Enhancement Review Programfor May 2015 Nurse Licensure ExaminationCOMMUNICABLE NURSING

Lecturer: Rho Vince C. Malagueño RM, RN Type of Exam: POST TEST Prepared by: Rho Vince C. Malagueño, RM, RN

DIRECTION: Choose the letter of the BEST answer by shading the corresponding letter of your choice in the answer sheet provided. STRICTLY NO ERASURE!

1. Growth and development progress in the following ways excepta. From cognitive to psychosexual c. From head to toeb. From trunk to the tip of extremities d. From general to specific

2. As described by Erikson, the major psychosocial conflict of an infant isa. Autonomy vs. shame and doubt c. Trust vs. mistrustb. Industry vs. inferiority d. Initiative vs. guilt

3. What is the legal basis of Essential Newborn Care?a. R.A. 9288 c. R.A. 2009b. DOH Circular # 2009-25 d. DOH Circular # 2005-29

4. The temperature of the delivery room should be ideal for the newborn. The following are appropriate in regulating the DR temperature, exceptI. Check for the air draftII. Turn off the airconditioning unitIII. The temperature should be at least 30 deg Ca. I, II b. I, II, IIIc. II, III d. III

5. Once the baby is already out, what is the appropriate initial intervention?a. Aspirate the mouth first before the noseb. Slap the buttocks to stimulate breathingc. Wash the baby to remove the excess vernix caseosad. Wipe with dry cloth

6. What is the dangerous sequela of hyporthermia of the newborn?a. Seizure b. respiratory depression c. Acidosis d. cold stress

Situation: Essential Newborn Care also dubbed as “Unang Yakap” was implemented to help reduce neonatal mortality rate in the Philippines. The following questions apply.

7. What is the correct sequence of the interventions in ENC?I. Aspiration of mouth then nose II. Properly timed cord clamping & CuttingIII. Early skin-to-skin contactIV. Immediate and thorough dryingV. Non-separation of the newborn

a. I, IV, III, II, V b. IV, III, II, V c. IV, II, III, V d. I, IV, II, III, V8. When the baby was already out, the nurse found out that he is apneic, what is the most appropriate initial action?

a. Perform rescue breathingb. Perform CPRc. Dry the baby thoroughlyd. Perform Tangential foot slap

9. The following are not complications of hypothermia in the newborn, except.I. InfectionII. Coagulation defectIII. AcidosisIV. Respiratory distress syndromeV. Intravenricular Hemorrhage

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VI. Delayed closure of foramen ovale.a. I, II, II only b. I, II, III, V, VI c. I, II, III, V d. I, II, III, IV, V, VI

10. When are you going to clamp and cut the cord, excepta. Within 5 min to prevent blood incompatibilityb. Within 1-3 minc. When the pulsation stopsd. Within 30 seconds if the baby is in distresse. None of the above

11. Which of the following is true about the procedures in Unang Yakap?I. Footprinting should be done routinely to prevent accidental exchange of babiesII. Always aspirate the newborn to establish airwayIII. Place the cord binder and prevent it from being wetIV. Fold the diaper above the stampV. If not breathing, perform tangential footslap to stimulateVI. Wash the baby immediately then dry thouroughlyVII. Inject Vit K at the gluteus medius to prevent bleedingVIII. Give prelacteals to enhance suckinga. I,II,III,VIII b. I, II, VIII c. II, IV, VIII d. all except III & VI e. NOTA

12. The following are signs of proper latching, but;I. Mouth wide openII. Lower lip turned inwardIII. More areola is seen above than belowIV. Chin hardly touches the breasta. I only b. All except I c. I, III, IV d. I, IV e. NOTA

13. Which of the following is true about growth, exceptI. Weight is more sensitive parameter than heightII. Weight is doubled at 6th monIII. Height doubles at 1 yearIV. It is qualitative

a. I only b. I, II c. II, III d. IV only e. III, IV14. Baby Mica is born with length of 50 cm. What will be her length after 6 months?

a. 56 cm b. 60 cm c. 62 cm d. 65 cm15. Which of the following is not part of Denver Developmental Screening test?

a. Gross Motor functionb. Fine Motor Functionc. Language Functiond. Play sociale. NOTA

16. Which of the following statement is not true?a. IQ is fixed and it increases with ageb. IQ is not fixedc. EQ is genetically predisposedd. NOTA

