Title DIAGNOSTIC EXAMINATION - NP2 - STUDENT COPY ✅

REFRESHER PHASE DIAGNOSTIC EXAMINATION NURSING PRACTICE 2 (NP2) NOVEMBER 2025 Philippine Nurse Licensure Examination Review Situation: During a journal club meeting of staff in the Pediatric ICU, Ricci is presenting a study regarding effective ways of preventing hospital-acquired pneumonia among critically-ill pediatric patients. 1. Which of the following is a significant finding of the study? A. There is no difference in the rate of pneumonia between pediatric patients born term and pre-term (p-value=0.04). B. The 5-minute APGAR score of the neonates correlate with the number of hospital stays due to pneumonia (r=-0.9, p-value=0.5) C. A chi-square of the sex of the pediatric patient, and the incidence of pneumonia is 1.83, p-value=0.1. D. A nurse-led intervention to prevent hospital-acquired pneumonia did not improve the rate of pneumonia among pediatric patients. 2. An intervention is reported in the journal article to decrease the incidence of pneumonia among pediatric patients. This study will follow which of the following guidelines in reporting? A. STROBE B. CONSORT C. PRISMA D. MOOSE 3. Another staff nurse presented a study that looks into the factors that decrease (or increase) the incidence of pneumonia in the pediatric ICU. What is the most likely research purpose of this study? A. Description B. Exploration C. Prediction D. Control 4. Which of the following sampling techniques produces a less likely representative sample for study? A. Convenience Sampling B. Stratified Sampling C. Purposive Sampling D. Nonprobability Sampling 5. The head nurse of the pediatric ICU reported a study that looked into how a nurse-led infection prevention intervention is implemented in Singapore, which included how the nurse-led team is composed, the manner how teams orient the different participating hospitals, and the factors associated with successful implementation. This refers to what kind of evaluation research? A. Process Analysis B. Outcome Analysis C. Impact Analysis D. Adherence Analysis Situation: Different communicable diseases spike up in today’s trends. It is important for the nurse to understand the background of different emerging diseases, its presentation, diagnosis and interventions associated to the diseases. The following questions apply to emerging communicable diseases. 6. Ebola virus was discovered in 1978 in Congo and re-appeared last 2014 in Guinea with case fatality rate of 50%. It has several different causative agents and is transmitted through direct or indirect contact to affected primates such as bats. It is also commonly known as the hemorrhagic fever. Given its signs and symptoms of myalgia, high fever, malaise, internal bleeding and shock, the nurse should anticipate all of the following management except: A. Intensive fluid replacement B. Contact tracing C. Isolation D. Close-door home care 7. Zika virus is another emerging disease which was discovered in Uganda in 1947. It is known to be transmitted through mosquito bites specifically of Aedesaegypti and albopictus. Aside from a known complication of microcephaly to infants born to a mother who had a history of Zika virus, which complication is known to develop among adults who have had a history of the disease? A. Guillain-Barre Syndrome B. Alzheimer’s disease C. Degenerative spondylosis D. Hunter’s syndrome 8. In caring for a client with AIDS and is currently on HAART therapy, which of the following statements indicates a need for further teaching regarding the management of the disease? A. “I should take my HAART medications with meals” B. “I should regularly check my liver function.” C. “I should immediately consult my physician if I experience abdominal pain which radiates to the back” D. “I could go swimming in a public resort with my family and friends” 9. Nurse Pau is teaching a group of student nurses about Dengue. Which of the following statements if said by the student indicates correct understanding of the topic being discussed? A. “The confirmatory test for Dengue virus is the complete blood count test” B. “20 or more petechial spots inside a 2.5 cm2 box may indicate presence of bleeding according to the principle of the Rumpel lead test” C. “The drug of choice for the client’s fever is acetylsalicylic acid” D. “There is a need to restrict the client’s fluid during Grade III Dengue Fever” 10. SARS and MERS-COV almost have the same presenting signs and symptoms. Although they both have the same causative agent which beta-coronavirus, MERS-COV has a higher case fatality rate of 30% compared to the 10% CFR of SARS. The difference between the statistics of the two diseases can be attributed to: A. The extent of respiratory complications in MERS-COV B. The presence of renal involvement in MERS-COV C. The easier diagnosis of SARS D. The self-limiting nature of SARS Situation: Epidemiology is the study of occurrence and distribution of health conditions such as disease, death, deformities or disabilities on human populations. It is also concerned on the probable factors which influence the development of these conditions. 11. In a far-flung community in Masbate, over the total of 7,500 male population, there are 45 cases of lung cancer recorded in 2012. Among the total cases, 42 males reported a history of chronic heavy use of cigarettes (25 or more per day) while the rest reported complete abstinence from smoking. Given this data, the nurse computes the relative risk ratio of smoking to the development of lung cancer as: A. 9 B. 12 C. 14 D. 3 TOP RANK REVIEW ACADEMY, INC. Page 1 | 8
