MATERNAL AND CHILD HEALTH PRACTICE - UPDATED GUIDE
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Course
Maternal-Child
Institution
123 University
MATERNAL AND CHILD HEALTH PRACTICE - UPDATED GUIDE
1. May arrives at the health care clinic and tells the nurse that her last menstrual period was 9 weeks ago. She also tells the nurse that a home pregnancy test was positive but she began to have mild cramps and is now having moderate vaginal blee...
infections; vaginal culture at 39 weeks pregnancy was positive.
MATERNAL AND CHILD HEALTH PRACTICE
– UPDATED GUIDE
1. May arrives at the health care clinic and tells the nurse that her last
menstrual period was 9 weeks ago. She also tells the nurse that a home
pregnancy test was positive but she began to have mild cramps and is
now having moderate vaginal bleeding. During the physical examination
of the client, the nurse notes that May has a dilated cervix. The nurse
determines that May is experiencing which type of abortion?
a. Inevitable
b. Incomplete
c. Threatened
d. Septic
2. Nurse Reese is reviewing the record of a pregnant client for her first
prenatal visit. Which of the following data, if noted on the client’s record,
would alert the nurse that the client is at risk for a spontaneous
abortion?
a. Age 36 years
b. History of syphilis
c. History of genital herpes
d. History of diabetes mellitus
3. Nurse Hazel is preparing to care for a client who is newly admitted to the
hospital with a possible diagnosis of ectopic pregnancy. Nurse Hazel
develops a plan of care for the client and determines that which of the
following nursing actions is the priority?
a. Monitoring weight
b. Assessing for edema
c. Monitoring apical pulse
d. Monitoring temperature
4. Nurse Oliver is teaching a diabetic pregnant client about nutrition and
insulin needs during pregnancy. The nurse determines that the client
understands dietary and insulin needs if the client states that the second
half of pregnancy require:
a. Decreased caloric intake
b. Increased caloric intake
c. Decreased Insulin
d. Increase Insulin
5. Nurse Michelle is assessing a 24 year old client with a diagnosis of
hydatidiform mole. She is aware that one of the following is
unassociated with this condition?
a. Excessive fetal activity.
b. Larger than normal uterus for gestational age.
c. Vaginal bleeding
d. Elevated levels of human chorionic gonadotropin.
6. A pregnant client is receiving magnesium sulfate for severe pregnancy
induced hypertension (PIH). The clinical findings that would warrant use
of the antidote , calcium gluconate is:
a. Urinary output 90 cc in 2 hours.
b. Absent patellar reflexes.
c. Rapid respiratory rate above 40/min.
d. Rapid rise in blood pressure.
7. During vaginal examination of Janna who is in labor, the presenting part
is at station plus two. Nurse, correctly interprets it as:
a. Presenting part is 2 cm above the plane of the ischial spines.
b. Biparietal diameter is at the level of the ischial spines.
c. Presenting part in 2 cm below the plane of the ischial spines.
d. Biparietal diameter is 2 cm above the ischial spines.
8. A pregnant client is receiving oxytocin (Pitocin) for induction of labor.
A condition that warrant the nurse in-charge to discontinue I.V. infusion
of Pitocin is:
a. Contractions every 1 ½ minutes lasting 70-80 seconds.
b. Maternal temperature 101.2
c. Early decelerations in the fetal heart rate.
d. Fetal heart rate baseline 140-160 bpm.
9. Calcium gluconate is being administered to a client with pregnancy
induced hypertension (PIH). A nursing action that must be initiated as
the plan of care throughout injection of the drug is:
a. Ventilator assistance
b. CVP readings
c. EKG tracings
d. Continuous CPR
10. A trial for vaginal delivery after an earlier caesareans, would likely to
be given to a gravida, who had:
a. First low transverse cesarean was for active herpes type 2
,b. First and second caesareans were for cephalopelvic disproportion.
c. First caesarean through a classic incision as a result of severe fetal distress.
d. First low transverse caesarean was for breech position. Fetus in
this pregnancy is in a vertex presentation.
11. Nurse Ryan is aware that the best initial approach when trying to
take a crying toddler’s temperature is:
a. Talk to the mother first and then to the toddler.
b. Bring extra help so it can be done quickly.
c. Encourage the mother to hold the child.
d. Ignore the crying and screaming.
12. Baby Tina a 3 month old infant just had a cleft lip and palate repair.
What should the nurse do to prevent trauma to operative site?
a. Avoid touching the suture line, even when cleaning.
b. Place the baby in prone position.
c. Give the baby a pacifier.
d. Place the infant’s arms in soft elbow restraints.
