All the questions in the quiz along with their answers are shown below.

Your answers are bolded. The correct

answers have a green background while the incorrect ones have a red background.
1. Craniocerebral injury in a child differs substantially from craniocerebral trauma in an adult. The nurse is aware
that the following identifies a negative difference between children and adults that could produce a life-threatening
complication for a child?
 Cerebral tissues in children are softer, thinner, and more flexible.
 A child's skull can expand more than an adult's can.
 Greater portions of a child's blood volume flows to the head.
 Hematomas in children can include subdural, epidural, and intracerebral.
If hemorrhage is associated with a head injury and it goes undetected, a child may experience hypovolemic shock
because a large portion of a child's blood volume goes to the head. In children, cerebral tissues are softer, thinner,
and more flexible — conditions that permit diffusion of the impact. Because a child's skull can expand more than an
adult's can, a greater amount of posttraumatic edema can occur without evidence of neurologic deficits. Subdural,
epidural, and intracerebral hematomas are the different types of head injury that can occur in children and adults.
2. When discharging baby James a 5-month-old infant from the hospital, the nurse checks to see whether the
parent's car restraint system for the infant is appropriate. Which of the following restraint systems would be safest?
 A front-facing convertible car seat in the middle of the backseat
 A rear-facing infant safety seat in the front passenger seat
 A rear-facing infant safety seat in the middle of the backseat
 A front-facing convertible car seat in the backseat next to the window
Infants from birth to 20 lb (9.1 kg) and under age 1 must be in a rear-facing infant or convertible seat in the backseat,
preferably in the middle. Infants and small children should never be placed in the front seat because of the risk of
injuries from a breaking front windshield and an expanding airbag. The position next to the window isn't preferred.
3. What is a normal systolic blood pressure for Jun-jun a 3-year-old child?
 100 mm Hg
 86 mm Hg
 120 mm Hg
 60 mm Hg
Using the formula systolic blood pressure = 80 + (age in years × 2), the estimated blood pressure for a 3-year-old
child is 80 + (3 × 2) = 86.
4. Russel, a toddler is receiving an infusion of total parenteral nutrition (TPN) via a Broviaccatheter. As the child
plays, the I.V. tubing becomes disconnected from the catheter. What should the nurse do first?
 Turn off the infusion pump.
 Position the child on the side.
 Clamp the catheter.
 Flush the catheter with heparin.
First, the nurse must clamp the catheter to prevent air entry, which could lead to air embolism. If an air embolism
occurs, the nurse should position the child on the side after clamping thecatheter. The nurse may turn off the infusion
pump after ensuring the child's safety. If blood has backed up in the catheter, the nurse may need to flush
the catheter with heparin; however, this isn't the initial priority.
5. Kristine, a 10-year-old girl visits the clinic for a check-up before entering school. The child's mother questions the
nurse about what to expect of her daughter's growth and development at this stage. Which response is most
appropriate?
 "Her physical development will be rapid at this stage and rapid development will continue from now on."
 "She'll become more independent and won't require parental supervision."
 "Don't anticipate any changes at this stage in her growth and development."
 "Friends will be very important to her, and she'll develop an interest in the opposite sex."
Friends become very important at this age. Children usually begin having an interest in the opposite sex around this
age, although they aren't always willing to admit it. Her physical development towards maturity continues, but it isn't
as rapid at this stage as in previous years. Although independence increases at this stage, children continue to need
parental supervision. Growth and development slow down but gradual changes continue to occur.
6. Marco, an 8-month-old infant is admitted with a febrile seizure. The infant weighs 17 lb (7.7 kg). The physician
orders ceftriaxone (Rocephin), 270 mg I.M. every 12 hours. (The safe dosage range is 50 to 75 mg/kg daily.)
The pharmacy sends a vial containing 500 mg, to which the nurse adds 2 ml of preservative-free normal saline
solution. The nurse should administer how many milliliters?
