COLEGIO DE SAN LORENZO DE RUIZ MANILA, INC

Catarman Northern Samar

College of Nursing
Competency Appraisal 1
PRETEST 1

Name: _______________________________________________________ Date: ________________

Directions: ENCIRCLE THE BEST ANSWER for the given situations/ questions. STRICTLY NO ERASURES/
SUPERIMPOSITIONS / ALTERATIONS.

I. CARE OF NEWBORN & INFANTS

1. A series of time bounded, chronologically-ordered, standard procedures that a baby receives at birth.
It walks/ guides a health worker through the process of preparing the delivery area, standard
precautions through essential newborn care practices, beginning at the time of perineal bulging until
one week of life.
a. Immediate Care of the Newborn
b. Essential Newborn Care
c. Apgar Scoring
d. Newborn Screening
2. Under the above protocol, what are the four major time-bound interventions/ four core steps?
a. Clearing of the air passage by suctioning, AGAR Scoring, Crede’s Prophylaxis, Skin Care by Oil
Bath, Cord Dressing.
b. Complete physical examination, Initial VS, Keeping the baby dry, Vitamin K, Proper
Identification of the Infant.
c. Immediate drying, skin to skin contact, properly timed clamping of the cord, non-separation
of baby from mother, and breastfeeding initiation.
3. Mrs. Chiban, 33 years old female: G3, P2; at her 38 weeks AOG is about to give birth. During the second
stage of pregnancy at the perineal bulging with presenting parts visible, as the nurse assisting in the
delivery, guided by the protocol (asked in item No. 1), you know that specific actions that should be
observed in thins time band include:
a. Mother is emotionally and physically prepared, father’s role in the pregnancy arranged,
materials for the delivery prepared and healthcare team present.
b. Ensure that the area of delivery is draft free, proper handwashing should be observed followed
by double gloving.
c. Drying the baby thoroughly with clean towel, disposing the wet towels and performing
assessment of the newborn.
4. Mrs. Chiban’s baby was delivered, as the nurse you know that within the first 30 seconds of the baby’s
birth (call out time of birth). What intervention should be given to the newborn?
a. Drying and provision of warmth
b. Suctioning and maintaining patent airway
c. Oil bath and removal of vernix casseosa.
5. During the first 30 seconds of the baby’s delivery, you know that it should be noted/ emphasized that
ASIDE from performing the intervention(s)/ action(s) for that specific time band. One must observe the
following, EXCEPT:
a. Initiation of Breastfeeding the soonest time possible.
b. Not to provide ventilation to the newborn unless warranted.
c. Not to perform suctioning unless the mouth/nose are blocked with secretions/ other material.
6. After 30 seconds, the newborn delivered by Mrs. Chiban necessary for the first 30 seconds and
displayed (+) breathing & crying. As the nurse you know that the next intervention to be provided will
be:
a. Initiation of Breastfeeding the soonest time possible.
b. Inoculation of Vitamin K
c. Skin-to-skin contact with the mother
d. Immediate or delayed cord clamping
7. Within the time band of 1-3 minutes post-delivery of the newborn, you know that the next intervention
that should be:
a. Initiation of Breastfeeding the soonest time possible.
b. Inoculation of Vitamin K
c. Skin-to-skin contact with the mother
d. Immediate or delayed cord clamping
8. Within the time band of 90 minutes post-delivery of the newborn, you know that the next
intervention that should be:

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Marvin D. Socorro, RN, MAN Competency Appraisal 1-PRETEST
 a. Initiation of Breastfeeding.
b. Inoculation of Vitamin K
c. Skin-to-skin contact with the mother
d. Immediate or delayed cord clamping
9. In clamping of the cord, as the assisting nurse, you know that this actions requires you to observe the
following, EXCEPT:
a. Remove the first set of gloves immediately prior to cord clamping, clamp and cut the cord
after cord pulsations have stopped (typically at 1 to 3 minutes), observe for oozing.
b. Put ties tightly around the cord at 2 cm and 5 cm from the newborn’s abdomen, clamp and
cut the cord after cord pulsations have stopped, cut between ties with sterile instrument.
c. Remove the first set of gloves immediately prior to cord clamping, milk the cord towards the
newborn, clamp and cut the cord after cord pulsations have stopped (typically at 1 to 3
minutes), observe for oozing.
10. In providing support for the initiation of breastfeeding, as the nurse you should know that on
counselling the mother on positioning and attachment; when the baby is ready, you should advise the
mother the following EXCEPT:
a. Make sure the newborn’s neck is not flexed nor twisted.
b. Hold the newborn’s body close to her body.
c. Support the newborn’s whole body, not just the neck and shoulders.
d. Make sure the newborn is facing the breast, with the newborn’s nose opposite her nipple
and chin not touching the breast.
11. As the delivery room nurse, you know that weighing, bathing, eye care, examinations, injections
(hepatitis B, BCG) should be done after what important milestone?
a. Skin-to-skin contact of newborn and mother (after 30 second post-delivery & thorough
drying).
b. Successful breastfeeding of the newborn and mother (90 minutes to 6 hours post-delivery).
c. Clamping and cutting of the cord before skin-to-skin contact with the mother (1-3 minutes
post-delivery).
12. Mrs. Chiban’s husband asked you regarding the washing/ bathing of her newborn two hours after the
baby was delivered and roomed-in. Noticing that there are whitish substance covering the baby scalp
and arms. Following the “protocol”, your BEST response should be:
a. Oil bath had already been performed to your baby after delivery. If there are substance left,
better leave it as it is to ensure that your baby will not be disturbed.
b. There is no need to rush the bathing/ washing of the baby. It is beneficial that we leave some
of the protective substance covering your child. However, we will do washing/ bathing after
6 hours or before discharge.
c. You don’t need to worry about the whitish substance covering that was not removed after
delivery. It offers protection and additional warmth for your baby. However, if you wish to
bathe your baby we can do it now.
13. APGAR Scoring remains the internationally acceptable assessment tool for newborns, this method of
assessing focuses on:
a. Color, heart rate, reflex, muscle tone, cry.
b. Heart rate, respiratory effort, temperature, blood pressure
c. Sucking reflex, appearance, muscle tone, respiratory effort
14. Mrs. Chiban’s baby had the following observed for APGRAR scoring a minute after birth and presented
the following assessment:
Pinkish face and extremities, breathing 60 breaths per minute and cries vigorously, pulse rate is 120
beats per minute, flexion of the extremities were noted, blood pressure and temperature were within
normal limits (as assessed by the resident on duty).
What is the APGAR score of baby Chiban?
a. 10
b. 8
c. 20
15. Another baby was delivered at DR table No. 2, a few steps from Mrs. Chiban and displayed the following
assessment:
Blueish extremities particularly the palms and soles of feet, heart rate 100 beats per minute, (+)
grimace, some flexion at the upper extremities, (-) at the lower extremities; crying is irregular and slow.
What is the APGAR score of the baby?
a. 10
b. 6
c. 8

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Marvin D. Socorro, RN, MAN Competency Appraisal 1-PRETEST
 16. The process of collecting few drops of blood from the newborn onto an appropriate collection card and
performing biochemical testing for determining if the newborn has a heritable condition.
a. Essential Newborn Care (ENC)
b. National Immunization Program (NIC
c. Newborn Screening (NBS)
17. The above procedure should be done at what point (hour/ days) after the delivery of the newborn.
a. Immediately after birth.
b. 48th – 72nd hour.
c. At least 24 hours
d. Either b or c is correct
18. The procedure (referred to in item no. 16) is mandated by what law?
a. RA 9288 of 2004
b. RA 7600 of 1992
c. RA 8423 of 1997
19. To ensure promotion of breastfeeding to mothers and full compliance of hospitals and birthing clinics.
What laws governs the promotion breastfeeding in the country?
a. RA 8423 of 1997 and E0 51 and its Revised Implementing Rules and Regulations (2006).
b. RA 7600 of 1992 and E0 51 and its Revised Implementing Rules and Regulations (2006).
c. RA 9288 of 2004 and RA 8504 of 1998
d. Both A and B are correct.
20. Based on the National Immunization Program’s – Childhood Immunization of 2016. What two (2)
vaccines should be ideally be inoculated at birth?
a. BCG and Vitamin K
b. BCG and Hepatitis B
c. BGC and Pentavalent Vaccine
d. Either A or B is correct.
21. Mrs. Chiban and her newborn are to be discharged from confinement. Mrs. Chiban expressed her
concern regarding exclusive breastfeeding of her baby, “feeling ko konti lang ang nadedede ng baby
ko sa akin, baka kasi dahil maliit ang suso ko… baka magutom sya”. As the nurse assigned to discharge
Mrs. Chiban your BEST response should be:
a. The size of breast doesn’t affect milk production at all; if you are breastfeeding your child by
demand there is nothing to worry. What your breast produces is sufficient for your baby.
b. The size of your breast doesn’t play a role on the adequacy of breastmilk produced. If you
feel that your baby is not receiving appropriate milk from one side of the breast, you can
shift to the other one.
c. I can schedule you to meet with your baby’s pediatrician, she can assess your breast for milk
production and tell you more about breastfeeding and if warranted she can prescribe the
best formula for your baby.
22. Mrs. Chiban during your discharge instructions if she can shift to formula feeding after a few weeks
because she is planning to resume with her normal professional activities and commitments. As the
nurse your best response would be:
a. Breastfeeding will not hinder in performing your professional activities and commitments.
You can express your milk, store it and have your baby’s caregiver give it to the baby as
demanded. There is much benefit that the baby can have if you adhere to exclusive
breastfeeding.
b. I don’t think that you are being serious on the benefit of breastfeeding to your baby. You are
in maternity leave for 90 days, I think that is being given to new mothers in order to take
care of your baby and provide for their needs. Furthermore, I, as a healthcare provider is
mandated by law not to promote formula feeding.
c. You must be having a difficult time breastfeeding; I believe your baby’s pediatrician can
prescribe you with the best breastmilk substitute for your baby. Anyway, there are lots of
choices and with the same benefits as of your breastmilk.
23.

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Marvin D. Socorro, RN, MAN Competency Appraisal 1-PRETEST