COMMUNICABLE DISEASES Q & A
1. A 20 year-old client has an infected leg wound from a motorcycle accident, and the client has returned home from the hospital. The client is to keep the affected leg elevated and is on contact precautions. The client wants to know if visitors can come. The appropriate response from the home health nurse is that:
a. Visitors must wear a mask and a gown
b. There are no special requirements for visitors of clients on contact c. Visitors should wash their hands before and after touching the client d. Visitors should wear gloves if they touch the client
C-
Visitors should wash their hands before and after touching the client Gown and gloves are worn by persons coming in contact with the wounds or infected equipment. Visitors should wash their hands before and after touching the client.
2. Several clients are admitted to an adult medical unit. The nurse would ensure airborne precautions for a client with which medical condition?
a. Autoimmune deficiency syndrome (AIDS) with cytomegalovirus (CMV) b. A positive purified protein derivative with an abnormal chest x-ray c. A tentative diagnosis of viral pneumonia with productive brown sputum. d. Advanced carcinoma of the lung with hemoptysis
B-
A positive purified protein derivative with an abnormal chest x-ray. The client who must be placed in airborne precautions is the client with a positive PPD (purified protein derivative) who has a positive x-ray for a suspicious tuberculin lesion. A sputum smear for acid fast bacillus would be done next. CMV usually causes no signs or symptoms in children and adults with healthy immune systems. When signs and symptoms do occur, they''re often similar to those of mononucleosis, including: sore throat, fever, muscle aches, fatigue. Good handwashing is recommended for CMV.
3. A child is admitted to the pediatric unit with a diagnosis of suspected meningococcal meningitis. Which admission orders should the nurse do first?
a. Institute seizure precautions
b. Monitor neurologic status every hour c. Place in respiratory/secretion precautions d. Cefataxime IV 50 mg/kg/day divided q6h
C-
Meningococcal meningitis has the risk of being a bacterial infection. The initial therapeutic management of acute bacterial meningitis includes respiratory/secretions precautions, initiation
of antimicrobial therapy, monitor neurological status along with vital signs, institute seizure precautions and lastly maintenance of optimum hydration. The first action is for nurses to take any necessary precautions to protect themselves and others from possible infection. Viral meningitis usually does not require protective measures of isolation.
4. A client is diagnosed with methicillin resistant staphylococcus aureus pneumonia. What type of isolation is most appropriate for this client?
a. Reverse b. Airbourne
c. Standard precautions d. Contact
D-
Contact precautions or Body Substance Isolation (BSI) involves the use of barrier protection (e.g. gloves, mask, gown, or protective eyewear as appropriate) whenever direct contact with any body fluid is expected. When determining the type of isolation to use, one must consider the mode of transmission. The hands of personnel continue to be the principal mode of transmission for methicillin resistant staphylococcus aureus (MRSA). Because the organism is limited to the sputum in this example, precautions are taken if contact with the patient''s sputum is expected. A private room and contact precautions , along with good hand washing techniques, are the best defenses against the spread of MRSA pneumonia.
5. Which of these clients with associated lab reports is a priority for the nurse to report to the public health department within the next 24 hours?
a. An infant with a positive culture of stool of Shigella
b. An elderly factory worker with a lab report that is positive for acid-fast bacillus smear
c. A young adult commercial pilot with a positive histopathological examination from an induced sputum for Pneumocystis carinii
d. A middle-aged nurse with a history of varicella-zoster virus and with crops of vesicles on an erythematous base that appear on the skin
B-
Tuberculosis is a reportable disease because persons who had contact with the client must be traced and often must be treated with chemoprophylaxis for a designated time. Options a and d may need contact isolation precautions. Option c findings may indicate the initial stage of the autoimmune deficency syndrome (AIDS).
6. A client is scheduled to receive an oral solution of radioactive iodine (131I). In order to reduce hazards, the priority information for the nurse to include during the instructions to the client is which of these statements?
a. In the initial 48 hours avoid contact with children and pregnant women, and after urination or defecation flush the commode twice
b. Use disposable utensils for 2 days and if vomiting occurs within 10 hours of the dose, do so in the toilet and flush it twice
c. Your family can use the same bathroom that you use without any special preacautions d. Drink plenty of water and empty your bladder often during the initial 3 days of therapy
A-
The client''s urine and saliva are radioactive for 24 hours after ingestion, and vomitus is
radioactive for 6 to 8 hours. The client should drink 3 to 4 liters a day for the initial 48 hours to help remove the agent from the body. Staff should limit contact with hospitalized clients to 30 minutes per day per person.
7. A newly admitted adult client has a diagnosis of hepatitis A. The charge nurse should reinforce to the staff members that the most significant routine infection control strategy, in addition to handwashing, to be implemented is which of these?
a. Apply appropriate signs outside and inside the room b. Apply a mask with a shield if there is a risk of fluid splash c. Wear a gown to change soiled linens form incontinence d. Have gloves on while handling bedpans with feces
D-
The specific measure to prevent the spread of hepatitis A is careful handling and protection while handling fecal material. All of the other actions are correct but not the most significant.
8. The nurse is assigned to a client newly diagnosed with active tuberculosis. Which of these protocols would be a priority for the nurse to implement?
a. Have the client cough into a tissue and dispose in a separate bag b. Instruct the client to cover the mouth with a tissue when coughing c. Reinforce for all to wash their hands before and after entering the room
d. Place client in a negative pressure private room and have all whoenter the room use masks with shields
D-
A client with active tuberculosis should be hospitalized in a negative pressure room to prevent respiratory droplets from leaving the room when the door is opened. Tuberculosis (TB) is caused by spore-forming mycobacteria, more often Mycobacterium tuberculosis. In developed countries the infection is airborne and is spread by inhalation of infected droplets. In underdeveloped countries (Africa, Asia, South America), transmission also occurs by ingestion or by skin invasion, particularly when bovine TB is poorly controlled
9. The school nurse is teaching the faculty the most effective methods to prevent the spread of lice in the school. The information that would be most important to include would be which of these statements?
b. Bedding and clothing can be boiled or steamed c. Children are not to share hats, scarves and combs d. Nit combs are necessary to comb out nits.
C-
Head lice live only on human beings and can be spread easily by sharing hats, combs, scarves, coats and other items of clothing that touch the hair. All of the options are correct statements. However they do not best answer the question of how to prevent the spread of lice in a school setting.
10. During the care of a client with a salmonella infection, the primary nursing intervention to limit transmission is which of these approaches?
a. Wash hands thoroughly before and after client contact b. Wear gloves when in contact with body secretions c. Double glove when in contact with feces or vomitus d. Wear gloves when disposing of contaminated linens
A-
Gram-negative bacilli cause Salmonella infection. Two million new cases appear each year. Lack of sanitation is the primary means of contamination. Thorough handwashing can prevent the spread of salmonella. Note that all of the options are correct actions. However, the primary action is to wash the hands.