 None because this isn't a safe dose
 0.08 ml
 1.08 ml
  1.8 ml
Because the infant weighs 17 lb (7.7 kg), the safe dosage range is 385 to 578 mg daily. The ordered dose, 540 mg
daily, is safe. To calculate the amount to administer, the nurse may use the following fraction method: 500 mg/2 ml =
270 mg/X ml 500X = 270 × 2 500X = 540 X = 540/500 X = 1.08 ml
7. When performing a physical examination on an infant, nurse Mariner notes abnormally low-set ears. This finding
is associated with:
 otogenous tetanus.
 tracheoesophageal fistula.
 congenital heart defects.
 renal anomalies.
Normally, the top of the ear aligns with an imaginary line drawn across the inner and outer canthus of the eye. Ears
set below this line are associated with renal anomalies or mental retardation. Low-set ears don't accompany
otogenous tetanus, tracheoesophageal fistula, or congenital heart defects.
8. A child with leukemia has just completed a course of methotrexate therapy. How soon should the nurse John
expect to see signs of bone marrow depression in this client?
 Within hours
 Within 2 weeks
 Within 1 month
 After induction therapy is completed
Bone marrow depression is most likely to occur 10 days after methotrexate is administered.
9. When caring for children who are sick, who have sustained traumas, or who are suffering from nutritional
inadequacies, nurse Marvin should know the correct hemoglobin (Hb) values for children. Which of the following
ranges would be inaccurate?
 Neonates: 10.6 to 16.5 g/dl
 3 months: 10.6 to 16.5 g/dl
 3 years: 9.4 to 15.5 g/dl
 10 years: 10.7 to 15.5 g/dl
To sustain them until active erythropoiesis begins, neonates have Hb concentrations higher than those of older
children. The normal value of Hb for neonates is 18 to 27 g/dl. Disease as well as such nonpathologic conditions as
age, sex, altitude, and the degree of fluid retention or dehydration can affect Hb values. The values for a 3-month-old,
a 3-year-old, and a 10-year-old are correct as stated above.
10. During a well-baby visit, a 2-month-old infant receives diphtheria pertussis tetanus (DPT) vaccine, trivalent oral
poliovirus vaccine, and Haemophilus influenzae b (Hib) vaccine. The parents state that the child's older brother has
never received the Hib vaccine and ask why the baby must have it. How should the nurse Trich respond?
 "This vaccine prevents infection by various strains of the influenza virus."
 "This vaccine protects against bacterial infections, such as meningitis and bacterial pneumonia."
 "This vaccine prevents infection by the hepatitis B virus.
 "This vaccine prevents chickenpox."
The Hib vaccine provides protection against serious childhood infections caused by H. influenzae type B virus, such
as meningitis and bacterial pneumonia. The influenza virus vaccine provides immunity to various strains of the
influenza virus. The Heptavax vaccine prevents infection by the hepatitis B virus. Chickenpox is caused by the
varicella virus; a chickenpox vaccine is now available.
When assessing a child, age 3 months, who has been diagnosed with heart failure, nurse Claire expects which
finding?
 Bounding peripheral pulses
 A gallop heart rhythm
 Widened pulse pressure
 Bradycardia
Heart failure may cause a gallop rhythm in a child. Bounding peripheral pulses, widened pulse pressure, and
bradycardia aren't associated with heart failure.
12. When feeding a neonate with a cleft lip, nurse Rose should expect to:
 administer I.V. fluids
 use a bulb syringe with a rubber tip.
 provide thickened formula.
 perform gastric gavage.
A bulb syringe with a rubber tip is a safe, effective feeding device for a neonate with a cleft lip. I.V. fluids are required
only during the immediate postoperative period, until the neonate can tolerate oral fluids. Thickened formula and
gastric gavage rarely are necessary for a neonate with a cleft lip.
13. A mother calls the clinic to report that her 9-month-old infant has diarrhea. Upon further questioning, nurse
Jamie determines that the child has mild diarrhea and no signs of dehydration. Which advice is most appropriate to
give this mother?
 Call back if your baby has 10 stools in 1 day.