12. In a birthday party in a community, several suspected case of food poisoning has been reported to the rural health unit. During the case-control study of the epidemiologic team, it has been found that the spaghetti which was served in the party was the possible cause of the poisoning. Among those 56 who attended the party, there were a total of 32 people who reported nausea and vomiting. Of the total poisoned individuals, 28 reported to have eaten spaghetti and 2 reported that they were not able to eat the meal provided. There were 24 individuals who haven’t had any episodes of nausea and vomiting. Of these 24, three reported to have consumed spaghetti from the party. Given the data, what is the odds ratio of food poisoning to the consumption of spaghetti in the party? A. 98 B. 24 C. 78 D. 23 13. In an epidemiologic study done on Poblacion Uno and PoblacionTres in Mendez, Cavite in June 2016, it has been known that the prevalence rate of measles among children aged 2-6 years old is 7.1 and 3.4, respectively. The following is a correct statement about the two barangays: A. Poblacion Uno has a higher herd immunity to measles compared to PoblacionTres. B. PoblacionTres has higher susceptibility to measles compared to Poblacion Uno. C. PoblacionTres has higher herd immunity to measles compared to Poblacion Uno. D. Both Barangays have the same herd immunity and susceptibility levels to measles. 14. This statistical data is the most sensitive and a good index of the general condition of a community as it is able to reflect the minimal changes in its environment and medical condition. A. Maternal mortality rate B. Crude death rate C. Infant mortality rate D. Crude birth rate 15. In an epidemiologic study in the province of Sorsogon, it has been seen that the case of Filiariasis recorded from years 2013-2015 were 12, 11, 14, respectively. This condition is known as: A. Sporadic B. Endemic C. Epidemic D. Chance Situation: Family nursing practice emphasizes the need to understand the behavior of the family as a dynamic, functioning unit which affects its capability to help itself and maintain equilibrium within self. Family community health nursing deals with an open and developing system of interacting personalities which may affect the health status of the community. 16. In the practice of family community health nursing, different theoretical frameworks were developed to better understand the ever dynamic system under the basic unit of the community. Which of the following statements explains the Family Systems Theory? A. “Views the family as a living social system within a context in which multiple environmental actions or factor occur over the life course. It is composed of interrelated and interdependent individuals who are organized into a single unit to attain specific family goals.” B. “Views the family as a unity of interacting personalities whose actions are based on meanings they derive from interactions and taken in an ever changing process of new interactions, new interpretations and new meanings” C. “Specifies four structural dimensions: role structure, value system, communication process, and power structure. It identifies five functional areas: affective function, socialization and family placement function, reproductive function, economic function and healthcare function.” D. “Based on the principle that in order to achieve wellness among family members and reduce or eliminate family health problems, the family as a functioning unit performs the following health tasks (1) recognize the presence of wellness state or health problem, (2) make decision about taking appropriate health action, (3) provide nursing care to the sick, (4) maintain home environment conducive to health maintenance and personal development and (5) utilize community resources for health care.” 17. Assessment data base is an important tool used in planning care for the whole family in the community. Data collection is an essential step for a successful diagnosis of family health problems as well as implementation of care needed by the clientele. This type of data collection infers communication and interaction patterns, task assumption and role perception of family members and home and environmental conditions. A. Interview B. Focused group discussion C. Observation D. Records review 18. Using the Family Systems Theory of Murray Bowen, data which is analyzed is then used in the diagnosis of the family health problems which is included in the typology of nursing problems in family health care. During the diagnosing part of planning care for Ventura family, Nurse Gia found out that Mr. Alex Ventura, 45yo, the head of the family reported that he is engaging unprotected sexual activities with multiple sexual partners without the knowledge of his wife. He also engages into physical activity at least 4 times a week. Mr. Alex’s sexual practices can be considered as a: A. Wellness condition B. Health threat C. Health deficit D. Foreseeable Crisis 19. Mrs. Aleli, Mr. Alex’s wife is on her 28th week AOG. They have five children in which 3 are currently attending school while two youngest children