MEDICAL COLLEGES OF NORTHERN PHILIPPINES Alimannao Hills, Peablanca Cagayan SCHOOL OF MIDWIFERY

GENERAL INSTRUCTIONS: 1. This test questionnaire contains 100 questions. 2. This exam is for 1 hour and 30 minutes only. You must pass your answer sheet when the time allotted has elapsed. Answer sheets that will be passed after the allotted time will NOT BE ACCEPTED. 3. Read the questions carefully and choose the BEST response. Shade only one (1) circle for each question on your answer sheets. Two or more circles shaded will invalidate your answer. 4. Do not put any unnecessary markings on the answer sheet. Doing so will invalidate your answers. 5. Keep the answer sheets neat and clean. DO NOT MUTILATE.

START HERE!
1. Which of the following is a OBJECTIVE data? A.Dizziness B. Chest pain C. Anxiety D. Blue nails 2. A blood pressure cuff that is too small for the patients arm may result to which of the following findings? A. A false low BP C. No significant decrease B. A false high BP D. No significant increase 3. When the radial pulse of your patient is irregular, the midwife should: A. Take the apical pulse B. Request another midwife to take the pulse C. Count the pulse for 30 sec and record d. Wait for 30 mins and count the radical pulse for one minute

4. Which of the following is NOT a contraindication in taking ORAL temperature?

A. Quadriplegic B. Presence of NGT C. Dyspnea D. Nausea and Vomitting 5. How many minutes are allowed to pass if the client had engaged in strenuous activities, smoked or ingested caffeine before taking his/her BP? A. 5 B. 10 C. 15 D. 30 6. Too narrow cuff will cause what change in the Clients BP? A. True high reading B. True low reading C. False high reading D. False low reading 7. How many minute/s is/are allowed to pass before making a re-reading after the first one? A. 1 B. 5 C. 15 D. 30

8.

Which of the following is a correct nursing action when collecting urine specimen from a client with an Indwelling catheter? A. Collect urine specimen from the drainage bag B. Detach catheter from the connecting tube and draw the specimen from the port C. Use sterile syringe to aspirate urine specimen from the drainage port D. Insert the syringe straight to the port to allow self sealing of the port 9. Which of the following is inappropriate in collecting mid stream clean catch urine specimen for urine analysis? A. Collect early in the morning, First voided specimen B. Do perineal care before specimen collection C. Collect 5 to 10 ml for urine D. Discard the first flow of the urine 10. This is the single most important procedure that prevents cross contamination and infection A. Cleaning B. Disinfecting C. Sterilizing D. Handwashing 11. This is considered as the most important aspect of handwashing A. Time B. Friction C. Water D. Soap 12. In handwashing by medical asepsis, Hands are held . A. Above the elbow, The hands must always be above the waist B. Above the elbow, The hands are cleaner than the elbow C. Below the elbow, Medical asepsis do not require hands to be above the waist D. Below the elbow, Hands are dirtier than the lower arms 13. The suggested time per hand on handwashing using the time method is A. 5 to 10 seconds each hand B. 10 to 15 seconds each hand C. 15 to 30 seconds each hand D. 30 to 60 seconds each hand 14. In putting sterile gloves, Which should be gloved first? A. The dominant hand B. The non dominant hand C. The left hand D. No specific order, Its up to the nurse for her own convenience 15. Which of the following should the nurse do when applying gloves prior to a surgical procedure? A. Slipping gloved hand with all fingers when picking up the second glove B. Grasping the first glove by inserting four fingers, with thumbs up underneath the cuff C. Putting the gloves into the dominant hand first D. Adjust only the fitting of the gloves after both gloves are on 16. Why does the nurse cleanse a female patient's perineum before inserting an intermittent

urinary catheter? a. To encourage the bladder to drain fully b. To encourage spontaneous voiding

