SITUATION 1

SITUATION 1: Mrs. Delas Alas, a Clinical Instructor, is reviewing some concept in Psychiatic Nursing with fourth year nursing students. 1. A basic concept in Psychiatric Nursing is that behavior: A. Cannot be observed B. Cannot be understood C. is be and purposeful D. is the main indicator of one's personality 2. In a therapeutic nurse-patient relationship, the nurse should focus on the client's: A. appearance B. feelings C. thoughts D. behavior 3. A fundamental concept in nursing is viewing a client as a whole organism with a unique personality. The nurse, therefore, should: A. focus on the client's behavior B. consider the values of the client C. focus on the client's strengths and weaknesses D. refrain from labeling the client as a psychiatric entity 4. Which of the conceptual models of psychiatric mental health practice stipulates that anxiety is experienced interpersonally? A. Medical B. Behavioral C. Interpersonal D. Psychoanalytic 5. Sofia was very kind to her intelligent sister but deep inside had hostile feelings towards her. She is manifesting what type of defense mechanism? A. Projection B. Displacement C. Reaction formation D. Sublimation SITUATION 2: Isabella, 27 years old, G3P2, full term is in active labor at home. 6. Home delivery can be allowed for Isabella considering that she:

A. has no prenatal check-up B. has no history of previous complications C. has ruptured membrane D. is full with less than 5 pregnancy 7. The following are signs of impending delivery, except: A. increasing bloody show B. rectal pressure C. constractions more frequent and of shorter duration D. rupture of membrane 8. The initial action of the nurse upon knowing that Isabella has watery vaginal discharge is: A. instruct her to lie on bed B. monitor her fetal heart tone C. advise her to take nothing by mouth D. observe the characteristics of the discharge 9. Which of the following statement best describes an internal rotation? A. Allows the passage of the presenting part through the irregular pelvis B. The smallest antero-posterior diameter of the fetal head is presented to the pelvis C. The greatest biparietal diameter of the fetal head is at or has passed the pelvic inlet D. The head descends as the chin is flexed more on the chest 10. When the fetal head is delivered, the nurse should: A. prepare to clamp the cord B. use bulb syringe to clear the mouth and nose of secretions C. apply abdominal pressure D. apply Ritgen Manuever SITUATION 3: Miss Guia Marquez is a new registered nurse assigned at the fertility clinic. 11. All of the following are physiologic effects of progesterone, except: A. movement of zygote through the oviduct B. Slightly elevated basal body temperature C. formation of corpus luteum D. inhibition of uterine contractility during pregnancy 12. There are many functions of estrogen, one of which is: A. elevates basal body temperature during ovulation B. inhibits uterine contractility C. promote lactation D. promote female secondary sex characteristics

13. Which of the following is a diagnostic test for fertility? A. Pap's smear B. Coomb's test C. Culdocentesis D. Hysterosalpingogram 14. Following ovulation, the ovum is normally viable for how many hours? A. 8 B. 24 C. 10 D. 12 15. Within the female reproductive tract, the sperm remains viable for how many days? A. 5 B. 4 C. 1 D. 3 SITUATION 4: Mona Santos is a G3P2 who sought consultation at the OPD due to cramps and easy fatigability. 16. What would be an appropriate nursing diagnosis for her easy fatigability? A. Pain related to leg cramps B. Disturbance in role performance related to fatigue C. Activity intolerance related to fatigue D. Self-care deficit related to weakness 17. Multivitamins with iron supplements were ordered. The nurse instructs Mona to take it: A. After each meal B. After breakfast C. Everytime she feels weak D. Before breakfast 18. Which of the following problems is likely to be associated with iron intake? A. Nausea B. Diarrhea C. Constipation D. Gas pain 19. Which of the following food will you advise to relieve her leg cramps? A. Mongo, cheese, dilis B. Pechay, squash, malungay C. Nuts, legumes, eggs

D. Rice, bread, rootcrops 20. She asked for a nutrition supplement to ease her leg cramps, which could be any of the following, except: A. Calci Aid B. Calcebone C. Cal De Ce D. Calpol SITUATION 5: The Regional Training Nurse must be qualified before assuming the position. 21. What is the basic qualification of the Public Health Nurse at the Regional Office? A. Three years abroad B. BSN, R.N. with masters degree C. Six years as CI D. Relative of the governor 22. What is the qualification of the public health nurse instructor? A. Recommended by the mayor B. BSN, RN with masters degree C. Experience as CI D. Experience in PHN 23. Functions and responsibilities of the regional training nurse begin with the use of the nursing process. Which process does she need to design a training program for nurses and midwives? A. Assessment B. Evaluation C. Intervention D. Planning 24. Even if the nurse is already in the highest position, there is a need to keep abreast. Which area of CHN should a nurse train or retrain? A. Community organizing B. Matrix of hospital administration C. Model of health care D. Use of high tech machines 25. Which one should a PHN retain as nursing value in her community health practice? A. Spiritual B. Good will C. Human Relations D. Academic

