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RECALLS EXAMINATION 8 NURSING PRACTICE II CARE OF HEALTHY / AT RISK MOTHER AND CHILD MAY 2025 Philippine Nurse Licensure Examination Review GENERAL INSTRUCTIONS: 1. This test questionnaire contains 100 test questions 2. Shade only one (1) box for each question on your answer sheets. Two or more boxes shaded will invalid your answer. 3. AVOID ERASURES. 4. Detach one (1) answer sheet from the bottom of your Examinee ID/Answer Sheet Set. 5. Write the subject title “NURSING PRACTICE II” on the box provided 1. Kanao, a client in her first trimester of pregnancy, presents with light vaginal bleeding and no associated pain. Nurse Shinobu provides instructions for self-monitoring and care. Which statement by the client indicates a need for additional teaching? A. "I will abstain from intercourse until 2 weeks after the bleeding completely stops." B. "I will monitor for any passage of clots or tissue and inform my healthcare provider immediately." C. "I will remain on complete bed rest for the rest of my pregnancy to prevent further complications." D. "I will document the frequency of perineal pad changes and note the color and quantity of bleeding." 2. Nurse Mitsuri is assessing a young patient in the emergency room who presents with moderate vaginal bleeding, uterine cramping, and a dilated cervix at 3 cm. Based on these findings, which type of spontaneous abortion should the nurse document? A. Incomplete abortion B. Inevitable abortion C. Complete abortion D. Threatened abortion 3. Tamayo,a 30-year-old patient, visits the clinic for a preconception consultation, expressing concerns about her history of pregnancy losses. She shares that she has experienced multiple miscarriages in previous pregnancies. Nurse Daki discusses recurrent abortion and provides information about its classification. The nurse explains that recurrent abortion is classified when a woman experiences: A. 2 or more spontaneous abortions in successive pregnancies B. 3 or more spontaneous abortions in successive pregnancies C. 5 or more spontaneous abortions in successive pregnancies D. More than 1 spontaneous abortion in successive pregnancies 4. Nurse Nezuko is providing care to a 25-year-old patient diagnosed with an incomplete abortion. The patient is scheduled for a dilation and curettage (D&C) procedure and expresses anxiety and curiosity about what the procedure entails. Mitsuri takes time to provide an explanation and ensure the patient feels informed and reassured. Which of the following is the most accurate explanation Nurse Nezuko can give about the D&C procedure? A. "This procedure uses medication and gentle suction to clean the uterus. It is a minimally invasive method to manage heavy bleeding." B. "This procedure removes tissue from inside your vagina. It clears the vaginal walls and helps stop any bleeding caused by the trauma." C. "This procedure involves removing blood clots and debris from your uterus using a vacuum. It is done to prevent further complications like infection." D. "This procedure removes tissue from inside your uterus. It clears the uterine lining and addresses heavy bleeding caused by the incomplete abortion." 5. Nurse Hina is explaining to a patient who has just experienced a missed abortion about their condition. The patient is trying to understand what a missed abortion means. Which of the following statements accurately describes a missed abortion? A. "A missed abortion occurs when parts of the products of conception have been passed, and part of those products remain in your uterus." B. "A missed abortion occurs when the fetus dies in your uterus but is retained. You will have regression of the growth of your uterus. You may also experience breast changes from this." C. "A missed abortion occurs when all the products of conception are expelled, and you have mild uterine cramping as a result." D. "A missed abortion is characterized by the sudden expulsion of the fetus from the uterus with heavy bleeding and cramping." 6. Patient Irene, a gravida 5, presents at 8 weeks gestation for a follow-up appointment. Upon assessment, the nurse notes that the patient’s uterus is larger than expected for the gestational age. Irene reports experiencing severe and persistent vomiting, accompanied by vaginal bleeding, which she describes as brown in color. She also mentions that the symptoms have been progressively worsening over the past few days. Based on the findings, the nurse suspects a specific complication. Considering Irene’s clinical presentation, what is the most likely diagnosis? A. Ectopic pregnancy B. Spontaneous abortion C. Placenta previa D. Gestational trophoblastic disease 7. Nurse Seulgi is educating a patient who has been diagnosed with a hydatidiform mole. The nurse is reviewing the key symptoms associated with this condition to ensure the patient understands the diagnosis and potential complications. Which of the following symptoms is characteristic of a hydatidiform mole? A. Heavy, bright red bleeding every 21 days. B. A "snowstorm" pattern on ultrasound with no fetus or gestational sac. C. Detection of fetal cardiac motion after 6 weeks gestation. D. Benign tumors in the smooth muscle of the uterus. 8. Nurse Wendy is educating her patient who has been diagnosed with a complete molar pregnancy. She is discussing the pathophysiology of the condition to help the patient understand the underlying causes. Which of the following factors are associated with a "complete" molar pregnancy? A. Fertilization of an egg by two sperm, leading to a triploid karyotype. B. Fertilization of a normal egg by a sperm carrying an extra chromosome. 1 | Page