are aged 1 and 3 respectively. During the interview, Mrs. Aleli verbalized that she is worried that the family would not be able to supply the needs of all their children and that they deem it necessary for the eldest child to stop her schooling. This condition is considered as: A. Wellness condition B. Health threat C. Health deficit D. Foreseeable Crisis 20. Maria, the eldest child of Aleli and Alex has been reported to have a feeling of nausea, vomiting and diarrhea. Upon Nurse Gia’s physical assessment, she observed that there is an abdominal protrusion on the child’s thin frame. Maria is also underweight and Aleli reported presence of worms in her daughter’s stool. This condition is: A. Wellness condition B. Health threat C. Health deficit D. Foreseeable Crisis 21. In the second-level assessment of Ventura family, Aleli reported that they think Maria is a healthy child and that there are no present health problems. The couple seemed defensive as they explained that they are trying their best to give the basic needs of their children. This reaction from Aleli indicates which family health nursing problem? A. Inability to recognize the presence of the problem B. Inability to make decisions with respect to taking appropriate health action C. Inability to provide adequate nursing care to the sick, disabled dependent or vulnerable member of the family D. Failure to utilize community resources for health care 22. When talking about the immunization status of their children, Alex stated that all of their children did not have complete immunization status despite knowing that it is available for free in the rural health unit. The couple reported to have a problem with the rural health midwife in the past and they have decided to never go back to the RHU for any services again. In the second-level assessment, which family health task does the family fail to perform? A. Inability to recognize the presence of the problem B. Inability to make decisions with respect to taking appropriate health action TOP RANK REVIEW ACADEMY, INC. Page 2 | 8
C. Inability to provide adequate nursing care to the sick, disabled dependent or vulnerable member of the family D. Failure to utilize community resources for health care Situation: Based on the standard of community health nursing practice, the nurse handles a caseload of clients in a cluster of municipalities, areas or clusters. In giving care for multiple families, there is a need to prioritize the needs of each family to be able to provide efficient and just care to all the clients in the community. 23. This criteria in health problem prioritization refers to the nature of and magnitude of the problems which can be minimized or totally prevented if an intervention is done under certain considerations: A. Nature of the problem B. Salience C. Modifiability of the condition D. Preventive potential 24. Effective family planning is a health intervention needed by the Versoza family due to their unsustainable large family number. During the planning phase, the couple verbalized that they deem the intervention necessary and the problem requires an immediate attention since the problem affects the quality of life of the whole family especially their children. What score would the nurse give to the level of salience of the Versoza family on the said problem? A. 1 B. 0.5 C. 2 D. 1.5 25. During the planning phase of the Valdez family on the current problem of HIV of their mother, Mrs. Leila. This problem was seen by the family as a problem which needs immediate attention with a moderate preventive potential as the complications and disease process can be halted but not prevented upon intervention. What prioritization score should the nurse give to the presenting problem of the Valdez family? A. 1.40 B. 3.16 C. 2 D. 1.0 Situation: Public health nursing has dynamically evolved as a practice which is influenced by the changing global and local trends in the Philippines. Public health nursing has evolved alongside the institution and development of the Department of Health which was mandated to promote and protect people’s health. 26. The term “Public Health Nursing” was coined by Lilian Wald who advocated for services to be available to all people. With the different definitions of public health nursing, the World Health Organization (WHO) defined the term as: A. “Nursing practice in a wide variety of community services and consumer advocate areas, and in a variety of roles, at times including independent practice, community health nursing is not confined to public health nursing agencies” B. “A service rendered by a professional nurse with communities, groups, families, individuals at home, in health centers, in clinics, in schools, in places of work for promotion of health, prevention of illness, care of the sick at home and rehabilitation” C. “A special field of nursing that combines the skills of nursing, public health and some phases of social assistance and functions as part of the total public health programme for the promotion of health, the improvement of conditions in the social and physical environment, rehabilitation of illness and disability” D. ““The art and science of preventing disease, prolonging life and promoting health through the organized efforts of society.” 