CD- COMPRE EXAM 1 1. A nursing instructor asks a nursing student to describe live or attenuated vaccines.

The student tells the instructor that these types of vaccines are: a. vaccines that have their virulence (potency) diminished so as to not produce a full-blown clinical illness. b. vaccines that contain pathogens made inactive by either chemical or heat. c. bacterial toxins that have been made inactive by either chemicals or heat. d. vaccines that have been obtained from the pooled blood of many people and provide antibodies to a variety of diseases. 2. Passive immunization is given as a preventive measure when a. Routine immunization is given b. Clinical recovery is on the way c. Exposure to a frank case has been observed d. Symptoms of the disease is manifested by the patient 3. A 6-month-old infant receives a DPT immunization at a well-baby clinic. The mother returns home and calls the clinic to report that the infant has developed swelling & redness at the site of injection. The nurse tells the mother to a. apply a warm compress to the injection site b. bring the infant back to the clinic c. apply an ice pack to the injection site d. monitor the infant for a fever 4. A nursing student is assigned to administer immunizations to children in a clinic. The nursing instructor asks the student about the contraindications to receiving an immunization. The student responds correctly by telling the instructor that a contraindication to receiving an immunization is if a child has a. a cold c. otitis media b. mild diarrhea d. a severe febrile illness 5. A 12-month-old received immunizations at his well-child visit. Fourteen days later, the mother reports that the child has red maculopapular rash on the trunk & extremities. This rash is most likely due to which of the following vaccines? a. DPT b. OPV c. MMR d. Hib 6. When a woman receives rubella vaccination, a nurse would give her which of the following instructions? a. Dont get pregnant for at least 3 months. b. Refrain from eating eggs & egg products for 48 hours. c. Limit contact with visitors for at least one week. d. Avoid breast-feeding the baby for at least 24 hours. 7. A 12 years old child comes into the clinic for the MMR vaccines for entry into the 6th grade the nurse asks the mother if the child had changes in health since last seen. Which statement by the mother would indicate a potential contraindication to MMR immunization?

a. My child had neomycin sulfate for acne and develop hives and difficulty in breathing b. After the last MMR my child developed a low grade and had a rash for the couple of days c. My childs brother is taking corticosteroids for juvenile rheumatoid arthritis d. My child just had a tuberculin TB test. 8. The parents of an 18-month-old baby who developed signs of tetanus are concerned about how the disease will affect their childs intellectual ability in the future. The nurses best response will be a. The childs intellectual functioning may be damaged. b. The childs intellectual functioning should remain intact. c. The childs intellectual functioning may be temporarily retarded. d. The childs intellectual functioning depends on the severity of complications. 9. A 7 day old child is brought to the health center because of inability to suck since yesterday. You suspect that this is a case of neonatal tetanus. As you asses the child which of the questions will you ask the mother in order to confirm your suspision? a. Did the child normally suck and cry 2-4 days before she was brought to the center? b. Did the child have convulsion? c. Have you observed stiffness of the childs body d. all of these questions 10. Which of these statements about tetanus is wrong? a. immunity last for 5 months in infants born to immune mother b. Immunity can be obtained after two primary doses of toxoid in mothers one moth before delivery. c. recovery from tetanus does not result in solid immunity d. tetanus bacillus is directly transmitted from man to man. 11. Prevention of tetanus neonatorum can be achieved through: a. increasing the immunization coverage of women of childbearing age with tetanus toxoid. b. immunizing newborns c. increasing the proportions of deliveries attended by the traditional birth attendants d. all of the above 12. If you were to conduct on the seminar on the prevention and control of tetanus neonatorium for your new midwives, which of the following should be given emphasis? a. Methods equipments and techniques of asepsis in childbirth b. Education of mothers on the practice of asepsis in the care of umbilical stamp. c. Education of birth attendants on the practice of strict asepsis d. All of these measures Situation: A 7 year old boy was admitted in the hospital because of convulsion 6 hours ago. A week ago the child experienced on and off cough and low grade fever. On examination, the nurse observes nuchal rigidity. 13. The most common cause of bacterial meningitis in children is a. Haemopilus influenzae B c. Neisseria meningitides

b. Streptococcus pnemoniae d. Meningococcus 14. To confirm the diagnosis, the doctor performed lumbar puncture. The result that would indicate that the cause of the disease is more of bacterial in origin would be a. Increased pressure, glucose, and protein b. Increased pressure, protein and decreased glucose c. Increased protein, low glucose, and pressure d. Cloudy CSF, increased protein and glucose 15. A mother brings the child to the health care clinic. The child has been complaining of severe headaches and has been vomiting. The child has a high fever, and the nurse notes the presence of nuchal rigidity in the child. The nurse suspects a possible diagnosis of bacterial meningitis. The nurse continues to assess the child for the presence of Kernigs sign. Which finding would indicate the presence of this sign. a. Inaability of the child to extend the legs fully when lying supine b. Flexion of the hips when the neck is flexed from a lying position c. Pain when the chin is pulled down to the chest d. Calf pain when the foot is dorsiflexed 16. A patient who is diagnosed with encephalitis is being treated with mannitol. Which of the following patient outcomes should indicate to a nurse that treatment with mannitol has been effective for a patient who has increased intracranial pressure? a. Decreased level of consciousness b. Increased urinary output c. Elevated body temperature d. Slowed papillary response 17. Maria Victoria, a 26-year-old female equestrian, developed fever, chills & body malaise for 5 days. On the 7th day of illness, she developed convulsions & was rushed to a tertiary hospital. As an ER nurse in that hospital, you noticed that the patients upper & lower extremities are in a flexed position. You very well know that this is a. decorticate rigidity c. nuchal rigidity b. decerebrate rigidity d. opisthotonus Situation: Mrs. Ferrer delivered a healthy baby girl weighing 6.8 lb. Due to knowledge deficit, the mother was not able to bring the neonate for immunization. When the child reached 3 years old, she developed pain on both knees & discomfort during standing and walking prompting her to prefer to sit or lie down. The child started having fever on the 3rd day after the leg pain. When the child was brought to a hospital, a diagnosis of Poliomyelitis was made. 18. During the early symptoms of poliomyelitis, the client usually suffers from a. coryza b. headache c. seizures d. vomiting Situation : Cristina, an 8-year-old girl was never given any kind of immunization because the family had never visited a health care unit. Now she is diagnosed to have acute poliomyelitis. 19. The major route of transmission of polio virus in poor sanitation environment is: a. Sewage disposal

