CDC Community/OB/Pedia

OBSTETRIC NURSING
SITUATIONAL
Situation: Nurse Minette is an Independent Nurse Practitioner following-up referred clients in their
respective homes. Here she handles a case of POSTPARTIAL MOTHER AND FAMILY focusing on HOME CARE.

Nurse Minette needs to schedule a first home visit to OB client Leah. When is a first home-care visit
typically made?
D. Within 1 week of discharge

Leah is developing constipation from being on bed rest. What measures would you suggest she take
to help prevent this?
D. Drink eight full glasses of fluid such as water daily

If you were Minette, which of the following actions would alert you that a new mother is entering a
postpartal taking-hold phase?
A. She urges the baby to stay awake so that she can breast-feed him or her

At 6-week postpartum visit what should this postpartal mothers fundic height be? A. Inverted and
palpable at the cervix
B. Six fingerbreadths below umbilicus

This postpartal mother wants to loose the weight she gained in pregnancy, so she is reluctant to
increase her caloric intake for breast-feeding. By how much should a lactating mother increase her
caloric intake during the first 6 months after birth?
B. 500 kcal/day

Situation: Please continue responding as a professional nurse in these other health situations through the
following questions.

Transmission of HIV from an infected individual to another person occurs:

C. Most commonly as a result of sexual contact

The medical record of a client reveals a condition in which the fetus cannot pass through the
maternal pelvis. The nurse interprets this as:
D. Fetopelvic disproportion

The nurse would anticipate a cesarean birth for a client who has which infection present at the
onset of labor?
C. Hepatitis

After a vaginal examination, the nurse determines that the clients fetus is in an occiput posterior
position. The nurse would anticipate that the client will have:
B. Intense back pain

The rationales for using a prostaglandin gel for a client prior to the induction of labor is to:
B. Numb cervical pain receptors

Situation: Nurse Lorena is a Family Planning and Infertility Nurse Specialist and currently attends to FAMILY
PLANNING CLIENTS AND INFERTILE COUPLES. The following conditions pertain to meeting the nursing
needs of this particular population group.

Dina, 17 years old, asks you how a tubal ligation prevents pregnancy. Which would be the best
answer?
C. Sperm can no longer reach the ova, because the fallopian tubes are blocked
The Dators are a couple undergoing testing for infertility. Infertility is said to exist when:
C. a couple has been trying to conceive for 1 year

Another client named Lilia is diagnosed as having endometriosis. This condition interferes with
fertility because:
A. endometrial implants can block the fallopian tubes

Lilia is scheduled to have a hysterosalphingogram. Which of the following instructions would you
give her regarding this procedure?
B. The sonogram of the uterus will reveal any tumors present

Lilias cousin on the other hand, knowing nurse Lorenas specialization asks what artificial
insemination by donor entails. Which would be your best answer if you were Nurse Lorena?
A. Donor sperm are introduced vaginally into the uterus or cervix

Situation: Nurse Joanna works as an OB-Gyne Nurse and attends to several HIGH-RISK PREGNANCIES:
Particular women with preexisting or Newly Acquired illness. The following conditions apply

Bernadette is a 22-year old woman. Which condition would make her more prone than others to
developing a Candida infection during pregnancy?
D. She has developed gestational diabetes

Bernadette develops a deep vein thrombosis following an auto accident and is prescribed heparin subQ. What should Joanna educate her about in regard to this?
D. Heparin does not cross placenta and so does not affect a fetus

The cousin of Bernadette with sickle-cell anemia alerted Joanna that she may need further instruction
on prenatal care. What statement signifies this fact?
B. I take an iron pill every day to help grow new red blood cells

Bernadette routinely takes acetylsalicylic acid (aspirin) for arthritis. Why should she limit or
discontinue this toward the end of pregnancy?
D. Salicylates can lead to increased maternal bleeding at childbirth

Bernadette received a laceration on her leg from her automobile accident. Why are lacerations of
lower extremities potentially more serious in pregnant women than others?
B. Increased bleeding can occur from uterine pressure on leg veins

Situation: Nette, a nurse palpates the abdomen of Mrs. Medina, a primigravida. She is unsure of the date of
her last menstrual period. Leopolds Maneuver is done. The obstetrician told that she appears to be 20
weeks pregnant.