c. To prevent bowel elimination during the procedure d. To reduce the patient's risk of urinary tract infection 17. What is the primary reason the nurse applies sterile gloves rather than clean ones when caring for a patient with a newly inserted suprapubic catheter? a. To protect the nurse and other patients from pathogens b. To collect a sterile urine sample c. To reduce the patient's risk of infection d. To reduce the patient's risk of injury 18. When preparing to insert an indwelling urinary catheter in a male patient, it is important for the nurse to do what? a. Remove the cotton balls from the kit for later use. b. Advance the catheter 10 to 12 inches or until urine flows. c. Lubricate the first 5 to 7 inches of the catheter. d. Hold the penis at a 45-degree angle during insertion
19. To determine the clients EDC, which day of the menstrual period will you ask?

A. B. C. D.

First Last Third Second

20. In Leopolds maneuver step #1, you palpated a soft broad mass that moves with the rest

of the mass. The correct interpretation of this finding is: a. The mass palpated is the head part c. The mass palpated is the fetal back b. The presentation is breech d. The mass palpated is the buttocks
21. In Leopolds maneuver step # 3 you palpated a hard round movable mass at the supra

pubic area. The correct interpretation is that the mass palpated is: a. The buttocks because the presentation is breech b. The mass palpated is the head c. The mass is the fetal back d. The mass palpated is the fetal small part 22. This maneuver is done by facing foot part of the woman, palpate fetal head pressing downward about 2 inches above the inguinal ligament. a. Fundal Grip b. Umbilical Grip c. Pawlicks Grip d. Pelvic Grip
23. During the demonstration about subcutaneous injection, you should position the syringe at what angle in

relation to your partners skin? a. 10-15 degrees c. 90 degrees b. 45 degrees d. 30 degrees 24. The maximum amount of medication that can be given intravascularly to the deltoid muscle is: a. 2 ml c. 2.5 ml b. 3 ml d. 5 ml
25. Proetz position is used to instill what type of medications?

a. Nasal medication b. Vaginal medication

c. Rectal medication d. Oral medication

26. When a patient drinks 9 ounces of milk, which of the following amounts should the nurse document?

a. 230 ml b. 250 ml

c. 310 ml d. 270 ml

27. You are assigned to administer insulin to a Type 1 Diabetes mellitus patient. Using an insulin syringe, you

should insert the needle at an angle of: a. 30 degrees

b. 45 degrees
28. A

c. 90 degrees

d. 10 degrees

patient is in the second stage of labor. During this stage, how frequently should the nurse in charge assess her uterine contractions? a. Every 5 minutes b. Every 15 minutes c. Every 30 minutes d. Every 60 minutes

27. A client with eclampsia begins to experience a seizure. Which of the following would the nurse in charge do first? a. Pad the side rails b. Place a pillow under the left buttock c. Insert a padded tongue blade into the mouth d. Maintain a patent airway 28. While caring for a multigravida client in early labor in a birthing center, which of the following foods would be best if the client requests a snack? a. Yogurt b. Cereal with milk c. Vegetable soup d. Peanut butter cookies 29. The multigravida mother with a history of rapid labor who us in active labor calls out to the nurse, The baby is coming! which of the following would be the nurses first action? a. Inspect the perineum b. Time the contractions c. Auscultate the fetal heart rate d. Contact the birth attendant

30. A client visits the clinic and tells the nurse that she thinks she is pregnant.. the first day of her last menstrual period was January 27. Using Naegeles rule, the clients expected date of delivery is: a. October 20 c. November 10 b. October 27 d. November 3 31. A primipara at 32 weeks gestation tells the nurse that she would like to perform some exercises to strengthen g her perineal muscles before her labor begins. Which of the following form of exercises would be most appropriate for this client? a. leg lifts c. squatting b. pelvic tilting d. brisk walking 32. Nurse Sakura is monitoring a client in labor. Sakura suspects umbilical cord compression if which of the following is noted on the external monitor tracing during a contraction? a. Early decelerations C. Variable decelerations b. Late decelerations D. Accelerations

33. Which among the following are considered as discomforts in the first trimester of pregnancy? a. Breast tenderness, vaginal bleeding, persistent vomiting, chills and fever, sudden escape of clear fluid, b. Palmar erythema,ankle edema, Braxton hicks contraction, abdominal and chest pain, increase and decrease in fetal movement

c. Constipation, backache, headache, dyspnea

d.