17. Which component of personality is based on conscience?a. Ego b. Id c. Super ego d. Phallic

18. When will the super ego be developed?a. Toddlerhood b. infancy c. Phallic stage d. School-age

19. What is the play of a toddler?a. Solitary b. parallel c. associative d. competitive e. foreplay

20. Where is the site of gratification of a an adolescent?a.oral b. anal c. genital d. nipples

21. What are the indicators that the child is ready to be toilet trained?I. Child can stand and sit with supportII. The child is able to maintain himself for at least 1 hourIII. The child can tell his mom if he has to voida. I, II b. II, III c. I, II, III, d. III

22. When the toddler always says no to whatever the mother tells him. What will be your most appropriate response?a. Tell the mother that the toddler is in the stage of autonomy vs. shame and doubt.b. Tell the mother that she needs to offer choicesc. Always ignore the child

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d. Ask the child what he really wants, and grant it.23. What conflict should an elderly resolve?a. generativity vs. stagnation c. Intimacy vs. isolation=b. Industry vs, inferiority d. ego integrity vs. despair24. According to Piaget’s theory, when does a child developed inductive reasoning?a. Pre-operational c. Formal operationb. Concrete operation d. Conventional25. When will an infant starts to cry with tears?a. 1 mon b. 2 monc. 3 mon d. 4 mon26. When will a child starts to walk alone?a. 1 year old b. 15 mon c. 10 mon d. 2 yrs 27. What is the fear of a preschool?a. stranger b. separation anxiety c. body mutilation d.rejection

Situation: Hospitalization among pediatric patients is very stressful. As a pediatric nurse, you have to support the sick child and the parents to go through this.28. The response that would be unusual in infants subjected to prolonged hospitalization would bea. Lack or slowness of weight gainb. Limited emotional response to stimulic. Excessive crying and clinging when approachedd. Looking at ceiling lights rather than at persons caring for them29. Before surgery to relieve intestinal obstruction, a 3 month old is kept on NPO and has an OGT in place to calm, as well as to meet the infant’s developmental needs best, you shoulda. allow the infants to hold on to favorite toyc. Hang a brightly colored mobile in the infant’s cribd. Place the infant on the abdomen and permit crawling30. To give the most support to the parents of an infant with an obvious physical defect, you should a. Discourage them from talking about the babyb. Encourage them to express their worries and tearsc. Tell them not to worry because the defect can be repairedd. show them post-operative photographs of the babies who had similar defects31. To meet the major developmental need of the newborn in the post-operative period you shoulda. Give the infant a pacifierb. Provide the infant with a soft cuddly toyc. Provide the infant with a soft cuddly toyd. Warm the infant’s formula feeding32. Play during infancy isa. initiated by oarents c. More important than in the later yearsb. a way of teaching d. Mostly used for physical development33. A pediatric nurse is providing instructions to a new mother regarding the psychosocial development of the newborn. Using Erikson’d psychosocial development theory, the nurse would instruct the mother to a. Allow the newborn to signal a needb. Anticipate all of the needs of the newbornc. Avoid the newborn during the first 10 minutes of cryingd. Attend to the newborn immediately when cryingSituation: Separation anxiety, the fear of the toddler is very evident during hospitalization. Pediatric nurses should have a thorough to explain this phenomenon to apprehensive parents.34. Duringa nap, a 3-year old hospitalized boy wets his bed. The best approach would be to a. Tell him to help with remaking the bedb. Change his clothes and make no issue of itc. Change his bed, putting a rubber sheet on itd. Explain that big boys should try call his mother35. On the 3rd day of hospitalization, 1 2-year old boy had been inconsolably crying and screaming begins to regress and is now lying quietly in the crib with blanket. You recognize that the child is in the stage ofa. Denialb. Despairc. Mistrustd. Rejection36. The nurse explains to the mother of a 2 year old girl that the child’s negativism is normal for her age and that it is helping her meet her need for:a. Trust b. Attention c. Discipline d. Independence