27. The public health nurse plays different vital roles in the promotion of health in different fields in the community. The PHN coordinates with other agencies for the provision of specific services at the same time conducts home visits in the community to evaluate the plan of care implemented on clients. When the nurse calls for active participation of the community through community organizing and mobilization to assist the community in solving their own problems and promote independence, which role is the nurse portraying? A. Management function B. Nursing care function C. Training function D. Research function 28. In the year 2000, the United Nations Millennium Declaration was signed wherein 189 participating UN member states agreed to try to achieve the 8 Millennium Development Goals in the year 2015. After the implementing period of the MDGs, the United Nations, through a deliberative process involving its 193 member states, came up with the Sustainable Development Goals 2030, officially known as the “Transforming our world: the 2030 Agenda for Sustainable Development”. Which of the following statements is not in line with the targets of the 17 SDGs? A. Ensure sustainable food production systems and implement resilient agricultural practices that increase productivity and production, that help maintain ecosystems, that strengthen capacity for adaptation to climate change, extreme weather, drought, flooding and other disasters and that progressively improve land and soil quality B. Ensure limited access to sexual and reproductive health-care services, including for family planning, information and education, and the integration of reproductive health into national strategies and programmes C. Ensure that all learners acquire the knowledge and skills needed to promote sustainable development, including, among others, through education for sustainable development and sustainable lifestyles, human rights, gender equality, promotion of a culture of peace and non-violence, global citizenship and appreciation of cultural diversity and of culture’s contribution to sustainable development D. Sustain per capita economic growth in accordance with national circumstances and, in particular, at least 7 per cent gross domestic product growth per annum in the least developed countries 29. Public health and public health nursing is a practice which primarily move in an increasingly health promotion direction beyond its responsibility of providing clinical and curative services in the community. All but one are principles of health promotion; A. It involves the population as a whole in the context of their everyday life, rather than focusing on people at risk from specific diseases B. It is primarily a medical service and not a societal and political venture in which healthcare professionals have a vital role C. It aims particularly at effective and concrete public participation which requires development of problem-defining and decision-making life skills both individually and collectively D. It is directed towards action on the determinants or causes of health. This requires a close cooperation between sectors beyond healthcare which reflects the diversity of conditions which influence health. 30. Nurse Lyka is assigned to a number of health centers in District 1 of the Province of Iloilo. She manages and oversees different groups of nurses in a total of 4 health centers from Oton, Miagao, Tigbauan, and Guimbal. She does objective assessment of different health programs, problems and services in all of these areas. She also initiates meetings, discussions and conferences with other nursing staff and health personnel to provide joint planning and stimulation of activities for staff improvement and capacity-building. Nurse Lyka performs the function of a: A. Public Health Nurse II B. Supervising Public Health Nurse C. Public Health Nurse V D. Nurse Program Supervisor TOP RANK REVIEW ACADEMY, INC. Page 3 | 8
Situation: Current epidemiological studies have revealed rent outbreaks of certain dormant diseases. The following questions are relevant: 31. Dengvaxia TM (CYD-TDV) is the first dengue vaccine to be licensed in Mexico in 2015 for use in individuals 9-45 years of age living in endemic areas. This was developed by Sanofi Pasteur. What is the route of administration for this vaccine? A. Intravenous B. Oral C. Intramuscular D. Subcutaneous 32. Determine the dosage of this vaccine. A. 6 injections of 0.5mL each at 3-month intervals B. 3 injections of 1mL each at 3-month intervals C. 6 injections of 1mL: each at 6-month intervals D. 3 injections of 0.5mL each at 6-month intervals. 33. Young women in your community are afraid that they could be infected with Zika virus, and they approached you in request of conducting a small gathering wherein you could share with them information about it. The following are vital points to be discussed about Zika virus, except: A. Developing the infection can only be confirmed by laboratory testing of blood and other bodily fluids. B. Being affected by Zika virus may cause neurological and autoimmune complications in the newborn. C. Mothers of children with microcephaly have been exposed to Zika virus. D. A means to control the spread of Zika virus is by vector side reduction/eradication. 