Nausea, vomiting, pyrosis, fatigue, leucorrhea

34. Proper body mechanics should be practice during bed making. The reason of raising the bed to comfortable working position prior to making a bed is? a. It prevents accidental fall of the patient. b. Because nursing is an art. c. It promotes ease of the procedure. d. So you don have to bend or over stretch. 35. You a nursing student assigned to the surgery ward of Dr. Giovannie L. Rockinyou Medical Center, in one of your duties you observed a nurse making an unoccupied bed miter the bottom flat sheet at the head of the bed. Being equipped with knowledge on bed making, you are aware that the nurse miters the bottom sheet to? a. Ensure and secure flat sheet will not loosen easily. b. Keep the patient comfortably on bed. c. Prevent bed sores on patients back. d. It is the institutions protocol on bed making. 36. Assembling all equipments before any nursing procedure provides for smoothness of the process, thus increasing patients comfort. The initial nursing action in performing bed making would be? a. Assessment of activity orders or restrictions in mobility. b. Lower side rails on both sides of the bed. c. Hand hygiene. d. Raising the bed to comfortable position. 37. The PHN bag is an important tool in providing nursing care during a home visit. The most important
principle of bag technique states that it

a. b. c. d.

Should not overshadow concern for the patient and his family.
Should minimize if not totally prevent the spread of infection

Should save time and effort. May be done in a variety of ways depending on the home situation, etc.

38. To maintain the cleanliness of the bag and its contents, which of the following must the nurse do?
a. b. c. d.
At the end of the visit, fold the lining on which the bag was placed, ensuring that the contaminated side is on the outside.

In the care of family members, as much as possible, use only articles taken from the bag. Wash his/her hands before and after providing nursing care to the family members. Put on an apron to protect her uniform and fold it with the right side out before putting it back into the bag

39. In what level of prevention according to Leavell and Clark does the nurse support the client in obtaining OPTIMAL HEALTH STATUS after a disease or injury? A. Primary B. Secondary C. Tertiary D. None of the above 40. In what level of prevention does the nurse encourage optimal health and increases persons susceptibility to illness?

A. Primary B. Secondary C. Tertiary D. None of the above 41. Also known as HEALTH MAINTENANCE prevention. A. Primary B. Secondary C. Tertiary D. None of the above
42. When removing gloves, which of the following is an inappropriate nursing action? A. Wash gloved hand first B. Peel off gloves inside out C. Use glove to glove skin to skin technique D. Remove mask and gown before removing gloves

43. A substance usually intended for use on inanimate objects, that destroys pathogens but not the spores. A. Sterilization B. Disinfectant C. Antiseptic D. Autoclave 44. This is a process of removing pathogens but not their spores A. Sterilization B. Auto claving C. Disinfection D. Medical asepsis 45. The third period of infectious processes characterized by development of specific signs and symptoms A. Incubation period B. Prodromal period C. Illness period D. Convalescent period 46. Where should you put a wet adult diaper? A. Green trashcan B. Black trashcan C. Orange trashcan D. Yellow trashcan 47. Estimate the number of pregnant women who will be given tetanus toxoid during an immunization outreach activity in a barangay with a population of about 1,500. A. 265 B. 300 C. 375 D. 400 48. Inadequate intake by the pregnant woman of which vitamin may cause neural tube defects?