Nette explains this because the fundus is:

A. At the level of the umbilicus, and the fetal heart can be heard with a fetoscope
In doing Leopolds Maneuver palpation which among the following IS NOT considered a good
preparation:
B. The hands of the nurse should be cold so that abdominal muscles would contract
and tighten

In her pregnancy, she experienced fatigue and drowsiness. This probably occurs because:
C. The fetus utilizes her glucose stores and leaves her with a low blood glucose

The nurse assesses the woman at 20 weeks gestation and expects the woman to report:
C. Feeling fetal kicks

Mrs. Medina comes to you for check-up on June 2, her EDC is June 11, what do you expect during
assessment?
C. Cervix open, fundic ht. 2 fingers below xyphoid process, floating

RhoGAM is given to Rh-negative women to prevent maternal sensitization from occurring. The nurse
is aware that in addition to pregnancy, Rh-negative women would also receive this medication after
which of the following?
C. Therapeutic or spontaneous abortion

Which of the following would the nurse include when describing the pathophysiology of gestational
diabetes?
B. Hypoinsulinemia develops early in the first trimester.

When providing prenatal education to a pregnant woman with asthma, which of the following would
be important for the nurse to do?
C. Ensure she seeks treatment for any acute exacerbation

Which of the following conditions would cause an insulin-dependent diabetic client the most
difficulty during her pregnancy?
A. Rh incompatibility

PROFESSIONAL ADJUSTMENT
Situation: As the CPE is applicable for all professional nurse, the professional growth and development of
Nurses with specialties shall be addressed by a Specialty Certification Council. The following questions
apply to these special groups of nurses.

Which of the following serves as the legal basis and statute authority for the Board of Nursing to
promulgate measures to effect the creation of a Specialty Certification Council and promulgate
professional development programs for this group of nurse-professionals?
C. R.A. 9173

By force of law, therefore, the PRC-Board of Nursing released Resolution No. 14 Series of 1999
entitled: Adoption of a Nursing Specialty Certification Program and Creation of Nursing Specialty
Certification Council. This rule-making power is called:
B. Regulatory Power

Under the PRC-Board of Nursing Resolution promulgating the adoption of a Nursing Specialty
Certification Program and Council, which two (2) of the following serves as the strongest for its
enforcement? (a) Advances made in Science and Technology have provided the climate for
specialization in almost all aspects of human endeavor; and (b) As necessary consequence, there has
emerged a new concept known as globalization which seeks to remove barriers in trade, industry and
services imposed by the national laws of countries all over the world; and (c) Awareness of this
development should impel the nursing sector to prepare our people in the services sector to meet the
above challenge; and (d) Current trends of specialization in nursing practice recognized by the
International Council of Nurses (ICN) of which the Philippines is a member for the benefit of the Filipino
in terms of deepening and refining nursing practice and enhancing the quality of nursing care.
C. a & c are strong justifications

Which of the following IS NOT a correct statement as regards Specialty Certification?

B. The Board of Nursing shall oversee the administration of the NSCP through the
various Nursing Specialty Boards which will eventually be created.

The NSCC was created for the purpose of implementing the Nursing Specialty policy under the
direct supervision and stewardship of the Board of Nursing. Who shall comprise the NSCC?
B. The chairperson and members of the Regulatory Board ipso facto acts as the CPE
Council

A nurse should be cognizant that professional programs for specialty certification by the Board of
Nursing accredited through the:
D. Philippine Nurse Association

Mr. Santos, R.N. works in a nursing home, and he knows that one of his duties is to be an advocate
for his patients. Mr. Santos knows a primary duty of an advocate is to;
C. safeguard the well being of every patient

COMMUNITY HEALTH NURSING

Situation: Nurse Anna is a new BSN graduate and has just passed her Licensure Examination for Nurses in
the Philippines. She has likewise been hired as a new Community Health Nurse in one of the Rural Health
Units in their City, which of the following conditions may be acceptable TRUTHS applied to Community
Health Nursing Practice.