b. Water system c. Fecal- oral d. Food stuff 20. When the virus is ingested, where does it multiply? a. Gastro- intestinal tract b. Integumentary system c. Urinary tract d. Reproductive tract 21. As a rural health nurse, your most important function in polio prevention is to: a. Educate the public on the advantages of immunization b. Distribute leaflets about the causes of polio c. Call all mother for lecture d. Refer all children to the doctor 22. Your health teaching to Cristina, the polio victim includes: a. Proper waste disposal b. Proper eating habits c. Regular health check-up d. Advocacy in health 23. The best nursing intervention in the case of Cristina with paralysis of lower extremity due to poliomyelitis is: a. Letting Cristina attend mother class b. Rendering physical comfort c. Rendering physical therapy exercises to limit atrophy d. Diet instruction 24. Sight & sound of water as well as drip of the faucet disturb a patient with rabies. Which of the following should the nurse do first in taking care of a patient with rabies? a. Place patient near the window b. Cover IV bottle with brown paper bag c. Give tepid sponge bath d. Place the patient near a utility room 25. If a dog bites a person, it should be a. Leashed immediately & observed for 10 days b. Killed immediately c. Brought to a veterinarian for examination to determine the presence of rabies in theblood d. punished by not giving food & water 26. A 10-year-old boy arrives with his mother at the emergency department after being bitten by a stray dog. There is a bleeding soft tissue injury on the inner aspect of the left forearm. The first nursing action would be a. Notify the barangay tanod to capture the dog b. Ask the mother if her son is allergic to horse serum c. assess the injury, vital signs, and past health history d. inoculate the child with human rabies immune globulin 27. Emilie Lopamia, a 35-year-old female was bitten by a stray dog on the left hand. She sought an advice of the nurse in the health center. The best response of the nurse is a. You should observe the dog for changes in behavior so you will know if the dog is possibly rabid or not. b. You should receive immunization for rabies immediately. c. You dont have to worry because its just a minor wound. d. You should receive immunization for rabies & tetanus as soon as possible.

28. Emilie asked the nurse regarding the incubation period of rabies. Which of the following statements made by the nurse is appropriate? a. The incubation period is about 2 weeks. b. The incubation period varies depending on the site of the bite. c. The incubation period is about 1 month. d. The incubation period is about 1 year. Situation: Mariel Balio, a 12-year-old girl was told by her mother to clean their backyard & burn the leaves of the jackfruit tree. After 5 days, Mariel experienced fever, body malaise & occasional petechial hemorrhages. She was brought to the Rural health unit. 29. Upon seeing Mariel, which of the following questions would the nurse ask to obtain history of the illness? a. Why didnt you show to your mother the skin lesions right away? b. Dont you have a maid to clean your backyard? c. Do you have a communicable disease? d. Were you bitten by mosquitoes when cleaning your backyard? 30. What is the vector of the patients illness? a. Female anopheles mosquito b. housefly c. cockroaches d. Aedes aegypti 31. Which of the following is immediately performed to Mariel which serves as the screening test for dengue hemorrhagic fever? a. ELISA b. Rumpel-leede test c. Complete blood count d. Sedimentation rate 32. The nurses primary concern during her care to Mariel is one of the following. a. report to authority b. monitor vital signs c. conduct research d. case finding 33. The community physician ordered CBC to Mariel. As the nurse taking care of the patient, your expected CBC finding in patients with dengue hemorrhagic fever is a. Increased WBC & decreased RBC b. Decreased hematocrit & increased platelet c. Decreased platelet & increased hematocrit d. Increased hematocrit & decreased hemoglobin 34. The best measure to control spread of Mariels illness is to a. avoid hanging clothes in the backyard b. keep water container open c. spay insecticides once a month d. eliminate breeding places of vector 35. Mr. Michael Bautista had a recent travel to Palawan & is suspected to have malaria. The most important diagnostic test in malaria is a. Erythrocyte sedimentation rate b. WBC count c. Peripheral blood smear d. Culture 36. The nurse is reviewing the chart of Mr. Bautista. Which of the following objective cue can be seen in the patients chart? a. splenomegaly