34. As an occupational nurse, you’ve been assigned to a response team from your company in controlling the spread of EBOLA infection in one of the affected areas. One of your tasks is to conduct health teaching on preventive measures against the spread of the disease. You must include the following concepts, except: A. Wear personal protective equipment when caring for a client with EBOLA B. Clients who had EBOLA but were treated should abstain from sexual intercourse for the rest of his life. C. A person with EBOLA becomes infectious upon the onset of signs and symptoms. D. A person with EBOLA remains infectious as long as the virus is present in his blood. 35. You are approached by Paul and Phoebe, a couple, during your medical mission to ask about EBOLA virus because Paul was infected several months ago. Fortunately, he survived. Now, they are planning to start a family. When they ask you about resuming their sexual practices, which statement is appropriate for you to say? A. Ebola virus can still be transmitted through blood for few years. B. Ebola can still be transmitted through sex for months C. Survivors can safely resume normal sexual practices without fear of Ebola virus transmission after two negative results in laboratory testing. D. Survivors can safely resume sexual practices provided that condom is used. Situation: Nurses play an active role in the prevention, management and containment of communicable diseases. 36. A client with human immunodeficiency virus positive had a 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; A. Positive B. Negative C. Uncertain D. Borderline Leprosy is a chronic mildly communicable disease that mainly affects the skin, the peripheral nerves and the mucosa of the upper respiratory tract. The Multi-Drug Therapy (MDT) is proven effective cure for leprosy and renders patients non-infectious a week after starting the treatment. 37. In a health education class conducted by the PHN, she informed them about the early signs and symptoms of Leprosy. Which of the following choices is inappropriate description of the disease? A. Lagopthalmus B. Painful nerves C. Muscle weakness D. Nasal bleeding 38. The PHN gave emphasis on signs and symptoms indicating the infection had advanced to a later stage. Which of the following information should be excluded A. Madorosis B. Hand contractures C. Loss of sensation on skin lesion D. Chronic ulcer German Measles is a viral exanthem infection, caused by a Paramyxo virus primarily affecting older children and young adults occurring sporadically in the Philippines due to mildness of the infection. The incubation period ranges from 10-21 days with clinical features simulating Measles, also a viral exanthem infection 39. Prior to the exposure of the nursing affiliates to the Pediatric-Isolation unit Mrs. Garcia, their C.I conducted pre-conference. She asks her students to describe the hallmark of Rubella infection which is lymphadenopathy. The C.I would not have to correct Elsa, one of the nursing affiliates if she states: A. It involves mucocutaneous lymph node syndrome B. The superficial cubital noles are enlarged C. This involves enlargement of axillary node D. The post cervical nodes and post auricular nodes are enlarged 40. Clarisse, a student nurse is currently performing assessment on Faith, a 9 year old child diagnosed with Rubella. Clarisse documented the typical exanthem known as Forscheimer. Which of the following assessment would support her findings? A. Pinkish to reddish lesions on soft palate/uvula B. Erythematous lesions over the neck C. Vesicles all over the trunk D. Petechial lesions over the face 41. Paramyxo virus is spread through direct contact with nasopharyngeal secretions of infected individual. The S.N is conducting health teachings to the mother. The health teachings to the mother. The health teachings were effective of the mother states. A. It is essential to isolate my other siblings who had Rubella infection last year B. I should not allow my child to play with neighbors who recently recovered from German measles C. Playmates who live next door with uncertain immunization are highly risk D. It is appropriate to inform my cousin who recently got married for us to communicate over the phone and reset an outside meeting a week from now. The WHO announced last April 2013 a new strain of H7N9 has been found in birds and people in China. The WHO reported H7N9 viruses had never before been detected in people from March 31, through April 30, 2013 however China reported more than 126 cases of human infection with this new type of H7N9 virus. 42. The CDC and global public health experts are monitoring H7N9 viruses in China for changes that could allow the infection to spread more easily among people. CDC issued a health alert for public health officials and clinicians regarding flu symptoms of H7N9 . Which of the ff. CDC information guidance were included in the advisory: A. Infection with H7N9 occurred after having contact with infected poultry or contaminated environment B. Symptoms started with high fever and cough. A lot of the cases have progressed to very serious illness including severe pneumonia. Septic shock and multi-organ failure leading to death C. CDC recommends oseltamivis (tamiflu) and zanamivis (relenza) for treatment of H7N9 D. Right now there is no vaccine to protect against this virus. It is alarming because the CDC team has documented person to person spread of the new virus A. All except B B. All except C TOP RANK REVIEW ACADEMY, INC. Page 4 | 8