11. A nurse administers the influenza vaccine to a client in a clinic. Within 15 minutes after the immunization was given, the client complains of itchy and watery eyes, increased anxiety, and difficulty breathing. The nurse expects that the first action in the sequence of care for this client will be to
a. Maintain the airway
b. Administer epinephrine 1:1000 as ordered c. Monitor for hypotension with shock d. Administer diphenhydramine as ordered
B-
All the answers are correct given the circumstances. The correct sequence of care is to administer the epinephrine, then maintain airway. In the early stages of anaphylaxis, when the patient has not lost consciousness and is normatensive, administering the epinephrine and then applying the oxygen, watching for hypotension and shock are later responses. The prevention of a severe crisis is maintained by using diphenhydramine.
12. A client with a diagnosis of Methicillin resistant Staphylococcus aureus (MRSA) has died. Which type of precautions is the appropriate type to use when performing postmortem care?
a. Airborne precautions b. droplet precautions
c. contact precautions
d. compromised host precautions
C-
The resistant bacteria remain alive for up to 3 days post death. Therefore, contact precautions must still be implemented. Also label the body so that the funeral home staff can protect themselves as well. Gown and gloves are required.
13. A nurse is stuck in the hand by an exposed needle. What immediate action should the nurse take?
a. Look up the policy on needle sticks b. Contact employee health services c. Immediately wash the hands with vigor d. Notify the supervisor and risk management
C-
The immediate action of vigorously washing will help remove possible contamination. Then the sequence would then be options 4, 1, 2.
14. The mother of a 2 month-old baby calls the nurse 2 days after the first DTaP, IPV, Hepatitis B and HIB immunizations. She reports that the baby feels very warm, cries inconsolably for as long as 3 hours, and has had several shaking spells. In addition to referring her to the emergency room, the nurse should document the reaction on the baby's record and expect which of the following? a. DTaP b. Hepatitis B c. Polio d. H. Influenza A-
The majority of reactions occur with the administration of the DTaP vaccination. Contradictions to giving repeat DTaP immunizations include the occurrence of severe side effects after a previous dose as well as signs of encephalopathy within 7 days of the immunization. 15. The nurse is teaching a class on HIV prevention. Which of the following should be emphasized as increasing risk?
a. Donating blood
b. Using public bathrooms c. Unprotected sex
d. Touching person with AIDS
Because HIV is spread through exposure to bodily fluids, unprotected intercourse and shared drug paraphernalia remain the highest risk for infection.
16. Which of the following manifestations observed by the school nurse confirms the presence of pediculosis capitis in students?
a. Scratching the head more than usual b. Flakes evident on a student’s shoulders c. Oval pattern occipital hair loss
d. Whitish oval specks sticking to the hair
D-
Diagnosis of pediculosis capitis is made by observation of the white eggs (nits) firmly attached to the hair shafts. Treatment includes shampoo application, such as lindane for children over 2 years of age, and meticulous combing and removal of all nits.
17. A client is admitted with a right upper lobe infiltrate and to rule out tuberculosis. The most appropriate action by the nurse to protect the self would be which of these?
a. Negative room ventilation b. Face mask with shield c. Particulate respirator mask d. Airborne precautions
C-
Tight fitting, high-efficiency masks are required when caring for clients who have suspected communicable disease of the airborne variety.
18. To prevent drug resistance common to tubercle bacilli, the nurse is aware that which of the following agents are usually added to drug therapy?
a. Anti-inflammatory agent
b. High doses of B complex vitamins c. Aminoglycoside antibiotic
d.Two anti-tuberculosis drugs
D-
Resistance of the tubercle bacilli often occurs to a single antimicrobial agent. Therefore, therapy with multiple drugs over a long period of time helps to ensure eradication of the organism. 19. An 18 month-old child is on peritoneal dialysis in preparation for a renal transplant in the near future. When the nurse obtains the child's health history, the mother indicates that the child has not had the first measles, mumps, rubella (MMR) immunization. The nurse understands that which of the following is true in regards to giving immunizations to this child?
b) The MMR vaccine should be given now, prior to the transplant c) An inactivated form of the vaccine can be given at any time d) The risk of vaccine side effects precludes giving the vaccine
B-
MMR is a live virus vaccine, and should be given at this time. Post-transplant,
immunosuppressive drugs will be given and the administration of the live vaccine at that time would be contraindicated because of the compromised immune system.
20. Which contraindication should the nurse assess for prior to giving a child immunizations?
a) Mild cold symptoms b) Chronic asthma
c) Depressed immune system d) Allergy to eggs
C-
Children who have a depressed immune system related to HIV or chemotherapy should not be given routine immunizations.
21. The nurse is caring for a client suspected to have Tuberculosis (TB). Which of the following diagnostic tests is essential for determining the presence of active TB?
a. Tuberculin skin testing b. Sputum culture
c. White blood cell count d. Chest X-ray
B-
The sputum culture is the most accurate method for determining the presence of active TB. 22. A client had arrived in the USA from a developing country 1 week prior. The client is to be admitted to the medical surgical unit with a diagnosis of AIDS with a history of unintended weight loss, drug abuse, night sweats, productive cough and a "feeling of being hot all the time." The nurse should assign the client to share a room with a client with the diagnosis of
a. Acute tuberculosis with a productive cough of discolored sputum for over three months b.Lupus and vesicles on one side of the middle trunk from the back to the abdomen c. Pseudomembranous colitis and C. difficile.
d. Exacerbation of polyarthritis with severe pain
A-
The client for admission has classic findings of pulmonary tuberculosis. Of the choices the client in option A has the similar diagnosis and it is acceptable to put these types of clients in the same
room when no other alternative exists. Clients are considered contagious until the cough is eliminated with medications which initially is a combination of 4 drugs simultaneously. 23. The nurse is attending a workshop about caring for persons infected with Hepatitis. Which statement is correct when referring to the incidence rate for Hepatitis?
a. The number of persons in a population who develop Hepatitis B during a specific period of time
b. The total number of persons in a population who have Hepatitis B at a particular time c. The percentage of deaths resulting from Hepatitis B during a specific time
d. The occurrence of Hepatitis B in the population at a particular time
A-
This is the correct definition of incidence of the disease
24. The nurse is taking a health history from parents of a child admitted with possible Reye's Syndrome. Which recent illness would the nurse recognize as increasing the risk to develop Reye's Syndrome? a. Rubeola b.Meningitis c. Varicella d. Hepatitis C-
Varicella (chicken pox) and influenza are viral illnesses that have been identified as increasing the risk for Reye's Syndrome. Use of aspirin is contraindicated for children with these infections. 25. A 15 month-old child comes to the clinic for a follow-up visit after hospitalization for
treatment of Kawasaki Disease. The nurse recognizes that which of the following scheduled immunizations will be delayed?
a. MMR b. Hib c. IPV d. DtaP
A-
Medical management of Kawasaki involves administration of immunoglobulins. Measles, mumps, rubella (MMR) is a live virus vaccine. Following administration of immunoglobulins, live vaccines should be held due to possible interference with the body's ability to form
antibodies.