b. Leucocytosis c. Increased platelet count d. Erythrocytosis 37. Nursing care of patients with Malaria include provision of comfort, avoidance of chills, proper elimination & accurate medication. Which of the following is most important in preventing spread of infection? a. eradicating breeding sites of vector b. educate patient regarding compliance with drug regimen c. isolation of patient d. avoid sharing utensils 38. A community health nurse teaches a mother comfort measures for her six-year-old child who has varicella-zoster virus. Which of the following actions, if taken by the mother, requires further intervention? a. Applying cortisone-based cream to the childs lesion b. Patting the childs lesions with calamine lotion c. Bathing the child with tepid sponge bath d. Trimming the childs fingernails very short 39. When teaching a mother about communicable diseases, the nurse informs her that chickenpox is a. communicable until all the vesicles have dried b. no longer communicable after a high fever has subsided c. not communicable as long as the vesicles are intact and surrounded by a red areola d. not communicable at all 40. The nurse manager is planning the clinical assignments for the day. The nurse manager avoids assigning which of the following staff members to the client with herpes zoster? a. the nurse who never had mumps b. an experienced nurse who never had chickenpox c. the nurse who never had roseola d. the nurse who never had german measles 41. A nurse is performing an assessment on a 3 year old child with chicken pox. The childd mother tells the nurse that the child keeps scratching at night, and the nurse teaches the mother about measures that will prevent an alteration in skin integrity. Which statement by the mother indicates that teaching was effective? A. I will apply generous amounts of a cortisone cream to prevent itching. B. I need to place white gloves on my childs hands at night. C. I need to keep my child ia a warm room at night so that covers will not cause my child to scratch. D. I will give my child a glass of warm milk at bedtime to help my child sleep. 42. Nursing care of patients with measles is avoidance of complications. Which of the following interventions is done when the child is sensitive to light? a. advise to wear dark glasses b. cover eyes with a piece of cloth c. place patient in a dim, quiet room d. shut down windows & door 43. A nurse is assessing a 12-month-old infant who recently had fever, runny nose, cough, and white spots in the mouth for 3 days. A rash developed that started on the face and spread to the whole body. The nurse should suspect that the child has

a. rubella b. rubeola c. varicella d. scarlet fever 44. The nurse is aware that rubeola often causes children to have a. a maculopapular rash b. a paroxysmal cough c. an enlarges parotid gland d. a generalized vesicular lesion 45. A child with rubeola (measles) is being admitted to the hospital. In preparing for the admission of the child, a nurse plans to place the child on which precautions? a. contact c. respiratory b. enteric d. protective 46. A nurse is caring for a child diagnosed with rubeola. The nurse notes that the physician has documented the presence of Koplik spots. Based on this documentation, which of the following would the nurse expect to note on assessment of the child. A. petechiae spots that are reddish and pinpoint on the soft palate. B. Whitish vesicles located across the chest C. Small, blue-white spots with a red base found on the buccal mucosa D. Pinpoint petechiae noted on both legs Situation: James, a 4-year-old boy is brought to the Rural Health Unit for cough, fever and rashes. The doctor diagnosed him with measles infection. 47. Which of the following should you do first? a. Perform nursing procedures c. Assess the patient b. Plan for your care regimen d. Identify nursing diagnosis 48. Which of the following procedure should you teach James sister when James has a fever at home? a. proper positioning c. Hot sitz bath b. Isolation technique d. Tepid sponge bath 49. Which of the following is the most common complication? a. Meningitis c. Otitis media b. Pneumonia d. Laryngitis 50. Which nursing consideration must be rendered to avoid complication of pneumonia? a. Protect eyes from glare of sunlight c. Ventilated room but free from drafts b. Correct technique of sponge bath d. Check prescribed medications faithfully 51. Nutrition is sometimes neglected due to patients inability to ask for food. What is your meal plan for kids with measles? a. ice cream and cookies c. KFC Chicken b. Fluids and crackers d. Mcdonalds sundae Situation: Madam Auring, a 25-year-old female sought consultation to a health center after having missed one

menstrual cycle period. It is confirmed that she is 6 weeks pregnant. 52. Further examination showed that Madam Auring is susceptible to rubella. When would it be most appropriate for her to receive rubella immunization? a. Immediately c. within 2 weeks before EDC b. during 2nd trimester d. During her postpartum hospitalization 53. Rubella, if acquired by a pregnant patient during the pregnancy may result in congenital defects in newborn which includes: 1. deaf-mutism 2. congenital cataract 3.microcephally 4. congenital heart defect a. 1,2 & 4 b. 2,3& 4 c. 1, 3, & 4 d. 1, 2, 3 & 4 e. 54. The following diseases are characterized by the appearance of skin rashes caused by a virus except: a. measles c. variola b. chickenpox d. scarlet fever 55. A child with rubella should be isolated from a/an a. 20-year-old brother living in the same house b. 3-year-old girl who lives next door c. 12-year-old sister who had rubeola during childhood d. 18-year-old female cousin who recently got married Situation: The patient has a sore that does not heal. Upon examination it reveals leprosy. 56. Mode of transmission of leprosy is a. Sharing food c. Borrowing utensils b. Sexual contact d. Prolonged skin to skin contact 57. Late sign of leprosy in male patients is enlargement of the breast known as: a. Clawing c. Madarosis b. Lagopthalmos d. Gynecomastia 58. Your role in prevention of leprosy is a. Health Education c. Personal Hygiene b. Proper nutrition d. BCG vaccination 59. Multi-drug therapy is being implemented by DOH. Where is the initial treatment done? a. Midwife residence c. baranggay captain office b. barangay health center d. rural health unit 60. Which of the following is/are mild leprae reaction? 1. Edema 2. Sudden increase in the number of lesions 3. Tenderness on the nerve 4. Sudden paralysis

