b. General Staff Course
c. At least 9 units in management and administration courses at the graduate level
d. Masters Degree in Nursing and General Staff Course
Answer: D
Rationale: Qualification for chief nurse in the military hospital must have Masters Degree in Nursing and General Staff Course

46. Nesty should be working in collaboration with the members of the health team.
Collaboration means:
a. Cooperation
b. Unity
c. Concerted efforts of individuals and groups to meet the goal
d. Loyalty to the health team
Answer: C
Rationale: Collaboration means a collegial working relationship with another health care provider in the provision of patient care
to meet the goal.

47. Which of the following pursues continuing professional education in emergency care order to be certified as a nurse specialist
in critical care. Which of the following agencies are mandated by law to be formulated and develop the comprehensive specialty
program?
Board of nursing
Accredited Professional Organization
1. Department of Health
2. Specialty Organizations
a. 1,2,3 b. 1,2,4 c. 1,3,4 d. 1,2,3,4
Answer: D
Rationale: In the Philippines the implementation of Board of Nursing Resolution No. 1903 of 1985 on CPE accreditation
program for nurses became effective by 1998. Continuing education programs may be offered by: national professional nursing
association such as PNA, LGN and ANSAP; professional organizations representing various nursing specialties; health agencies
with specialties and employing agencies in the form of in-service training programs.

Situation: Ms. Baluyot is the newly appointed manager of primary hospital in Sta. Fe.
As a new Manager, she deems it appropriate that she gains competence in her professional responsibilities.
48. Ms. Baluyot knows that the fundamental responsibility of a nurse is in fourfold. Which is the most basic of these
responsibilities?
a. Promote Health c. Restoration of Health
b. Prevention of Illness d. Alleviation of Suffering
Answer: A
Rationale: As independent practitioners, nurses are primarily responsible for the promotion of health.

49. Which of the following demonstrates the responsibility towards her profession?
1. Participate in the development and implementation of standards of Nursing practice her department.
2.Ensures that the core competencies of her staff are enhanced.
3. Participates in the activities of the local chapter of the PNA and ANSAP
4. Lobbies for the implementation of the incentives and benefit system for Nurses and dependents as stipulated in the law.
a. 1,2,3 b. 2,3,4 c. 3,4 d. 1,2,3,4
Answer: D
Rationale: All of these demonstrate the responsibility of a nurse towards her profession. Nurses should assert the implementation
of labor standards and lobby for favourable legislations to improve existing socio economic conditions of nurses. Nurses help to
determine and implement desirable standards of nursing practice and nursing education. They must participate actively in the
development and growth of the nursing profession. They are enjoined to members of the PNA and avail of the prevailing
continuing education unit privilege.

50.When Ms. Baluyot is certain that Marie Flor, a new Nurse, is not competent in taking care of critically ill patient , she would
not be ethical if she:
a. Discusses this concern with Marie Flor herself
b. Assigns another Nurse to the patient
c. Explains to Marie Flor the nature of the condition of the patient and the need for a competent Nurse to handle the increased
demand for care
d.Discusses to the other Nurse that Marie Flor is new and lacking in skills for the needs of the patient.
Answer: D
Rationale: Nurses should honor and safeguard the reputation and dignity of the members of nursing and other professions. They
shall refrain from making unfair and unwarranted comments or criticisms on their competence, conduct, and procedure or do
anything that will bring discredit to a colleague and to any member of the other professions.

MATERNITY NURSING
1. You performed the leopold’s maneuver and found the following: breech presentation, fetal back at the right side of the mother.
Based on these findings, you can hear the fetal heart beat (PMI) BEST in which location?
A. Left lower quadrant
B. Right lower quadrant
C. Left upper quadrant
D. Right upper quadrant
Answer: Right lower quadrant
Rationale: Right lower quadrant. The landmark to look for when looking for PMI is the location of the fetal back in relation to
the right or left side of the mother and the presentation, whether cephalic or breech. The best site is the fetal back nearest the
head.

2. In Leopold’s maneuver step #1, you palpated a soft broad mass that moves with the rest of the mass. The correct interpretation
of this finding is:
A. The mass palpated at the fundal part is the head part.
B. The presentation is breech.
C. The mass palpated is the back
D. The mass palpated is the buttocks.
Answer: (D) The mass palpated is the buttocks.
Rationale: The palpated mass is the fetal buttocks since it is broad and soft and moves with the rest of the mass.

3. In Leopold’s maneuver step # 3 you palpated a hard round movable mass at the supra pubic area. The correct interpretation is
that the mass palpated is:
A. The buttocks because the presentation is breech.
B. The mass palpated is the head.
C. The mass is the fetal back.
D. The mass palpated is the fetal small part
Answer: The mass palpated is the head.
Rationale: When the mass palpated is hard round and movable, it is the fetal head.

4. The hormone responsible for a positive pregnancy test is:

A. Estrogen
B. Progesterone
C. Human Chorionic Gonadotropin
D. Follicle Stimulating hormone
Answer: (C) Human Chorionic Gonadotropin
Rationale: Human chorionic gonadotropin (HCG) is the hormone secreted by the chorionic villi which is the precursor of the
placenta. In the early stage of pregnancy, while the placenta is not yet fully developed, the major hormone that sustains the
pregnancy is HCG.

5. The hormone responsible for the maturation of the graafian follicle is:
A. Follicle stimulating hormone
B. Progesterone
C. Estrogen
D. Luteinizing hormone
Answer: (A) Follicle stimulating hormone
Rationale: The hormone that stimulates the maturation if the of the graafian follicle is the Follicle Stimulating Hormone which is
released by the anterior pituitary gland.

7. The most common normal position of the fetus in utero is:

A. Transverse position
B. Vertical position
C. Oblique position
D. None of the above
Answer: Vertical position
Rationale: Vertical position means the fetal spine is parallel to the maternal spine thus making it easy for the fetus to go out the
birth canal. If transverse or oblique, the fetus can’t be delivered normally per vagina.

8. In the later part of the 3rd trimester, the mother may experience shortness of breath. This complaint maybe explained as:
A. A normal occurrence in pregnancy because the fetus is using more oxygen
B. The fundus of the uterus is high pushing the diaphragm upwards
C. The woman is having allergic reaction to the pregnancy and its hormones
D. The woman maybe experiencing complication of pregnancy
Answer: The fundus of the uterus is high pushing the diaphragm upwards
Rationale: From the 32nd week of the pregnancy, the fundus of the enlarged uterus is pushing the respiratory diaphragm
upwards. Thus, the lungs have reduced space for expansion consequently reducing the oxygen supply.

9. Which of the following findings in a woman would be consistent with a pregnancy of two months duration?
A. Weight gain of 6-10 lbs. and presence of striae gravidarum
B. Fullness of the breast and urinary frequency
C. Braxton Hicks contractions and quickening
D. Increased respiratory rate and ballottement
Answer: Fullness of the breast and urinary frequency
Rationale: Fullness of the breast is due to the increased amount of progesterone in pregnancy. The urinary frequency is caused
by the compression of the urinary bladder by the gravid uterus which is still within the pelvic cavity during the first trimester.

10. Which of the following is a positive sign of pregnancy?

A. Fetal movement felt by mother
B. Enlargement of the uterus
C. (+) pregnancy test
D. (+) ultrasound
Answer: (D) (+) ultrasound
Rationale: A positive ultrasound will definitely confirm that a woman is pregnant since the fetus in utero is directly visualized.

11. What event occurring in the second trimester helps the expectant mother to accept the pregnancy?
A. Lightening
B. Ballotment
C. Pseudocyesis
D. Quickening
Answer: (D) Quickening
Rationale: Quickening is the first fetal movement felt by the mother makes the woman realize that she is truly pregnant. In early
pregnancy, the fetus is moving but too weak to be felt by the mother. In the 18th-20th week of gestation, the fetal movements
become stronger thus the mother already feels the movements.

12. Shoes with low, broad heels, plus a good posture will prevent which prenatal discomfort?
A. Backache
B. Vertigo
C. Leg cramps
D. Nausea
Answer: (A) Backache
Rationale: Backache usually occurs in the lumbar area and becomes more problematic as the uterus enlarges. The pregnant
woman in her third trimester usually assumes a lordotic posture to maintain balance causing an exaggeration of the lumbar
curvature. Low broad heels provide the pregnant woman with a good support.