26. The recent increase in the reported cases of active tuberculosis (TB) in the United States is attributed to which factor?
a. The increased homeless population in major cities b. The rise in reported cases of positive HIV infections c. The migration patterns of people from foreign countries d. The aging of the population located in group homes
B-
Between 1985 and 2002 there has been a significant increase in the reported cases of TB. The increase was most evident in cities with a high incidence of positive HIV infection. Positive HIV infection currently is the greatest known risk factor for reactivating latent TB infections as well. 27. A client with hepatitis A (HAV) is newly admitted to the unit. Which action would be the priority to include in the plan of care within the initial 24 hours for this client?
a. Wear masks with shields if potential splash b. Use disposable utensils and plates for meals Wear gown and gloves during client contact
d. Provide soft easily digested food with frequent snacks
C-
HAV is usually transmitted via the fecal-oral route. That means that someone with the virus handles food without washing his or her hands after using the bathroom. The virus can also be contracted by drinking contaminated water, eating raw shellfish from water polluted with sewage or being in close contact with a person who's infected — even if that person has no signs and symptoms. In fact, the disease is most contagious before signs and symptoms ever appear. The nurse should recognize the importance of isolation precautions from the initial contact with the client on admission until the noncontagious convalescence period.
28. A child is diagnosed with poison ivy. The mother tells the nurse that she does not know how her child contracted the rash since he had not been playing in wooded areas. As the nurse asks questions about possible contact, which of the following would the nurse recognize as highest risk for exposure?
a. Playing with toys in a back yard flower garden b. Eating small amounts of grass while playing "farm" c. Playing with cars on the pavement near burning leaves d. Throwing a ball to a neighborhood child who has poison ivy
C-
Smoke from burning leaves or stems of the poison ivy plant can produce a reaction. Direct contact with the toxic oil, urushiol, is the most common cause for this dermatitis.
29. A female client diagnosed with genital herpes simplex virus 2 (HSV 2) complains of dysuria, dyspareunia, leukorrhea and lesions on the labia and perianal skin. A primary nursing action with the focus of comfort should be to
b. Cleanse the genitalia twice a day with soap and water c. Spray warm water over genitalia after urination d. Apply heat or cold to lesions as desired
A-
Frequent sitz baths may sooth the area and reduce inflammation. The other actions are correct actions. However, they would not address the entire group of problems.
30. A client with HIV infection has a secondary herpes simplex type 1 (HSV-1) infection. The nurse knows that the most likely cause of the HSV-1 infection in this client is
a. Immunosuppression b. Emotional stress
c. Unprotected sexual activities d. Contact with saliva
A-
The decreased immunity leads to frequent secondary infections. Herpes simplex virus type 1 is an opportunistic infection. The other options may result in HSV-1. However they are not the most likely cause in clients with HIV.
31. When teaching adolescents about sexually transmitted diseases, what should the nurse emphasize that is the most common infection?.
a. Gonorrhea b. Chlamydia c. Herpes d. HIV
B-
Chlamydia has the highest incidence of any sexually transmitted disease in this country. Prevention is similar to safe sex practices taught to prevent any STD: use of a condom and spermicide for protection during intercourse.
32. The nurse is assigned to a newly delivered woman with HIV/AIDS. The student asks the nurse about how it is determined that a person has AIDS other than a positive HIV test. The nurse responds
a. "The complaints of at least 3 common findings." b. "The absence of any opportunistic infection." c. "CD4 lymphocyte count is less than 200." d. "Developmental delays in children."
CD4 lymphocyte counts are normally 600 to 1000. In 1993 the Center for Disease Control defined AIDS as having a positive HIV plus one of these – the presence of an opportunistic infection or a CD4 lymphocyte count of less than 200.
33. A client is in her third month of her first pregnancy. During the interview, she tells the nurse that she has several sex partners and is unsure of the identity of the baby's father. Which of the following nursing interventions is a priority?
a. Counsel the woman to consent to HIV screening b. Perform tests for sexually transmitted diseases c. Discuss her high risk for cervical cancer
A-
The client''s behavior places her at high risk for HIV. Testing is the first step. If the woman is HIV positive, the earlier treatment begins, the better the outcome.
34. A nurse is to collect a sputum specimen for acid-fast bacillus (AFB) from a client. Which action should the nurse take first?
a. Ask client to cough sputum into container b. Have the client take several deep breaths c. Provide a appropriate specimen container d. Assist with oral hygiene
D-
Obtain a specimen early in the morning after mouth care. The other responses follow this first action: the client should take several deep breaths then cough into the appropriate container which is sterile for the AFB specimen of the sputum.
34. A 20 year-old client has an infected leg wound from a motorcycle accident, and the client has returned home from the hospital. The client is to keep the affected leg elevated and is on contact precautions. The client wants to know if visitors can come. The appropriate response from the home health nurse is that:
a. Visitors must wear a mask and a gown
b. There are no special requirements for visitors of clients on contact precautions c. Visitors should wash their hands before and after touching the client
d. Visitors should wear gloves if they touch the client
C-
Gown and gloves are worn by persons coming in contact with the wounds or infected equipment. Visitors should wash their hands before and after touching the client.
35. Several clients are admitted to an adult medical unit. The nurse would ensure airborne precautions for a client with which medical condition?
b. A positive purified protein derivative with an abnormal chest x-ray c. A tentative diagnosis of viral pneumonia with productive brown sputum d. Advanced carcinoma of the lung with hemoptasis
B-
The client who must be placed in airborne precautions is the client with a positive PPD (purified protein derivative) who has a positive x-ray for a suspicious tuberculin lesion. A sputum smear for acid fast bacillus would be done next. CMV usually causes no signs or symptoms in children and adults with healthy immune systems. When signs and symptoms do occur, they''re often similar to those of mononucleosis, including: sore throat, fever, muscle aches, fatigue. Good handwashing is recommended for CMV.
36. A client is diagnosed with methicillin resistant staphylococcus aureus pneumonia. What type of isolation is most appropriate for this client?
a. Reverse b. Airbourne
c. Standard precautions d. Contact
D-
Contact precautions or Body Substance Isolation (BSI) involves the use of barrier protection (e.g. gloves, mask, gown, or protective eyewear as appropriate) whenever direct contact with any body fluid is expected. When determining the type of isolation to use, one must consider the mode of transmission. The hands of personnel continue to be the principal mode of transmission for methicillin resistant staphylococcus aureus (MRSA). Because the organism is limited to the sputum in this example, precautions are taken if contact with the patient''s sputum is expected. A private room and contact precautions , along with good hand washing techniques, are the best defenses against the spread of MRSA pneumonia.
37. Which of these clients with associated lab reports is a priority for the nurse to report to the public health department within the next 24 hours?
a. An infant with a postive culture of stool for Shigella
b. An elderly factory worker with a lab report that is positive for acid-fast bacillus smear
c. A young adult commercial pilot with a positive histopathological examination from an induced sputum for Pneumocystis carinii
d. A middle-aged nurse with a history of varicella-zoster virus and with crops of vesicles on an erythematous base that appear on the skin
B-
Tuberculosis is a reportable disease because persons who had contact with the client must be traced and often must be treated with chemoprophylaxis for a designated time. Options a and d may need contact isolation precautions. Option c findings may indicate the initial stage of the autoimmune deficency syndrome (AIDS).
38. A newly admitted adult client has a diagnosis of hepatitis A. The charge nurse should reinforce to the staff members that the most significant routine infection control strategy, in addition to handwashing, to be implemented is which of these?
a. Apply appropriate signs outside and inside the room b. Apply a mask with a shield if there is a risk of fluid splash c. Wear a gown to change soiled linens from incontinence d. Have gloves on while handling bedpans with feces D-
The specific measure to prevent the spread of hepatitis A is careful handling and protection while handling fecal material. All of the other actions are correct but not the most significant.