a. 1, 2 & 3 are correct b. 1 & 3 are correct c. 2 & 4 are correct d. 4 only e. all of the above 61. Nursing care of patients with Diphtheria is provision of complete bed rest. Which nursing intervention must be done to a child with laryngeal diphtheria? a. ice chips every hour b. cookies & candies for snacks c. Crackers for lunch d. small & frequent feeding 62. The characteristic lesion of diphtheria is a grayish-white membrane which can block breathing & swallowing. Which of the following pertains to this membrane? a. Kopliks spots b. Forscheimer spots c. Papule d. Pseudomembrane 63. The bacteria which causes diphtheria is also known as a. Spirochete b. Klebs-Loeffler bacillus c. Cholera d. Amoeba Situation: Camille, a 4-year-old girl was brought to a hospital due to paroxysms of cough. Initial assessment of the physician was pertussis 64. Which of the following accurately describes symptoms of pertussis? 1. successive coughing 2. vomiting 3. whooping followed by paroxysms of cough 4. barking cough. a. 1, 2 and 3 c. 2 & 4 e. all of the above b. 1 & 3 d. 4 only 65. Which laboratory procedure is done to diagnose pertussis? a. Saliva examination c. gram staining of nasopharyngeal secretion b. Culture of nasopharyngeal swab d. blood culture 66. When blood is examined which blood component is elevated in pertussis? a. Eosinophils c. RBC b. Lymphocytes d. neutrophils 67. A clinic nurse provides instructions to a mother regarding the care of her child who is diagnosed with croup. Which statement by the mother indicates a need for further instructions? a I will place a cool mist humidifier next to my childs bed. b.Sips of warm fluids during a croup attack will help. c. I will give Tynelol for the fever. d. I will give cough syrup every night at bedtime. Situation: Mr. Ferdinand Lu, a 35-year-old executive is confined in the Medical ward due to pneumonia. 68. After performing your physical assessment to the patient, which of the following signifies that he is having pneumonia? a. chest auscultation revealing bronchio-vesicular breath sounds b. equal chest expansion occurring every inspiration c. tactile fremitus is decreased over the affected area d. percussion is resonant on the intercostals spaces

69. Steam inhalation was ordered by the physician. The action of this is to a. dilate the bronchioles, thus increasing the viscosity of secretions b. reduce the viscosity of secretions c. increase the viscosity of secretions d. inhibit the growth of microorganism 70. Sputum examination for culture & sensitivity was ordered. This would ascertain which of the following facts? a. the correct analgesic to minimize his chest pain during inspiration b. the right antibiotic which would be most curative c. the right drug to minimize secretions d. the correct position during coughing 71. The following are the nursing guidelines for chest physiotherapy. Which of the following should not be applied to Mr. Lu? a. perform postural drainage at least 1 hour after meals b. teach deep breathing & coughing exercises c. allow patient to continue postural drainage despite feelings of discomfort d. avoid chest tapping in areas of severe pain 72. a client with pneumonia has a temperature of 102.6 deg F, is diaphoretic, and ahs a productive cough. The nurse include which of the following measures in the plan of care? a. Position changes every 4 hours b. sunctioning to clear secretions c. Frequent linen changes d. Frequent offering of bed pan 73. Bed rest is prescribed for a client with pneumonia during acute phase of the illness. Bed rest serves which of the following purposes? a. it reduces the cellular demand for oxygen b. it decreases the episodes of coughing c. it promotes safety d. it promotes clearance of secretions 74. The cyanosis that accompanies bacterial pneumonia is primarily caused by which of the following? a. decreased cardiac output b.pleural effusion c.inadequate peripheral circulation d.decreased oxygenation of the blood 75. A client with pneumonia is experiencing pleuritic chest pain. Which of the following describes pleuritic chest pain? a. a mild but constant aching in the chest b. severe midsternal pain c .moderate pain that worsen on inspiration d .muscle spasm pain that accompanies coughing 76.Which of the following measures would most likely be successful in reducing pleuritic cheast pain in client with pneumonia? a. encourage the client to breath slowly b.have the client practice abdominal breathing c.offer the client incentive spirometry d.Teach the client to splint the ribcage when coughing 77. Which of the following mental status changes may occur when a client with pneumonia is first experiencing hypoxia? a. coma

b. apathy c. Irritability d. Depression 78. A client with pneumonia has a temperature ranging between 101 and 102 deg F and periods of diaphoresis. Based on this information, which of the following nursing interventions would be priority? A. Maintain Complete bed rest b. administer oxygen therapy c. provide frequent linen changes d. provide fluid intake of 3 liters/day 79. Which of the following would be appropriate expected outcome for an elderly client recovering from bacterial pneumonia? a. A respiratory rate of 25 to 30 breaths/ min b. The ability to perform activities of daily living c. A maximum lost of 5 to 10 pounds of body weight d. Chest pain that is minimized by splinting the ribcage. 80. A community health nurse is conducting an educational session with community members regarding tuberculosis. The nurse tells the group that one of the first symptoms associated with tuberculosis is a. a bloody, productive cough b. a cough with the expectoration of mucoid sputum c. chest pain d. dyspnea 81. A nurse performs an admission assessment on a client with a diagnosis of tuberculosis. The nurse reviews the results of which diagnostic test that will confirm this diagnosis? a. bronchoscopy c. sputum culture b. chest x-ray film d. tuberculin skin test 82. A client who is HIV (+) has had Mantoux skin test. The nurse notes a 7-mm area of induration at the site of the skin test. The nurse interprets the result as what? a. positive c. inconclusive b. negative d. it needs repeat testing 83. A nurse in the out-patient department performed Mantoux skin test today (Tuesday) to an adult client. What statement made by the client indicates that he understood the instruction well? a. I will come back on Saturday for you to read the result. b. I will come back on Thursday, same time, for you to read the result. c. I dont need to come back anymore. d. I will come back anytime. 84. A client exposed to tuberculosis is taking isoniazid (INH) and develops signs & symptoms of the disease. The client is instructed to add rifampicin & pyrazinamide to the medication regimen. A nurse explains to the client that the purpose of adding this second medication is a. that rifampicin offsets the side effects of isoniazid b. to be certain that resistant organisms are eliminated c. that these medications potentiate each other d. that isoniazid offsets the side effects of rifampicin