Which of the following is the primary focus of community health nursing practice?
D. Promotion of health

In community health nursing, which of the following is our unit of service as nurses?
D. The Family

A very important part of the Community Health Nursing Assessment Process includes:
A.the application of professional judgment in estimating importance of facts to
family and community

In community health nursing it is important to take into account the family health data coupled with
an equally important need to perform ocular inspection of the area as activities which are powerful
elements of:
B. assessment

The initial step in PLANNING process in order to engage in any nursing project or activities at the
community level involves
B. Monitoring

Situation: There are other important basic knowledge in the performance of our task as Community Health
Nurse in relation to IMMUNIZATION, these include:

The correct temperature to store vaccines in a refrigerator is:

B. between 2 deg C and +8 deg C

Which of the following vaccines is not done by intramuscular (IM) injection?

A. Measles vaccine

This vaccine content is derived from RNA recombinants.

C. Hepatitis B vaccines

This is the vaccine needed before a child reaches one (1) year in order for him/her to qualify as a
fully immunized child.
B. Measles

Which of the following dose of tetanus toxoid is given to the mother to protect her infant from
neonatal tetanus and likewise provide 10 years protection for the mother?
D. Tetanus toxoid 4

You were able to identify factors that lead to respiratory problems in the community where your
health facility serve. Your primary role therefore in order to reduce morbidity due to pneumonia is to:
A. Teach mothers how to recognize early signs and symptoms of pneumonia

Which of the following is the principal focus of the CARI program of the Department of Health?
C. Mortality reduction through early detection

Situation: One important tool a community health nurse uses in the conduct of his/her activities is the CHN
Bag. Which of the following BEST DESCRIBES the use of this vital facility for our practice?

The community/Public Health Bag is:

B. an essential and indispensable equipment of the community health nurse

What is the rationale in the use of bag technique during home visits?
B. It saves time and effort of the nurse in the performance of nursing procedures

Which among the following is important in the use of the bag technique during home visit?
D. Minimize if not totally prevent the spread of infection

This is an important procedure of the nurse during home visits.

D. proper hand washing

In consideration of the steps in applying the bag technique, which side of the paper lining of the
CHN bag is considered clean to make a non-contaminated work area?
D. The inside surface

Situation: As a Community Health Nurse relating with people in different communities, and in the
implementation of health programs and projects you experience vividly as well the varying forms of
leadership and management from the Barangay Level to the Local Government/Municipal or City Level.

The following statements can correctly be made about Organization and management:
A. An organization (or company) is people. Values make people persons; values give vitality, meaning
and direction to a company. As the people of an organization value, so the company becomes.
B. Management is the process by which administration achieves its mission, goals, and objectives.
C. Management effectiveness can be measured in terms of accomplishment of the purpose of the
organization while management efficiency is measured in terms of the satisfaction of individual
motives.
D. Management principles are universal therefore, one need not be concerned about peoples, culture,
values, traditions and human relations.
D. B, A and C only

Management by Filipino values advocate the consideration of the Filipino goals trilogy according to
the Filipino priority-values which are:
D. Family goals, organizational goals, national goals

Since the advocacy for the utilization of Filipino value-system in management has been
encouraged, the Nursing sector is no except, management needs to examine Filipino values and
discover its positive potentials and harness them to achieve:
B. Organizational commitments, organizational objectives and employee satisfaction

The following statements can correctly be made about an effective and efficient community or even
agency managerial-leader.
A. Considers the achievement and advancement of the organization she/he represents as well as his
people
B. Considers the recognition of individual efforts toward the realization of organizational goals as well
as the welfare of his people

C. Considers the welfare of the organization above all other consideration by higher administration
D. Considers its own recognition by higher administration for purposes of promotion and prestige.
C. B, C, and D are correct

Whether management at the community or agency level, there are 3 essential types of skills
managers must have, these are:
A. Human relation skills, technical skills, and cognitive skills
B. Conceptual skills, human relation/behavioral skills, and technical skills
C. Technical skills, budget and accounting skills, skills in fund-raising
D. Manipulative skills, technical skill, resource management skills
A. A and D are correct

DOCUMENTATION
Situation: Records contain those comprehensive descriptions of patients health conditions and needs and
at the same serve as evidences of every nurses accountability in the care giving process. Nursing records
normally differ from institution to institution nonetheless they follow similar patterns of meeting needs for
specific types of information. The following pertains to documentation/records management.