39. Which approach is the best way to prevent infections when providing care to clients in the home setting?
a. Handwashing before and after examination of clients
b. Wearing nonpowdered latex free gloves to examine the client c. Using a barrier between the client's furniture and the nurse's bag d. Wearing a mask with a shield during any eye/mouth/nose examination
A-
Handwashing remains the most effective way to avoid spreading infection. However, too often nurses do not practice good handwashing techniques and do not teach families to do so. Nurses need to wash their hands before and after touching the client and before entering the nursing bag. All of the options are correct. The sequence for priority actions would be options a, c, b, and d. 40. The nurse is assigned to a client newly diagnosed with active tuberculosis. Which of these protocols would be a priority for the nurse to implement?
a. Have the client cough into a tissue and dispose in a separate bag b. Instruct the client to cover the mouth with a tissue when coughing c. Reinforce for all to wash their hands before and after entering the room
d. Place client in a negative pressure private room and have all who enter the room use masks with shields
D-
A client with active tuberculosis should be hospitalized in a negative pressure room to prevent respiratory droplets from leaving the room when the door is opened. Tuberculosis (TB) is caused by spore-forming mycobacteria, more often Mycobacterium tuberculosis. In developed countries the infection is airborne and is spread by inhalation of infected droplets. In underdeveloped countries (Africa, Asia, South America), transmission also occurs by ingestion or by skin invasion, particularly when bovine TB is poorly controlled.
41. Transmission of HIV from an infected individual to another person occurs:
b. Only if there is a large viral load in the blood c. Most commonly as a result of sexual contact d. In all infants born to women with HIV infection
C-
Situation: 42 - 46
Linda is 4 years old and with her sister come to see you for her inflamed tonsils. Upon
assessment, you found inflammation of pharynx, larynx with adherent grayish rnembrane. You know that it is diphtheria.
42. What is the cause of characteristic lesions in diphtheria?
a. Patches of grayish membrane b. Infectious mononucleosis c. Liberation of specific toxin d. Bacterial pharyngitis
C-
43. What happens when bacteria are infected Cory bacteria phage containing the gene?
a. Lesions appear c. Intermediate body type b. Toxin production d. Infection occurs
B-
44. To prevent transmission of diphtheria, what should the nurse teach the family?
a. Burn patients articles b. Disinfect sotted articles c. Separate patients artictes
d. Avoid contact with soiled clothes
B-
45. Effective control of diphtheria is wide spread immunizations. Which groups of vaccines are administered together?
a. BCQ b. DPT
c. Booster in Grade I d. To triple dose
B-
46. Specific treatment for strongly suspected person with diphtheria is an anti toxin. Which antibiotic on the other hand is used for diphtheria?
a. 20.000-1,000,000 units of erythromycin b. 20,000-1,000,000 units of erythropoietin c. 20,000-1,000,000 units of gentamycin d. 20,000-1,000,000 units of chlorampenicol A- Situation: 47 - 50
Infection is pregnancy may cause considerable injury, both to the mother and the fetus, thus prompt diagnosis management is indicated:
47. Chickenpox is primarily transmitted through the:
a. Respiratory route b. Oral route
c. Skin to skin transmission d. Anal route
A-
48. Vaccination of the live attenuated form of this organism is contraindicated for woman who may become pregnant within 3 months.
a. Diphtheria b. Tetanus c. Rubella d. Hepatitis
C-
49. This is a serologic test for syphilis which involves antibody detection by microscopic flocculation of the antigen suspension:
a. VDRL
b. Fluorescent treponemal antigen antibodies c. Treponema pallidum hemoglobin.
d. Treponema pallidum immunoassay
50. Prevention of Gonococcal opthalmia is done through the practice use of:
a. Ophthalmic preparation with erythromycin or tetracycline b. Any of these
c. None of these
d. 1% of silver nitrate eye drops
B-
51. be normal cmmensally of humans. In immune compromised humanshowever it may cause oral / vulvo vaginal thrush:
a. Candida albicans b. Coccidiodes imitus c. Histoplasma capsulatum d. Morganella morganii A- Situation: 52 – 56
Tuberculosis is one of the health problems in themucicipality of pillar where you are assigned as a public health nurse
52. The magnitude of the problem in a community can be measured throught the following diagnostic method.
a. All of these
b. Tubercullin testing
c. Bacteriological examination d. Chest X-ray examination
A-
53. The following are integrated into the regular activities of the rural health unit.
a. All of these
b. BCG immunization c. Case finding
d. Sputum microscopy
A-
54. In a follow visit to a TB patient you explained to the other member of the family that the patient is communicable:
a. As long as the patient is coughing b. About 1 year or 2 years after infections
c. AS long as the tubercle bacilli is discharge in the sputum d. About 4-12 weefc from infection
C-
55. In response to the question as to how communicable is the patient you explained that the degree of communic&biiity depends on:
a. Number of bacilli discharged b. Virulence of the bacilli
c. Chances of the bacilli to be spread through coughing and talking. d. All these factors
D-
56. T0 minimize/ prevent the soread of TB your health teaching includes which of the following:
a. Covering of nose and mouth when coughing or sneezing b. Adherence to prescribed dosage and duration of treatment c. Proper disposal of sputum and secretion soiled tissues d. All these teachings
D-
Situation: 57 - 61
You are conducting a health education class on AIDS participated by a group of college students. You emphasized preventive and control measures as follows:
57. The most logical means of preventing transmission of HIV from mother to child is that:
a. HIV positive woman should not become pregnant
b. HIV positive woman and their partners must be informed of the possible risk to the fetus. c. HIV positive pregnant woman must be under close medical supervision.
d. Infants 0-15 months must be under close medical supervision
B-
58. The following safety precautions are important against AIDS.
a. Advise clients not to share toothbrushes and razors
b. Sterilize instruments for ear holing, tattooing and acupuncture c. All these are important
C-
59. Screening for HIV should be offered routinely to the following groups except:
a. None of these groups
b. People who feel they are sick
c. Babies of woman with HIV infection d. Intravenous drug users seeking treatment
B-
60. You Explained that one preventive measure against AIDS is to practice safe sex such as:
a. Having sex with woman having her menstrual period b. Anal sex
c. Oral sex
d. Having a monogamous relationship
D-
61. A student asks "if you accidentally discovered that one of your friends in the community is HIV positve, what will you do?
a. Give him the usual friendly treatment as before
b. Tell your other friends about it so that they will know how to protect their self c. Advise other members of the family to separate their eating utensils
d. Secretly avoid his company.
A-
Situation: 62 - 66
Bacterial conjunctivitis is common usually during summer months. Knowledge of this disease will provide you with appropriate health teachings..