85. A nurse is caring for a client diagnosed with tuberculosis. Which assessment, if made by the nurse, would not be consistent with the usual clinical presentation of tuberculosis and may indicate the development of a concurrent problem? a. productive cough c. chills & night sweats b. anorexia & weight loss d. high-grade fever 86. A nurse has conducted discharge teaching with a client who was diagnosed with tuberculosis. The client has been taking medication for a week and a half. The nurse evaluates that the client has understood the information if the client makes which of the following statements? a. I need to continue drug therapy for 2 months. b. I should not be contagious after at least 2 weeks of medication therapy. c. I cant shop at the mall for the next 6 months. d. I can return to work if a sputum culture comes back negative. 87. A client has been taking isoniazid (INH) for a month and a half. The client complains to a nurse about numbness, paresthesias, and tingling in the extremities. The nurse interprets that the client is experiencing a. small blood vessel spasm c. impaired peripheral circulation b. hypercalcemia d. peripheral neuritis 88. A client will start a 6-month course therapy with isoniazid (INH). A nurse plans to teach the client to a. use alcohol in small amounts only b. report yellow eyes or skin immediately c. increase intake of cheese & milk d. avoid vitamin supplements during therapy 89. A client has been started on long-term therapy with rifampicin. A nurse teaches the client that the medication a. should be double dosed if one dose is forgotten b. may be discontinued independently if symptoms are gone in 3 months c. should always be taken with food or antacids d. causes orange discoloration of sweat, tears, urine, & feces 90. A nurse has given a client taking ethambutol information about the medication. The nurse determines that the client understands the instructions if the client states to immediately report a. gastrointestinal side effects b. impaired sense of hearing c. orange-red discoloration of body secretions d. difficulty in discriminating the color red from green Situation: Tuberculosis, a primary respiratory disease is common among malnourished individuals living in crowded places. The DOH survey last 1997 revealed that there are approximately 16 million afflicted with the disease. 91. The bacteria causing the disease is a. Mycobacterium bovis b. Mycobacterium tuberculosis c. Mycobacterium africanum d. Mycobacterium leprae Situation: Mang Romy is malnourished living in a squatters area. He came in the health center due to loss of weight easy, fatigability, chronic cough and low grade fever. 92. The main source of infection pulmonary tuberculosis is: a. crowded living quarters b. unavailability of potable drinking water

c. direct contact with infected person d. unsanitary surroundings 93. A physician orders an X-ray examination for patient. What is the purpose for this? a. To check if patient have relatives with TB b. To see the evidence of having the disease c. Determine severity of the lesions in the lungs d. To aid in doctors prescriptions. 94. The nurse notes 12 mm of induration at the site of a Mantoux test when a client returns to the health office to have it read. The nurse should explain to the client that this is a. Test result is negative, & no follow-up is needed. b. Test was used for screening and a TINE test will now be given. c. Skin test is inconclusive and will have to be repeated in six weeks. d. The result is positive and a need for further tests, including chest x-ray is indicated 95. Staff nurses learn that a patient they have been caring for during the last few weeks has just been diagnosed with tuberculosis. When the nurses express concern about contracting tuberculosis themselves, the charge nurses response should be based on which of the following statements? a. Tuberculosis is easily treated with short course of antibiotics b. The Mantoux test is used to confirm diagnosis of tuberculosis c. Tuberculosis is not highly infectious when standard precautions are followed d. Vaccination with BCG will be used to immunize the nurses against infection 96. Before returning a child who is being treated for tuberculosis to his home, the community health nurse determines a. that the child has a private room b. that all family members have been tested c. proper room ventilation d. home school placement 97. Which of the following statements, if made by a patient who has tuberculosis, would indicate a correct understanding of disease transmission? a. The disease can be acquired from breast milk. b. The disease does not spread beyond the lungs. c. I contracted the disease through bird droppings. d. I can be infected more than once with this disease. 98. Which of the following instructions should a nurse give to a patient who has tuberculosis and is receiving rifampicin? a. Stay out of the sun while you are taking the medication. b. Expect your urine to turn reddish-orange. c. Take your medication on an empty stomach. d. Take your medication until your skin test is negative. 99. A patient who is taking INH, Rifampicin, PZA and pyridoxine for the treatment of tuberculosis asks a nurse why the Vitamin B6 (pyridoxine) is necessary. The nurse would respond that a. Vitamin B6 is necessary for the absorption of INH. b. Vitamin B6 activates the metabolism of INH. c. INH leads to Vitamin B6 depletion, which leads to neurotoxic effects. d. INH can cause anorexia, which leads to vitamin B6 depletion. 100. What is the rationale that supports multidrug treatment for clients with tuberculosis? a. Multiple drugs potentiate the drug actions b. Multiple drugs reduce undesireable side effects c. Multiple drugs allow reduced dosages to be given d. Multiple drugs reduce development of resistant strains of the bacteria