 Feed your baby clear liquids only.
 Continue your baby's normal feedings
 Notify your baby's day care of his illness.
If an infant has mild diarrhea, his mother should be advised to continue his normal diet and to call back if the diarrhea
doesn't stop or if he shows signs of dehydration. Notifying the day care about the infant's illness is important but
doesn't take priority.
14. Nikki, a 10-month-old child with recurrent otitis media (middle ear inflammation) is brought to the clinic for
evaluation. To help determine the cause of the child's condition, the nurse should ask the parents:
 "Does water ever get into the baby's ears during shampooing?"
 "Do you give the baby a bottle to take to bed?"
 "Have you noticed a lot of wax in the baby's ears?"
 "Can the baby combine two words when speaking?"
In a young child, the eustachian tube is relatively short, wide, and horizontal, promoting drainage of secretions from
the nasopharynx into the middle ear. If the child takes a bottle to bed and drinks while lying down, fluids may pool in
the pharyngeal cavity, increasing the risk of otitis media. Cerumen in the external ear canal doesn't promote the
development of otitis media. However, during shampooing, water may become trapped in the external ear canal by
large amounts of cerumen, possibly causing otitis externa (external ear inflammation). Persistent fluid in the middle
ear may impair language development and hearing; however, a 10-month-old child isn't expected to combine two
words when speaking.
15. A hospitalized infant, age 10 months, begins to choke while eating and quickly becomes unconscious. A foreign
object isn't visible in the infant's airway, but respirations are absent and the pulse is 50 beats/minute and thready.
Nurse May attempts rescue breathing, but the ventilations are unsuccessful. What should the nurse do next?
 Deliver four back blows.
 Deliver four chest thrusts.
 Perform chest compressions.
 Deliver four abdominal thrusts.
If rescue breathing is unsuccessful in a child under age 1, the nurse should deliver four back blows, followed by four
chest thrusts, to try to expel the object from the obstructed airway. The nurse shouldn't perform chest compressions
because the infant has a pulse and because chest compressions are ineffective without a patent airway for
ventilation. The nurse shouldn't use abdominal thrusts for a child under age 1 because they can injure the abdominal
organs.
16. Jay, an 8-month-old is admitted to the pediatric unit following a fall from his high chair. The child is awake, alert,
and crying. The nurse should know that a brain injury is more severe in children because of:
 increased myelination.
 intracranial hypotension.
 cerebral hyperemia.
 a slightly thicker cranium.
Cerebral hyperemia (excess blood in the brain) causes an initial increase in intracranial pressure in the head of an
injured child. The brain is less myelinated in a child and more easily injured than an adult brain. Intracranial
hypertension — not hypotension — places the child at greater risk for secondary brain injury. A child's cranium is
thinner and more pliable, causing the child to receive a more severe injury.
17. A healthy, 6-month-old infant is brought to the well-baby clinic for a checkup. When assessing the infant's
anterior fontanel the nurse Eve expects it to be:
 open.
 sunken.
 closed.
 bulging.
The anterior fontanel is open in a healthy, 6-month-old infant. Normally, it closes between ages 9 and 18 months. It
should feel flat and firm. A sunken fontanel indicates dehydration. Although coughing or crying may cause temporary
bulging, persistent bulging and tenseness of the fontanel signals increased intracranial pressure.
18. To obtain the most accurate measurement of an infant's height (length), nurse Mary should measure which of
the following?
 Recumbent height with the infant lying on the side
 Recumbent height with the infant supine
  Recumbent height with the infant prone
 Standing height with the infant held upright
For the most accurate measurement, the nurse should place the infant in a supine position and then measure
recumbent height. Measuring recumbent height with the infant lying on the side would yield an inaccurate result.
Measuring recumbent height with the infant prone would yield an inaccurately long result because it includes the
length of the foot. Measuring standing height with the infant held upright would yield an inaccurate result until the
child no longer needs assistance to stand up straight.