C. Fertilization of an egg with no genetic material by a single sperm. D. Partial development of fetal tissue alongside abnormal placental tissue. 9. Patient Joy, who is 8 weeks pregnant, presents to the ER with complaints of unilateral lower abdominal pain, dizziness, and light vaginal spotting. Which of the following interventions would be the priority for this patient? A. Administer Rh immunoglobulin if the patient is Rh-negative. B. Prepare to administer methotrexate to stop the growth of the pregnancy. C. Obtain a quantitative hCG test to assess for a normal or abnormal pregnancy. D. Prepare for an ultrasound to determine the location of the pregnancy. 10. Patient Nayeon, a 32-year-old woman, presents with symptoms suggestive of an ectopic pregnancy. During the assessment, Nurse Jeongyeon reviews her medical history, which includes multiple episodes of pelvic inflammatory disease (PID) and previous tubal surgery. Based on this information, which of the following is the most likely cause of Nayeon's ectopic pregnancy? A. Increased progesterone levels during early pregnancy. B. Scar tissue formation to the fallopian tubes. C. Use of an intrauterine device (IUD) for contraception that scars the uterine tissue. D. Advanced maternal age and genetic factors. 11. Nurse Sana suspects that Patient Momo, a 28-year-old woman at 7 weeks of pregnancy, may have an ectopic pregnancy. Which of the following symptoms is most consistent with a diagnosis of ectopic pregnancy? A. Painless vaginal bleeding. B. Sudden, stabbing pain in the lower quadrant. C. Abdominal cramping. D. Throbbing pain in the upper quadrant. 12. Patient Jihyo, at 22 weeks gestation, presents with complaints of pelvic pressure and mild cramping. On examination, her cervix is found to be dilated to 2 cm with no contractions present. Which of the following would be an appropriate intervention for this patient? A. Administer a tocolytic to prevent premature labor. B. Monitor the patient with serial cervical length measurements and place a cerclage if necessary. C. Recommend bed rest and avoid sexual activity for the remainder of the pregnancy because this is a sign of inevitable/imminent abortion. D. Schedule an induction of labor to avoid further complications. 13. Patient Mina, at 16 weeks gestation, has a history of a second-trimester miscarriage due to cervical insufficiency. She is now pregnant again and presents for routine follow-up. The healthcare provider decides to place a cervical cerclage. What should the Nurse Dahyun educate the patient about regarding this procedure? A. "A cerclage is a procedure where the cervix is stitched to prevent it from dilating prematurely." B. "A cerclage will need to be removed at 24 weeks gestation to prevent infection." C. "The cerclage is a permanent solution to cervical insufficiency and does not require monitoring." D. "Once the cerclage is placed, you should avoid all physical activity, including walking." 14. Patient Chaeyoung is 10 weeks pregnant and presents to the clinic complaining of severe nausea and vomiting, resulting in dehydration and weight loss. Which of the following is most likely to be included in the patient’s treatment plan? A. Prescribe over-the-counter antiemetics to manage nausea B. Administer IV fluids and electrolytes to rehydrate and correct imbalances C. Recommend a high-protein diet to control nausea D. Advise the patient to rest at home and avoid all medications until symptoms improve 15. Nurse Tzuyu is reviewing the lab tests of four prenatal clients. Which of the following management strategies would be most appropriate for a client diagnosed with hyperemesis gravidarum based on lab findings? A. Administer calcium supplements. B. Administer potassium replacement. C. Administer diuretics as ordered. D. Provide oral calcium-rich foods. 16. A 32-week pregnant client presents with painless bright red vaginal bleeding. An ultrasound reveals the placenta is completely covering the cervix. The nurse recognizes the need for immediate action. Which of the following is the priority intervention for this client? A. Administer oxytocin to induce labor. B. Prepare the client for a cesarean section delivery. C. Encourage ambulation to promote circulation. D. Perform a vaginal exam to assess the extent of bleeding. 