SITUATION 6: PHC utilizes linkages all over the world. 26. Who receives referral from intermediate level of care? A. Chief Nurse B. First line hospital personnel C. Cardiologist D. Medical director 27. When first line hospital workers are done with the patient severe dehydration patient goes home to your level of care. In what way could you provide support? A. Linkage with public works B. Bring patient for check-up C. Refer clients with same problems D. Give IVs in case of repeat dehydration 28. The dual role of PHC workers are as community health care developer and community development. How could you link and provide care at the same time? A. Health direction for better tomorrow B. Health care available even with high cost C. Health care procedure with supplies D. Health care accessibility with low cost 29. PHC is a system which emphasizes well being of all segments. What is the result of this effort? A. Progressive well being B. Progressive nation building C. Economic development and technology D. Economic progress and self reliance 30. PHC activities are fully integrated with other sectors. Which sector is always involved? A. Industries B. Politician C. Congress D. Public works SITUATION 7: Vikki Sales is admitted at the ER with the following findings: Cervical dilatation is 6 cms; fully effaced; cephalic presentation; 40 weeks AOG. 31. The nurse observes that Vikki's abdomen has irregular scar lines as a result of stretching of the skin. This refers to: A. Linea nigra

B. Chloasma C. Striae gravidarum D. Melasma 32. The obstetrician remarks that the fetus is dipping, which means that fetus is: A. still floating B. reached the ischial spine C. in station +1 D. descending but has not reached the ischial spines 33. The nurse records the uterine contractions of Vikki. Which are the characteristics of true labor? I. Occur at regular intervals II. Intervals gradually shorten III. Intensity remains unchanged IV. Intensity gradually increases A. I and IV B. II and III C. I and III D. I,II and IV 34. Vikki asks if she can take her meal. What should be the appropriate response of the nurse? A. "Your IV fluid is enough to give you nourishment." B. "You can take a light meal." C. "No, the doctor orders you to be kept NPO." D. "You can not take food nor oral fluids because you're now in active labor."
SITUATION 8: As a professional nurse practitioner, it is expected that you are aware of issues and concerns affecting the health care delivery system in the country. 36. Traditionally, the most common services of the health care delivery system include: A. Prevention of diseases and promotion of health B. Hospice and care of the terminally ill C. diagnosis and treatment of diseases D. rehabilitation and gerontological care 37. Ideally, rehabilitation services begin: A. Upon admission of clients in the health care system B. upon discharge of clients from the health care system C. after the client's physical condition stabilizes

D.soon after the client's request for rehabilitation services 38. In the Philippines, most if not all, day care centers can be managed and/or organized by nurses because they provide: A. ambulatory care to clients of all ages and are usually situated in malls B. emergency psychiatric care and counseling to clients experiencing extreme stress C. care and supervision of older clients usually those with emotional disturbances D. care and supervision of pre-school children usually located in the barangay 39. The Department of Health is faced with health issues and concerns that need immediate attention for the greater benefit of the general population. Which of the following issues involving health services can be directly addressed by nurses either individuallu or collectively? A. Increasing cost of hospitalization B. Unemployment and underemployment C. Access to health care facility D. Quality health care services 40. The legal permission obtained from the client before an invasive procedure, involvement in research or administration invasive procedure, involvement in research or administration of experimental medication and intervention is: A. Affidavit B. Contract C. Informed consent D. Power of attorney SITUATION 9: Baby Boy Soriano, 36 weeks gestational age, was admitted at the nursery. His birth weight is 3,400 grams, and birth lenth is 49 cms. 41. The birth length of Baby Soriano is considered: A. Long B. Average C. Too short D. Short 42. Baby Soriano was placed on NPO for the first twelve hours for two reasons, which are to allow time for: I. Mucus and amniotic fluid to leave the oral passages II. The baby to rest III. Milk secretion of the mother IV. Early diagnosis of any digestive malformation