62. Conjunctivitis is transmitted through:
a. Contact with discharges from conjunctivae of infected persons b. Mechanical transmission with vectors such as flies
c. Contact with discharges from upper respiratory tract. d. All these mode of transmission
D-
a. 12 to 15days b. 6 to 12 hours c. 5 to 12 days d. 24 to 72 hours D-
64. This is most comunicable during:
a. All these stages of the disease b. Lacrimal stage
c. Course of active in infection d. Prodromal stage
B-
65. The spread of conjunctivitis can be prevented through
a. Treatment of infected member of the family b. Personal hygiene
c. Practice of all these health measure d. Good diet and living conditions
C-
66. The following measure for the control of conjunctivitis which of these does not belong?
a. Reporting ofcase to local health officials
b. Advising children not to attend school during the acute stage c. Terminail disinfection of soiled articles
d. Immunizations of contacts
D-
Situatton: 67 - 71
Janice now 8 years old was never given any kind of immunization because the family had never visited health care unit Now she is diagnosed to have acute poliomyelitis.
67. The major route of this transmission of polio virus in poor sanitation environment is:
a. Sewage disposal b. Water system c. Fecal-oral d. Food staff
C-
68. When virus is ingested where does it multiply
a. Alimentary tract b. Integumentary system c. Urinary tact
d. Reproductive tract
A-
69. As a rural health nurse your most important function in pofio prevention is to
a. Educate the public on the advantages of immunization b. Distribute leaflets about the causes of polio
c. Call all mother for a lecture d. Refer all children to the doctor
A-
70. Your health teaching to Janice, the polio victim includes
a. Proper waste disposal b. Proper eating habits c. Regular health check up d. Advocacy in health
A-
71. The best nursing intervention in the case of Janice is with paralysis of lower extremity due to poliomyelitis is;
a. Letting Janice attend mothers class b. Rendering physical comfort c. Referral for physical therapy d. Diet instruction
C-
Situation: 71 - 75
Infectious monucleosis is common among lovers John and Joan came to see you for fever sore throat and lymph adenopathy. They are scheduled to get married next month.
71. How did both contact the disease: a. Droplet
b. Food for snacks c. Kissing
d. HIV infection
A-
72. Which among the following will you include in your health teaching
a. Appropriate hygienic measure b. top kissing each other
c. Immunization for both d. See the doctor for steroids
A-
73. Mononucleosis in children happens because of an acceptable practice of grand parents in feeding their grand children with pre chewed food, what is your teachings?
a. Prepare soft diet
b. Feed babies only with bottles. c. Avoid pre chewing of babies food d. Pulverize meat before feeding
C-
74. The causative organism is?
a. Chlamydia b. Epstein barr c. Burkitts d. Bronholm
B-
75. What is your health teachings for the couple?
a. Give away soiled articles b. Burn the hankies
c. Dip utensils in boiling water d. Throw clothes to the river
C-
Lilia a 23 year old medical student develops severe vomiting and diarrhea. She appears markedly dehydrated incoherent and lethargic.
76. Which of the following will be a reliable index for Lilia's dehydration?
a. Decrease in hematocrit count b. Change in body weight c. General appearance d. Elevated blood pressure
B-
77. Lilia may benefit from which of the following drugs
a. Lomotil b. Codeine sulfate c. Metamucil d. Phosposoda
A-
78. What fluids will be most likely indicated for her condition?
a. Gatorade b. AM c. Cola
d. High glucose energy drink
A-
79. Wnat will be the first sign of dehydration for her condition?
a. Thirst
b. Poor skin turgor c. Dry lips
d. Sunken eye ball
A-
80. To prevent cross transmission to other people what would he the simplest prevention?
a. Hand washing b. Alcohol application c. Water Chlorination d. Boiling of water
A-
Situation: 81 - 85
Benito lives in a farm where the rice paddies are continuously gets flooded. On a stormy night Benito found dead rats floating in his paddles. He never knew that these rats were contaminated with leptospirosis.
81. Benito went to RHU and looked for the Doctor, but he was attending an update in the city what should you do?
a. Check vital signs
b. Bring him to the hospital c. Start IV to open blood vessels d. Call the doctor
A-
82. The common feature of leptospirosis are the following but one is not
a. Fever b. Chills c. Headache d. Vomiting B-
83. Upon nursing assessment you found out that Benito has an open wound. What is the mode of transmission of leptospirosis?
a. Use of belongings b. Rats and rodent c. Open skin contact d. Droplet spread
C-
84. Your nursing function is to educate the people regarding the importance of immunization and prevention. Which one is your nursing function in leptospirosis?
a. Explanation of phatophysiology b. Health education
c. Nutrition and exercise d. Medication
85. Treatment of leptospirosis is asymptomatic but usually this drug is prescribed mg orally once a month. a. Doxycyciine b. Ciprobay c. Rocalthrol d. Amoxicillin A- Situation: 86 - 90
Immunity may be natural or acquired but here is no absolute immunity
86. What kind of immunity is the state of resistance to infection inherent in the body not brought about by the previous attack, of the disease?
a. Passive b. Natural c. Anaphylactic d. Active
B-
87. What kind of immunity is acquired resulting from previous attack of the disease or repeated exposure to doses of an organism?
a. Anaphylactic b. Active c. Passive d. Natural B-
88. What is the term which means there is an increase susceptibility to special substances especially protein. When this is introduced in the body the response which is a delayed hypersensitivity reaction may be alarming?
a. Anaphylaxis b. Antidote c. Serum sickness d; Dermatologist A-
produced by the persons own body cells? a. Passive b. Active c. Natural d. Prophylactic A-
90. Before introduction of any foreign substances to the body it is the duty of the nurse to prepare a syringe with aminophylline anaphylactic shock what do you call this procedure.
a. Horse serum b. Antidote c. Sensitivity d. Dermatologist B- Situation: 91 - 95
Infection and immunity is two important process.
91. What is the term which means the entry and development of an infectious agent in the body?
a. Incidence b. Infection c. Infestation d. Incubation
B-
92. What is the term which means resistance of the body associated with the presence of antibodies or cells having specific action on microorganism or toxin?
a. Immunity b. Mortality c. Morbidity d. Pathogenicity
A-
93. What is an incidence rate used to include all person in the population who become chronically ill?
a Immunity b. Pathogenicity
c. Mortality d. Morbidity
D-
94. What is the rate calculated in the same way using a numerator number of deaths occurring during a stipulated time?
a. Immunity b. Pathogenicity c. Mortality d. Morbidity
C-
95. What kind of infection occurs after the patient has been admitted or even after discharge which were acquired during or even after hospitalizations.
a. Transmission b. Quarantine c. Isolation d. Nosocomial D- Situation: 96 -
Mang Inasal is malnourished, living in a crowded area. He came in the health center due to loss of weight easy fatigability chronic dry cough and low grade fever.
96. The main source of infection pulmonary tuberculous is:
a. Crowded living quarters
b. Unavailability of portable drinking water c. Direct contact with infected person d. Unsanitary surrounding
A-
97. A physician orders an X- ray examination for the patient. What is the purpose for this?
a. To check if patient have relative with TB b. To see the evidence of having the disease c. Determine severity of the lesions in the lungs d. To aid in doctors prescriptions.