This special form is used when the patient is admitted to the unit. The nurse completes the
information in this record particularly his/her basic personal data, current illness, previous health
history, health history of the family, emotional profile, environmental history as well as physical
assessment together with nursing diagnosis on admission. What do you call this record?
B. Nursing Health History and Assessment Worksheet

These are sheets/forms which provide an efficient and time saving way to record information that
must be obtained repeatedly at regular and/or short intervals of time. This does not replace the
progress notes; instead this record of information on vital signs, intake and output, treatment,
postoperative care, post partum care, and diabetic regimen, etc. This is used whenever specific
measurements or observations are needed to be documented repeatedly. What is this?
B. Graphic Flow Sheets

These records show all medications and treatment provided on a repeated basis. What do you call
this record?
D. Medicine and Treatment Record

This flip-over card is usually kept in a portable file at the Nurses Station. It has 2-parts: the activity
and treatment section and a nursing care plan section. This carries information about basic
demographic data, primary medical diagnosis, current orders of the physician to be carried out by the
nurse, written nursing care plan, nursing orders, scheduled tests and procedures, safety precautions in
patient care and factors related to daily living activities. This record is used in the charge-of-shift
reports or during the bedside rounds or walking rounds. What record is this?
D. Nursing Kardex

Most nurses regard this conventional recording of the date, time, and mode by which the patient
leaves a healthcare unit but this record includes importantly, directs of planning for discharge that
starts soon after the person is admitted to a healthcare institution. It is accepted that collaboration or
multidisciplinary involvement (of all members of the health team) in discharge results in
comprehensive care. What do you call this?
A. Discharge Summary

ETHICS
Situation: As Filipino Professional Nurses we must be knowledgeable about the Code of Ethics for Filipino
Nurse and practice these by heart. The next questions pertain to this Code of Ethics.

Which of the following is TRUE about the Code of Ethics of Filipino Nurses?
C. The present code utilized the Code of Good Governance for the Professions in the
Philippines

Based on the Code of Ethics for Filipino Nurses, what is regarded as the hallmark of nursing
responsibility and accountability?
C. Health, being a fundamental right of every individual

Which of the following nurses behavior is regarded as a violation of the Code of Ethics of
Filipino Nurses?
D. Nurse Reviewers and/ or nurse review center managers who pays a considerable
amount of cash for reviewees who would memorize items from the licensure exams
and submit these to them after the examination.

PEDIATRIC NURSING
Situation: Still in your self-managed Child Health Nursing Clinic, you encounter these cases pertaining to
the CARE OF CHILDREN WITH PULMONARY AFFECTIONS.

Josie brought her 3 months old child to your clinic because of cough and colds. Which of the
following is your primary action?
B. Assess the patient using the chart on management of children with cough
In responding to the care concerns of children with severe disease, referral to the hospital is of the
D. Difficulty to awaken
Which of the following is the most important responsibility of a nurse in the prevention of
unnecessary deaths from pneumonia and other severe diseases?
C. Provision of Careful Assessment

Situation: You are working as a Pediatric Nurse in you own Child Health Nursing Clinic. The following cases
pertain to ASSESSMENT AND CARE OF THE NEWBORN AT RISK conditions.

Theresa, a mother with a 2 year old daughter asks, at what age can I be able to take the blood
pressure of my daughter as a routine procedure since hypertension is common in the family? Your
answer to this is:
D. When shes 6 years old

You typically gag children to inspect the back of their throat. When is it important NOT to elicit a
gag reflex?
C. When a child has symptoms of epiglottitis

Baby John was given a drug at birth to reverse the effects of a narcotic given to his mother in labor.
What drug is commonly used for this:
A. Naloxone (Narcan)

Why are small-for-gestational-age newborns at risks for difficulty maintaining body temperature?
A. They do not have as many fat stores as other infants

Baby John develops hyperbilirubinemia. What is a method used to treat hyperbilirubinemia in a

newborn?
D. Early feeding to speed passage of meconium

Situation: You are the nurse in the Out-Patient Department and during your shift you encountered multiple
childrens condition. The following questions apply.