101. The client with TB is to be discharged home with community health nurse follow-up. Of the following interventions, which would have the highest priority? a. offering the client emotional support b. teaching the client about the disease and its treatment c. coordinating various agency services d. Assessing the clients environment for sanitation 102. The nurse should caution sexually active female clients taking INH that the drug has which of the following effects? a. Increases the risk of vaginal infection b. Has mutagenic effects on ova c. Decreases the effectiveness of oral contraceptives d. Inhibits ovulation 103.Clients who have had active TB are at risk for recurrence. Which of the following conditions increases that risk? b. Cool and damp weather c. Active exercise and exertion d. Physical and emotional stress e. Rest and inactivity 104.The nurse should include which of the following instructions when developing a teaching plan for clients who are receiving INH and rifampicin for treatment of TB? a. Take the medications with antacids b. Double the dosage if a drug dose is forgotten c. Increase intake of dairy products d. Limit alcohol intake Situation: Mandy started to complain severe headache and high grade fever for almost two weeks. She remembered eating sapin sapin in a nearby store. The initial impression of the admitting doctor was typhoid fever. 105. The organ of predilection of typhoid infection is: a. small intestine c. gallbladder b. colon d. Spleen 106. Mandy reported presence of black or tarry stool a day prior to admission. Based on the natural history of disease, she is on what stage of the disease process? a. prodomal satge c. defervescence stage b. fastidial stage d. recovery stage 107. Nurse Arianne examined Mandy. She was trying to look for the an exanthema of typhoid fever which is a. maculopapular rashes on trunk c. bluish discoloration on arms b. petechial rashes on extremities d. migratory painless nodules 108. The confirmatory test for typhoid on the first week of illness is a. Widal test c. Typhidot b. Urine culture d. Blood culture 109. The stool culture of a child with profuse diarrhea reveals Salmonella bacilli. After teaching the mother about the course of Salmonella enteritis, which of the following statements by the mother indicates effective teaching? a.Some people become carriers and stay infectious for a long time b. After the acute stage passes the organism is usually not present in the stool.

c. Although the organism may be alive indefinitely, in time it will be of no danger to anyone. d. If my child continues to have the organism in the stool, an antitoxin can help destroy the organism. 110. Which of the following would be the best activity for the nurse to include in the plan of care for an infant experiencing severe diarrhea? a. Monitoring the total 8 hour formula intake b. Weighing the infant each day c. Checking the anterior fontanel every shift d. Monitoring abdominal skin turgor every shift 111. Which of the following would be most appropriate for the nurse to teach the mother of a 6 month old infant hospitalized with severe diarrhea to help comfort her infant who is fussy? a. Offering a pacifier b.Placing a mobile above the crib c. Sitting at the crib side talking to the infant d.Turning the television on to cartoons 112.Which of the following nursing diagnosis would be appropriate for the nurse to identify as a priority diagnosis for an infant just admitted to the hospital with a diagnosis of gastroenteritis? a.Pain related to repeated episodes of vomiting b.Deficient Fluid volume related to excessive losses from severe diarrhea c.Impaired parenting related to infants loss of fluid d.Impaired Urinary Elimination related to increased fluid intake feeding pattern 113.Which of the following would the nurse use to determine achievement of the expected outcome for an infant with severe diarrhea and nursing diagnosis of Deficient Fluid volume related to passage of profuse amounts of watery diarrhea? a. Moist mucous membranes b.Passage of a soft, formed stool c.Absence of diarrhea for a 4 hour period d.Ability to tolerate intravenous fluids well 114.A child is admitted to the pediatric unit with the diagnosis of severe gastroenteritis. Which of the following would be most appropriate for the nurse to do? a. Institute standard precautions b. Place the child in a semiprivate room c. Use regular eating utensils d. Single- bag all linens 115. Of the following would most likely alert the nurse to the possibility that a preschooler is experiencing moderate dehydration? a. Vomiting b. Diaphoresis c. Absence of tear formation d. Decreased urine specific gravity 116.The physician orders IV fluid replacement therapy with potassium chloride to be added for a child with severe gastroenteritis. Before adding the potassium chloride to the IV, which of the following assessments would be most important?

a. Ability to void b. Passage of stool today c. Baseline echocardiogram d. Serum calcium level 117.Which of the following would first alert the nurse to suspect that a child with severe gastroenteritis who has been receiving IV therapy for the past several hours may be developing circulatory overload? a. a drop in blood pressure b. change to slow, deep respirations c. auscultation of moist crackles d. marked increase in urine output 118. To help prevent an infant from contracting infectious diarrhea, the nurse should instruct the mother on which topic? a. When to introduce solid foods into the infants diet b. How to prepare, handle & store infant formula c. When to have the child immunized d. When to bring the infant to the clinic for routine check-ups 119. A nursing student is assigned to admit to the hospital a child who has been experiencing vomiting & diarrhea. A physician establishes a diagnosis of acute gastroenteritis & isotonic dehydration. A nursing instructor asks the student to describe isotonic dehydration. The nursing student responds accurately by telling to the instructor that isotonic dehydration a. occurs when water & electrolytes are lost in about the same proportions as they exist in the body b. occurs when the loss of electrolytes is greater than the loss of water c. occurs when the loss of water is greater than the loss of electrolytes d. causes the serum sodium level to rise above 150 mEq/L 120. A clinic nurse is assessing a child for dehydration. The nurse determines that the child is moderately dehydrated if which symptom is noted on assessment? a. flat fontanels c. moist mucous membranes b. pale skin color d. oliguria 121. Bloody & mucoid stool associated with tenesmus is pathognomonic of a. diphtheria c. bacillary dysentery b. violent dysentery d. amoebic dysentery 122. The intermediate vector of schistosomiasis is a. mosquitoes c. rats b. flies d. fresh water snail 123. Diet of patient with acute parotitis should contain a. High Na, High CHO, High fats b. Low Na, Low CHO, Low fats c. High CHO, High fats d. High CHO, Low fats 124.A mother is worried because her 5-year-old son acquired mumps infection. She asks about the most severe complication of this infection. The best response of the nurse should be a. You dont have to worry because there is no known complication of mumps. b. Although rare, the most severe complication of mumps is encephalitis. c. Your son will become sterile for life. d. Your child may develop pneumonia.