13. When a pregnant woman experiences leg cramps, the correct nursing intervention to relieve the muscle cramps is:
A. Allow the woman to exercise
B. Let the woman walk for a while
C. Let the woman lie down and dorsiflex the foot towards the knees
D. Ask the woman to raise her legs
Answer: (C) Let the woman lie down and dorsiflex the foot towards the knees
Rationale: A Leg cramp is caused by the contraction of the gastrocnimeus (leg muscle). Thus, the intervention is to stretch the
muscle by dosiflexing the foot of the affected leg towards the knee.

14. From the 33rd week of gestation till full term, a healthy mother should have prenatal check up every:
A. week
B. 2 weeks
C. 3 weeks
D. 4 weeks
Answer: (A) week
Rationale: In the 9th month of pregnancy the mother needs to have a weekly visit to the prenatal clinic to monitor fetal condition
and to ensure that she is adequately prepared for the impending labor and delivery.

15. The expected weight gain in a normal pregnancy during the 3rd trimester is
A. 1 pound a week
B. 2 pounds a week
C. 10 lbs a month
D. 10 lbs total weight gain in the 3rd trimester
Answer: (A) 1 pound a week
Rationale: During the 3rd trimester the fetus is gaining more subcutaneous fat and is growing fast in preparation for extra uterine
life. Thus, one pound a week is expected.

16. In the Batholonew’s rule of 4, when the level of the fundus is midway between the umbilicus and xyphoid process the
estimated age of gestation (AOG) is:
A. 5th month
B. 6th month
C. 7th month
D. 8th month
Answer: (C) 7th month
Rationale: In Bartholomew’s Rule of 4, the landmarks used are the symphysis pubis, umbilicus and xyphoid process. At the
level of the umbilicus, the AOG is approximately 5 months and at the level of the xyphoid process 9 months. Thus, midway
between these two landmarks would be considered as 7 months AOG.

17. The following are ways of determining expected date of delivery (EDD) when the LMP is unknown EXCEPT:
A. Naegele’s rule
B. Quickening
C. Mc Donald’s rule
D. Batholomew’s rule of 4
Answer: (A) Naegele’s rule
Rationale: Naegele’s Rule is determined based on the last menstrual period of the woman.

18. If the LMP is Jan. 30, the expected date of delivery (EDD) is
A. Oct. 7
B. Oct. 24
C. Nov. 7
D. Nov. 8
Answer: (C) Nov. 7
Rationale: Based on the last menstrual period, the expected date of delivery is Nov. 7. The formula for the Naegele’s Rule is
subtract 3 from the month and add 7 to the day.

19. Kegel’s exercise is done in pregnancy in order to:

A. Strengthen perineal muscles
B. Relieve backache
C. Strengthen abdominal muscles
D. Prevent leg varicosities and edema
Answer: (A) Strengthen perineal muscles
Rationale: Kegel’s exercise is done by contracting and relaxing the muscles surrounding the vagina and anus in order to
strengthen the perineal muscles

20. Pelvic rocking is an appropriate exercise in pregnancy to relieve which discomfort?

A. Leg cramps
B. Urinary frequency
C. Orthostatic hypotension
D. Backache
Answer: (D) Backache
Rationale: Backache is caused by the stretching of the muscles of the lower back because of the pregnancy. Pelvic rocking is
good to relieve backache.

21. The main reason for an expected increased need for iron in pregnancy is:
A. The mother may have physiologic anemia due to the increased need for red blood cell mass as well as the fetal requires about
350-400 mg of iron to grow
B. The mother may suffer anemia because of poor appetite
C. The fetus has an increased need for RBC which the mother must supply
D. The mother may have a problem of digestion because of pica
Answer: (A) The mother may have physiologic anemia due to the increased need for red blood cell mass as well as the fetal
requires about 350-400 mg of iron to grow
Rationale: About 400 mgs of Iron is needed by the mother in order to produce more RBC mass to be able to provide the needed
increase in blood supply for the fetus. Also, about 350-400 mgs of iron is need for the normal growth of the fetus. Thus, about
750-800 mgs iron supplementation is needed by the mother to meet this additional requirement.

22. The diet that is appropriate in normal pregnancy should be high in

A. Protein, minerals and vitamins
B. Carbohydrates and vitamins
C. Proteins, carbohydrates and fats
D. Fats and minerals
Answer: (A) Protein, minerals and vitamins
Rationale: In normal pregnancy there is a higher demand for protein (body building foods), vitamins (esp. vitamin A, B, C, folic
acid) and minerals (esp. iron, calcium, phosphorous, zinc, iodine, magnesium) because of the need of the growing fetus.

24. Which of the following signs will require a mother to seek immediate medical attention?
A. When the first fetal movement is felt
B. No fetal movement is felt on the 6th month
C. Mild uterine contraction
D. Slight dyspnea on the last month of gestation
Answer: B. No fetal movement is felt on the 6th month
Rationale: Fetal movement is usually felt by the mother during 4.5 – 5 months. If the pregnancy is already in its 6th month and
no fetal movement is felt, the pregnancy is not normal either the fetus is already dead intra-uterine or it is an H-mole.

25. You want to perform a pelvic examination on one of your pregnant clients. You prepare your client for the procedure by:
A. Asking her to void
B. Taking her vital signs and recording the readings
C. Giving the client a perineal care
D. Doing a vaginal prep
Answer: (A) Asking her to void
Rationale: A pelvic examination includes abdominal palpation. If the pregnant woman has a full bladder, the manipulation may
cause discomfort and accidental urination because of the pressure applied during the abdominal palpation. Also, a full bladder
can impede the accuracy of the examination because the bladder (which is located in front of the uterus) can block the uterus.

26. When preparing the mother who is on her 4th month of pregnancy for abdominal ultrasound, the nurse should instruct her to:
A. Observe NPO from midnight to avoid vomiting
B. Do perineal flushing properly before the procedure
C. Drink at least 2 liters of fluid 2 hours before the procedure and not void until the procedure is done
D. Void immediately before the procedure for better visualization
Answer: (C) Drink at least 2 liters of fluid 2 hours before the procedure and not void until the procedure is done
Rationale: Drinking at least 2 liters of water 2 hours before the procedure will result to a distended bladder. A full bladder is
needed when doing an abdominal ultrasound to serve as a “window” for the ultrasonic sound waves to pass through and allow
visualization of the uterus (located behind the urinary bladder).

27. The nursing intervention to relieve “morning sickness” in a pregnant woman is by giving
A. Dry carbohydrate food like crackers
B. Low sodium diet
C. Intravenous infusion
D. Antacid
Answer: (A) Dry carbohydrate food like crackers
Rationale: Morning sickness maybe caused by hypoglycemia early in the morning thus giving carbohydrate food will help.

28. The common normal site of nidation/implantation in the uterus is

A. Upper uterine portion
B. Mid-uterine area
C. Lower uterine segment
D. Lower cervical segment
Answer: (A) Upper uterine portion
Rationale: The embryo’s normal nidation site is the upper portion of the uterus. If the implantation is in the lower segment, this
is an abnormal condition called placenta previa.

29. Mrs. Santos is on her 5th pregnancy and has a history of abortion in the 4th pregnancy and the first pregnancy was a twin. She
is considered to be
A. G 4 P 3
B. G 5 P 3
C. G 5 P 4
D. G 4 P 4
Answer: G 5 P 3
Rationale: Gravida refers to the total number of pregnancies including the current one. Para refers to the number of pregnancies
that have reached viability. Thus, if the woman has had one abortion, she would be considered Para 3. Twin pregnancy is counted
only as 1.

30. The following are skin changes in pregnancy EXCEPT:

A. Chloasma
B. Striae gravidarum
C. Linea negra
D. Chadwick's sign
Answer: (D) Chadwick's sign
Rationale: Chadwick's sign is bluish discoloration of the vaginal mucosa as a result of the increased vascularization in the area.

31. Which of the following statements is TRUE of conception?

A. Within 2-4 hours after intercourse conception is possible in a fertile woman
B. Generally, fertilization is possible 4 days after ovulation
C. Conception is possible during menstruation in a long menstrual cycle
D. To avoid conception, intercourse must be avoided 5 days before and 3 days after menstruation
Answer: (A) Within 2-4 hours after intercourse conception is possible in a fertile woman
Rationale: The sperms when deposited near the cervical os will be able to reach the fallopian tubes within 4 hours. If the woman
has just ovulated (within 24hours after the rupture of the graafian follicle), fertilization is possible.

