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2 | Page B. Some feeling of after pains C. Voiding frequently, 50-75 mL per episode of voiding D. Pinkish to brownish vaginal discharge 13. Richelle had vaginal delivery of her first baby 6 weeks ago and you see her for follow-up postpartum visits. She is feeding well and is bottle-feeding her infant successfully. During your physical assessment, you EXPECT normal findings as: A. Having some pink striae but starting to fade B. Tender breast, some milk expressed C. Fundus 6cm below the umbilicus on palpation D. With creamy, yellow vaginal discharge 14. In the postpartum period, you should instruct your client to perform which of the following exercises to strengthen her pelvis floor muscles? A. Kegel exercises B. lung exercise C. push-up D. sit-ups 15. Another nursing focus is the monitoring of postpartum clients for possible complications. Postpartum hemorrhage is one of the primary causes of maternal mortality associated with child bearing. Which among the following T’s is the most frequent cause of postpartum hemorrhage? A. Tissue B. Trauma C. Tone D. Thrombin Situation: Telling and sharing are very important tools of transmitting health awareness to clients particularly during children's growth and development years. These conditions apply. 16. A mother asks you when the soft spot on the front of the baby's head will close. Your appropriate response is " the anterior fontanel will close: A. By 12 to 18 months of age" B. Shortly after the posterior fontanel; closes" C. In a 6 months" D. By the time the baby is 1 year old" 17. Another mother asks you to explain what fine motor skills are. She has heard that it has something? to do with a school- aged child's ability to draw and color within the lines, and she wants to know what this means in an infant. You would explain that fine motor development is the ability to: A. Write and draw, and that infants do not have any fine motor skills yet B. Use all of the fingers of both hands equally well in a coordinated manner C. Picks up items and moves them from place to place in a voluntary fashion D. Coordinates hand to eye movement in an orderly and progressive manner 18. As you are working with the parents of Shaira, a 32 months old child, was having a tantrum, becoming aggressive and running away. The nurse knows that the patient is in which developmental stage? A. Trust vs mistrust B. Initiative vs guilt C. Autonomy vs shame and doubt D. Identity vs role confusion 19. The parents of Carl, a toddler who has intrusive behavior and in need of redirection, asked you how to respond to their child. Your most appropriate response is: A. Separate Carl from others for him to think how best he should rightly interact with others" B. "Let Carl know the behavior is not acceptable by speaking with a firm, loud voice" C. Send Carl to his room and set a later time for a serious talk" D. Gently touch Carl's shoulder to get his attention and with a firm eye-to-eye contact speak to him with concern" 20. Dina, a mother of a 34 month old boy is upset that her child began to wet in bed and thumbsuck after being admitted to the hospital, Dina asked you to explain why this happens. Which of the following is your best response? A. "this behavior is a defense mechanisms when normal routine changes" B. "your child probably do not like me or another nurse assigned to him" C. "bedwetting and thumb-sucking are the child's way of getting even for abandonment" D. " your toddler is angry and this is a way of telling you of his unhappiness" SCENARIO: As the fetus grows, body organ systems develop from specific tissue layers. Knowing these is helpful to know because coexisting congenital disorders found in newborns usually arise from the same germ layer. 21. Which among the Germ layers that forms the brain and spinal cord? A. Ectoderm B. Mesoderm C. Endoderm D. Epidermis 22. Heart is the muscle at the center of the circulatory system that pumps blood around the body as it beats. The nurse is aware that it is from which germ layer? A. Ectoderm B. Mesoderm C. Endoderm D. Epidermis 23. The trachea and esophagus arise from the same germ layer which makes it common for a birth anomaly such as fistula to occur between them. Which germ layer it arises from? A. Ectoderm B. Mesoderm C. Endoderm D. Epidermis 24. Kizzy, a pregnant client, is currently working in a company. She tells the nurse that she has to work because her husband’s income is not enough to sustain their everyday needs. She asks the nurse how she can prevent fetal teratogens. A. Avoid any room where smoker gathers B. Refrain from drinking alcohol C. Ask employer for a statement on hazardous substances at work site D. AOTA Situation: In your area of assignment which is LABOR AND DELIVERY, you get to handle varied cases of birthing mothers. The following conditions apply. 25. You are attending to Fiona, whose cervix is completely dilated and with the fetal head is at 2 (-) station. The head of Fiona's fetus has not descended in the past hour. What most appropriate initial assessment should you make? A. Determine if Fiona's bladder is distended B. Assess fetal status, fetal heart tones, and scalp pH C. Submit Fiona for x-rays to determine fetal size D. Notify the surgical team so that an operative delivery can be planned 26. A newborn, at 1 minute after vaginal delivery, is pink with blue hands and feet, has a lusty cry. heart rate of 140, prompt response to stimulation with crying, and maintains minimal flexion, with sluggish movement. If you should perform an Apgar score, how would you score for this newborn? A. 8 B. 9 C. 10 D. 7 27. A postpartum mother, after giving birth 6 hours ago, was checked by the nurse and noted a temperature of 38C. The nurse knows that the appropriate action to do is: A. Report immediately to the physician because it may be a sign of infection B. Encourage the mother to take in fluids. C. Inform the mother to be on bed rest without bathroom privilege D. Do nothing as this is expected. 28. A breastfeeding mother has received advice from the nurse on how to stop engorgement. Which of the following acts by the mother demonstrates that the instruction was successful? A. Every after feeding, she pumps her breast