19. This parasitic disease that has similar manifestations as pulmonary tuberculosis is:
 Capillariasis
 Filariasis
 Ascariasis
 Paragonimiasis
The Department of Health (DOH) just recently uncovered a parasitic disease affecting lungs of people who are fond
of eating raw or insufficiently cooked crabs or crustaceans in many parts of the country called Paragonimiasis, it has
similar manifestations as pulmonary tuberculosis that frequently it is misdiagnosed as such.
20. DOH data on seropositive cases of HIV pint out that majority of all who tested positive were:
 Commercial sex workers from 17 to 34 years old
 Males from 19 to 49 years old
 Females from 25 to 46 years old
 None of these is accurate
DOH data on seropositive cases of HIV point out that 85 percent who tested positive were males from 19 to 49 years
old.
21. Mrs. Cruz informed the nurse in-charge that her 12 year old girl has been afflicted with cerebrospinal fever 2
years ago. The nurse understand that the mother is referring to what condition:
 Meningococcemia
 Encephalitis
 Epilepsy
 Hepatitis
Meningococcemia is also called meningococcal meningitis or cerebrospinal fever.
22. It is the goal of the DOH to declare the country rabie free by:
 2010
 2015
 2020
 2025
The battlecry of the rabies control program of the DOH is “SUMUNOD SA BATAS RABIES”. All agencies involved are
gearing up their efforts towards the goal of declaring the Philippines as Rabies Free by the 2020.
23. To be effective, Marjorie applies the lindane lotion in the following manner except:
 It is applied before going to sleep
 The lotion is applied from the neck down the entire body.
 It should be left for 2-4 hours.
 Soap and water is used to wash off the medication from the skin.
The lotion applied to the skin and left for 8-12 hours to be effective.
24. The causative agent of scabies is the:
 Female itch mite called Sarcoptes scabiei
 Male and female itch mite Sarcoptes scabiei
 Eggs of arcoptes scabiei the hatch under the skin
 The toxins implanted by the itch mite Sarcoptes scabiei.
The causative agent of scabies is the male and female itch mite Sarcoptes scabiei. The female itch mite burrows
under the epidermis to lay eggs and the male itch mite resides on the surface of the skin.
25. Community-based groups were organized and trained to respond to any situation similar to that of a SARS
threat. These groups are called:
 Disease Outbreak Emergency Response Team (DOERT)
 Barangay Health Emergency Response Teams (BHERT)
 Barangay Health Watch (BHW)
 Community Health Action Group (CHAG)
Community-based groups called Barangay Health Emergency Response Teams (BHERT) were organized and
trained to respond to any situation similar to that of a SARS threat.
26. As an RHU nurse, you are aware that the duration of the treatment for patient classified under category 1 with
tuberculosis meningitis or spinal disease with :
 9 months
 7 months
 8 months
 4 months
The maintenance phase of Category I is extended from 4 months to 7 months in patients with this type TB or
complication.
27. The Polio vaccine is given orally, by drops for which reason?
 It is a project of Rotary international
 It is only a one dose vaccine
 It is prepared in liquid form
 Infant is just six weeks old
All the immunizing agents are in liquid form except BCG and measles which are in powder form.
28. If measles is given at nine months, what is the percentage that measles can be prevented?
 75%
 85%
 95%
 100%
When measles is given to 9 months, it provides 85% protection. When given at 1 year, it provides 95% protection.
29. Nurse Sarah is aware that before the administration of RhIg, she should review the laboratory data of a
pregnant client. RhIg is given to pregnant women who are:
 Rh positive and Coombs’ positive
 Rh negative and Coombs’ positive
 Rh positive and Coombs’ negative
 Rh negative and Coombs’ negative
RhIg is given to prevent active formation of antibodies when an Rh-negative individual is at risk for sensitization; if
given to an Rh-positive person, an injection of the RhIg would cause hemolysis of RBC.
30. Marian with a large fetus is to have a pudendal block during the second stage of labor. The nurse plans to
instruct the client that once the block is working she:
 May loose bladder sensation
 Will not feel an episiotomy
 May lose the ability to push
 Will no longer feel contraction
A pudendal block provides anesthesia to the perineum.