Situation: Mr. Reyes, 25-year-old clerk is admitted to the hospital with a chief complaint of easy fatigability associated with fever, amber-colored urine & clay colored stools. He is diagnosed with Acute Viral Hepatitis type B. On the fourth hospital day, he developed jaundice & strongly insisted that his visitors be restricted to her immediate family members. 125. Potential problems that a nurse may encounter include all of the following except a. Bleeding b. Pruritus c. Weight loss d. Hyperglycemia 126 Based on the data given, one of the nursing diagnosis is a. Depression related to feelings of guilt b. Anxiety related to feeling of impending doom c. Body image disturbance related to altered skin appearance d. Anger & hostility related to restriction of physical activity 127. The nurse observes that Mr. Reyes has clay-colored stools. He asked you why is this so. The reason for this is that a. Hepatic uptake of bilirubin is impaired b. Excretion of fecal urobilinogen is increased c. Conjugated bilirubin reenters the bloodstream d. Excretion of conjugated bilirubin into the intestines is decreased 128. To best reduce the risk of spread of Mr. Reyes disease, the nurse must observe the proper disposal of the patients a. Urine & feces b. Nasogastric secretions c. Used needles & syringes d. Feces & oral secretions 129.The nurse plans care for the client with Hepatitis A with the understanding that the causative virus will be excreted from the clients body primarily through the: a. skin b. feces c. urine d. blood 130. The nurse is planning a staff development program for health care staff on how to care for the clients with hepatitis A. Which of the following precautions would the nurse indicate as essential when caring for clients with Hepatitis A? a. Gowning when entering aclients room b. Wearing a mask when providing care c. Assigning the client to a private room d. Wearing gloves when giving direct care 131. When developing a plan of care for the client with viral hepatitis, the nurse should incorporate nursing orders that reflect the primary treatment. Emphasis will be on ensuring that the client receives which of the following? a. adequate bed rest b. generous fluid intake c. regular antibiotic therapy d. daily IV theraphy 132.In a client with viral hepatitis, the nurse would closely assesses for indicators of which of the following abnormal laboratory values? a. prolonged PT b.decreased blood glucose level c.elevated serum potassium d.decreased serum calcium

133. Which of the follwing diets would most likely be prescribed for a client with viral hepatitis? a. high fat, low protein b. high protein, low carbohydrates c.high crbohydrates, high calorie d. low sodium, low fat 134. The nurse develops a teaching plan for the client about how to prevent the transmission of hepatitis A. Which of the following discharge instructions is appropriate for the client? a. Spray the house to eliminate infected insects b. Tell the family members to try to stay away from the client. c. Tell the family members to wash their hands frequently d. Disinfect all clothing and eating utensils 135. The nurse assesses that the client with hepatitis is experiencing fatigue, weakness, and a general feeling of malaise. The client tires rapidly during morning care . Based on this information, which of the following would be an appropriate nursing diagnosis? a. Impaired physical mobility related to malaise b. Self-cared Deficit related to fatigue c. Ineffective Coping related to long term illness d. Activity Intolerance related to fatigue 136. A client has been admitted to the hospital with a diagnosis of hepatitis B. the client tells the nurse, Ifeel so isolated from my friends and family. Nobody wants to be around me. What would be the most appropriate nursing diagnosis for this client? a. Anxiety related to feelings of isolation b. Social isolation related to significant others fear of contracting disease c. Powerlessness related to lack of social support d. Low-self Esteem related to feelings of rejection. 137. A delivery room nurse was unable to perform newborn care to a neonate. In the history of the postpartum mother, she recently was diagnosed with gonococcal infection that was untreated. Which of the following will most likely to occur in the neonate? a. The neonate will have bleeding problems due to lack of vitamin K b. The neonate will develop ophthalmia neonatorum c. The neonate will not have any medical problems d. The neonate will develop respiratory failure 138. Cristina Yap, a 30-year-old female came to a clinic due to burning sensation in the genital area. The physician diagnosed her with non-gonococcal urethritis. The nurse knows that the most likely etiologic agent of non-gonococcal urethritis is a. Neiserria gonorrhea c. Chlamydia trachomatis b. Trichomonas vaginalis d. Haemophilus ducreyi Situation: A 24-year-old male presents to the OPD with a 3 day history of burning sensation on urination which progressed to the development of purulent, yellowish-to-greenish urethral discharge. The nurse suspects of STD. 139. On laboratory examination, the diagnosis of gonorrhea is confirmed by which of the following on the report of the staining result? a. Gram negative intracellular diplocci c. Numerous spirochetes