C-
98. In TB control program of DOH it has specific objectives; one on prevention is another program which is focused in children, which one below on this program?
a. Differential prophylaxis
b. Sputum collection and examination c. EPI for BCG vaccine
d. Tuberculin skin testing
C-
99. On health education which one is the responsibility of the community health nurse?
a. Intensive and responsive IEC campaign b. Intersection coordination
c. Supervision and monitoring d. Periodic reporting and recording
A-
100. If assigned to conduct research related to TB control which would provide epidemiological and sociological information? Choose one method of data collection.
a. Identify operational problem c. Read related literature b. Prevalence survey
d. Include TB cases as population
D-
101. A client is admitted to the health care facility with active tuberculosis. The nurse should include which intervention in the plan of care?
a. Putting on a mask when entering the client’s room. b. Instructing the client to wear a mask at all times
c. Wearing a gown and gloves when providing direct care
d. Keeping the door to the client’s room open to observe the client A-
Because tuberculosis is transmitted by droplet nuclei from the respiratory tract, the nurse should put on a mask when entering the client’s room. Having the client wear a mask at all the times would hinder sputum expectoration and make the mask moist from respirations. If no contact with the client’s blood or body fluids is anticipated, the nurse need not wear a gown or gloves when providing direct care. A client with tuberculosis should be in a room with laminar air flow, and the door should be closed at all times.
102. The nurse is caring for four clients on a step-down intensive care unit. The client at the highest risk for developing nosocomial pneumonia is the one who:
a. has a respiratory infection b. is intubated and on a ventilator c. has pleural chest tubes
d. is receiving feedings through a jejunostomy tube
B-
When clients are on mechanical ventilation, the artificial airway impairs the gag and cough reflexes that help keep organisms out of the lower respiratory tract. The artificial airway also prevents the upper respiratory system from humidifying and heating air to enhance mucociliary clearance. Manipulations of the artificial airway sometimes allow secretions into the lower airways. Whit standard procedures the other choices wouldn’t be at high risk.
103. A woman whose husband was recently diagnosed with active pulmonary tuberculosis (TB) is a tuberculin skin test converter. Management of her care would include:
a. scheduling her for annual tuberculin skin testing
b. placing her in quarantine until sputum cultures are negative c. gathering a list of persons with whom she has had recent contact d. advising her to begin prophylactic therapy with isoniazid (INH)
Individuals who are tuberculin skin test converters should begin a 6-month regimen of an antitubercular drug such as INH, and they should never have another skin test. After an individual has a positive tuberculin skin test, subsequent skin tests will cause severe skin
reactions but won’t provide new information about the client’s TB status. The client doesn’t have active TB, so can’t transmit, or spread, the bacteria. Therefore, she shouldn’t be quarantined or asked for information about recent contacts.
Situation: 104 - 108
The patient have sore that does not heal. Upon examination it reveals leprosy.
104. Mode of transmission of leprosy is?
a. Sharing food b. Sexual contact c. Borrowing utensils d. Droptet infection
105. Late signs and symptoms of leprosy in male patients is enlargement of the breast known as: a. Clawing b. Madarosis c. Gynecomastia d. Lagopthalmos C-
106. Your role in prevention of leprosy is
a. Health education b. Personal hygiene c. Proper nutrition d. BCG vaccination
D-
107. Multi drug therapy is being implemented by the DOH. Where is the initial treatment done?
a. Midwifes residence b. Barangay captain office c. Barangay health station d. Rural health unit
D-
108. Which of the following vaccine is used in the prevention of leprosy?
a. OPV b. EPI c. DPT d. BCG D- Situation: 109 - 113
Beth is a pre schooler. One evening she developed irritating cough. Which gradually became paroxysmal and characterized by:
1. Violent cough without intervening inhalation 2. Browing of high pitched inspirational whoop 3. Tenacious whooping at night
4. Vomiting of ingested food.
a. 2 and 3 . b. 2 and 4 c. 1 and 2 d. 1 and 3
C-
110. Which laboratory procedure is done to diagnose pertussis?
a. Saliva examination b. Culture examination c. Swab examination d. Culture and sensitivity
C-
111. When blood is examined which blood component is elevated in pertussis
a. Eosinophils b. Lynphocytes c. WBC
d. CBC
C-
112. Treatment for pertussis during outbreak is ordered for 14 days which among these may be ordered by the doctor,
a. Erythromycin b. Ampicillin c. Penicillin d. Crystalline
C-
113. Preventive measure is immunization before the 7th birthday. These vaccines are simultaneously give with 2 other what are they?
a. Tetanus toxoid and polio b. Tetanus toxoid and diphtheria c. Diphtheria and polio
d. Diphtheria and tetanus D-
Situation: 114 - 118
One of the leading cause of morbidity and mortality is pulmonary infections. Acute respiratory infection (ARI) could be managed at home, given the proper protocol:
114. Which of the following should a nurse include in the health teachings given to mothers to prevent ARI?
a. Wash hands after using the toilet b. Avoid smoking in the home
c. Avoid droplet infection d. Consult the doctor regularly
B-
115. In adults with pneumonia or ARI in the home, which drug must be available at the RHU based on standard management?
a. Chloramphenicol b. Oxygen tanks c. Co-trimoxazole d. Injectable gentamycin
C-
116. In far flung areas, who could dispense ARI standard orders in case of pneumonia in children?
a. Sanitarian b. Midwife c. Nurse
d. Barangay health worker
B-
117. During home visit, the nurse assessed the child with ARI. Which of the following signs indicate immediate medical attention?
a. Inability to drink b. Restlessness
c. Temperature is 37.7 °C d. Poor appetite
A-
a. Measles immunization b. Avoid smoking c. Breastfeeding d. Good ventilation C- Situation: 119 - 123
Communicable diseases are classified according to portal of entry
119. Which of the following C.D. is NOT through the upper respiratory system?
a. Chicken pox b. Measles c. Mumps d. Malaria
D-
120. Which of the following C.D. is NOT gastrointestinal tract as portal of entry?
a. Leprosy b. Paratyphoid c. Typhoid d. Dysentery
A-
121. Which of the following is NOT skin and mucous membrane entry?
a. Gonorrhea b. Dengue c. Scabies d. Syphilis
B-
122. Which of the following are NOT immediate vectors?
a. Rocky mountain fever b. Yellow fever
c. Ringworm d. Relapsing fever
C-
123. Microorganisms have the ability to invade the body tissue and proliferate causing infections. One factor is virulence of organism. What is the other factor?
a. Weakness of the body b. Resistance of the organism c. Resistance of the host d. Weakness of the organism
C-
Situation: 123 - 127
The Department of Health reports that Acute Respiratory Infection (ARI) especially pneumonia remains to be the leading causes of death among Filipino children.
123. Nurse, which of the following is the FIRST step in the prevention of unnecessary death from pneumonia?
a. Identification of treatment b. Interpretation of signs
c. Assessment by asking question d. Clarification of problems
C-
124. Which of the following is the MAJOR factor which contributes to the -problem like ARI?
a. Poor nutrition of mother and child b. Inadequate training of health workers
c. Mothers failure to recognize signs and symptoms d. Lack of antibiotic to treat pneumonia
C-
125. Mrs. Cruz brought her 3.5 months granddaughter, Therese to the Rural Health Unit because of inability to feed well, cough, and abnormality sleeping. Which classification of pneumonia is this? a. No pneumonia b. Severe c. Influenza d. Very severe D-
126. If Therese needs procaine penicillin, what unit dose is given at the RHU before referring her to the district hospital?
a. 400,000 c. 200,000 b. 300.000 d. 800,000 A-
127. If Therese is in the home, which one of the following is a priority to be taught to Therese mother?
a. Clear nose if it interferes with feeding b. Bring child to RHU at once
c. Give antibiotic for 5 days d. Weight the child every morning
C-
Situation: 128 – 132
Ms. Chesca went with her friend to a picnic and developed diarrhea after reaching home late in the afternoon.