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37. When teaching a mother how to prevent accidents while caring for her 6 month old, the nurse should emphasize that at this age child can usually;a. Sit up c. Crawl lengthy distancesb. Roll over d. Stand while holding onto furniture38. When performing a physical assessment of a newborn with Down syndrome, the nurse should carefully evaluate the infant’s;a. Heart Sounds b. Anterior fontanel c. Pupillary reaction d. Lower extremities39. If a child develops cyanosis early during a tonic-clonic seizure, it is most appropriate for the nurse to:a. Insert an airway c. Use a padded tongue bladeb. Administer oxygen d. Observe without untervening40. A physician orders the following for a young child with the diagnosis of Wilm’s tumor. The nurse should question the physician regarding orders related to preparation for:a. an IVP c. a nephrectomyb. A renal biopsy d. An abdominal CT scan41. Cleft lip is common among;a. girls b. boys c. either d. NOTA42. What is the preferred method of feeding the child with clift lipa. using rubber tipped syringe c. ordinary bottle with rubber nippleb. using cup d. NOTA43 The newborn was born with tracheoesophageal atresia, what would the associated condition if the fetus has TEA?

a. Renal agenesis c. polyhydramniosb. Oligohydramnios d. Heart disease

44. It is the projection of medulla to the cervical canal resulting from overgrowth of neural tube, this condition is called;a. Reye’s syndrome c. Medulla genesis imperfectab. Arnold-chiarri deformity d. Kawasaki disease45. A newborn who had imperforate anus had undergone surgical repair, which of the following is not appropriate?a. Teach the guardian rectal dilatationb. Diaper is placed and tucked on the abdomen covering the entire genitals to prevent bedwetc. position the newborn side lyingd. NOTA46. Upon palpation of the abdomen, the nurse felt an olive shaped mass. This is indicative of?a. intussusception b. pyloric stenosisc. Hirshprung’s disease d. Wilm’s Tumor47. What is the purpose of barium enema in newborn having intussusception?a. diagnosisb. for therapeuticc. noned. a & b48. Where is the location of abdominal cramps in patients with Crohn’s Disease?a. LLQ b. LUQ c. RUQ d. RLQ49. Which of the following is true about diet of patient with Crohn’s Disease?a. High CHON, high Calorie, High residue c. High CHON, Low Calorie, Low Residueb. Low CHON, High Calorie, Low Residue d. Hugh CHON, High Calorie, High Residue50. Which of the following is true about necrotizing colitis, except;a. May result to peritonitisb. Usual complication of exchange transfusionc. Increase incidence among bottle fed infantd. May require TPN51. What is the initial sign of hydrocephalus among infant?a. lethargy b. seizure c. headache d. larger head circumference52. Which of the following is not a sign of Increase ICP , exceptI. HypertensionII. BradycardiaIII. BradypneaIV. Low pitch shrill cryV. Projectile vomitingVI. Widened pulse pressurea. IV only b. except IV c. all d. I,II,IV,V,VI53. Which of the following drug may be helpful in hydrocephalus?a. acetaminophenb. antibiotic c. carbonic anhydrase inhibitor d. digoxin54. What is the appropriate position of a child post VP shunting procedure?a. HOB elevated 45 degrees c. flat

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b. Turned to affected side d. Trendelenburg55. What is the initial sign of shunt failure?a. abdominal pain c. dilated scalp veinb. fever d. sunset eyes56. Which of the following is untrue about VP shunt, excepta. shunt is connected to the heart ventricles to the peritoneumb. it is temporary onlyc. connection from the brain to the atrium of the heartd. NOTA57. What is the possible disorder caused by Vit B9 deficiency?a. Non fusion of posterior laminae c. megaloblastic anemiab. pernicious anemia d. hydrocephalus58. Which of the following is true about Reyes syndrome, but?I. It is an acute encephalopathyII. It may be preceded by viral infectionIII. It is treated with ASAIV. It cause fatty livera. I, II b. III.IV c. III d. IV59. Which of the following is true about Duchenne’s Muscular Dystrophy?I. It is an x-linked dominant genetic disorderII. It is characterized by atrophy and muscle weaknessIII. both genders have equal case ratioIV. It may be treated with steroidsa. I, II,III,IV b. I, II,IV c. II d. II,III60. Which of the following is true about Cerebral Palsy?I. permanent, progressive neurologic disorderII. It is a motor function impairmentIII. May be related to prenatal or postnatal hypoxiaIV. characterized by asymmetry in motion or controla. I, II, III, IV b. II, III, IV c. NOTA d. I, II, IV61. Which of the following is true about Hip dysplasia?I. Maintain legs adducted after repairII. Manifested by asymmetry of gluteal foldsIII. Apply multiple diapersa. I, II, III b. II only c. NOTA d. I, II62. When the foot is lower than the heel, and turned outward, this is termeda. calcaneo varus c. equino varusb. calcaneo valgus d. equino valgus63. Which if the following is true about scoliosis?I. Common among girlsII. Exercise is part of the managementIII. The corrective management is Milwaukee bracea. I, II, III b. I, II c. I, III d. II, III64. Which of the following is correct regarding Milwaukee brace?a. It is worn 24 hours a day c. It is a corrective managementb. worn for 6 months d. NOTA65. What are the manifestations of Patau’s SyndromeI. Small headII. Small jawIII. small eyesIV. Low set earsV. Cleft lipa. I,II,III,IV,V b. I,III,IV,V c. I,II,III,V d. I,II,III66. The murmurs in Ventricular septal defect is usually heard ona. 1st -2nd ICS b. 3rd-4th ICS c. 5th-6th ICS d. NOTA67. Cyanotic Heart disease is a. R-L shunt b. L-R shunt c. Ventricle to Atria shunt d. V-P shunt68. What is the characteristic sign of patent ductus arteriosus?a. Choking c. intermittent machinery murmurb. continuous machinery murmurs d. tachycardia