32. Which of the following are the functions of amniotic fluid?

1. Cushions the fetus from abdominal trauma
2. Serves as the fluid for the fetus
3. Maintains the internal temperature
4.Facilitates fetal movement
A. 1 & 3
B. 1, 3, 4
C. 1, 2, 3
D. All of the above
Answer: (D) All of the above
Rationale: All the four functions enumerated are true of amniotic fluid.

33. You are performing abdominal exam on a 9th month pregnant woman. While lying supine, she felt breathless, had pallor,
tachycardia, and cold clammy skin. The correct assessment of the woman’s condition is that she is
A. Experiencing the beginning of labor
B. Having supine hypotension
C. Having sudden elevation of BP
D. Going into shock
Answer: Having supine hypotension
Rationale: Supine hypotension is characterized by breathlessness, pallor, tachycardia and cold clammy skin. This is due to the
compression of the abdominal aorta by the gravid uterus when the woman is on a supine position.

34. Smoking is contraindicated in pregnancy because

A. Nicotine causes vasodilation of the mother’s blood vessels
B. Carbon monoxide binds with the hemoglobin of the mother reducing available hemoglobin for the fetus
C. The smoke will make the fetus and the mother feel dizzy
D. Nicotine will cause vasoconstriction of the fetal blood vessels
Answer: Carbon monoxide binds with the hemoglobin of the mother reducing available hemoglobin for the fetus
Rationale: Carbon monoxide is one of the substances found in cigarette smoke. This substance diminishes the ability of the
hemoglobin to bind with oxygen thus reducing the amount of oxygenated blood reaching the fetus.

35. Which of the following is the most likely effect on the fetus if the woman is severely anemic during pregnancy?
A. Large for gestational age (LGA) fetus
B. Hemorrhage
C. Small for gestational age (SGA) baby
D. Erythroblastosis fetalis
Answer: (C) Small for gestational age (SGA) baby
Rationale: Anemia is a condition where there is a reduced amount of hemoglobin. Hemoglobin is needed to supply the fetus with
adequate oxygen. Oxygen is needed for normal growth and development of the fetus.

36. Which of the following signs and symptoms will most likely make the nurse suspect that the patient is having hydatidiform
mole?
A. Slight bleeding
B. Passage of clear vesicular mass per vagina
C. Absence of fetal heart beat
D. Enlargement of the uterus
Answer: Passage of clear vesicular mass per vagina
Rationale: Hydatidiform mole (H-mole) is characterized by the degeneration of the chorionic villi wherein the villi becomes
vesicle-like. These vesicle-like substances when expelled per vagina and is a definite sign that the woman has H-mole.

37. Upon assessment the nurse found the following: fundus at 2 fingerbreadths above the umbilicus, last menstrual period (LMP)
5 months ago, fetal heart beat (FHB) not appreciated. Which of the following is the most possible diagnosis of this condition?
A. Hydatidiform mole
B. Missed abortion
C. Pelvic inflammatory disease
D. Ectopic pregnancy
Answer: (A) Hydatidiform mole
Rationale: Hydatidiform mole begins as a pregnancy but early in the development of the embryo degeneration occurs. The
proliferation of the vesicle-like substances is rapid causing the uterus to enlarge bigger than the expected size based on ages of
gestation (AOG). In the situation given, the pregnancy is only 5 months but the size of the uterus is already above the umbilicus
which is compatible with 7 months AOG. Also, no fetal heart beat is appreciated because the pregnancy degenerated thus there is
no appreciable fetal heart beat.

38. When a pregnant woman goes into a convulsive seizure, the MOST immediate action of the nurse to ensure safety of the
patient is:
A. Apply restraint so that the patient will not fall out of bed
B. Put a mouth gag so that the patient will not bite her tongue and the tongue will not fall back
C. Position the mother on her side to allow the secretions to drain from her mouth and prevent aspiration
D. Check if the woman is also having a precipitate labor
Answer: (C) Position the mother on her side to allow the secretions to drain from her mouth and prevent aspiration
Rationale: Positioning the mother on her side will allow the secretions that may accumulate in her mouth to drain by gravity thus
preventing aspiration pneumonia. Putting a mouth gag is not safe since during the convulsive seizure the jaw will immediately
lock. The mother may go into labor also during the seizure but the immediate concern of the nurse is the safety of the baby. After
the seizure, check the perineum for signs of precipitate labor.

39. A gravido-cardiac mother is advised to observe bedrest primarily to

A. Allow the fetus to achieve normal intrauterine growth
B. Minimize oxygen consumption which can aggravate the condition of the compromised heart of the mother
C. Prevent perinatal infection
D. Reduce incidence of premature labor
Answer: Minimize oxygen consumption which can aggravate the condition of the compromised heart of the mother
Rationale: Activity of the mother will require more oxygen consumption. Since the heart of a gravido-cardiac is compromised,
there is a need to put a mother on bedrest to reduce the need for oxygen.

40. A pregnant mother is admitted to the hospital with the chief complaint of profuse vaginal bleeding, AOG 36 wks, not in labor.
The nurse must always consider which of the following precautions:
A. The internal exam is done only at the delivery under strict asepsis with a double set-up
B. The preferred manner of delivering the baby is vaginal
C. An emergency delivery set for vaginal delivery must be made ready before examining the patient
D. Internal exam must be done following routine procedure
Answer: (A) The internal exam is done only at the delivery under strict asepsis with a double set-up
Rationale: Painless vaginal bleeding during the third trimester maybe a sign of placenta previa. If internal examination is done in
this kind of condition, this can lead to even more bleeding and may require immediate delivery of the baby by cesarean section. If
the bleeding is due to soft tissue injury in the birth canal, immediate vaginal delivery may still be possible so the set up for
vaginal delivery will be used. A double set-up means there is a set up for cesarean section and a set-up for vaginal delivery to
accommodate immediately the necessary type of delivery needed. In both cases, strict asepsis must be observed.

41. Which of the following signs will distinguish threatened abortion from imminent abortion?
A. Severity of bleeding
B. Dilation of the cervix
C. Nature and location of pain
D. Presence of uterine contraction
Answer: Dilation of the cervix
Rationale: In imminent abortion, the pregnancy will definitely be terminated because the cervix is already open unlike in
threatened abortion where the cervix is still closed.

42. The nursing measure to relieve fetal distress due to maternal supine hypotension is:
A. Place the mother on semi-fowler’s position
B. Put the mother on left side lying position
C. Place mother on a knee chest position
D. Any of the above
Answer: Put the mother on left side lying position
Rationale: When a pregnant woman lies on supine position, the weight of the gravid uterus would be compressing on the vena
cava against the vertebrae obstructing blood flow from the lower extremities. This causes a decrease in blood return to the heart
and consequently immediate decreased cardiac output and hypotension. Hence, putting the mother on side lying will relieve the
pressure exerted by the gravid uterus on the vena cava.

43. To prevent preterm labor from progressing, drugs are usually prescribed to halt the labor. The drugs commonly given are:
A. Magnesium sulfate and terbutaline
B. Prostaglandin and oxytocin
C. Progesterone and estrogen
D. Dexamethasone and prostaglandin
Answer: (A) Magnesium sulfate and terbutaline
Rationale: Magnesium sulfate acts as a CNS depressant as well as a smooth muscle relaxant. Terbutaline is a drug that inhibits
the uterine smooth muscles from contracting. On the other hand, oxytocin and prostaglandin stimulates contraction of smooth
muscles.

44. In placenta praevia marginalis, the placenta is found at the:

A. Internal cervical os partly covering the opening
B. External cervical os slightly covering the opening
C. Lower segment of the uterus with the edges near the internal cervical os
D. Lower portion of the uterus completely covering the cervix
Answer: (C) Lower segment of the uterus with the edges near the internal cervical os
Rationale: Placenta marginalis is a type of placenta previa wherein the placenta is implanted at the lower segment of the uterus
thus the edges of the placenta are touching the internal cervical opening/os. The normal site of placental implantation is the upper
portion of the uterus.

