NURSING PRACTICE II part 1

NURSING PRACTICE II

Situation: Mariah is a 31 year old lawyer who has been

married for 6 months. She consults you for guidance in

relation with her menstrual cycle and her desire to get

pregnant.

1. She wants to know the length of her menstrual

cycle. Her previous menstrual period is October

22 to 26. Her LMB is November 21. Which of the

following number of days will be your correct

response?

A. 29

B. 28

C. 30

D. 31

2. You advised her to observe and record the signs

of Ovulation. Which of the following signs will

she likely note down?

1. A 1 degree Fahrenheit rise in basal body

temperature

2. Cervical mucus becomes copious and

clear

3. One pound increase in weight

4. Mittelschmerz

A. 1, 2, 4

B. 1, 2, 3

C. 2, 3, 4

D. 1, 3, 4

3. You instruct Mariah to keep record of her basal

temperature every day, which of the following

instructions is incorrect?

A. If coitus has occurred; this should be

reflected in the chart

B. It is best to have coitus on the evening

following a drop in BBT to become

pregnant

C. Temperature should be taken

immediately after waking and before

getting out of bed

D. BBT is lowest during the secretory

phase

4. She reports an increase in BBT on December 16.

Which hormone brings about this change in her

BBT?

A. Estrogen

B. Gonadotropine

C. Progesterone

D. Follicle stimulating hormone

5. The following month, Mariah suspects she is

pregnant. Her urine is positive for Human

chorionic gonadotrophin. Which structure

produces Hcg?

A. Pituitary gland

B. Trophoblastic cells of the embryo

C. Uterine deciduas

D. Ovarian follicles

Situation: Mariah came back and she is now pregnant.

6. At 5 month gestation, which of the following

fetal development would probably be achieve?

A. Fetal movement are felt by Mariah

B. Vernix caseosa covers the entire body

C. Viable if delivered within this period

D. Braxton hicks contractions are observed

7. The nurse palpates the abdomen of Mariah.

Now At 5 month gestation, What level of the

abdomen can the fundic height be palpated?

A. Symphysis pubis

B. Midpoint between the umbilicus and the

xiphoid process

C. Midpoint between the symphysis pubis

and the umbilicus

D. Umbilicus

8. She worries about her small breasts, thinking

that she probably will not be able to breastfeed

her baby. Which of the following responses of

the nurse is correct?

A. “The size of your breast will not affect

your lactation”

B. “You can switch to bottle feeding”

C. “You can try to have exercise to increase

the size of your breast”

D. “Manual expression of milk is possible”

9. She tells the nurse that she does not take milk

regularly. She claims that she does not want to

gain too much weight during her pregnancy.

Which of the following nursing diagnosis is a

priority?

A. Potential self-esteem disturbance

related to physiologic changes in

pregnancy

B. Ineffective individual coping related to

physiologic changes in pregnancy

C. Fear related to the effects of pregnancy

D. Knowledge deficit regarding nutritional

requirements of pregnancies related to

lack of information sources

10. Which of the following interventions will likely

ensure compliance of Mariah?

A. Incorporate her food preferences that

are adequately nutritious in her meal

plan

B. Consistently counsel toward optimum

nutritional intake

C. Respect her right to reject dietary

information if she chooses

D. Inform her of the adverse effects of

inadequate nutrition to her fetus

Situation: Susan is a patient in the clinic where you work.

She is inquiring about pregnancy.

11. Susan tells you she is worried because she

develops breasts later than most of her friends.

Breast development is termed as:

A. Adrenarche

B. Thelarche

C. Mamarche

D. Menarche

12. Kevin, Susan’s husband tells you that he is

considering vasectomy After the birth of their

new child. Vasectomy involves the incision of

which organ?

A. The testes

B. The epididymis

C. The vas deferens

D. The scrotum

13. On examination, Susan has been found of having

a cystocele. A cystocele is:

A. A sebaceous cyst arising from the vulvar fold

B. Protrusion of intestines into the vagina

C. Prolapse of the uterus into the vagina

D. Herniation of the bladder into the

vaginal wall

14. Susan typically has menstrual cycle of 34 days.

She told you she had coitus on days 8, 10, 15 and

20 of her menstrual cycle. Which is the day on

which she is most likely to conceive?