b. Gram positive extracellular diplococci d. Gram negative extracellular diplococci 140. The nurse knows that the easiest factor to break in the infectious process to prevent STD spread would be a. Reservior c. Agent b. Mode of transmission d. Portal of entry 141. The prevention and control of STD is made difficult by a. Lack of drugs specific for STD c. No government program on STD b. Self-medication of infected persons d. Lack of better laboratory facility 142. Nurse is very active in contact tracing and epidemiologic treatment of all gonococcal identified contacts to prevent a. Development of resistant strain c. Non venereal transmission b. Asymptomatic infection d. Re-infection 143. The patient made the following statement to the nurse. Which statement would need reinforcement of health teachings? a. I need to take drugs for prophylaxis the next time I do it b. Gonorrhea does not confer lifelong immunity c. The disease can also be transmitted through other means d. I will finish the prescribed medication to prevent resistance of microorganism 144. A female client with gonorrhea informs the nurse that she had sexual intercourse with her boyfriend and asks the nurse Would he experience any symptoms? The nurse responds that in males, the initial manifestation is a. Impotence b. Scrotal swelling c. Sterility d. Dysuria Situation: Mr. Larry Hipolito, a 25 y/o male came to an outpatient clinic complaining of pain over the hypogastrium & yellowish discharge from his urethra. A diagnosis of gonorrhea is made. 145. Since Larry has gonorrhea, he most likely has which of these symptoms? a. a maculo-papular rash on the pubic area b. a painless ulcer on the penis c. wart-like lesions on the scrotum d. pain upon urination 146. Larry was instructed to remain in the clinic for at least 30 minutes so that adverse reactions to the medication can be detected. Which of these comments made by Larry is indicative of an adverse reaction to the specific drug? a. My chest feels tight b. I need to go to the bathroom. c. I need a glass of water. d. My hands are shaky. 147. Larry asked for possible complications if he had not received treatment for gonorrhea. He would be told that one such complication is a. liver atrophy b. epididymis c. peripheral vascular disease d. ectopic pregnancy 148. Characteristic lesion of primary syphilis is a. chancroid b. condyloma lata c. gumma d. chancre

149. A client is suspected of having late-stage syphilis. When obtaining a health history, the nurse recognizes that the statement by the client that would most support this diagnosis would be a. I noticed a wart on my penis. b. I have sores all over my mouth. c. I have been losing a lot of hair lately. d. Im having trouble keeping my balance. Situation: Mark Smith, a 37 y/o male has 19 years history of IV drug abuse. He has poor appetite, nausea, & weight loss of 10 kg in the past 6 months. A diagnosis of HIV was made. 150. To initiate a nursing care plan for Mr. Smith, the nurse should consider that a depressed immune system is caused by which of these pathophysiological alterations? a. Decreased leucocyte count b. low platelet count c. reduction of nucleated RBC d. Increased sedimentation rate 151. Lesions that will characterize Mr. Smith is in the advanced stage of the illness is a. condyloma lata b. gumma c. Kaposis sarcoma d. Pneumocyctis carinii pneumonia 152. A patient who is HIV positive is admitted to an isolation unit for treatment of tuberculosis. The nurse observes that the patient has difficulty following instructions, short-term memory loss & difficulty concentrating. The nurse should be aware that these behaviors a. will disappear when isolation is no longer required b. are symptoms of AIDS dementia complex c. are normal for the early stage of infection d. are a result of mycobacterium infection 153. A patient who has AIDS develops Pneumocyctis carinii pneumonia (PCP). The patient asks the nurse, How did I get this pneumonia? The nurses response should be based on which of these statements about PCP? a. It occurs in immunosuppresed persons from proliferation of organisms that are normally present in the body b. It is transmitted from close contact with an infected individual who has a suppressed immune system. c. It results from exposure to a carrier of the organism who has not taken appropriate precautions. d. It is most often acquired from unprotected sex with an infected individual. 154. An HIV-positive patient is prescribed zidovudine and ganciclovir. The nurse should be aware that both drugs have which of the following side effects? a. Peripheral neuropathy b. Insomnia c. Anticholinergic effects d. Bone marrow suppression 155. Blood screening tests of the immune system of a client with AIDS would indicate a. a decrease in CD4 T cells b. an increase in thymosine (thymic hormone) c. an increase in immunoglobulin E d. a decrease in erythrocytes 156. Mr. Santos, a 48-year-old male is an HIV suspect admitted in San Lazaro. In assessing the patients condition for possible HIV infection, the least expected symptom to occur is a. Night sweating b. Fever c. Fungal infection in the mouth d. Acute diarrhea

157. The nurse is caring for the client with acquired immunodeficiency syndrome. The nurse detects early infection with Pneumocystis carinii by monitoring the client for which clinical manifestation? a. dyspnea on exertion c. fever b. dyspnea at rest d. cough 158. The nurse is caring for the client with AIDS who is experiencing night fever & sweats. Which nursing intervention would be the least helpful in managing this symptom? a. keep a change of bed linens nearby in case they are needed b. administer an antipyretic after the client has spike of fever c. make sure the pillow has a plastic cover d. keep liquids at bedside 159. The client exposed to human immunodeficiency virus about 3 months ago has seroconverted to an HIV-positive status. The nurse anticipates that the client will experience which of the following at this time? a. oral lesions c. purplish skin lesions b. chronic cough d. no signs & symptoms 160. The client with AIDS has raised dark purplish-colored lesions on the trunk of the body. The nurse anticipates that which of the following procedures will be done to confirm whether these lesions are due to Kaposis sarcoma? a. Enzyme-linked immunosorbent assay c. western blot b. skin biopsy d. lung biopsy