45. In which of the following conditions can the causative agent pass through the placenta and affect the fetus in utero?
A. Gonorrhea
B. Rubella
C. Candidiasis
D. moniliasis
Answer: Rubella
Rubella is caused by a virus and viruses have low molecular weight thus can pass through the placental barrier. Gonorrhea,
candidiasis and moniliasis are conditions that can affect the fetus as it passes through the vaginal canal during the delivery
process.

46. Which of the following can lead to infertility in adult males?

A. German measles
B. Orchitis
C. Chicken pox
D. Rubella
Answer: Orchitis
Rationale: Orchitis is a complication that may accompany mumps in adult males. This condition is characterized by unilateral
inflammation of one of the testes which can lead to atrophy of the affected testis. About 20-30% of males who gets mumps after
puberty may develop this complication.

47. Papanicolaou smear is usually done to determine cancer of

A. Cervix
B. Ovaries
C. Fallopian tubes
D. Breast
Answer: (A) Cervix
Rationale: Papanicolaou (Paps) smear is done to detect cervical cancer. It can’t detect cancer in ovaries and fallopian tubes
because these organs are outside of the uterus and the abnormal cells from these organs will not be detected from a smear done on
the cervix.

48. Which of the following causes of infertility in the female is primarily psychological in origin?
A. Vaginismus
B. Dyspareunia
C. Endometriosis
D. Impotence
Answer: (A) Vaginismus
Rationale: Vaginismus is primarily psychological in origin. Endometriosis is a condition that is caused by organic abnormalities.
Dyspareunia is usually caused by infection, endometriosis or hormonal changes in menopause although may sometimes be
psychological in origin.

49. Before giving a repeat dose of magnesium sulfate to a pre-eclamptic patient, the nurse should assess the patient’s condition.
Which of the following conditions will require the nurse to temporarily suspend a repeat dose of magnesium sulfate?
A. 100 cc. urine output in 4 hours
B. Knee jerk reflex is (+)2
C. Serum magnesium level is 10mEg/L.
D. Respiratory rate of 16/min
Answer: (A) 100 cc. urine output in 4 hours
Rationale: The minimum urine output expected for a repeat dose of MgSO4 is 30 cc/hr. If in 4 hours the urine output is only 100
cc this is low and can lead to poor excretion of Magnesium with a possible cumulative effect, which can be dangerous to the
mother.

50. Which of the following is TRUE in Rh incompatibility?

A. The condition can occur if the mother is Rh(+) and the fetus is Rh(-)
B. Every pregnancy of an Rh(-) mother will result to erythroblastosis fetalis
C. On the first pregnancy of the Rh(-) mother, the fetus will not be affected
D. RhoGam is given only during the first pregnancy to prevent incompatibility
Answer: (C) On the first pregnancy of the Rh(-) mother, the fetus will not be affected
Rationale: On the first pregnancy, the mother still has no contact with Rh(+) blood thus it has not antibodies against Rh(+). After
the first pregnancy, even if terminated into an abortion, there is already the possibility of mixing of maternal and fetal blood so
this can trigger the maternal blood to produce antibodies against Rh(+) blood. The fetus takes it’s blood type usually form the
father

COMMUNITY HEALTH NURSING

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 illness
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.
Answer: To enhance the capacity of individuals, families and communities to cope with their health needs
Rationale: 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 services are based on the available resources within the community.
D. Priority setting is based on the magnitude of the health problems identified.
Answer: The nurse has to conduct community diagnosis to determine nursing needs and problems.
Rationale: Community-based practice means providing care to people in their own natural environments: the home, school and
workplace, for example.

3. Population-focused nursing practice requires which of the following processes?

A. Community organizing
B. Nursing process
C. Community diagnosis
D. Epidemiologic process
Answer: (C) Community diagnosis
Rationale: 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. R.A. 1054 is also known as the Occupational Health Act. Aside from 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: agricultural, 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
Answer: Location of the workplace in relation to health facilities
Rationale: 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. 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
Answer: 101
Rationale: Again, this is based on R.A. 1054.

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. Environmental manager
Answer: (D) Environmental manager
Rationale: Ergonomics is improving efficiency of workers by improving the worker’s environment through appropriately
designed furniture, for example.

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 of their municipality
Answer: (C) Public health nurse of the RHU of their municipality
Rationale: You’re right! This question is based on R.A.1054.

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 basic 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.
Answer: The statement is false; people pay indirectly for public health services.
Rationale: Community health services, including public health services, are pre-paid services, though taxation, for example.

9. According to C.E.Winslow, which of the following is the goal of Public Health?

A. For people to attain their birthrights of health and longevity
B. For promotion of health and prevention of disease
C. For people to have access to basic health services
D. For people to be organized in their health efforts
Answer: (A) For people to attain their birthrights of health and longevity
Rationale: According to Winslow, all public health efforts are for people to realize their birthrights of health and longevity.

10. We say that a Filipino has attained longevity when he is able to reach the average lifespan of Filipinos. What other statistic
may be used to determine attainment of longevity?
A. Age-specific mortality rate
B. Proportionate mortality rate
C. Swaroop’s index
D. Case fatality rate
Answer: (C) Swaroop’s index
Rationale: Swaroop’s 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. 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 services.
D. Public health nursing focuses on preventive, not curative, services.
Answer: (D) Public health nursing focuses on preventive, not curative, services.
Rationale: 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. 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
Answer: (D) The worth and dignity of man
Rationale: This is a direct quote from Dr. Margaret Shetland’s statements on Public Health Nursing.

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 care
C. Improve the general health status of the population
D. Health in the hands of the Filipino people by the year 2020
Answer: Ensure the accessibility and quality of health care (none)

14. Region IV Hospital is classified as what level of facility?

A. Primary
B. Secondary
C. Intermediate
D. Tertiary
Answer: (D) Tertiary
Rationale: Regional hospitals are tertiary facilities because they serve as training hospitals for the region.

15. Which 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.
Answer: Their services are provided on an out-patient basis.
Rationale: Primary facilities government and non-government facilities that provide basic out-patient services.

16. Which is an example of the school nurse’s health care provider functions?
A. Requesting for BCG from the RHU for school entrant immunization
B. Conducting random classroom inspection during a 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 time
Answer: Conducting random classroom inspection during a measles epidemic
Rationale: Random classroom inspection is assessment of pupils/students and teachers for signs of a health problem prevalent in
the community.

17. When the nurse determines whether resources were maximized in implementing Ligtas Tigdas, she is evaluating
A. Effectiveness
B. Efficiency
C. Adequacy
D. Appropriateness
Answer: Efficiency
Rationale: Efficiency is determining whether the goals were attained at the least possible cost.
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
Answer: (D) Rural Health Unit
Rationale: R.A. 7160 devolved basic health services to local government units (LGU’s ). The public health nurse is an employee
of the LGU.

19. R.A. 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
Answer: (C) To empower the people and promote their self-reliance
Rationale: People empowerment is the basic motivation behind devolution of basic services to LGU’s.

20. Who is the Chairman of the Municipal Health Board?

A. Mayor
B. Municipal Health Officer
C. Public Health Nurse
D. Any qualified physician
Answer: (A) Mayor
Rationale: The local executive serves as the chairman of the Municipal Health Board.

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
Answer: (A) Primary
Rationale: The entry of a person into the health care delivery system is usually through a consultation in out-patient services.

22. The public health nurse is the supervisor of rural health midwives. Which of the following is a supervisory function of the
public health nurse?
A. Referring cases or patients to the midwife
B. Providing technical guidance to the midwife
C. Providing nursing care to cases referred by the midwife
D. Formulating and implementing training programs for midwives
Answer: Providing technical guidance to the midwife
Rationale: 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. 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
Answer: (C) Municipal Health Officer
Rationale: 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. You are the public health nurse in a municipality with a total population of about 20,000. There are 3 rural health midwives
among the RHU personnel. How many more midwife items will the RHU need?
A. 1
B. 2
C. 3
D. The RHU does not need any more midwife item.
Answer: (A) 1
Rationale: Each rural health midwife is given a population assignment of about 5,000.

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
Answer: (D) Municipal Health Board
Rationale: As mandated by R.A. 7160, basic health services have been devolved from the national government to local
government units.