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69. Patent ductus arteriosus can be managed thrua. ligation b. indomethacin c. both d. NOTA70. Which of the following is true about coarctation of aorta except;I.it is stricture of aortaII. Increase BP in Upper extremitiesIII. Increase femoral pulseIV. May lead to left sided heart enlargementa. I,III b. III c. IV d. NOTA71. Which of the following are not problems of TOF, butI. Pulmonary stenosisII. Left ventricular hypertrophyIII. ASDIV. Overriding aortaa. I,II,III,IV b. except II & III c. I,II,IV d. except I & IV72. A child with Epiglottitis can be managed by:a. Supine positionb. tripod position c. HiB vaccinationd. NOTA73. Which if the following is an ominous sign of patient with asthmatic attack?a. presence of wheezing b. absent wheezing c. DOB d. cyanosis74. Which of the following food can be given to a child with glutein sensitive enteropathy?a. Cake c. steamed cornb. animal shape rice crackers d. except a75. The most dreaded complication of PKU is a. severe liver damage c. Diarrheab. mental retardation. D. musty odor urine76. Which of the following activities may be allowed to a child with sickle cell anemia, excepta. drinking more fluids c. tour to a libraryb. trip to Baguio d. Browsing the internet77. Which of the following is not true about x-linked genetic conditionsa. disorders that affect male child c. the mother is never a carrierb. disorders that affect female d. they are all passed equally to males and females78. Which of the metabolic disorders causes cataract?a. PKU b. galactosemia c. Congenital hypothyroidism d. cystic fibrosis79. A baby was born 2 hours ago by Cesarean section. The newborn has a myelomeningocele with the sac intactand has been placed in an incubator. The nurse, when planning care for the baby, should focus on potential for:A. Disuse syndromeB. InfectionC. Fluid volume deficitD. Decreased cardiac output80. Appropriate nursing interventions for a newborn’s myelomeningocele sac prior to surgery include using sterile technique and:A. Leaving the sac open to airB. Applying petrolatum to cover the sacC. Applying moist saline dressingsD. Applying dry dressings81. To maintain proper alignment of the hips and lower extremities in a baby with a myelomeningocele, the nurseshould position the baby with the:A. Hips abducted and feet in a neutral positionB. Hips adducted and feet flexedC. Hips subluxed and feet extendedD. Hips adducted and feet in a natural position82. Prior to surgery for a myelomeningocele, the nurse would place the baby in which of the following positions?A. ProneB. Right sideC. Left sideD. Dorsal83. A newborn baby is diagnosed with a myelomeningocele. The nurse measures his head circumference daily to assess for the development of what complication?A. HydroceleB. HordeolumC. HypsarrhythmiaD. Hydrocephalus