31. Nurse Oliver is aware that an anticoagulant drug that a pregnant client with Thrombophlebitis can safely receive
is:
 Dicumarol
 Anisindione
 Heparin sodium
 Warfarin sodium
Heparin can be used during pregnancy because it does not cross the placental barrier and will not cause
hemorrhage.
32. Juday is receiving an intravenous infusion of magnesium sulfate. Nurse Ron should have its antidote readily
available. The nurse knows that the antidote for magnesium sulfate is:
 Protamine sulfate
 Calcium gluconate
 Sodium bicarbonate
 Naloxone hydrochloride
Calcium gluconate will reverse the central nervous system depressant action of magnesium sulfate.
33. When performing a routine physical assessment on a client who is beyond her childbearing years, nurse Bea
identifies that the client has enlarged breasts with galactorrhea. The nurse would expect the physician to order a test
for:
 Estrogen levels
 Prolactin levels
 Oxytocin levels
 Progesterone levels
Prolactine is a hormone that is produced and secreted by the anterior pituitary; a pituitary tumor is the most probable
cause of elevated prolactin levels the result in lactation not associated with childbirth.
34. Mrs. Reyes is scheduled for a vaginal hysterectomy. She asks the nurse about the changes she should expect
after surgery. Nurse Krina should explain that she will:
 No longer ovulate
 Undergo a physiologic menopause eventually.
 Experience an immediate “surgical menopause”
 Have some discomfort during sexual intercourse.
As the term “hysterectomy” implies, only the uterus is removed, therefore, the client will eventually have a physiologic
menopause.
35. Nurse Leng in the women’s health clinic recognizes that a client who complains of swelling of the labia and
throbbing pain in the labial area after sexual intercourse should be treated for:
 Urethritis
 Bartholinitis
 Vaginal hematoma
 Inflamed Skene’s glands
The bartolin glands are located beneath the vaginal vestibule; if cysts form and they become infected they cause
labial, vaginal, or pelvic pain particularly during or after intercourse (dyspareunia).
36. Before a client leaves the hospital after a mastectomy, it is most important that nurse Maureen teach her to:
 Apply breast prosthesis
 Curtail some of her usual activities
 Avoid household tasks that require stretching
 Regularly examine her remaining breast for abnormalities
A clients who have cancer of one breast are at risk for development of cancer in the other breast.
37. Tanya who had a child with Tay-Sachs disease is pregnant and is have an amniocentesis performed to
determine if the fetus has the disease. The nurse counsels her to plan the procedure at the optimal time of:
 6 to 8 weeks’ gestation
 14 to 16 weeks’ gestation
 18 to 20 weeks’ gestation
 22 to 24 weeks’ gestation
An amiocentesis is done at this time because a therapeutic abortion can be legally and safety performed if desired by
the parents.
38. When assessing a female client who is suspected of having primary syphilis, nurse Ronald should expect the
client to exhibit the early sign for:
 Flat wart like plaques around he vagina and anus
 An indurated painless nodule on the vulva that begins to drain.
 Glistening patches in the mouth covered with a yellow exudate
 A maculopapular on the palms of the hands and soles of feet.
This is a description of a chancre, which is the initial sign of syphilis.
39. May at 12 week’s gestation expels the products of conception. Since the client’s blood type is Rh negative, the
nurse should:
 Administer RhoGAM immediately after delivery
 Administer RhoGAM within 72 hours after delivery
 Not giv RhoGAM because the gestation was only 12 weeks.
 Not give RhoGAM because it s not used when the fetus is dead.
RhoGAM should be given within 72 hours after delivery to have an impact on future pregnancies.