26. As an epidemiologist, the nurse is responsible for reporting cases of notifiable diseases. What law mandates reporting of cases
of notifiable diseases?
A. Act 3573
B. R.A. 3753
C. R.A. 1054
D. R.A. 1082
Answer: (A) Act 3573
Rationale: 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. 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 is 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 places of residence.
Answer: Health education and community organizing are necessary in providing community health services.
Rationale: The community health nurse develops the health capability of people through health education and community
organizing activities.

28. Which disease was declared through Presidential Proclamation No. 4 as a target for eradication in the Philippines?
A. Poliomyelitis
B. Measles
C. Rabies
D. Neonatal tetanus
Answer: Measles
Rationale: Presidential Proclamation No. 4 is on the Ligtas Tigdas Program.

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
Answer: Bar
Rationale: 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. 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
Answer: (D) Core group formation
Rationale: 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. In which step are plans formulated for solving community problems?
A. Mobilization
B. Community organization
C. Follow-up/extension
D. Core group formation
Answer: Community organization
Rationale: 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. 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 community’s resources in dealing with health problems
D. To maximize the community’s resources in dealing with health problems
Answer: (D) To maximize the community’s resources in dealing with health problems
Rationale: Community organizing is a developmental service, with the goal of developing the people’s self-reliance in dealing
with community health problems. A, B and C are objectives of contributory objectives to this goal.

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
Answer: (A) Participate in community activities for the solution of a community problem
Rationale: Participation in community activities in resolving a community problem may be in any of the processes mentioned in
the other choices.

34. Tertiary prevention is needed in which stage of the natural history of disease?
A. Pre-pathogenesis
B. Pathogenesis
C. Prodromal
D. Terminal
Answer: (D) Terminal
Rationale: 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. Isolation of a child with measles belongs to what level of prevention?

A. Primary
B. Secondary
C. Intermediate
D. Tertiary
Answer: (A) Primary
Rationale: The purpose of isolating a client with a communicable disease is to protect those who are not sick (specific disease
prevention).

36. On the other hand, Operation Timbang is _____ prevention.

A. Primary
B. Secondary
C. Intermediate
D. Tertiary
Answer: Secondary
Rationale: Operation Timbang is done to identify members of the susceptible population who are malnourished. Its purpose is
early diagnosis and subsequently, prompt treatment.

37. Which type of family-nurse contact will provide you with the best opportunity to observe family dynamics?
A. Clinic consultation
B. Group conference
C. Home visit
D. Written communication
Answer: (C) Home visit
Rationale: Dynamics of family relationships can best be observed in the family’s natural environment, which is the home.

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 de los Reyes family has been diagnosed as mentally retarded. This is classified as a
A. Health threat
B. Health deficit
C. Foreseeable crisis
D. Stress point
Answer: Health deficit
Rationale: Failure of a family member to develop according to what is expected, as in mental retardation, is a health deficit.

39. The de los Reyes couple have a 6-year old child entering school for the first time. The de los Reyes family has a
A. Health threat
B. Health deficit
C. Foreseeable crisis
D. Stress point
Answer: (C) Foreseeable crisis
Rationale: Entry of the 6-year old into school is an anticipated period of unusual demand on the family.

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 experiences among people with similar health problems.
D. It develops the family’s initiative in providing for health needs of its members.
Answer: It provides an opportunity to do first hand appraisal of the home situation.
Rationale: 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. Which is CONTRARY to the principles in planning a home visit?

A. A home visit should have a purpose or objective.
B. The plan should revolve around family health needs.
C. A home visit should be conducted in the manner prescribed by the RHU.
D. Planning of continuing care should involve a responsible family member.
Answer: (C) A home visit should be conducted in the manner prescribed by the RHU.
Rationale: The home visit plan should be flexible and practical, depending on factors, such as the family’s needs and the
resources available to the nurse and the family.

42. The PHN bag is an important tool in providing nursing care during a home visit. The most important principle of 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 a variety of ways depending on the home situation, etc.
Answer: Should minimize if not totally prevent the spread of infection.
Rationale: Bag technique is performed before and after handling a client in the home to prevent transmission of infection to and
from the client.

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.
Answer: (A) Wash his/her hands before and after providing nursing care to the family members.
Rationale: Choice B goes against the idea of utilizing the family’s resources, which is encouraged in CHN. Choices C and D
goes against the principle of asepsis of confining the contaminated surface of objects.

44. The public health nurse conducts a study on the factors contributing to the high mortality rate due to heart disease 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
Answer: Analytical
Rationale: Analytical epidemiology is the study of factors or determinants affecting the patterns of occurrence and distribution
of disease in a community.

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
Answer: (D) Evaluating the effectiveness of the implementation of the Integrated Management of Childhood Illness
Rationale: Epidemiology is used in the assessment of a community or evaluation of interventions in community health practice.

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 disease
B. Monitoring the condition of the cases affected by the communicable disease
C. Participating in the investigation to determine the source of the epidemic
D. Teaching the community on preventive measures against the disease
Answer: (C) Participating in the investigation to determine the source of the epidemic
Rationale: 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. 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
Answer: (A) Delineate the etiology of the epidemic
Rationale: Delineating the etiology of an epidemic is identifying its source.

48. Which is a characteristic of person-to-person propagated epidemics?

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 a gradual build up of cases before the epidemic becomes easily noticeable.
Answer: (D) There is a gradual build up of cases before the epidemic becomes easily noticeable.
Rationale: A gradual or insidious onset of the epidemic is usually observable in person-to-person propagated epidemics.

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
Answer: (A) Establishing the epidemic
Rationale: 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. 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 variation
Answer: Cyclical variation
Rationale: A cyclical variation is a periodic fluctuation in the number of cases of a disease in the community.
PSYCHIATRIC NURSING
1. Mental health is defined as:
A. The ability to distinguish what is real from what is not.
B. A state of well-being where a person can realize his own abilities can cope with normal stresses of life and work productively.
C. Is the promotion of mental health, prevention of mental disorders, nursing care of patients during illness and rehabilitation
D. Absence of mental illness
Answer: A state of well-being where a person can realize his own abilities can cope with normal stresses of life and work
productively.
Rationale: Mental health is a state of emotional and psychosocial well being. A mentally healthy individual is self aware and self
directive, has the ability to solve problems, can cope with crisis without assistance beyond the support of family and friends
fulfill the capacity to love and work and sets goals and realistic limits. A. This describes the ego function reality testing. C. This
is the definition of Mental Health and Psychiatric Nursing. D. Mental health is not just the absence of mental illness.

2. Which of the following describes the role of a technician?

A. Administers medications to a schizophrenic patient.
B. The nurse feeds and bathes a catatonic client
C. Coordinates diverse aspects of care rendered to the patient
D. Disseminates information about alcohol and its effects.
Answer: (A) Administers medications to a schizophrenic patient.
Rationale: Administration of medications and treatments, assessment, documentation are the activities of the nurse as a
technician. B. Activities as a parent surrogate. C. Refers to the ward manager role. D. Role as a teacher.

3. Liza says, “Give me 10 minutes to recall the name of our college professor who failed many students in our anatomy class.”
She is operating on her:
A. Subconscious
B. Conscious
C. Unconscious
D. Ego
Answer: (A) Subconscious
Rationale: Subconscious refers to the materials that are partly remembered partly forgotten but these can be recalled
spontaneously and voluntarily. B. This functions when one is awake. One is aware of his thoughts, feelings actions and what is
going on in the environment. C. The largest potion of the mind that contains the memories of one’s past particularly the
unpleasant. It is difficult to recall the unconscious content. D. The conscious self that deals and tests reality.

4. The superego is that part of the psyche that:

A. Uses defensive function for protection.
B. Is impulsive and without morals.
C. Determines the circumstances before making decisions.
D. The censoring portion of the mind.
Answer: (D) The censoring portion of the mind.
Rationale: The critical censoring portion of one’s personality; the conscience. A. This refers to the ego function that protects
itself from anything that threatens it.. B. The Id is composed of the untamed, primitive drives and impulses. C. This refers to the
ego that acts as the moderator of the struggle between the id and the superego.

5. Primary level of prevention is exemplified by:

A. Helping the client resume self care.
B. Ensuring the safety of a suicidal client in the institution.
C. Teaching the client stress management techniques
D. Case finding and surveillance in the community
Answer: (C) Teaching the client stress management techniques
Rationale: Primary level of prevention refers to the promotion of mental health and prevention of mental illness. This can be
achieved by rendering health teachings such as modifying ones responses to stress. A. This is tertiary level of prevention that
deals with rehabilitation. B and D. Secondary level of prevention which involves reduction of actual illness through early
detection and treatment of illness.