13. Which action should nurse Marian include in the care plan for a 2
month old with heart failure?
a. Feed the infant when he cries.
b. Allow the infant to rest before feeding.
c. Bathe the infant and administer medications before feeding.
d. Weigh and bathe the infant before feeding.
14. Nurse Hazel is teaching a mother who plans to discontinue breast
feeding after 5 months. The nurse should advise her to include which foods
in her infant’s diet?
a. Skim milk and baby food.
b. Whole milk and baby food.
c. Iron-rich formula only.
d. Iron-rich formula and baby food.
15. Mommy Linda is playing with her infant, who is sitting securely alone
on the floor of the clinic. The mother hides a toy behind her back and the
infant looks for it. The nurse is aware that estimated age of the infant
would be:
a. 6 months
b. 4 months
c. 8 months
d. 10 months
16. Which of the following is the most prominent feature of public
health nursing?
a. It involves providing home care to sick people who are not confined in
the hospital.
b. Services are provided free of charge to people within the catchments area.
c. The public health nurse functions as part of a team providing a
public health nursing services.
d. Public health nursing focuses on preventive, and not curative, services.
17. When the nurse determines whether resources were maximized
in implementing Ligtas Tigdas (Measles Prevention), she is
evaluating:
a. Effectiveness
b. Efficiency
c. Adequacy
d. Appropriateness
18. Vangie is a new B.S.N. graduate. She wants to become a Public
Health Nurse. Where should she apply?
a. Department of Health
b. Provincial Health Office
c. Regional Health Office
d. Rural Health Unit
19. Tony is aware the Chairman of the Municipal Health Board is:
a. Mayor
b. Municipal Health Officer
c. Public Health Nurse
d. Any qualified physician
20. Myra is the public health nurse in a municipality with a total population
of about 20,000. There are 3 rural health midwives among the RHU
personnel. How many more midwife items will the RHU need?
a. 1
b. 2
c. 3
d. The RHU does not need any more midwife item.
21. According to Freeman and Heinrich, community health nursing is a
developmental service. Which of the following best illustrates this
statement?
a. The community health nurse continuously develops himself personally
and professionally.
b. Health education and community organizing are necessary in providing
,community health services. 33. Nurse Gina is aware that the most common condition found during
c. Community health nursing is intended primarily for health promotion the second-trimester of pregnancy is:
and prevention and treatment of disease. a. Metabolic alkalosis
d. The goal of community health nursing is to provide nursing services b. Respiratory acidosis
to people in their own places of residence. c. Mastitis
22. Nurse Tina is aware that the disease declared through d. Physiologic anemia
Presidential Proclamation No. 4 as a target for eradication in the 34. Nurse Lynette is working in the triage area of an emergency
Philippines is? department. She sees that several pediatric clients arrive simultaneously.
a. Poliomyelitis The client who needs to be treated first is:
b. Measles a. A crying 5 year old child with a laceration on his scalp.
c. Rabies b. A 4 year old child with a barking coughs and flushed appearance.
d. Neonatal tetanus c. A 3 year old child with Down syndrome who is pale and asleep in
23. May knows that the step in community organizing that involves his mother’s arms.
training of potential leaders in the community is: d. A 2 year old infant with stridorous breath sounds, sitting up in his
a. Integration mother’s arms and drooling.
b. Community organization 35. Maureen in her third trimester arrives at the emergency room with
c. Community study painless vaginal bleeding. Which of the following conditions is
d. Core group formation suspected?
24. Beth a public health nurse takes an active role in community a. Placenta previa
participation. What is the primary goal of community b. Abruptio placentae
organizing? c. Premature labor
a. To educate the people regarding community health problems d. Sexually transmitted disease
b. To mobilize the people to resolve community health problems 36. A young child named Richard is suspected of having pinworms. The
c. To maximize the community’s resources in dealing with health problems. community nurse collects a stool specimen to confirm the diagnosis.
d. To maximize the community’s resources in dealing with health problems. The nurse should schedule the collection of this specimen for:
25. Tertiary prevention is needed in which stage of the natural history a. Just before bedtime
of disease? b. After the child has been bathe
a. Pre-pathogenesis c. Any time during the day
b. Pathogenesis d. Early in the morning
c. Prodromal 37. In doing a child’s admission assessment, Nurse Betty should be alert
d. Terminal to note which signs or symptoms of chronic lead poisoning?