A. 8th day

B. Day 15

C. 10th day

D. Day 20

15. While talking with Susan, 2 new patients arrived

and they are covered with large towels and the

nurse noticed that there are many cameraman

and news people outside of the OPD. Upon

assessment the nurse noticed that both of them

are still nude and the male client’s penis is still

inside the female client’s vagina and the male

client said that “I can’t pull it”. Vaginismus was

your first impression. You know that The

psychological cause of Vaginismus is related to:

A. The male client inserted the penis too

deeply that it stimulates vaginal closure

B. The penis was too large that is why the

vagina triggered its defense to attempt

to close it

C. The vagina does not want to be

penetrated

D. It is due to learning patterns of the

female client where she views sex as

bad or sinful

Situation: Overpopulation is one problem in the

Philippines that causes economic drain. Most Filipinos

are against in legalizing abortion. As a nurse, Mastery of

contraception is needed to contribute to the society and

economic growth.

16. Supposed that Dana, 17 years old, tells you she

wants to use fertility awareness method of

contraception. How will she determine her

fertile days?

A. She will notice that she feels hot, as if

she has an elevated temperature.

B. She should assess whether her cervical

mucus is thin, copious, clear and

watery.

C. She should monitor her emotions for

sudden anger or crying

D. She should assess whether her breasts

feel sensitive to cool air

17. Dana chooses to use COC as her family planning

method. What is the danger sign of COC you

would ask her to report?

A. A stuffy or runny nose

B. Slight weight gain

C. Arthritis like symptoms

D. Migraine headache

18. Dana asks about subcutaneous implants and she

asks, how long will these implants be effective.

Your best answer is:

A. One month

17

B. Five years

C. Twelve months

D. 10 years

19. Dana asks about female condoms. Which of the

following is true with regards to female

condoms?

A. The hormone the condom releases

might cause mild weight gain

B. She should insert the condom before

any penile penetration

C. She should coat the condom with

spermicide before use

D. Female condoms, unlike male condoms,

are reusable

20. Dana has asked about GIFT procedure. What

makes her a good candidate for GIFT?

A. She has patent fallopian tubes, so

fertilized ova can be implanted on them

B. She is RH negative, a necessary

stipulation to rule out RH incompatibility

C. She has normal uterus, so the sperm can

be injected through the cervix into it

D. Her husband is taking sildenafil, so all

sperms will be motile

Situation: Nurse Lorena is a Family Planning and

Infertility Nurse Specialist and currently attends to

FAMILY PLANNING CLIENTS AND INFERTILE COUPLES.

The following conditions pertain to meeting the nursing

needs of this particular population group.

21. Dina, 17 years old, asks you how a tubal ligation

prevents pregnancy. Which would be the best

answer?

A. Prostaglandins released from the cut

fallopian tubes can kill sperm

B. Sperm cannot enter the uterus because

the cervical entrance is blocked.

C. Sperm can no longer reach the ova,

because the fallopian tubes are blocked

D. The ovary no longer releases ova as

there is nowhere for them to go.

22. The Dators are a couple undergoing testing for

infertility. Infertility is said to exist when:

A. A woman has no uterus

B. A woman has no children

C. A couple has been trying to conceive for 1 year

D. A couple has wanted a child for 6

months

23. Another client named Lilia is diagnosed as having

endometriosis. This condition interferes with

fertility because:

A. Endometrial implants can block the

fallopian tubes

B. The uterine cervix becomes inflamed

and swollen

C. The ovaries stop producing adequate

estrogen

D. Pressure on the pituitary leads to

decreased FSH levels

24. Lilia is scheduled to have a

hysterosalphingogram. Which of the following

instructions would you give her regarding this

procedure?

A. She will not be able to conceive for 3

months after the procedure

B. The sonogram of the uterus will reveal

any tumors present

C. Many women experience mild bleeding

as an after effect

D. She may feel some cramping when the

dye is inserted

25. Lilia’s cousin on the other hand, knowing nurse

Lorena’s specialization asks what artificial

insemination by donor entails. Which would be

your best answer if you were Nurse Lorena?