A. II and IV B. III and IV C. I and III D. I and II 43. What hormone is for the production of milk? A. Oxytocin B. Progesterone C. Estrogen D. Prolactin 44. How often should Mrs. Soriano burp her newborn? A. Every ten minutes B. In the middle and at the end of the feeding C. After each feeding D. Before and after each feeding 45. Mrs. Soriano asks which is the best position for her baby if she is to lay him in his crib. The baby should be on his: A. Back, with his head flat B. Back, with his head slightly elevated C. Either side, with his head flat on the crib D. Stomach, with his head slightly elevated

SITUATION 10: Nursing care after delivery is as important as any stage of delivery. 46. The cord of the baby must be cut in between 2 clamps and cut using sterile scissors of blade. Then where is the baby placed? A. Breast of mother B. Side of mother C. Give to gradmother D. Baby's own mat on bed 47. The first two hours after delivery the mother should be watched for bleeding. What should be the most important parameter to check? A. vital signs B. Uterus C. Placenta D. Laceration 48. What should be inspected on the baby? A. Breast circumference

B. APGAR and defects C. Height in centimeters D. Weight in kilograms 49. Home deliveries should be visited at postpartum. How many hours after delivery should be first home visit? A. 36 B. 12 C. 24 D. 48 50. What is most important during the postpartum home visit? A. Breastfeeding practices B. Baby's milk formula C. Nutrition of mothers D. Bleeding and infection
SITUATION 11: The National Health plan is a blueprint of the DOH including health problems, policy, threats, strategies and targets. 51. Which of the following is an important policy thrust? A. Step ladder education B. Immunization day C. Information D. Anti-smoking 52. Which exciting programs captures spirit and styles? A. Health in the hands of the people B. Collaboration in the health finacing C. Decentralization of health service D. "23 in 93" 53.What exemplifies preventive and promotive programs which embark on family-oriented programs? A. Hospital with preventive cause infection B. Hospital as center of awareness C. Preventive programs against smoking D. Preventive programs against drug addiction 54. What is believed to be a guarantee of effective delivery of health services? A. Integration B. Reorganization

C. Devolution D. Promotion 55. What global menace is affecting twelve million people, some cases not even reported (1993 statistics): A. Human Immunodeficiency B. Human Virus Immunodeficiency C. Acquired Immune Deficiency Syndrome D. Human Deficiency Syndrome SITUATION 12: One of the things that the nurse should do to ensure quality nursing care is to formulate a nursing goal for clients based on some theoretical nursing model that she can adopt in planning nursing care. 56. One example of a nursing model is the self-deficit theory. In this model, nursing care becomes necessary when client is unable to fulfill biological, psychological, developmental of social needs. This model was popularized by: A. Dorothea Orem B. Hildegard Peplau C. Faye Abdellah D. Virginia Henderson 58. The goal of nursing according to the nursing theory of Florence Nightingale is to: A. develop interaction between nurse and client B. care for and help clients retain total self care C. facilitate the body's reparative processes by manipulating client's environment D. reduce stress so that client can move more easily through the recovery process 59. In interacting with patients, a nurse can be governed by Travelbee's nursing model. The framework for practice in this model is that: A. "Interpersonal process is viewed as human to human relationship." B. "Client continuously changes and co-exists with environment." C. "Caring is central and unifying domain for nursing knowledge and practice." D. "Nursing process is defined as dynamic interpersonal process between nurse, client and health care system." 60. Which of the following statements best supports the concepts that nursing is dynamic? A. "Every patient is a unique physical, emotional, social and spiritual being." B. "It is important that the patient participate in the overall nursing care plan of the nurse." C. "Nursing practice is expanding in the light of the modern developments that take place around her."

D. "The health status of every patient is constantly changing and the nurse must be cognizant and responsive to these changes." SITUATION 13: The DOH present a situation where maternal and child health care is adequate in our country. To obtain quality health care, there are programs and services in all levels of care. 61. The Under Five Care Program is a child health related service which will ensure wellness and survival of children. Which age range is this program focused? A. Below 3 years B. Perinatal age C. 0-59 months D. 0-36 months 62. Iron deficiency anemia in pregnant women, lactating mothers, infants and pre-schoolers increased as per finding of the National Nutrition Survey. What is the highest cause of this anemia? A. Poor absorption B. Increased demand C. Low dietary intake D. Blood loss 63. Children's dental care starts at the proper age of weaning. Prevent dentistry is emphasized to children under five. At what age should proper tooth brushing begin? A. when child should school B. after 2 years old C. before 2 years old D. upon weaning 64. Dental caries of temporary teeth need to be given attention. Consulting a dentist for this problem is for what purpose? A. Temporary filling of temporary tooth B. Installation of braces C. Replace temporary with false tooth D. Pulling out temporary tooth 65. Isolation technique in the home is difficult to do but fundamental principles must be followed. Soiled articles with discharges should be boiled in water before laundry. How long should these articles be boiled? A. One hour B. Two hours C. One half day D. Thirty minutes