You assessed a child with visible severe wasting, he has:

D. Marasmus

Which of the following conditions is NOT true about contraindication to immunization?

B. do not give BCG if the child has known hepatitis

Which of the following statements about immunization is NOT true:

A child with diarrhea who is due for OPV should receive the OPV and make extra dose
on the next visit

A child with visible severe wasting or severe palmar pallor may be classified as:
B. severe malnutrition/anemia

A child has some palmar pallor can be classified as:

A. Moderate anemia/normal weight

Situation: Please continue responding as a professional nurse in theses varied health situations through
the following questions.

Which of the following medications would the nurse expect the physician to order for recurrent
convulsive seizures of a 10-year old child brought to your clinic?
A. Phenobarbital

Situation: Nurse Michelle works with a Family Nursing Team in Calbayog Province specifically handling a
UNICEF Project for Children. The following conditions pertain to CARE OF THE FAMILIES WITH
PRESCHOOLERS.

Ronnie asks constant questions. How many does a typical 3-year-old ask in a days time?
D. 300-400

Ronnie will need to change to a new bed because his baby sister will need Ronnies old crib. What
measure would you suggest that his parents take to help decrease sibling rivalry between Ronnie and
his new sister?
D. Ask him to get his crib ready for the new baby

Ronnies parents want to know how to react to him when he begins to masturbate while watching
television. What would you suggest?
C. They remind him that some activities are private

How many words does a typical 12-month-old infant use?

D. Two, plus mama and papa
As a nurse. You reviewed infant safety procedures with Bryans mother. What are two of
the most common types of accidents among infants?
A. Aspiration and falls

NURSING RESEARCH
Situation: You are actively practicing nurse who just finished your Graduate Studies. You learned the value
of Research and would like to utilize the knowledge and skills gained in the application of research to
Nursing service. The following questions apply to research.

Which type of research inquiry investigates the issues of human complexity (e.g. understanding the
human expertise)?
D. Quantitative Research

Which of the following studies is based on quantitative research?

C. A study measuring the effects of sleep deprivation on wound healing

Which of the following studies is based on qualitative research?

A. A study examining clients reactions to stress after open heart surgery

An 85 year old client in a nursing home tells a nurse, I signed the papers for that research study
because the doctor was so insistent and I want him to continue taking care of me. Which client right is
being violated?
A. Right of self determination
A supposition or system of ideas that is proposed to explain a given phenomenon, best defines:
A. A paradigm

INTEGRATED MANAGEMENT OF CHILDHOOD ILLNESSES

Situation: Among common conditions found in children especially among poor communities are ear
infections/problems. The following questions apply.

A child with ear problem should be assessed for the following, EXCEPT:
A. is there any fever?

If the child does not have ear problem, using IMCI, what should you as the nurse do?
D. Go to the next question, check for malnutrition

A ear discharge that has been present for more than 14 days can be classified as:
B. chronic ear infection

An ear discharge that has been present for less than 14 days can be classified as:
C. acute ear infection

If the child has severe classification because of ear problem, what would be the best thing that you
as the nurse can do?
B. refer urgently

Situation: If the child with diarrhea registers one sign in the pink row and one in the yellow row in the IMCI
Chart

We can classify the patient as:

D. severe dehydration

The child with no dehydration needs home treatment. Which of the following is not included in the
rules for home treatment in this case:
B. gives oresol every 4 hours

A child who has had diarrhea for 14 days but has no sign of dehydration is classified as:
D. persistent diarrhea

If the child has sunken eyes, drinking eagerly, thirsty and skin pinch goes back slowly, the
classification would be:
C. some dehydration

Carlo has had diarrhea for 5 days. There is no blood in the stool, he is irritable. His eyes are sunken,
the nurse offers fluid to Carlo and he drinks eagerly. When the nurse pinched the abdomen, it goes
back slowly. How will you classify Carlos illness?
C. some dehydration