A. Niacin B. Riboflavin C. Folic Acid D. Thiamine 49. You are in a clients home to attend to a delivery. Which of the following will you do first? A. Set up a sterile area B. Put on a clean gown and apron C. Cleanse the clients vulva with soap and water D. Note the interval, duration and intensity of labor and contractions 50. In preparing a primigravida for breastfeeding, which of the following will you do? A. Tell her that lactation begins within a day after delivery B. Teach her nipple stretching exercises if her nipples are everted C. Instruct her to wash her nipples before and after each breastfeeding D. Explain to her that putting the baby to breast will lessen blood loss after delivery 51. A primigravida is instructed to offer her breast to the baby for the first time within 30 minutes after delivery. What is the purpose of offering the breast this early? A. To initiate the occurrence of milk letdown B. To stimulate milk production by the mammary acini C. To make sure that the baby is able to get the colustrum D. To allow the woman to practice breastfeeding in the presence of the health worker 52. In a mothers class, you discuss proper breastfeeding technique. Which of these is a sign that the baby has lactated on the breast property? A. The baby takes shallow, rapid sucks B. The mother does not feel nipple pain C. The babys mouth is only partly open D. Only the mothers nipple is inside the babys mouth 53. A pregnant woman had just received her 4th dose of tetanus toxoid. Subsequently, her baby will have protection against tetanus for how long? A. 1 year B. 3 years C. 10 years D. Lifetime 54.Which of the following findings in a woman would be consistent with a pregnancy of two months duration? A.Weight gain of 6-10 lbs. and presence of striae gravidarum B.Fullness of the breast and urinary frequency C.Braxton Hicks contractions and quickening D.Increased respiratory rate and ballottement 55. Shoes with low, broad heels, plus a good posture will prevent which prenatal discomfort? A.Backache B.Vertigo C.Leg cramps D.Nausea

56. When a pregnant woman experiences leg cramps, the correct nursing intervention to relieve the muscle cramps is: A.Allow the woman to exercise B.Let the woman walk for a while C.Let the woman lie down and dorsiflex the foot towards the knees D.Ask the woman to raise her legs 57.Kegels exercise is done in pregnancy in order to:

A.Strengthen perineal muscles B.Relieve backache C.Strengthen abdominal muscles D.Prevent leg varicosities and edema 58. Pelvic rocking is an appropriate exercise in pregnancy to relieve which discomfort? A.Leg cramps B.Urinary frequency C.Orthostatic hypotension D.Backache 59. The main reason for an expected increased need for iron in pregnancy is: A.The mother may have physiologic anemia due to the increased need for red blood cell mass as well as the fetal requires about 350-400 mg of iron to grow B.The mother may suffer anemia because of poor appetite C.The fetus has an increased need for RBC which the mother must supply D.The mother may have a problem of digestion because of pica 60. The diet that is appropriate in normal pregnancy should be high in A.Protein, minerals and vitamins B.Carbohydrates and vitamins C.Proteins, carbohydrates and fats D.Fats and minerals 61. Which of the following means that a drugs needs to be given immediately? A. Prn C. Stat B. O.D D. Ad lib 62. In the hierarchy of needs, this is considered to be the highest priority. These are things necessary for survival A. Physiological needs C. Self- esteem needs b. Love and belongingness needs D. Need for self actualization 63. The correct perineal care procedure in bed is: A. Rotating motion C. Sideward motion b. Down-up technique D. Up-down technique 64. The first manifestation of inflammation is A. Redness on the affected area B. Swelling of the affected area C. Pain, which causes guarding of the area D. Increase heat due to transient vasodilation 65. Which of the following statement, if made by the nurse, is considered not therapeutic?

A. How did you deal with your anxiety before? B. It must be awful to feel anxious. C. How does it feel to be anxious? D. What makes you feel anxious? 66. Which of the following is incorrect with regards to proper urine testing using Benedicts Solution? A. Heat around 5ml of Benedicts solution together with the urine in a test tube B. Add 8 to 10 drops of urine C. Heat the Benedicts solution without the urine to check if the solution is contaminated D. If the color remains BLUE, the result is POSITIVE 67. +++ Positive result after Benedicts test is depicted by what color? A. Blue B. Green C. Yellow D. Orange 68. The best position for any procedure that involves vaginal and cervical examination is A. Dorsal recumbent B. Side lying C. Supine D. Lithotomy 69. A client who is unconscious needs frequent mouth care. When performing a mouth care, the best position of a client is: A. Fowlers position B. Side lying C. Supine D. Trendelenburg 70. When doing perineal care in preparation for delivery, the nurse should observe the following EXCEPT A.Use up-down technique with one stroke B.Clean from the mons veneris to the anus C.Use mild soap and warm water D.Paint the inner thighs going towards the perineal area

