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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


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