6. Situation: In a home visit done by the nurse, she suspects that the wife and her child are victims of abuse.
Which of the following is the most appropriate for the nurse to ask?
A. “Are you being threatened or hurt by your partner?
B. “Are you frightened of you partner”
C. “Is something bothering you?”
D. “What happens when you and your partner argue?”
Answer: (A) “Are you being threatened or hurt by your partner?
Rationale:The nurse validates her observation by asking simple, direct question. This also shows empathy. B, C, and D are
indirect questions which may not lead to the discussion of abuse.

7. The wife admits that she is a victim of abuse and opens up about her persistent distaste for sex. This sexual disorder is:
A. Sexual desire disorder
B. Sexual arousal Disorder
C. Orgasm Disorder
D. Sexual Pain Disorder
Answer: (A) Sexual desire disorder
Rationale: Has little or no sexual desire or has distaste for sex. B. Failure to maintain the physiologic requirements for sexual
intercourse. C. Persistent and recurrent inability to achieve an orgasm. D. Also called dyspareunia. Individuals with this disorder
suffer genital pain before, during and after sexual intercourse.
8. What would be the best approach for a wife who is still living with her abusive husband?
A. “Here’s the number of a crisis center that you can call for help .”
B. “Its best to leave your husband.”
C. “Did you discuss this with your family?”
D. “Why do you allow yourself to be treated this way”
Answer: (A) “Here’s the number of a crisis center that you can call for help.”
Rationale: Protection is a priority concern in abuse. Help the victim to develop a plan to ensure safety. B. Do not give advice to
leave the abuser. Making decisions for the victim further erodes her esteem. However discuss options available. C. The victim
tends to isolate from friends and family. D. This is judgmental. Avoid in anyway implying that she is at fault.

9. Which comment about a 3 year old child if made by the parent may indicate child abuse?
A. “Once my child is toilet trained, I can still expect her to have some"
B. “When I tell my child to do something once, I don’t expect to have to tell"
C. “My child is expected to try to do things such as, dress and feed.”
D. “My 3 year old loves to say NO.”
Answer: “When I tell my child to do something once, I don’t expect to have to tell"
Rationale: Abusive parents tend to have unrealistic expectations on the child. A,B and C are realistic expectations on a 3 year
old.

10. The primary nursing intervention for a victim of child abuse is:
A. Assess the scope of the problem
B. Analyze the family dynamics
C. Ensure the safety of the victim
D. Teach the victim coping skills
Answer: (C) Ensure the safety of the victim
Rationale: The priority consideration is the safety of the victim. Attend to the physical injuries to ensure the physiologic safety
and integrity of the child. Reporting suspected case of abuse may deter recurrence of abuse. A,B and D may be addressed later.

11. Situation: A 30 year old male employee frequently complains of low back pain that leads to frequent absences from work.
Consultation and tests reveal negative results.
The client has which somatoform disorder?
A. Somatization Disorder
B. Hypochondriaisis
C. Conversion Disorder
D. Somatoform Pain Disorder
Answer: (D) Somatoform Pain Disorder
Rationale: This is characterized by severe and prolonged pain that causes significant distress. A. This is a chronic syndrome of
somatic symptoms that cannot be explained medically and is associated with psychosocial distress. B. This is an unrealistic
preoccupation with a fear of having a serious illness. C. Characterized by alteration or loss in sensory or motor function resulting
from a psychological conflict.

12. Freud explains anxiety as:

A. Strives to gratify the needs for satisfaction and security
B. Conflict between id and superego
C. A hypothalamic-pituitary-adrenal reaction to stress
D. A conditioned response to stressors
Answer: ( Conflict between id and superego
Rationale: Freud explains anxiety as due to opposing action drives between the id and the superego. A. Sullivan identified 2
types of needs, satisfaction and security. Failure to gratify these needs may result in anxiety. C. Biomedical perspective of
anxiety. D. Explanation of anxiety using the behavioral model.

13. The following are appropriate nursing diagnosis for the client EXCEPT:
A. Ineffective individual coping
B. Alteration in comfort, pain
C. Altered role performance
D. Impaired social interaction
Answer: (D) Impaired social interaction
Rationale: The client may not have difficulty in social exchange. The cues do not support this diagnosis. A. The client
maladaptively uses body symptoms to manage anxiety. B. The client will have discomfort due to pain. C. The client may fail to
meet environmental expectations due to pain.

14. The following statements describe somatoform disorders:

A. Physical symptoms are explained by organic causes
B. It is a voluntary expression of psychological conflicts
C. Expression of conflicts through bodily symptoms
D. Management entails a specific medical treatment
Answer: (C) Expression of conflicts through bodily symptoms
Rationale: Bodily symptoms are used to handle conflicts. A. Manifestations do not have an organic basis. B. This occurs
unconsciously. D. Medical treatment is not used because the disorder does not have a structural or organic basis.

15. What would be the best response to the client’s repeated complaints of pain:
A. “I know the feeling is real tests revealed negative results.”
B. “I think you’re exaggerating things a little bit.”
C. “Try to forget this feeling and have activities to take it off your mind”
D. “So tell me more about the pain”
Answer: (A) “I know the feeling is real tests revealed negative results.”
Rationale: Shows empathy and offers information. B. This is a demeaning statement. C. This belittles the client’s feelings. D.
Giving undue attention to the physical symptom reinforces the complaint.

16. Situation: A nurse may encounter children with mental disorders. Her knowledge of these various disorders is vital.
When planning school interventions for a child with a diagnosis of attention deficit hyperactivity disorder, a guide to remember is
to:
A. provide as much structure as possible for the child
B. ignores the child’s overactivity.
C. encourage the child to engage in any play activity to dissipate energy
D. removes the child from the classroom when disruptive behavior occurs
Answer: (A) provide as much structure as possible for the child
Rationale: Decrease stimuli for behavior control thru an environment that is free of distractions, a calm non –confrontational
approach and setting limit to time allotted for activities. B. The child will not benefit from a lenient approach. C. Dissipate energy
through safe activities. D. This indicates that the classroom environment lacks structure.

17. The child with conduct disorder will likely demonstrate:

A. Easy distractibility to external stimuli.
B. Ritualistic behaviors
C. Preference for inanimate objects.
D. Serious violations of age related norms.
Answer: (D) Serious violations of age related norms.
Rationale: This is a disruptive disorder among children characterized by more serious violations of social standards such as
aggression, vandalism, stealing, lying and truancy. A. This is characteristic of attention deficit disorder. B and C. These are noted
among children with autistic disorder.

18. Ritalin is the drug of choice for chidren with ADHD. The side effects of the following may be noted:
A. increased attention span and concentration
B. increase in appetite
C. sleepiness and lethargy
D. bradycardia and diarrhea
Answer: (A) increased attention span and concentration
Rationale: The medication has a paradoxic effect that decrease hyperactivity and impulsivity among children with ADHD. B, C,
D. Side effects of Ritalin include anorexia, insomnia, diarrhea and irritability.

19. School phobia is usually treated by:

A. Returning the child to the school immediately with family support.
B. Calmly explaining why attendance in school is necessary
C. Allowing the child to enter the school before the other children
D. Allowing the parent to accompany the child in the classroom
Answer: (A) Returning the child to the school immediately with family support.
Rationale: Exposure to the feared situation can help in overcoming anxiety. A. This will not help in relieving the anxiety due
separation from a significant other. C. and C. Anxiety in school phobia is not due to being in school but due to separation from
parents/caregivers so these interventions are not applicable. D. This will not help the child overcome the fear
20. A 10 year old child has very limited vocabulary and interaction skills. She has an I.Q. of 45. She is diagnosed to have Mental
retardation of this classification:
A. Profound
B. Mild
C. Moderate
D. Severe
Answer: (C) Moderate
Rationale: The child with moderate mental retardation has an I.Q. of 35-50 Profound Mental retardation has an I.Q. of below 20;
Mild mental retardation 50-70 and Severe mental retardation has an I.Q. of

20-35.
21. The nurse teaches the parents of a mentally retarded child regarding her care. The following guidelines may be taught except:
A. overprotection of the child
B. patience, routine and repetition
C. assisting the parents set realistic goals
D. giving reasonable compliments
Answer: (A) overprotection of the child
Rationale: The child with mental retardation should not be overprotected but need protection from injury and the teasing of other
children. B,C, and D Children with mental retardation have learning difficulty. They should be taught with patience and
repetition, start from simple to complex, use visuals and compliment them for motivation. Realistic expectations should be set
and optimize their capability.

