Title DIAGNOSTIC EXAMINATION - NP2 - KEY.pdf ✅

REFRESHER PHASE DIAGNOSTIC EXAMINATION NURSING PRACTICE 2 (NP2) NOVEMBER 2024 Philippine Nurse Licensure Examination Review Situation: As a Community Health Nurse, you must be aware of the different legal laws related to health care to promote awareness on proper health teaching to the people. 1. Republic Act 1054 is known as the: A. School Health Act B. Occupational Health Act C. Mother and Child Health Act D. Family Health Act 2. A muriatic acid factory has 195 workers. As mandated by Republic At 1054, the factory needs to have: A. A graduate first aid provider B. Part time physician & dentist C. Full time physician & dentist D. Occupational health nurse 3. Almost all Hospitals in the Philippines observe the Expanded Breastfeeding Promotion Act of 2009 is: A. RA 12800 B. RA 9800 C. RA 7600 D. RA 10028 4. It is mandated that a Community health Nurse must be aware of the Universal Law on Immunization which is the: A. PD 4 B. PD 5 C. PD 6 D. PD 7 5. Nurse Rona explains to the mother the importance of Breastfeeding which is based on Milk Code of: A. EO 51 B. PD 51 C. EO 15 D. PD 15 Situation: Immunization is one of the significant programs of the Department of Health to prevent childhood morbidity. 6. Nurse Dorothy is preparing to administer vaccinations to children. She knows that the following are correct EXCEPT: A. The vaccination schedule should not be restarted from the beginning even if the interval between doses exceeded the recommended interval by months or years. B. Giving doses of a vaccine at less than the recommended 4 weeks interval may lessen the antibody response. C. Lengthening the interval between doses of vaccines leads to higher antibody levels. D. Use one syringe and one needle for all the children receiving the same vaccination. 7. Rose, a mother of a 7-month-old baby, is asking the nurse in the Health Center regarding the 7 vaccine preventable diseases. All of the following diseases are included EXCEPT: A. Diphtheria B. Measles C. Poliomyelitis D. Dengue 8. Kurt, 4 years old, has Measles. His mother asks the nurse if there is a chance that Kurt will contract the virus again. The nurse’s response should be based on her knowledge that: A. reactivation of old infection is common with Measles. B. immunity from Measles is lifelong after the first attack. C. no immunity is induced by the infection. D. immunity from Measles is just for 6 months after the first attack. 9. When can you say that a child is already a “Fully Immunized Child”? A. If he received one dose of BCG, 3 doses of OPV, 2 doses of DPT, 3 doses of HB and one dose of measles before his/her first birthday. B. If he received two doses of BCG, 3 doses of OPV, 3 doses of DPT, 3 doses of HB and one dose of measles before his/her first birthday. C. If he received one dose of BCG, 2 doses of OPV, 3 doses of DPT, 3 doses of HB and one dose of measles before his/her first birthday. D. If he received one dose of BCG, 3 doses of OPV, 3 doses of DPT, 3 doses of HB and one dose of measles before his/her first birthday. 10. Annabelle, a new mother, asks the nurse about the purpose of the first BCG vaccination given to her son. The nurse’s best response should be: A. “An early start with BCG reduces the chance of severe pertussis.” B. “The extent of protection against polio is increased the earlier the BCG is given.” C. “BCG given at earliest possible age protects the possibility of TB meningitis and other TB infections in which infants are prone.” D. “An early start of BCG reduces the chance of being infected and becoming a carrier. It prevents liver cirrhosis and liver cancer.” Situation: One of the dramatic advances of immunization is the decline of infectious diseases to children and also to mothers. 11. A Public health nurse prepares the necessary equipments before immunization. Which of the following vaccines is/are most sensitive to heat? 1. OPV 2. DPT 3. BCG 4. HepB 5. Measles A. 1,3,5 B. 1,5 C. 2,3,4 D. 2,4 12. This is a practice in immunization that aims to assure that all vaccines are utilized before its expiry date. A. “first expiry and first out” B. “last expiry and last out” C. “first expiry and last out” D. “last expiry and first out” 13. Nurse George, the Public Health Nurse, is preparing to administer the Measles vaccine. He knows that this vaccine is administered: A. Orally B. Intradermally C. Subcutaneously D. Intramuscularly 14. Nurse George administered DPT1 to Baby Lynzee. Maria, Lynzee’s mom, asked Nurse George about what she needs to expect after the administration of DPT1? The Nurse TOP RANK REVIEW ACADEMY, INC. Page 1 | 8