26. The nurse is caring for a primigravid client in the labor and delivery area. a. Irritability and seizures
Which condition would place the client at risk for disseminated b. Dehydration and diarrhea
intravascular coagulation (DIC)? c. Bradycardia and hypotension
a. Intrauterine fetal death. d. Petechiae and hematuria
b. Placenta accreta. 38. To evaluate a woman’s understanding about the use of diaphragm
c. Dysfunctional labor. for family planning, Nurse Trish asks her to explain how she will use the
d. Premature rupture of the membranes. appliance. Which response indicates a need for further health teaching?
27. A full term client is in labor. Nurse Betty is aware that the fetal heart a. “I should check the diaphragm carefully for holes every time I use it”
rate would be: b. “I may need a different size of diaphragm if I gain or lose weight more
a. 80 to 100 beats/minute than 20 pounds”
b. 100 to 120 beats/minute c. “The diaphragm must be left in place for at least 6 hours after intercourse”
c. 120 to 160 beats/minute d. “I really need to use the diaphragm and jelly most during the middle of
d. 160 to 180 beats/minute my menstrual cycle”.
28. The skin in the diaper area of a 7 month old infant is excoriated and 39. Hypoxia is a common complication of laryngotracheobronchitis.
red. Nurse Hazel should instruct the mother to: Nurse Oliver should frequently assess a child with
a. Change the diaper more often. laryngotracheobronchitis for:
b. Apply talc powder with diaper changes. a. Drooling
c. Wash the area vigorously with each diaper change. b. Muffled voice
d. Decrease the infant’s fluid intake to decrease saturating diapers. c. Restlessness
29. Nurse Carla knows that the common cardiac anomalies in children d. Low-grade fever
with Down Syndrome (trisomy 21) is: 40. How should Nurse Michelle guide a child who is blind to walk to
a. Atrial septal defect the playroom?
b. Pulmonic stenosis a. Without touching the child, talk continuously as the child walks down
c. Ventricular septal defect the hall.
d. Endocardial cushion defect b. Walk one step ahead, with the child’s hand on the nurse’s elbow.
30. Malou was diagnosed with severe preeclampsia is now receiving I.V. c. Walk slightly behind, gently guiding the child forward.
magnesium sulfate. The adverse effects associated with magnesium sulfate d. Walk next to the child, holding the child’s hand.
is: 41. When assessing a newborn diagnosed with ductus arteriosus,
a. Anemia Nurse Olivia should expect that the child most likely would have an:
b. Decreased urine output a. Loud, machinery-like murmur.
c. Hyperreflexia b. Bluish color to the lips.
d. Increased respiratory rate c. Decreased BP reading in the upper extremities
31. A 23 year old client is having her menstrual period every 2 weeks that d. Increased BP reading in the upper extremities.
last for 1 week. This type of menstrual pattern is bets defined by: 42. The reason nurse May keeps the neonate in a neutral thermal
a. Menorrhagia environment is that when a newborn becomes too cool, the
b. Metrorrhagia neonate requires:
c. Dyspareunia a. Less oxygen, and the newborn’s metabolic rate increases.
d. Amenorrhea b. More oxygen, and the newborn’s metabolic rate decreases.
32. Jannah is admitted to the labor and delivery unit. The critical c. More oxygen, and the newborn’s metabolic rate increases.
laboratory result for this client would be: d. Less oxygen, and the newborn’s metabolic rate decreases.
a. Oxygen saturation 43. Before adding potassium to an infant’s I.V. line, Nurse Ron must be sure
b. Iron binding capacity to assess whether this infant has:
c. Blood typing a. Stable blood pressure
d. Serum Calcium b. Patent fontanelles
, c. Moro’s reflex 54. In Integrated Management of Childhood Illness, the nurse is aware that
d. Voided the severe conditions generally require urgent referral to a hospital. Which
44. Nurse Carla should know that the most common causative factor of the following severe conditions DOES NOT always require urgent referral
of dermatitis in infants and younger children is: to a hospital?
a. Baby oil a. Mastoiditis
b. Baby lotion b. Severe dehydration
c. Laundry detergent c. Severe pneumonia
d. Powder with cornstarch d. Severe febrile disease
45. During tube feeding, how far above an infant’s stomach should the 55. Myrna a public health nurse will conduct outreach immunization in a
nurse hold the syringe with formula? barangay Masay with a population of about 1500. The estimated number
a. 6 inches of infants in the barangay would be:
b. 12 inches a. 45 infants
c. 18 inches b. 50 infants
d. 24 inches c. 55 infants
46. In a mothers’ class, Nurse Lynnette discussed childhood diseases such as d. 65 infants
chicken pox. Which of the following statements about chicken pox is 56. The community nurse is aware that the biological used in
correct? Expanded Program on Immunization (EPI) should NOT be stored in the
a. The older one gets, the more susceptible he becomes to the freezer?