22. The parents express apprehensions on their ability to care for their maladaptive child. The nurse identifies what nursing
diagnosis:
A. hopelessness
B. altered parenting role
C. altered family process
D. ineffective coping
Answer: altered parenting role
Rationale: Altered parenting role refers to the inability to create an environment that promotes optimum growth and
development of the child. This is reflected in the parent’s inability to care for the child. A. This refers to lack of choices or
inability to mobilize one’s resources. C. Refers to change in family relationship and function. D. Ineffective coping is the
inability to form valid appraisal of the stressor or inability to use available resources

23. A 5 year old boy is diagnosed to have autistic disorder.

Which of the following manifestations may be noted in a client with autistic disorder?
A. argumentativeness, disobedience, angry outburst
B. intolerance to change disturbed relatedness, stereotypes
C. distractibility, impulsiveness and overactivity
D. aggression, truancy, stealing, lying
Answer: intolerance to change, disturbed relatedness, stereotypes
Rationale: These are manifestations of autistic disorder. A. These manifestations are noted in Oppositional Defiant Disorder, a
disruptive disorder among children. C. These are manifestations of Attention Deficit Disorder D. These are the manifestations of
Conduct Disorder

24. The therapeutic approach in the care of an autistic child include the following EXCEPT:
A. Engage in diversionary activities when acting -out
B. Provide an atmosphere of acceptance
C. Provide safety measures
D. Rearrange the environment to activate the child
Answer: (D) Rearrange the environment to activate the child
Rationale: The child with autistic disorder does not want change. Maintaining a consistent environment is therapeutic. A. Angry
outburst can be rechannelled through safe activities. B. Acceptance enhances a trusting relationship. C. Ensure safety from self-
destructive behaviors like head banging and hair pulling.

25. According to Piaget a 5 year old is in what stage of development:

A. Sensory motor stage
B. Concrete operations
C. Pre-operational
D. Formal operation
Answer: (C) Pre-operational
Rationale: Pre-operational stage (2-7 years) is the stage when the use of language, the use of symbols and the concept of time
occur. A. Sensory-motor stage (0-2 years) is the stage when the child uses the senses in learning about the self and the
environment through exploration. B. Concrete operations (7-12 years) when inductive reasoning develops. D. Formal operations
(2 till adulthood) is when abstract thinking and deductive reasoning develop.

26. Situation: The nurse assigned in the detoxification unit attends to various patients with substance-related disorders.
A 45 years old male revealed that he experienced a marked increase in his intake of alcohol to achieve the desired effect This
indicates:
A. withdrawal
B. tolerance
C. intoxication
D. psychological dependence
Answer: tolerance
Rationale: tolerance refers to the increase in the amount of the substance to achieve the same effects. A. Withdrawal refers to the
physical signs and symptoms that occur when the addictive substance is reduced or withheld. B. Intoxication refers to the
behavioral changes that occur upon recent ingestion of a substance. D. Psychological dependence refers to the intake of the
substance to prevent the onset of withdrawal symptoms.

27. The client admitted for alcohol detoxification develops increased tremors, irritability, hypertension and fever. The nurse
should be alert for impending:
A. delirium tremens
B. Korsakoff’s syndrome
C. esophageal varices
D. Wernicke’s syndrome
Answer: (A) delirium tremens
Rationale: Delirium Tremens is the most extreme central nervous system irritability due to withdrawal from alcohol B. This
refers to an amnestic syndrome associated with chronic alcoholism due to a deficiency in Vit. B C. This is a complication of liver
cirrhosis which may be secondary to alcoholism . D. This is a complication of alcoholism characterized by irregularities of eye
movements and lack of coordination.

28. The care for the client places priority to which of the following:
A. Monitoring his vital signs every hour
B. Providing a quiet, dim room
C. Encouraging adequate fluids and nutritious foods
D. Administering Librium as ordered
Answer: (A) Monitoring his vital signs every hour
Rationale: Pulse and blood pressure are usually elevated during withdrawal, Elevation may indicate impending delirium tremens
B. Client needs quiet, well lighted, consistent and secure environment. Excessive stimulation can aggravate anxiety and cause
illusions and hallucinations. C. Adequate nutrition with sulpplement of Vit. B should be ensured. D. Sedatives are used to relieve
anxiety.

29. Another client is brought to the emergency room by friends who state that he took something an hour ago. He is actively
hallucinating, agitated, with irritated nasal septum.
A. Heroin
B. cocaine
C. LSD
D. marijuana
Answer: cocaine
Rationale: The manifestations indicate intoxication with cocaine, a CNS stimulant. A. Intoxication with heroine is manifested by
euphoria then impairment in judgment, attention and the presence of papillary constriction. C. Intoxication with hallucinogen like
LSD is manifested by grandiosity, hallucinations, synesthesia and increase in vital signs D. Intoxication with Marijuana, a
cannabinoid is manifested by sensation of slowed time, conjunctival redness, social withdrawal, impaired judgment and
hallucinations.

30. A client is admitted with needle tracts on his arm, stuporous and with pin point pupil will likely be managed with:
A. Naltrexone (Revia)
B. Narcan (Naloxone)
C. Disulfiram (Antabuse)
D. Methadone (Dolophine)
Answer: Narcan (Naloxone)
Rationale: Narcan is a narcotic antagonist used to manage the CNS depression due to overdose with heroin. A. This is an opiate
receptor blocker used to relieve the craving for heroine C. Disulfiram is used as a deterrent in the use of alcohol. D. Methadone is
used as a substitute in the withdrawal from heroine

31. Situation: An old woman was brought for evaluation due to the hospital for evaluation due to increasing forgetfulness and
limitations in daily function.
The daughter revealed that the client used her toothbrush to comb her hair. She is manifesting:
A. apraxia
B. aphasia
C. agnosia
D. amnesia
Answer: (C) agnosia
Rationale: This is the inability to recognize objects. A. Apraxia is the inability to execute motor activities despite intact
comprehension. B. Aphasia is the loss of ability to use or understand words. D. Amnesia is loss of memory.

32. She tearfully tells the nurse “I can’t take it when she accuses me of stealing her things.” Which response by the nurse will be
most therapeutic?
A. ”Don’t take it personally. Your mother does not mean it.”
B. “Have you tried discussing this with your mother?”
C. “This must be difficult for you and your mother.”
D. “Next time ask your mother where her things were last seen.”
Answer: (C) “This must be difficult for you and your mother.”
Rationale: This reflecting the feeling of the daughter that shows empathy. A and D. Giving advise does not encourage
verbalization. B. This response does not encourage verbalization of feelings.

33. The primary nursing intervention in working with a client with moderate stage dementia is ensuring that the client:
A. receives adequate nutrition and hydration
B. will reminisce to decrease isolation
C. remains in a safe and secure environment
D. independently performs self care
Answer: (C) remains in a safe and secure environment
Rationale: Safety is a priority consideration as the client’s cognitive ability deteriorates.. A is appropriate interventions because
the client’s cognitive impairment can affect the client’s ability to attend to his nutritional needs, but it is not the priority B. Patient
is allowed to reminisce but it is not the priority. D. The client in the moderate stage of Alzheimer’s disease will have difficulty in
performing activities independently

34. She says to the nurse who offers her breakfast, “Oh no, I will wait for my husband. We will eat together” The therapeutic
response by the nurse is:
A. “Your husband is dead. Let me serve you your breakfast.”
B. “I’ve told you several times that he is dead. It’s time to eat.”
C. “You’re going to have to wait a long time.”
D. “What made you say that your husband is alive?
Answer: (A) “Your husband is dead. Let me serve you your breakfast.”
Rationale: The client should be reoriented to reality and be focused on the here and now.. B. This is not a helpful approach
because of the short term memory of the client. C. This indicates a pompous response. D. The cognitive limitation of the client
makes the client incapable of giving explanation.

