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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
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