17. Nurse Seungcheol is caring for a postpartum client who delivered a newborn after a pregnancy complicated by placenta previa. As part of the plan of care, which of the following risks should the nurse prioritize monitoring for in this client? A. Chronic hypertension B. Infection C. Hemorrhage D. Disseminated intravascular coagulation 18. A client with placenta previa at 34 weeks gestation is being monitored for bleeding. Nurse Jeonghan should explain that the primary complication associated with this condition is: A. Risk of uterine rupture during labor. B. Increased likelihood of preterm labor. C. Increased risk of postpartum hemorrhage. D. Risk of gestational hypertension or preeclampsia. 19. A client is admitted to the labor suite with complaints of painless vaginal bleeding. Nurse Joshua is preparing for the examination and knows that which of the following routine labor procedures is contraindicated in this situation? A. Hemoglobin and hematocrit evaluation B. Leopold's maneuvers C. External electronic fetal heart rate monitoring D. A manual pelvic examination 20. Nurse Jun is reviewing the ultrasound results of a woman admitted to the maternity unit. The ultrasound reveals that the placenta is covering the entire internal cervical os. The nurse understands that the client is experiencing which condition? A. Complete placenta previa B. Low-lying placenta previa C. Marginal placenta previa D. Abruptio placentae 21. Nurse Hoshi is caring for a client diagnosed with abruptio placentae. During labor, which of the following is the priority nursing assessment? A. All vital signs, especially heart rate and blood pressure B. Frequency, duration, and intensity of contractions C. The presence of both clear and red vaginal discharge as this is indicates the abruptio placentae is resolved D. Effacement and dilation of the cervix 22. A client at 30 weeks gestation is diagnosed with placental abruption. Nurse Jessica notices that the fetus is showing signs of distress. What is the nurse’s next priority? A. Prepare for an emergency cesarean delivery. B. Perform Leopold’s Maneuver. C. Check for vaginal bleeding using IE and initiate blood transfusions. D. Perform a pelvic exam to assess the degree of separation. 23. Nurse Esther is assigned to assist with caring for a client with abruptio placentae who is experiencing vaginal bleeding. The nurse collects data from the client, knowing that abruptio placentae is accompanied by which additional finding? A. Uterine tenderness on palpation B. Soft abdomen on palpation C. No complaints of abdominal pain D. Lack of uterine irritability or tetanic contractions 24. Nurse Ruth is planning home care for a woman diagnosed with preterm labor who is being discharged. Which of the following concerns must the nurse address? A. Home health care providers will be necessary. B. Restricted activity and medications will be necessary to prevent recurrence of preterm labor. C. Prolonged bed rest may cause negative physiological effects. 2 | Page
D. Nursing assessments will be different from those done in the hospital setting. 25. Nurse Wonwoo is caring for a client receiving magnesium sulfate for preterm labor. Which of the following findings would alert the nurse to possible side effects of the medication? A. Serum magnesium level of 10 mg/dL B. Urine output of 160 mL in 4 hours C. Respiratory rate of 16 breaths/min D. Deep tendon reflexes 2+ and no clonus 26. A pregnant client reports morning sickness, nausea and vomiting, missed periods, and breast tenderness. Which of these would be classified as a presumptive sign of pregnancy? A. Fetal outline felt by examiner B. Positive pregnancy test. C. Breast tenderness. D. Fetal heart tones detected by Doppler. 27. A 10-week pregnant client asks the nurse how to determine if she’s truly pregnant. Nurse Mingyu is correct if he explains that a positive sign of pregnancy is: A. Enlarged breasts. B. Presence of fetal heart tones detected by Doppler. C. Positive pregnancy test. D. Presence of Quickening 28. A patient asks Nurse Yor about the signs and symptoms of pregnancy. Nurse Yor is correct if she states: A. "The first perception of fetal movement that you have felt at 16th to 20th week of gestation is a probable sign of pregnancy." B. "The compressibility and softening of the lower uterine segment that occurs about the 6th week is a probable sign." C. "The examiner palpating fetal movement at 18 weeks is a probable sign." D. "Pigmentation changes such as linea nigra and melasma are considered probable signs of pregnancy." 