SITUATION 14: Dennis and Yna are a newly married couple and are interested to know more about sexuality. 66. Which of the following characteristics is indicative that the couple is sexually healthy? The couple: A. exhibit congruence of the various components of sexual identity B. manifest ability to form a lasting relationship C. demonstrate an integration of the somatic, emotional intellectual and social aspects of sexual well being 67. Which of the following are physiologic changes during the excitement phase of the male sexual response cycle: A. Develops a recurring contractions of the muscles of the penis and deep perineum B. A high level of sexual tension is maintained C. Heart and respiration rates may double and BP rises 67% above resting level D. Vasocongestion of the penis shaft is diminished 68. What are the characteristics of normal sperms? A. Big heads, long tail and pearly white color B. Big heads, short tail and yellowish color C. Small heads, long tail and white color D. Small heads, long tail and pearly white color 69. Dennis asks about impotence. Which of the following is true about impotence? It: A. refers to the inability of the man to have and maintain a penile eretion B. occurs when the man is unable to ejaculate inside the vagina C. is the inability to procreate D. is synonymous to painful coitus 70. What is the primary sex gland of Yna? A. Ovaries B. Uterus C. Breasts D. vagina
SITUATION 15: cHN is a synthesis of nursing practice and public health practice. 71. What is the aim of CHN? A. To serve all ages of the population B. Promoting and preserving health C. Development of human being D. Limitation to certain age only

72. Which one is the primary focus of CHN? A. Healthy food B. Healthy continuum C. Health habits D. Health promotion 73. Where is cHN extended? A. Individuals, families and communities B. Female population only C. Mature and elderly D. Adolescents, adult and aged 74. What are the criteria to become a public health nurse? A. BSN graduate with license B. Specialist in CHN C. Specialist in any field D. Cum laude on graduation 75. The dynamic care of this nursing tool provides measurement of progress. What is the scientific systematic process for quality care? A. Nursing policies B. Nursing standard C. Nursing procedures D. Nursing process SITUATION 16: Change with the health care system has accelerated during the past decade. This is brought about by changes in technology and the national economy and the increasing number of population, to name a few. 76. One of the most recent developments that was enacted to help subsidize the cost of health services both for the employed and the unemployed is: A. Medical Act B. National Amelioration Pay C. National Health Insurance Act D. Workmen's Compensation Act 77. Lately, health promotion and disease prevention services have been getting increased attention in the Department of Health. One of the implications of these changes, as far as the scope of nursing practice is concerned, with emphasis in the application of which of the following competencies: A. Therapeuatic use of self B. Health education C. Execution of using procedures and techniques D. Administration of treatment and medication 78. The latest census has shown an increase in the life span among Filipinos resulting to an increase in the number of elderly population. In addition to these data, it is observed that the cost of hospitalization is getting more expensive and unaffordable to majority of the people. These facts can bring about an increase in the demand of which of the following nursing services? A. Managed care services B. Clinical specialization C. Hospice and home care services D. Acute care services

79. The latest trend that has developed to deliver care based on prepaid fees with emphasis on health promotion and illness prevention is covered under: A. Government insurance plan B. Preferred provider organization C. Private insurance plan D. Health maintainance organization 80. Hospitals nowadays are encouraged, if not required to offer comprehensive health services to include illness prevention and health promotion. To implement this program, hospitals especially government hospitals have already added in the regular services the following: A. Rehabilition centers B. Newborn screening C. Wellness centers D. Intensive Care Units SITUATION 17: Many changes in the DOH happened since 1901. In 1975, the DOH National Health Plan reviewing the health system. 81. What was implemented after the restructuring of the DOH? A. Philippine Heart Center of Asia B. Alta Mata Restructuring of WHO C. Tertiary Hospitals D. Restructured health Care Delivery System 82. Why was there devolution? A. To bring services near the people B. To empower local politicians C. To become self reliance D. To stop funding from natinal funds 83. Dr. Winslaw defines public health as science and art of preventing deseases. What's art in public health? A. Leadership skills of the nurse B. Organizing people to participate C. Creativity in making health programs D. Team building in group work 84. Harlon stresses that public health is dedicated to common attainment of highest level of physical health, mental and social well being. What is the concise definition? A. Emotional quotient B. Total well being C. Focus on physical fitness D. Fragmented health 85. In community health, assessment of the client requires multidisciplinary approach. Who is the team leader of the group? A. Nursing students B. Doctor C. Trained healer D. Nurse SITUATION 18: Miss Sylvia, a saleslady, is coplaining of pain on her left leg.