128. Which of the following would NOT cause her diarrhea?
a. Intestinal bacterial infection b. Psychogenic disorders
c. Excessive ingestion of fresh sea foods d. Ingestion of fresh fruits
B-
129. Which of the following associated symptoms may suggest a developing ulcerative colitis?
a. Abdominal cramping b. Chills
c. Nausea and vomiting d. Anorexia
A-
130. Considering her cases the general principles for assessing and intervening to prevent and correct fluid electrolytes imbalance are the following EXCEPT:
a. Assess for fluid and electrolyte balance b. Develop a care plan
c. Consult a dietician to determine the kind and amount of food intake d. Implement the plan
C-
131. Among the following interventions, which of these diets would correct and prevent protein deflate?
a. Low in protein
b. High in caibohydrates and appetizing c. High in protein and appetizing
d. Low in carbohydrates
C-
132. How would you assess her for any sign of dehydration?
a. Sunken Fontanel b. Fair skin turgor c. Tea-colored urine d. Concentrated urine
D-
Situation: 133 - 136
Tuberculosis, a primary disease is common among malnourished individuals living in crowded places. The Dept. of Health survey of 1997 reveals that there are 600,000 actively spreading the disease, and 16 million Filipinos are afflicted.
133. The bacteria producing the disease is:
a. Mycobacterium
b. Mycobacterium africanum c. Mycobacterium tuberculosis d. Mycobacterium leprae
C-
134. Which of the following is the mode of transmission pulmonary tuberculosis?
a. Ingested food b. Skin contact c. Airborne droplet
d. Used utensils
C-
135. Which vaccine is a preventive measure during infancy and grade school entrants?
a. BCG b. DPT
c. Tuberculin d. OPV
A-
135. As a nurse, which of the following topics is considered your health teaching in cases if communicable diseases?
a. Prevalence of the disease in the community b. Annual risk of infection
c. Mode of spread and control measure d. Morality rate among adults and infants
C-
136. Which of the following comprehensive strategies used to detect and cure tuberculosis?
a. Category and Treatment Regimen b. Case finding and maintenance
c. Direct Observe Treatment Short Course d. Strengthen national TB Control Program
C-
Situation: 137 - 141
Rico is a 2-year-old. He attended a birthday party of a playmate. When he came home, he vomited-about one cup of semi-digested food.
137. You are the nurse Rico's neighborhood. His mother called you to advise what to do. You would tell Rico's mother to:
a. Go to the hospital right away
b. Tell you what food Rico ate at the party c. Take vital signs of Rico
d. Call the doctor in the neighborhood
138. Vomiting is a sign of gastrointestinal disturbance. What other symptom would you anticipate when thesis a history of acting spoiled food?
a. Diarrhea b. Fever c. Pain
d. Constipation
A-
139. The preparation at home that Rico's mother could give Rico to replace fluid loss is salt and sugar solution. Which formula is correct for one liter of water?
a. One tablespoon salt to two tablespoon of sugar b. One portion of salted one portion sugar
c. One cup salt and one cup sugar
d. One teaspoon salt and eight teaspoon sugar
D-
140. If vomiting and diarrhea persist. Rico's stool should be examined. Which bacteria could be identified from contaminated food such s egg, meat, poultry, and water?
a. Clostridium bolulinum b. Salmonella typhimurium c. Staphylococcus aereus d. Escherichia Coli-ETEC B-
141. lf Rico is hospitalized, which intravenous fluid is usually prescribed by physicians?
a. Dextrose 50%
b. Dextrose 5% in water c. Normal salt solution d. Lactated Ringers Solution
D-
142. A tuberculin skin test with purified protein derivative (PP!) tuberculin is performed as part of a routine physical examination. The nurse should instruct the client to make an appointment so the test can be read in:
a. 3 days b. 5 days
c. 7 days d. 10 days
A-
143. A nurse is caring for a client with a nosocomial infection caused by methicillin-resistant Staphylococcus aureus. Contact precautions are initiated. The nurse prepares to provide colostomy care to the client. The nurse obtains which of the following protective items required in performing this procedure?
a. Gloves, gown and goggles b. Gloves and goggles
c. Gloves, gown and shoe protectors d. Gloves and a gown
-A
Goggles are worn to protect the mucous membranes of the eyes during interventions that may produce splashes of blood, body fluids, secretions, or excretions. In addition, contact precautions require the use of gloves, and a gown should be worn if direct client contact is anticipated. Options B and D are incorrect because they are incomplete.Option C is incorrect because shoe protectors are not necessary.
144. Hepa patients prescribed activity level is bed rest with bathroom privilege. The purpose of bed rest for the patient is to:
a. Reduce the body’s need for oxygen
b. Reduce the metabolic demands of the liver c. Control the spread of the disease
d. Prevent the breakdown of body’s fats B-
145. Although it is present in other secretions, the virus Hepa-A will be excreted from the body primarily through this
a. Skin b. Feces c. Urine d. Mucus
B-
146. Contaminated hands are often responsible for the transmission of hepatitis. In addition, the virus that caused the patient’s Hepatitis is very often spread by
b. Infected rodents
c. Contaminated foods and liquids
d. Contaminated clothing and eating utensils
C-
147. As a result of having had Hepa A, the patient should be instructed never to
a. Drink alcohol b. Donate blood c. Smoke
d. Eat fatty foods
D-
148. School children with varicella should be kept out of school for at least
a. 1 week before the appearance of rashes b. 1 week after recovery
c. 1 week after first eruption appears or until the vesicle is dry d. 1 and half month after appearances of rashes
C-
149. The great incidence of communicable diseases in the country can be attributed to the following
a. Poor economic condtion b. Poor environmental sanitation c. Inadequate health education d. All of the above
D-
150. The problem that affects prevalence of GIT diseases are
1. Lack of safe water
2. unsanitary excreta disposal 3. poor ventation 4. Crowded housing a. 1 and 2 b. 1 and 3 c. 1, 2 and 3 d. 2 and 4