29. Nurse Ahyeon is conducting a routine assessment of a pregnant client. The client is at 20 weeks gestation. The nurse performs a ballottement exam. What does this test help to assess? A. The ability to hear the fetal heartbeat B. The presence of fetal movement C. The rebound of the fetus when the examiner's finger taps the cervix D. The softness of the lower uterine segment 30. Nurse Asa is reviewing the pregnancy history of a client. Her patient is currently pregnant, and she has had two previous pregnancies: one was a full-term birth at 39 weeks, and the other was a preterm delivery at 32 weeks. She reported having one pregnancy that ended at 12 weeks. Using the GTPAL system, what is the correct scoring for this client? A. G3 T1 P1 A2 L2 B. G3 T2 P0 A1 L2 C. G2 T1 P1 A1 L2 D. G3 T1 P1 A1 L2 36. A woman with gestational diabetes at 36 weeks' gestation reports during her routine antepartum visit, "I’m so happy! My blood sugar levels have decreased, and I’ve been able to cut my insulin dose by half." The nurse should be concerned that this could indicate: A. The woman is in good glycemic control. B. The maternal pancreas is increasing its insulin production. C. A placental problem requiring further investigation. D. A potential fetal problem requiring further assessment. 37. Nurse Chiquita is caring for a pregnant woman with gestational diabetes at 8 months gestation. During a routine fetal surveillance, the woman's blood sugar at 2 PM is measured at 60 mg/dL. The nurse should take which action? A. Administer regular insulin according to the sliding scale ordered. B. Record the blood sugar reading as reassuring. C. Reassess the blood sugar in 30 minutes. D. Offer the woman 4 ounces of apple juice. 38. Nurse Rami is conducting a follow-up visit with a patient diagnosed with gestational diabetes. The patient is reviewing her management plan, including dietary changes and self-monitoring of blood glucose levels. The nurse listens carefully to the patient and her statements about managing the condition. Which statement by the patient indicates the need for further teaching? A. "I will eat only three meals a day to keep my blood sugar levels stable." B. "I can eat sugary snacks after the baby is born." C. "I will try to maintain a balanced diet, including complex carbohydrates and protein." D. I will check my blood sugar before meals and 2 hours after eating." 39. Nurse Pharita is reviewing the health history of four pregnant women. Which of the following clients is at an increased risk for developing gestational diabetes and should be monitored more closely? A. Gravida 1 who is 24 years old B. Gravida 2 with a body mass index of 22 C. Gravida 3 whose previous children weighed 6 lb, 4 oz and 7 lb, 5 oz at birth D. Gravida 2 who is pregnant with triplets 40. During a prenatal visit, Nurse Rora informs a client that she will be tested for gestational diabetes. The nurse explains that the test used for screening is: A. Glycosylated hemoglobin test B. Postprandial glucose test C. Oral glucose tolerance test D. Capillary Blood Glucose Test 41. Nurse Ruka is caring for a newborn who is suspected of having hemolytic disease. Which of the following statements regarding the diagnosis and management of hemolytic diseases of the newborn is correct? A. ABO incompatibility is more likely to cause severe anemia compared to Rh incompatibility. B. The indirect Coombs' test is performed on the mother before birth to detect antibodies, and the direct Coombs' test is performed on the newborn's cord blood after birth. C. Exchange transfusions are required frequently in cases of hemolytic diseases due to Rh incompatibility. D. Rh incompatibility only occurs when an Rh-negative mother carries an Rh-positive fetus. 42. A pregnant woman with Rh-negative blood type delivers a newborn with Rh-positive blood. The newborn develops severe jaundice, and the doctor suspects hemolytic disease of the newborn (HDN). Which of the following is the most likely cause of this condition? A. The mother has been sensitized to Rh-positive blood in a previous pregnancy. B. The mother has developed an autoimmune disorder that affects fetal blood. C. The mother received excessive amounts of RhoGAM during the pregnancy. D. The newborn inherited the Rh-negative blood type from both parents. 43. Nurse Ningning is explaining Rh incompatibility and hemolytic disease of the newborn to an expectant mother. The nurse states that the key preventative measure for future pregnancies is: A. Monitoring the newborn's bilirubin levels more frequently. B. Ensuring the mother receives blood transfusions if she has a positive Coombs' test to prevent Rh incompatibility to future pregnancies. C. Giving the newborn a blood transfusion within the first 24 hours after birth. D. Administering Rh immunoglobulin (RhoGAM) at 28 weeks and within 72 hours of delivery. 44. Nurse Manon is reviewing the physician's orders for a patient admitted with premature rupture of membranes (PROM). Which of the following orders should Nurse Manon question? A. Administer Ampicillin 1 gm IVPB every 6 hours. B. Monitor maternal temperature every 4 hours. C. Conduct intermittent fetal heart rate monitoring. D. Perform a vaginal exam every shift. 45. Nurse Sophia is reviewing the medical history of a client at 30 weeks’ gestation who previously experienced premature rupture of membranes (PROM). Which statement by the client suggests the need for further teaching? 3 | Page

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