35. Dementia unlike delirium is characterized by:

A. slurred speech
B. insidious onset
C. clouding of consciousness
D. sensory perceptual change
Answer: insidious onset
Rationale: Dementia has a gradual onset and progressive deterioration. It causes pronounced memory and cognitive
disturbances. A,C and D are all characteristics of delirium.

36. Situation: A 17 year old gymnast is admitted to the hospital due to weight loss and dehydration secondary to starvation.
Which of the following nursing diagnoses will be given priority for the client?
A. altered self-image
B. fluid volume deficit
C. altered nutrition less than body requirements
D. altered family process
Answer: fluid volume deficit
Rationale: Fluid volume deficit is the priority over altered nutrition (A) since the situation indicates that the client is dehydrated.
A and D are psychosocial needs of a client with anorexia nervosa but they are not the priority.

37. What is the best intervention to teach the client when she feels the need to starve?
A. Allow her to starve to relieve her anxiety
B. Do a short term exercise until the urge passes
C. Approach the nurse and talk out her feelings
D. Call her mother on the phone and tell her how she feels
Answer: (C) Approach the nurse and talk out her feelings
Rationale: The client with anorexia nervosa uses starvation as a way of managing anxiety. Talking out feelings with the nurse is
an adaptive coping. A. Starvation should not be encouraged. Physical safety is a priority. Without adequate nutrition, a life
threatening situation exists. B. The client with anorexia nervosa is preoccupied with losing weight due to disturbed body image.
Limits should be set on attempts to lose more weight. D. The client may have a domineering mother which causes the client to
feel ambivalent. The client will not discuss her feelings with her mother.

38. The client with anorexia nervosa is improving if:

A. She eats meals in the dining room.
B. Weight gain
C. She attends ward activities.
D. She has a more realistic self concept.
Answer: Weight gain
Rationale: Weight gain is the best indication of the client’s improvement. The goal is for the client to gain 1-2 pounds per week.
(A)The client may purge after eating. (C) Attending an activity does not indicate improvement in nutritional state. (D) Body
image is a factor in anorexia nervosa but it is not an indicator for improvement.

39. The characteristic manifestation that will differentiate bulimia nervosa from anorexia nervosa is that bulimic individuals
A. have episodic binge eating and purging
B. have repeated attempts to stabilize their weight
C. have peculiar food handling patterns
D. have threatened self-esteem
Answer: (A) have episodic binge eating and purging
Rationale: Bulimia is characterized by binge eating which is characterized by taking in a large amount of food over a short
period of time. B and C are characteristics of a client with anorexia nervosa D. Low esteem is noted in both eating disorders

40. A nursing diagnosis for bulimia nervosa is powerlessness related to feeling not in control of eating habits. The goal for this
problem is:
A. Patient will learn problem solving skills
B. Patient will have decreased symptoms of anxiety.
C. Patient will perform self care activities daily.
D. Patient will verbalize how to set limits on others.
Answer: (A) Patient will learn problem solving skills
Rationale:

41. In the management of bulimic patients, the following nursing interventions will promote a therapeutic relationship EXCEPT:
A. Establish an atmosphere of trust
B. Discuss their eating behaviour.
C. Help patients identify feelings associated with binge-purge behaviour
D. Teach patient about bulimia nervosa
Answer: Discuss their eating behaviour.
Rationale: The client is often ashamed of her eating behaviour. Discussion should focus on feelings. A,C and D promote a
therapeutic relationship

42. Situation: A 35 year old male has intense fear of riding an elevator. He claims “ As if I will die inside.” This has affected his
studies
The client is suffering from:
A. agoraphobia
B. social phobia
C. Claustrophobia
D. xenophobia
Answer: (C) Claustrophobia
Rationale: Claustrophobia is fear of closed space. A. Agoraphobia is fear of open space or being a situation where escape is
difficult. B. Social phobia is fear of performing in the presence of others in a way that will be humiliating or embarrassing. D.
Xenophobia is fear of strangers.

43. Initial intervention for the client should be to:

A. Encourage to verbalize his fears as much as he wants.
B. Assist him to find meaning to his feelings in relation to his past.
C. Establish trust through a consistent approach.
D. Accept her fears without criticizing.
Answer: (D) Accept her fears without criticizing.
Rationale:The client cannot control her fears although the client knows its silly and can joke about it. A. Allow expression of the
client’s fears but he should focus on other productive activities as well. B and C. These are not the initial interventions.

44. The nurse develops a counter transference reaction. This is evidenced by:
A. Revealing personal information to the client
B. Focusing on the feelings of the client.
C. Confronting the client about discrepancies in verbal or non-verbal behavior
D. The client feels angry towards the nurse who resembles his mother.
Answer: (A) Revealing personal information to the client
Rationale: A. Countertransference is an emotional reaction of the nurse on the client based on her unconscious needs and
conflicts. B and C. These are therapeutic approaches. D. This is transference reaction where a client has an emotional reaction
towards the nurse based on her past.

45. Which is the desired outcome in conducting desensitization:

A. The client verbalize his fears about the situation
B. The client will voluntarily attend group therapy in the social hall.
C. The client will socialize with others willingly
D. The client will be able to overcome his disabling fear.
Answer: (D) The client will be able to overcome his disabling fear.
Rationale: The client will overcome his disabling fear by gradual exposure to the feared object. A,B and C are not the desired
outcome of desensitization.

46. Which of the following should be included in the health teachings among clients receiving Valium:
A. Avoid taking CNS depressant like alcohol.
B. There are no restrictions in activities.
C. Limit fluid intake.
D. Any beverage like coffee may be taken
Answer: (A) Avoid taking CNS depressant like alcohol.
Rationale: Valium is a CNS depressant. Taking it with other CNS depressants like alcohol; potentiates its effect. B. The client
should be taught to avoid activities that require alertness. C. Valium causes dry mouth so the client must increase her fluid intake.
D. Stimulants must not be taken by the client because it can decrease the effect of Valium.

47. Situation: A 20 year old college student is admitted to the medical ward because of sudden onset of paralysis of both legs.
Extensive examination revealed no physical basis for the complaint.
The nurse plans intervention based on which correct statement about conversion disorder?
A. The symptoms are conscious effort to control anxiety
B. The client will experience high level of anxiety in response to the paralysis.
C. The conversion symptom has symbolic meaning to the client
D. A confrontational approach will be beneficial for the client.
Answer: (C) The conversion symptom has symbolic meaning to the client
Rationale: the client uses body symptoms to relieve anxiety. A. The condition occurs unconsciously. B. The client is not
distressed by the lost or altered body function. D. The client should not be confronted by the underlying cause of his condition
because this can aggravate the client’s anxiety.

48. Nina reveals that the boyfriend has been pressuring her to engage in premarital sex. The most therapeutic response by the
nurse is:
A. “I can refer you to a spiritual counselor if you like.”
B. “You shouldn’t allow anyone to pressure you into sex.”
C. “It sounds like this problem is related to your paralysis.”
D. “How do you feel about being pressured into sex by your boyfriend?”
Answer: (D) “How do you feel about being pressured into sex by your boyfriend?”
Rationale: Focusing on expression of feelings is therapeutic. The central force of the client’s condition is anxiety. A. This is not
therapeutic because the nurse passes the responsibility to the counsellor. B. Giving advice is not therapeutic. C. This is not
therapeutic because it confronts the underlying cause.

49. Malingering is different from somatoform disorder because the former:

A. Has evidence of an organic basis.
B. It is a deliberate effort to handle upsetting events
C. Gratification from the environment are obtained.
D. Stress is expressed through physical symptoms.
Answer: It is a deliberate effort to handle upsetting events
Rationale: Malingering is a conscious simulation of an illness while somatoform disorder occurs unconscious. A. Both disorders
do not have an organic or structural basis. C. Both have primary gains. D. This is a characteristic of somatoform disorder.

50. Unlike psychophysiologic disorder Linda may be best managed with:

A. medical regimen
B. milieu therapy
C. stress management techniques
D. psychotherapy
Answer: (C) stress management techniques
Rationale: Stress management techniques is the best management of somatoform disorder because the disorder is related to
stress and it does not have a medical basis. A. This disorder is not supported by organic pathology so no medical regimen is
required. B and D. Milieu therapy and psychotherapy may be used a therapeutic modalities but these are not the best.