complications of chickenpox. a. DPT
b. A single attack of chickenpox will prevent future episodes, b. Oral polio vaccine
including conditions such as shingles. c. Measles vaccine
c. To prevent an outbreak in the community, quarantine may be imposed d. MMR
by health authorities. 57. It is the most effective way of controlling schistosomiasis in an
d. Chicken pox vaccine is best given when there is an impending outbreak endemic area?
in the community. a. Use of molluscicides
47. Barangay Pinoy had an outbreak of German measles. To prevent b. Building of foot bridges
congenital rubella, what is the BEST advice that you can give to women in c. Proper use of sanitary toilets
the first trimester of pregnancy in the Barangay Pinoy? d. Use of protective footwear, such as rubber boots
a. Advise them on the signs of German measles. 58. Several clients is newly admitted and diagnosed with leprosy. Which of
b. Avoid crowded places, such as markets and movie houses. the following clients should be classified as a case of multibacillary
c. Consult at the health center where rubella vaccine may be given. leprosy?
d. Consult a physician who may give them rubella immunoglobulin. a. 3 skin lesions, negative slit skin smear
48. Myrna a public health nurse knows that to determine possible sources b. 3 skin lesions, positive slit skin smear
of sexually transmitted infections, the BEST method that may be undertaken c. 5 skin lesions, negative slit skin smear
is: d. 5 skin lesions, positive slit skin smear
a. Contact tracing 59. Nurses are aware that diagnosis of leprosy is highly dependent on
b. Community survey recognition of symptoms. Which of the following is an early sign of
c. Mass screening tests leprosy?
d. Interview of suspects a. Macular lesions
49. A 33-year old female client came for consultation at the health center b. Inability to close eyelids
with the chief complaint of fever for a week. Accompanying symptoms c. Thickened painful nerves
were muscle pains and body malaise. A week after the start of fever, the d. Sinking of the nosebridge
client noted yellowish discoloration of his sclera. History showed that he 60. Marie brought her 10 month old infant for consultation because of fever,
waded in flood waters about 2 weeks before the onset of symptoms. Based started 4 days prior to consultation. In determining malaria risk, what will
on her history, which disease condition will you suspect? you do?
a. Hepatitis A a. Perform a tourniquet test.
b. Hepatitis B b. Ask where the family resides.
c. Tetanus c. Get a specimen for blood smear.
d. Leptospirosis d. Ask if the fever is present everyday.
50. Mickey a 3-year old client was brought to the health center with the 61. Susie brought her 4 years old daughter to the RHU because of cough
chief complaint of severe diarrhea and the passage of “rice-watery” stools. and colds. Following the IMCI assessment guide, which of the following is a
The client is most probably suffering from which condition? danger sign that indicates the need for urgent referral to a hospital?
a. Giardiasis a. Inability to drink
b. Cholera b. High grade fever
c. Amebiasis c. Signs of severe dehydration
d. Dysentery d. Cough for more than 30 days
51. The most prevalent form of meningitis among children aged 2 months 62. Jimmy a 2-year old child revealed “baggy pants”. As a nurse, using
to 3 years is caused by which microorganism? the IMCI guidelines, how will you manage Jimmy?
a. Hemophilus influenzae a. Refer the child urgently to a hospital for confinement.
b. Morbillivirus b. Coordinate with the social worker to enroll the child in a feeding program.
c. Streptococcus pneumoniae c. Make a teaching plan for the mother, focusing on menu planning for
d. Neisseria meningitidis her child.
52. The student nurse is aware that the pathognomonic sign of measles d. Assess and treat the child for health problems like infections and
is Koplik’s spot and you may see Koplik’s spot by inspecting the: intestinal parasitism.
a. Nasal mucosa 63. Gina is using Oresol in the management of diarrhea of her 3-year old
b. Buccal mucosa child. She asked you what to do if her child vomits. As a nurse you will tell
c. Skin on the abdomen her to:
d. Skin on neck a. Bring the child to the nearest hospital for further assessment.
53. Angel was diagnosed as having Dengue fever. You will say that there is b. Bring the child to the health center for intravenous fluid therapy.
slow capillary refill when the color of the nail bed that you pressed does c. Bring the child to the health center for assessment by the physician.
not return within how many seconds? d. Let the child rest for 10 minutes then continue giving Oresol more slowly.
a. 3 seconds 64. Nikki a 5-month old infant was brought by his mother to the health
b. 6 seconds center because of diarrhea for 4 to 5 times a day. Her skin goes back slowly
c. 9 seconds after a skin pinch and her eyes are sunken. Using the IMCI guidelines, you will
d. 10 seconds classify this infant in which category?
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