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84. A 4-month-old infant is admitted to the hospital with acute diarrhea and dehydration. Initial nursing assessmentof the infant reveals:A. Tenting of skinB. Low hematocritC. Bulging fontanelleD. Weight gain85. A 13-year-old female client has asthma. The nurse teaches her ways to reduce possible asthma attacks andexplains the need to avoid:A. Mild exerciseB. Turtles as petsC. SwimmingD. Extremes in temperature86. A 1-year-old infant with eczema is placed in elbow restraints to keep him from scratching. To prevent problemswith immobility, the nurse should:A. Allow him out of restraints when supervised by the nurse or motherB. Release restraints for meals and bath timeC. Release restraints one at a time every 4 hoursD. Allow him out of restraints when he is asleep at night and during naps

86. A 2-year-old child is admitted to the hospital with Hirschsprung’s disease. During the nursing history, the mother describes the child’s stool to the nurse as foulsmelling and:A. Small, hard pebblesB. Large and frothyC. CordlikeD. Ribbonlike87. The nurse explains to a toddler’s parents that the treatment of choice for Hirschsprung’s disease (aganglionic colon) would be:A. Surgical removal of affected colonB. Modified diet high in fiberC. Medication to stimulate the colonD. Permanent colostomy88. A 7-year-old child is admitted to the hospital with nephrotic syndrome. During the assessment, the nurse is aware that a classic symptom is:A. Increased urine outputB. HematuriaC. Elevated blood pressureD. Proteinuria89. During the edematous phase of nephrotic syndrome, an important nursing intervention is to:A. Provide meticulous skin careB. Encourage fluid intakeC. Encourage moderate activityD. Weigh the client every other day90. A 7-year-old boy with nephrotic syndrome is placed on steroid therapy. Which statement by his mother indicates to the nurse an understanding of steroid therapy?A. “Steroids will improve his acne.”B. “He will have permanent Cushing features.”C. “Steroids will mask infections.”D. “He may get diarrhea.”91. In evaluating the effectiveness of the prednisone therapy, the nurse realizes that a child with nephrotic syndromewill continue to take the drug until after:A. Edema has disappearedB. Urine no longer contains proteinC. Hematuria has resolvedD. His “moon” face has disappeared92. A 3-year-old child is brought to the emergency room by her parents. She has a broken right leg. The mother tellsthe admitting nurse that the child had fallen off her tricycle. The father tells the physician that the child had fallen down the stairs. The parents are concerned about their child’s condition, and it is obvious she loves them. She is quiet and not talkative. She is the youngest of four children. During the initial assessment, what should clue the nurse to the possibility of child abuse?A. The child’s not being talkativeB. Report of conflicting dataC. The child’s being the youngest child

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D. Parents’ concern about her condition93. Which of the following data the nurse learns about a mother in conversation support the possibility of child abuse of her 3-year-old daughter?A. Has a healthy self-esteemB. Has a history of a happy childhoodC. Viewed the child differently than the other childrenD. Thought the child was developmentally advanced forher age94. The nurse has a legal responsibility in child abuse cases to:A. Collect additional data before taking further actionB. Directly report her suspicions to the local child protection agencyC. Discuss her suspicions with the parentsD. Notify the physician of her suspicions95. A mother brings her 3-month-old son to the emergency room. He is crying with apparent acute abdominal pain.After initial assessment, intussusception is suspected. What type of stool would the nurse expect the mother to report?A. Black tarlikeB. RibbonlikeC. Red currant-jellylikeD. Frothy and foul smelling96. A 1-month-old infant is at the physician’s office for a follow-up visit after surgery for pyloric stenosis. The nurse would identify which of the following as the best indicator that the infant is recovering well from his surgery?A. Mother reports infant is feeding well every 4 hours.B. The infant has demonstrated a satisfactory weight gain.C. The infant is in the 90th percentile in length on the growth chart.D. Mother reports infant has a normal stool pattern.97. A baby has died from sudden infant death syndrome (SIDS). SIDS is often initially mistaken for:A. Failure to thriveB. Viral infectionC. MeningitisD. Child abuse98. When parents have lost an infant to SIDS, the nurse would plan to insert teaching content about the parents’ reactions. The nurse would plan to include content related to:A. AngerB. DepressionC. GuiltD. Hostility99. During a parenting class for toddlers, the nurse informs parents that the major cause of blindness in children older than 2 years old is:A. GlaucomaB. TraumaC. HyperopiaD. Infection100. Which food would the nurse teach a mother of a child with celiac disease to avoid in the diet?A. Oatmeal or oat productsB. Fresh fruits or vegetablesC. Chicken or poultry productsD. Cow’s milk and products containing milk

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