86. Upon physical assessment there are dilated veins on the affected part. To determine the imcompetence of the deep and superficial veins, which of these is not useful for her diagnostic examination? A. Retrograde filling tests B. Phlebography C. Doppler's flowmeter D. Encephalography 87. Which of the following is the possible cause of varicose veins? A. Frequent leg cramps B. Prolonged standing C. Always walking D. Prolonged leg exercise 88. Your health teaching is to use one of the following to enhance the circulation of the blood flow: A. Knee length stocking B. Ace bandages C. Panty hose stocking D. ROlled garter stocking 89. From her work, what activity would you advice her to do? A. Lie down and elevate the legs B. Lie on her side with one pillow in between the knees C. Shower with warm water to relax her nerves D. Sit down and elevate the legs on another chair 90. In case of leg pain, what medicine is not advisable for her? A. Biogesic B. Doloxone C. Aspirin D. Ponstan SITUATION 19: Mrs. Perla, 38 years of age, complains of chest pain and was admitted to the hospital. 91. How would you assess whether she has angina pectoris? There is: A. substernal chest pain B. crushing chest pain C. stabbing chest pain D. vertigo upon standing 92. If it is angina pectoris, which drug should be given to relieve her from chest pain? A. Marijuana B. crushing chest pain C. Demerol D. vertigo upon standing 93. If she were having M.I. was would be the characteristic of the chest pain? A. Crushing B. Stabbing C. Excruciating D. Rubbing 94. Diagnosed as M.I., what drug is best to relieve her from chest pain?

A. Ponstan B. Marijuana C. Nitroglycerine D. Demerol 95. If PRN drug is not administered in case of severe chest pain, she can have: A. apnea B. cardiac C. tachycardia D. hyperventilation SITUATION 20: Baby Sandra, born by NSD, weighs 3000 grams, and measures 49 cm long. She is roomed-in with her mother after 24 hours in the nursery. 96. What is the most beneficial advantage of rooming in? A. Makes all phases of childbearing as natural as possible B. Promotes faster involution C. Increases the ability of the mother to take care of herself and her baby D. Promotes mother and child bonding at an early stage 97. Which of the following is referred to as lactogenic hormone? A. Diethylstilbestrol B. Prolactin C. Estrogen D. Progesterone 98. The mother complains of the inability of Baby Sandra to empty either breast. Which of the following instruction is not helpful? A. Give glucose water as supplement B. Breastfeed the neonate on demand C. Breastfeed the neonate every2-3 hours or on demand whichever comes first D. Offer the breast every 4 hours 99. On the third day, Baby Sandra develops yellowish discoloration of the skin. This condition can be explained as: A. disorder of the digestive system B. dysfunction of the liver C. normal physiological jaundice D. disorder of the blood clotting mechanism 100. which of the following is the most important instruction to be given to the mother on newborn care? A. Proper feeding techniques B. Techniques in bathing the baby C. Prevention of diaper rash D. Prevention of infection ANSWER KEYS INTEGRATED COMPREHENSIVE TEST I 1. C 2. B 3. A 4. C 5. B 6. B

7. D 8. D 9. C 10. B 11. C 12. D 13. D 14. D 15. D 16. C 17. B 18. C 19. A 20. D 21. B 22. D 23. D 24. A 25. C 26. B 27. B 28. D 29. D 30. A 31. C 32. D 33. D 34. D 35. C 36. A 37. A 38. D 39. D 40. C 41. B 42. C 43. D 44. B 45. B 46. A 47. B 48. B 49. C 50. D 51. D 52. A 53. D 54. A 55. C 56. A 57. A 58. C 59. A 60. D

61. C 62. C 63. B 64. A 65. D 66. D 67. A 68. D 69. A 70. A 71. B 72. D 73. A 74. B 75. D 76. C 77. B 78. C 79. D 80. C 81. D 82. A 83. C 84. B 85. A 86. D 87. B 88. B 89. A 90. C 91. A 92. B 93. B 94. D 95. C 96. D 97. B 98. A 99. C 100.A