A-
151. Cholera may be diagnosed if a child may manifest the following signs and symptoms
a. Bloody stools b. Mucoid stools c. Rice-watery stools d. Black stools
C-
152. Filariasis caused by worm-like parasite invades the
a. Respiratory system b. GIT
c. Lymphatic system d. Urinary tract
C-
153. The test used to diagnose typhoid fever is the
a. Dick test b. Schick test c. Widal test d. Stress test
C-
154. The drug of choice for typhoid fever is
a. Penicillin
b. Chloramphenicol c. Terramycin d. Rifampicin
B-
155. Which of the following best fits typical rash of varicella?
a. Maculopapular rash
b. Maculopapular, vesicular rash c. Erythromatous
d. Pseudomembrane formation
156. The diagnostic feature of the rubella is the presence of
a. Polymorphous rash b. Koplik spot
c. Rose red spots
d. Pseudomembrane formation
A-
157. German measles incurred by pregnant women during their first trimester of pregnancy causes teratogenic effects which include, except;
a. Microcephaly
b. Congenital heart defects c. Mental retardation d. None of the above
D-
158. One of the following is characteristic diagnostic features of pertussis
a. Inspiratory whoop b. Lymphadenopathy c. Heart murmur d. Tourniquet test (+)
A-
159. It is an acute enteric fever manifested by a sustained bacteremia, reticuloenthelial involvement, and microorganism formation and ulceration of the distal form
a. Dysentery b. Hepatitis c. Typhoid fever d. Cholera
C-
160. A point in differentiating varicella from variola is that in chickenpox, the lesions appear
a. Like blisters b. Corps
c. In the mucosa d. Like crusts
B-
161. The lesions is chickenpox are found mainly on the
a. Soles of the feet b. Trunks
c. Forearm
d. Palms of the hands
B-
162. The room is darkened as part of the nursing care of a patient ill with tetanus because
a. Light is painful to the eyes b. Light is stimulating to spasms c. Light will kill the organism d. Light is not conductive to sleep
B-
163. Philippine hemorrhagic fever is caused by
a. Aedes aegypti b. Anopheles
c. Plasmodium ovale d. None of these
A-
164. Which of the following is most important procedure to teach in typhoid fever?
a. Taking the temperature b. Preparation of the liquid diet c. Disinfection of the excreta d. All of these
C-
165. A pattern of disease occurrence wherein there is an unusually great number of diseases ina short period of time
a. Sporadic b. Epidemic c. Pandemic d. Endemic
Situation: 166 – 170
Communicable diseases remains a major health problem in the Philippines. The nurse plays an important role in controlling the spread of any communicable diseases.
166. The control of any communicable disease depends to a large measure upon following except
a. Application of effective control measures b. Nature of the disease itself
c. Knowledge of appropriate technology d. Discipline of the health providers
D-
167. First line of defense of the body against infection is
a. Physical fitness b. Full immunization c. An intact skin d. Personal hygiene
C-
168. Which of the following statements on breaking the chain of infection is true?
a. Every link in the chain of infection can be interrupted b. A virulent agent can resist infection
c. The mode of direct contact is often direct entry
d. An inappropriate portal of entry will not support infection
A-
169. Newborn babies have limited ability to produce antibodies heance, immunization should not be given earlier that
a. 2 months b. 1 month c. 3 months d. 3 weeks
D-
170. Health education in the prevention and control of communicable disease is a vital component to
a. Help individual cope with illness b. Reduce the risk of exposure c. Modify risk behavior
d. Diminish psychosocial stress
C-
Situation: 171 – 175
In an orientation program of new nurses, you were requested to update them on Hepa B. The discussion were on the following
171. On the nature of the diseases, the following statements are correct except
a. Most people get well completely and develop lifelong immunity b. The reservoir of Hepa B virus is man
c. The prior of communicability is only during the acute clinical course of the disease d. Some infants infected with this disease are not able to develop
C-
172. The mode of transmission of the disease is/are the following
a. Through personal items b. Through sexual intercourse
c. Any of these modes of transmission d. From mother to child during birth
C-
173. The nurse plays a vital role on the implementation of control measures. Which of these is/are important
a. Disinfection of equipment or any article contaminated with blood, saliva and semen b. All of these are important
c. Immunization of members of family and other contacts
d. High risk pregnant women should be tested for the presence of Hepa B antigen
B-
174. Hepa B vaccination have incorporated with the plans of EPI. The main target of this vaccination are the
a. Carriers
b. Newborns and infants c. School children
d. Preschoolers
B-
175. Hepa B vaccination is given as follows
a. 2 doses at 3 weeks interval b. 3 doses at 4 weeks interval c. 2 doses at 4 weeks interval d. 4 doses at 3 weeks interval
B-
Situation: 176 – 179
Epidemiologic investigation was done by the Rural health unit because of outbreaks of typhoid fever
176. As public health nurse, you know that the typhoid fever is caused by
a. Improper personal hygiene
b. Inhalation of contamination water c. Intake of unsafe water or food d. Ticks
C-
177. The primary purpose of conducting this investigation is to
a. Identify the groups who are at risk of contacting the disease b. Delineate the etiology of the disease
c. Encourage cooperation and support of community
d. Identify geographical location where the disease would most likely occur
A-
178. Which of the following sources of data will not be necessary?
a. Records maintained by the hospital b. Health care reports
c. Population census d. None of the above
179. As a public health nurse in rural health unit, you have a vital role in the conduct of epidemiological investigation and this is among others the.
a. Institute appropriate control measures in a confirmed outbreak
b. Checking the presence of signs and symptoms according to the standards of the case c. Monitor selected number of disease by weekly charting or graphing these are they occur
in the barangay
d. Planning and securing necessary resourced needed for the disease. B-
Situation: 180 – 183
A patient is admitted to the hospital with a diagnosis of infections Hepatitis
180. What would you consider as primary nursing treatment?
a. High fluid intake
b. Prompt antibiotic therapy c. Adequate bed rest
d. IV therapy
C-
181. Which of the following diet would most likely be prescribed by the M.D.
a. High fat b. Balanced diet c. High CHON d. Bilirubin CHO
B-
182. Which of the following laboratory test best assess the patient’s liver functioning? a. Glucose tolerance
b. Creatinine
c. Serum transminase d. Billirubin level
C-
183. The primary portal of exit of Hepa A virus is the
a. Mucus b. Skin c. Urine
d. Feces
D-
184. the prevention and control measures of parasitic infection are based on which of the following
a. Understanding of the parasite’s life cycle and their transmission pattern b. All of these
c. Participation and cooperation of the community d. Availability of antihelmintic drugs in the area
B-
185. the etiology agent of hemorrhagic fever
a. Anopheles mosquito b. Flaviviruses
c. Aedes aegypti d. RNA virus
C-
186. Early treatment of dengue fever included all of the following except
a. Prevention of shock b. Monitoring of vital sings
c. Administration of IV as ordered d. None of the above
D-
187. The period of communicability of variella
a. 1 day before the appearance of rashes
b. 1 day before and 6 days after the appearance of rashes c. Pre-incubation period
d. None of the above
B-
188. Group of cells that appear first during the inflammatory stage
a. Neutrophils b. Basophils c. Lymphocytes
d. All of the above
A-
189. Intermittent occurrence of a few isolated and unrelated cases in a given locality is best described as a. Epidemics b. Sporadic c. Endemics d. Pandemics B-
190. it is antiviral substance produced within the cells that inhibit the growth and multiplication of virus a. Properdin b. Interferon c. Lysozome d. Tears B-
191. the only Ig that passes the placental barrier
a. IgA b. IgG c. IgM d. IgE
B-
192. Ig responsible for the medication of allergic response
a. IgA b. IgG c. IgM d. IgE
D-
193. Nursing care for an adolescent admitted with tentanus following a puncture wound should be primarily directed toward