A. Donor sperm are introduced vaginally

into the uterus or cervix

B. Donor sperm are injected intraabdominally

into each ovary

C. Artificial sperm are injected vaginally to

test tubal patency

D. The husband’s sperm is administered

intravenously weekly

Situation: You are assigned to take care of a group of

patients across the lifespan.

26. Pain in the elder persons requires careful

assessment because they:

A. experienced reduce sensory perception

B. have increased sensory perception

C. are expected to experience chronic pain

D. have a decreased pain threshold

27. Administration of analgesics to the older persons

requires careful patient assessment because

older people:

A. are more sensitive to drugs

B. have increased hepatic, renal and

gastrointestinal function

C. have increased sensory perception

D. mobilize drugs more rapidly

28. The elderly patient is at higher risk for urinary

incontinence because of:

A. increased glomerular filtration

B. decreased bladder capacity

C. diuretic use

D. dilated urethra

29. Which of the following is the MOST COMMON

sign of infection among the elderly?

A. decreased breath sounds with crackles

B. pain

C. fever

D. change in mental status

30. Priorities when caring for the elderly trauma

patient:

A. circulation, airway, breathing

B. airway, breathing, disability (neurologic)

C. disability (neurologic), airway, breathing

D. airway, breathing, circulation

31. Preschoolers are able to see things from which

of the following perspectives?

A. Their peers

B. Their own and their mother’s

C. Their own and their caregivers’

D. Only their own

32. In conflict management, the win-win approach

occurs when:

A. There are two conflicts and the parties

agree to each one

B. Each party gives in on 50% of the

disagreements making up the conflict

C. Both parties involved are committed to

solving the conflict

D. The conflict is settled out of court so the

legal system and the parties win

33. According to the social-interactional perspective

of child abuse and neglect, four factors place the

family members at risk for abuse. These risk

factors are the family members at risk for abuse.

These risk factors are the family itself, the

caregiver, the child, and

A. The presence of a family crisis

B. The national emphasis on sex

C. Genetics

D. Chronic poverty

34. Which of the following signs and symptoms

would you most likely find when assessing and

infant with Arnold-Chiari malformation?

A. Weakness of the leg muscles, loss of

sensation in the legs, and restlessness

B. Difficulty swallowing, diminished or

absent gag reflex, and respiratory

distress

C. Difficulty sleeping, hypervigilant, and an

arching of the back

D. Paradoxical irritability, diarrhea, and

vomiting.

35. A parent calls you and frantically reports that her

child has gotten into her famous ferrous sulfate

pills and ingested a number of these pills. Her

child is now vomiting, has bloody diarrhea, and is

complaining of abdominal pain. You will tell the

mother to:

A. Call emergency medical services (EMS)

and get the child to the emergency room

B. Relax because these symptoms will pass

and the child will be fine

C. Administer syrup of ipecac

D. Call the poison control center

36. A client says she heard from a friend that you

stop having periods once you are on the “pill”.

The most appropriate response would be:

A. “The pill prevents the uterus from

making such endometrial lining, that is

why periods may often be scant or

skipped occasionally.”

B. “If your friend has missed her period,

she should stop taking the pills and get a

pregnancy test as soon as possible.”

C. “The pill should cause a normal

menstrual period every month. It

sounds like your friend has not been

taking the pills properly.”

D. “Missed period can be very dangerous

and may lead to the formation of

precancerous cells.”

37. The nurse assessing newborn babies and infants

during their hospital stay after birth will notice

which of the following symptoms as a primary

manifestation of Hirschsprung’s disease?

A. A fine rash over the trunk

B. Failure to pass meconium during the

first 24 to 48 hours after birth

C. The skin turns yellow and then brown

over the first 48 hours of life

D. High-grade fever

38. A client is 7 months pregnant and has just been

diagnosed as having a partial placenta previa.

She is stable and has minimal spotting and is

being sent home. Which of these instructions to

the client may indicate a need for further

teaching?