40. A client at 10 week’s gestation hones the prenatal clinic to report that she has been experiencing some vaginal
bleeding and abdominal cramping. Nurse Marilyn arranges for her to go to the local hospital. The vaginal examination
reveals that her cervix is 2 cm dilated. The nurse concludes that the client is having:
 A septic abortion
 A threatened abortion
 An inevitable abortion
 An incomplete abortion
Once cervical dilation has begun, the abortion is classified as inevitable.
41. A couple is concerned about the risks associated with an in vitro fertilization embryo transfer (IVF-ET). Nurse
Kris response would be:
 Embryonic HIV
 Ectopic pregnancy
  Congenital anomalies
 Hyperemesis gravidarum
There is an increased risk of ectopic pregnancy with IVF-ET.
42. While Susan is being prepared for surgery because of ruptured tubal pregnancy, she complains of feeling light-
headed. Her pulse is very rapid, and her color is pale. The nurse assesses that the client may be:
 Hyperventilating
 Going into shock
 Extremely anxious
 Developing an infection
Hemorrhage can result from a ruptured tubal pregnancy and shock can ensue.
43. A client at 43 weeks’ gestation has just delivered a typical postmature baby. Nurse Jannah would come to this
conclusion because the newborn has:
 Few creases on the soles of the feet
 Vernix covering the back and buttocks
 Dry peeling skin over the hands and feet
 A red, puffy appearance of the face and neck
Dry peeling skin is related to decreased vernix and prolonged immersion in amniotic fluid.
44. Norma, the mother of newborn with exstrophy of the bladder tells the nurse that the doctor said her child may
develop an unusual gait when learning to walk. Nurse Maureen explains that these children may develop a waddling
gait because of:
 Genu varum
 Tibial torsion
 Subluxation of the femur
 Separation of the pubic bones
The lack of completion of fatal bladder development may interfere with the development of the pelvis.
45. After surgery for repair of a myelomeningocele, nurse Patty should observe the baby for one of the first
indications of impending hydrocephalus, which would be:
 Frequent crying
 Bulging fontanels
 Change in vital signs
 Difficulty with feeding
After closure, spinal fluid may accumulate and back up into the brain, increasing intracranial pressure and causing
the fontanels to bulge.
46. Nurse Antoinette assesses a newborn and observes central cyanosis. Central cyanosis is indicative of
congenital heart defects that affect cardiac circulation by:
 Shunting blood right to left
 Shunting blood left to right
 Obstructing flow of blood from the left side of the heart.
 Preventing shunting of blood between left and right sides of the heart.
Right to left shunts result in inadequate perfusion of blood, not enough blood flows to the lungs for oxygenation.
47. Jenny’s laboratory results indicate the presence of cocaine and alcohol. The characteristic in her newborn that
would indicate to the nurse that the baby has been affected by fetal alcohol syndrome would be:
 Cleft lip
 Polydactyly
 Umbilical hernia
 Small upturned nose
The abnormal facies associated with fetal alcohol syndrome includes a small, upturned nose, which is distinctive in
these infants.
48. Nurse Trinity is aware that an ABO incompatibility is most common when the mother is:
 Type A
 Type B
 Type O
 Type AB
Mother’s with type O blood have anti-A and anti-b antibodies that are transferred across the placenta; this is the most
common incompatability because the mother is type O in 20% of all pregnancies.
49. Nurse Anne is caring for a toddler in respiratory arrest. The nurse will assist with endotracheal intubation and
use an uncuffed tube because the:
 vocal cords provide a natural seal.
  trachea is shorter.
 larynx is anterior and cephalad.
 cricoid cartilage is the narrowest part of the larynx.
The cricoid cartilage in the toddler is the narrowest part of larynx and provides a natural seal. This keeps the
endotracheal tube in place without requiring a cuff. The vocal cords are narrower in an adult. The trachea is shorter
and the larynx is anterior and cephalad, but these aren't reasons to choose an uncuffed tube.
50. Dr. Rodriguez orders an antibiotic for a child, age 6, who has an upper respiratory infection. To avoid tooth
discoloration, the nurse expects the physician to avoid prescribing which drug?
 penicillin
 erythromycin
 tetracycline
 amoxicillin