71. It is an obstruction of a blood vessel by air carried via the bloodstream. A. Circulatory overload B. Air embolism C. Phlebitis D. Infiltration 72. It is a complication defined as inflammation of the wall of the vein A. Allergic reaction B. Phlebitis C. Circulatory overload D. Infiltration 73. Which stage of pressure ulcer development does the ulcer extend into the subcutaneous tissue? a. Stage I b. Stage II

c. Stage III d. Stage IV 74. When the method of wound healing is one in which wound edges are not surgically approximated and integumentary continuity is restored by granulations, the wound healing is termed a. Second intention healing b. Primary intention healing c. Third intention healing d. First intention healing 75. When assessing the clients wound for sign of infection, the nurse should look for the presence of which of the following? A. Granulation tissue B. Pink tissue C. Purulent drainage D. Well approximated edges 76. Five teaspoon is equivalent to how many milliliters (ml)?
A. 30 ml B. 25 ml C. 12 ml D. 22 ml

77. The most important purpose of cleansing bed bath is:

A. To cleanse, refresh and give comfort to the client who must remain in bed B. To expose the necessary parts of the body C. To develop skills in bed bath D. To check the body temperature of the client in bed 78. The nurse prepare IM injection that is irritating to the subcutaneous tissue. Which of the following is the best action in order to prevent tracking of the medication A. Use a small gauge needle B. Apply ice on the injection site C. Administer at a 45 angle D. Use the Z-track technique

79. In which step of the nursing process would the nurse ask a patient if the medication she
administered relieved his pain? A. Assessment B. Analysis C. Planning D. Evaluation

80. Lochia normally disappears after how many days postpartum?

A.5 days B.7-10 days

C.18-21 days D.28-30 days 81. Which of the following is an abnormal vital sign in postpartum? A.Pulse rate between 50-60/min B.BP diastolic increase from 80 to 95mm Hg C.BP systolic between 100-120mm Hg D.Respiratory rate of 16-20/min 81. After how many weeks after delivery should a woman have her postpartal check-up based on the protocol followed by the DOH? A.2 weeks B.3 weeks C.6 weeks D.12 weeks 82. The following are nursing interventions to relieve episiotomy wound pain EXCEPT A.Giving analgesic as ordered B.Sitz bath C.Perineal heat D.Perineal care 83. Birth Control Methods and Infertility: In basal body temperature (BBT) technique, the sign that ovulation has occurred is an elevation of body temperature by A.1.0-1.4 degrees centigrade B.0.2-0.4 degrees centigrade C.2.0-4.0 degrees centigrade D.1.0-4.0 degrees centigrade 84. Lactation Amenorrhea Method(LAM) can be an effective method of natural birth control if A.The mother breast feeds mainly at night time when ovulation could possibly occur B.The mother breastfeeds exclusively and regularly during the first 6 months without giving supplemental feedings C.The mother uses mixed feeding faithfully D.The mother breastfeeds regularly until 1 year with no supplemental feedings 85. Intra-uterine device prevents pregnancy by the ff. mechanism EXCEPT A.Endometrium inflames B.Fundus contracts to expel uterine contents C.Copper embedded in the IUD can kill the sperms D.Sperms will be barred from entering the fallopian tubes 86. Oral contraceptive pills are of different types. Which type is most appropriate for mothers who are breastfeeding? A.Estrogen only B.Progesterone only C.Mixed type- estrogen and progesterone D.21-day pills mixed type