A. Maintain bed rest with bathroom

privileges

B. Avoid intercourse for three days.

C. Call if contractions occur.

D. Stay on left side as much as possible

when lying down.

39. A woman has been rushed to the hospital with

ruptured membrane. Which of the following

should the nurse check first?

A. Check for the presence of infection

B. Assess for Prolapse of the umbilical

cord

C. Check the maternal heart rate

D. Assess the color of the amniotic fluid

40. The nurse notes that the infant is wearing a

plastic-coated diaper. If a topical medication

were to be prescribed and it were to go on the

stomachs or buttocks, the nurse would teach the

caregivers to:

A. avoid covering the area of the topical

medication with the diaper

B. avoid the use of clothing on top of the

diaper

C. put the diaper on as usual

D. apply an icepack for 5 minutes to the

outside of the diaper

41. Which of the following factors is most important

in determining the success of relationships used

in delivering nursing care?

A. Type of illness of the client

B. Transference and counter transference

C. Effective communication

D. Personality of the participants

42. Grace sustained a laceration on her leg from

automobile accident. Why are lacerations of

lower extremities potentially more serious

among pregnant women than other?

A. lacerations can provoke allergic

responses due to gonadotropic hormone

release

B. a woman is less able to keep the

laceration clean because of her fatigue

C. healing is limited during pregnancy so

these will not heal until after birth

D. increased bleeding can occur from

uterine pressure on leg veins

43. In working with the caregivers of a client with an

acute or chronic illness, the nurse would:

A. Teach care daily and let the caregivers

do a return demonstration just before

discharge

B. Difficulty swallowing, diminished or

absent gag reflex, and respiratory

distress.

C. Difficulty sleeping, hypervigilant, and an

arching of the back

D. Paradoxical irritability, diarrhea, and

vomiting

44. Which of the following roles BEST exemplifies

the expanded role of the nurse?

A. Circulating nurse in surgery

B. Medication nurse

C. Obstetrical nurse

D. Pediatric nurse practitioner

45. According to DeRosa and Kochura’s (2006)

article entitled “Implement Culturally Competent

Health Care in your work place,” cultures have

different patterns of verbal and nonverbal

communication. Which difference does?

A. NOT necessarily belong?

B. Personal behavior

C. Subject matter

D. Eye contact

E. Conversational style

46. You are the nurse assigned to work with a child

with acute glomerulonephritis. By following the

prescribed treatment regimen, the child

experiences a remission. You are now checking

to make sure the child does not have a relapse.

Which finding would most lead you to the

conclusion that a relapse is happening?

A. Elevated temperature, cough, sore

throat, changing complete blood count

(CBC) with diiferential

B. A urine dipstick measurement of 2+

proteinuria or more for 3 days, or the

child found to have 3-4+ proteinutria

plus edema.

C. The urine dipstick showing glucose in the

urine for 3 days, extreme thirst, increase

in urine output, and a moon face.

D. A temperature of 37.8 degrees (100

degrees F), flank pain, burning

frequency, urgency on voiding, and

cloudy urine.

47. The nurse is working with an adolescent who

complains of being lonely and having a lack of

fulfillment in her life. This adolescent shies away

from intimate relationships at times yet at other

times she appears promiscuous. The nurse will

likely work with this adolescent in which of the

following areas?

A. Isolation

B. Lack of fulfillment

C. Loneliness

D. Identity

48. The use of interpersonal decision making,

psychomotor skills, and application of

knowledge expected in the role of a licensed

health care professional in the context of public

health welfare and safety is an example of:

A. Delegation

B. Responsibility

C. Supervision

D. Competence

49. The painful phenomenon known as “back labor”

occurs in a client whose fetus in what position?

A. Brow position

B. Breech position

C. Right Occipito-Anterior Position

D. Left Occipito-Posterior Position

50. FOCUS methodology stands for:

A. Focus, Organize, Clarify, Understand

and Solution

B. Focus, Opportunity, Continuous, Utilize,

Substantiate

C. Focus, Organize, Clarify, Understand,

Substantiate

D. Focus, Opportunity, Continuous

(process), Understand, Solution