3 | Page B. the mother feeds her infant on demand C. Ten minutes are spent feeding the baby on each side of the breast. D. She adds formula as a supplement to each feeding. 29. A multigravida postpartum mother reported having excruciating stomach cramps every time she is nursing her infant. Which of the nurse's subsequent answers is appropriate? A. Suggest to the mother to give the baby bottle feeding for several days until the pain subsides. B. Give the mother instruction on how to massage her fundus. C. Give the patient instructions on how to breastfeed in different positions. D. Describe how hormones in breastfeeding work. Situation: If emergencies occur inside healthcare facilities where supplies and equipments are expectedly available and assumed complete, similar healthcare situations are also present in “pre-hospital” or "pre-institutional” settings requiring the same degree of nursing care management. The following applies. 30. During the second second trimester of pregnancy, a pregnant woman is ideally given her first dose of tetanus toxoid by intramuscular injection. Which of the following is appropriate for the disposition of used syringes and needles in the pre-institutional settings? A. Cap again before throwing in garbage cans B. Decontaminate before even reusing C. Place in puncture – proof containers D. Place in a garbage can 31. The pregnant client with a threatened miscarriage is advised by the nurse to avoid coitus for two weeks which she asks the purpose why. The nurse responds correctly: A. It prevents infection B. It prevents threatened miscarriage to change to imminent C. It pokes the live fetus D. It is unethical and unprofessional 32. Mrs. Niana Chan came to you with an obstetric history of three (3) spontaneous abortions, is now 12 weeks pregnant, and attending her OB’s high risk clinic. Mrs. Chan expresses to you her concern over this pregnancy. In order for you to determine that the patient is experiencing Imminent miscarriage occur when: A. Bright red vaginal bleeding B. Abdominal cramping C. Cervical dilation 33. You are faced with a patient, Micah, who is suspected of having a ruptured tubal pregnancy. In obtaining the history from this client you should expect the client to indicate that her symptoms of pain in the lower abdomen and vaginal bleeding starting: A. Midway through the second semester B. At the beginning of the last trimester C. Immediately after implantation occurred D. About the sixth (6th) week of pregnancy 34. You are assessing a client, Chenny, with pregnancy- induced hypertension, you expect Chenny with pregnancy- induced hypertension, you expect Chenny’s blood pressure to be: A. 30/15 mmHg over the baseline BP of Chenny ’s prior to pregnancy on 2 occasions at 6 hours apart or 140/90 mmHg and over B. Above her baseline BP during her non-pregnancy state and accompanied by headache C. 150/100 mmHg while standing and sitting since prior to pregnancy D. Above her baseline BP during her non-pregnancy state and fluctuating at each reading 35. You are caring for Rachelle, a patient on MgS04 therapy for severe pre-eclampsia. The danger signal prompting alert for the first sign of excessive blood magnesium level is: A. Disappearance knee – jerk reflex B. Increased respiratory rate C. Development of cardiac dysrhythmia D. Disturbance in sensorium SCENARIO: There is a 1.47% increase of population in the Philippines in 2022. A Family Planning Health program was held in a hospital where topics about contraceptives were discussed. Nurse Tonia is on duty and she encountered the following questions: 36. Jena went to the clinic and confirmed with the nurse about the use of diaphragm. She should be instructed to leave it in place after coitus for at least how many hours? A. 1 hour B. 6 hours C. 12 hours D. 24 hours 37. A 38 year old female, with 4 children, came to the clinic and inquired about her options for contraception methods. She also stated that she smokes a pack of cigarettes a day. The nurse advised her to avoid: A. Oral contraceptives B. IUD C. Cervical cap D. Diaphragm 38. Kenna, a 19-year-old working student, was trembling. She told the nurse she forgot to take her prescribed active contraceptive pills for two consecutive days. She started crying and asked the nurse what to do. The nurse should instruct: A. Ignore it, take one now and use other contraceptive such as spermicide for a month B. Take two pills now then continue tomorrow with your usual schedule C. Throw out the rest of the pack and start a new pack of pills D. Let’s inform the physician. 39. Caroline consults the nurse because her 16-year-old daughter asks her how she can avoid the pressure of unwanted sex? The nurse should not suggest: A. Tell the daughter to discuss it with her partner which sexual activities will permit or not B. Be certain that her partner understands that when she say “NO”, she means it C. Avoid being in a high-pressure situations such as a party with known drug use D. Tell her daughter that accepting drugs is fine if she is with her close friends 40. The nurse is teaching the client about a natural family planning method which is the basal body temperature method. The woman does not need any further teaching when she states that: A. “Sa araw ng ovulation ko ay tataas ng 1°C ang temperature ko” B. “Iche-check ko ang temperature ko sa umaga pagkatapos ko mag exercise” C. “Kapag bumaba po ang temperature ko tapos kinabukasan biglang tumaas, dapat hindi ako makipagtalik hanggang dalawang araw pagkatapos ito tumaas” D. “Kapag paiba-iba ang oras ng gising ko, makakaapekto ito sa BBT method” 41. The mucus of the uterine cervix changes in structure and consistency each month during a menstrual cycle. Which assessment of cervical mucus suggests that the woman is about to ovulate? I. Scant cervical mucus II. (+) Spinnbarkeit III. Highly viscous cervical mucus IV. (+) Ferning A. i, ii, iii, iv B. ii, iii, iv C. i, ii, iv D. ii, iv SCENARIO: Infancy is designated as the period of time from 1 month to 1 year of age. The nurse works in an OB-Gyne & delivery room knows that infants undergo such rapid development. 42. Baby Didi, a 1-year-old infant weighs 22.5lbs. If the infant gains weight normally, the nurse knows that Didi’s weight when she was 6 months is:

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