health and health promotion. 31. She used a problem tree to analyze the community problems. The diagram includes that: A. Health problems have solution B. Poverty is the cause of all health problems C. Health is influenced by many factors D. People can solve existing problems 32. Health needs and interventions are categorized as primary, secondary, and tertiary. If the outcome of health is “complications” from disease: this is classified under: A. Primary B. Secondary C. Tertiary D. All of the above 33. In order to help achieve its mission of the Philippine Health Care Delivery System (PHCDS) the Department of Health (DOH) adopted which of the following best strategies ? A. Focusing on programs that will fight poverty at the family and community level B. Family empowerment rather than individual C. People centered programs D. All these strategies 34. Public Health Nurse Clarita is guided by the Primary Health Care’s contribution to National Health Development. . Nurse Clarita is aware that this is best illustrated by: A. Provision of adequate health services B. Reduction in the Community’s mortality and morbidity C. Mobilization of people effort for production activities D. Increase social awareness and civic consciousness 35. In the Health Center Integrated Management of Childhood Illness (IMCI), conditions are classified so that corresponding urgency could be determined. Which of the following severe conditions does not always require urgent referral to a hospital? A. Mastoiditis B. Severe Dehydration C. Severe Pneumonia D. Severe Febrile disease — NO 36-40 Situation: The Integrated Management of Childhood Illness strategy has been introduced as a strategy for survival, growth, and development among children. IMCI includes preventive and curative treatments based on the combination of the health care deliveries in the community. 41. Which among these clients is not covered by the IMCI protocol? A. A mother’s 5-day-old child with wheezing B. A three-month-old infant noted to have diarrhea C. A six-year-old patient suspected to have measles D. A two-year-old infant with fever 42. In identifying malarial risks for a certain area, which among these conditions would indicate high-risk? A. More than 5% of the fever cases in children are due to malaria B. Less than 5% of the fever cases in children are due to malaria C. More than 10% of the fever cases in children are due to malaria D. Less than 10% of the fever cases in children are due to malaria 43. A 5-month-old infant is brought to the health center. No danger signs and other problems were noted except for pus draining from his ear. The mother said it has been present for 5 days already. Based on the proper classification, which among these actions is best? A. Advice for follow-up in 2 days. B. Give Paracetamol for pain. C. Refer to the hospital immediately. D. Instill quinolone drops after dry wicking three times daily for two weeks 44. Oral thrush is present in an infant with HIV. In which stage of HIV does the patient fall under? A. Asymptomatic B. Mild C. Moderate D. Severe 45. Which of these is not included in the preferred antiretroviral regimen for HIV-patients who are 3 years old and above? A. Nevirapine (NVP) B. Efavirenz (EFV) C. Abacavir (ABC) D. Lamivudine (3TC) Situation: The Essential Intrapartum and Newborn Care (EINC) is composed of standards and protocols that are evidence-based and suggested to be adopted by the hospitals and other birthing facilities in the country. 46. As per the EINC, when may a newborn be bathed or washed to prevent hypothermia? A. Immediately after delivery B. Within 1 hour after delivery C. 2 hours after delivery D. At least 6 hours after delivery 47. Which of these is not a recommended practice during the intrapartal period? A. Perineal shaving prior to delivery B. Spontaneous pushing in a semi-upright position C. Continuous support during childbirth D. Administration of oxytocin before placental delivery 48. You are counselling a woman on proper attachment and suckling during breastfeeding. Further instruction is needed with which of the following statements made by the mother? A. “The upper lip should be turned outwards, with the lower lip inwards” B. “The baby’s mouth should be wide open.” C. “My baby’s chin should be touching my breast” D. “Pauses between suckling are normal.” 49. Which of these is not anymore recommended as a newborn care practice? A. Immediate drying B. Skin to skin contact C. Immediate cord clamping D. Initiation of early breastfeeding 50. Why is properly-timed cord clamping important? A. It reduces iron reserves of the newborn for less load for the kidneys. B. It reduces the newborn’s blood volume and prevent increased cardiac load. C. It promotes placental transfusion and prevents iron-deficiency anemia. D. It supports the need for blood transfusions in newborns. 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. 51. 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. 52. 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 53. 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 TOP RANK REVIEW ACADEMY, INC. Page 3 | 8
B. Exploration C. Prediction D. Control 54. 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 55. 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. 56. Ebola virus was discovered in 1978 in Congo and re-appeared last 2014 in Guinea with a 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 57. 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 58. 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” 59. 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” 60. 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. 61. 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 62. 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 63. 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. 64. 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 65. 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 TOP RANK REVIEW ACADEMY, INC. Page 4 | 8