A.dock,glgui

7/27/2019 A.dock,glgui

http://slidepdf.com/reader/full/adockglgui 1/5

1

JAMIATU MARAWI AL-ISLAMIA FOUNDATION

COLLEGE OF HEALTH SCIENCES

NURSING DEPARTMENT

NCM 101

(Removal Exam)

A comprehensive Multiple Choice Exam

Name:_______________________________________ Course/Year: ______________

Score: ____________

A. A term neonate is to be released from hospital at 2 days of age.The nurse performs a physical examination before discharge.

1. Nurse Valerie examines the neonate’s hands and palms. Which of the following findings requires further assessment?

a) Many crease across the palm.b) Absence of creases on the palm.c) A single crease on the palm.d) Two large creases across the palm.

2.The mother asks when the “soft spots” close? The nurse explainsthat the neonate’s anterior fontanel will normally close by age…

a) 2 to 3 months.b) 6 to 8 months.c) 12 to 18 months.d) 20 to 24 months.

3. When performing the physical assessment, the nurse explains to themother that in a term neonate, sole creases are…

a) Absent near the heels.b) Evident under the heels only,c) Spread over the entire foot.d) Evident only towards the transverse arch.

4. When assessing the neonate’s eyes, the nurse notes the following:absence of tears, corneas of unequal size, constriction of the pupils inresponse to bright light, and the presence of red circles on the pupilson ophthalmic examination. Which of these findings needs further assessment?

a) The absence of tears.b) Corneas of unequal size.c) Constriction of the pupils.d) The presence of red circles on the pupils.

5. After teaching the mother about the neonate’s positive Babinskireflex, the nurse determines that the mother understands theinstructions when she says that a positive Babinski reflex indicates….

a) Immature muscle coordination.b) Immature central nervous system.c) Possible lower spinal cord defect.d) Possible injury to nerves that innervate the feet.

B. Nurse Kris is responsible for assessing a male neonateapproximately 24 hours old. The neonate was delivered vaginally.

6. The nurse should plan to assess the neonate’s physical condition….

a) Midway between feedings.b) Immediately after a feeding.c) After the neonate has been NPO for three hours.d) Immediately before a feeding.

7. The nurse notes a swelling on the neonate’s scalp that crosses thesuture line. The nurse documents this condition as…

a) Cephallic hematoma.b) Caput succedaneum.c) Hemorrhage edema.d) Perinatal caput.

8. The nurse measures the circumference of the neonate’s heads andchest, and then explains to the mother that when the twomeasurements are compared, the head is normally about…

a) The same size as the chest.b) 2 centimeter larger than the chest.c) 2 centimeter smaller than the chest.d) 4 centimeter larger than chest.

9. After explaining the neonate’s cranial molding, the nurse determinesthat the mother needs further instructions from which statement?

a) “The molding is caused by an overriding of the cranial bones.”b) “The degree of molding is related to the amount of pressure on thehead.”c) “The molding will disappear in a few days.”d) “The fontanels may be damaged if the molding does not resolvedquickly.”

10. When instructing the mother about the neonate’s need for sensoryand visual stimulation, the nurse should plan to explain that the mosthighly develop sense in the neonate is…

a) Taskb) Smellc) Touchd) Hearing

C. Nurse Joan works in a children’s clinic and helps with the carefor well and ill children of various ages.

11. A mother brings her 4 month old infant to the clinic. The mother asks the nurse when she should wean the infant from breastfeedingand begin using a cup. Nurse Joan should explain that the infant willshow readiness to be weaned by…

a) Taking solid foods well.b) Sleeping through the night.c) Shortening the nursing time.d) Eating on a regular schedule.

12. Mother Arlene says the infant’s physician recommends certainfoods but the infant refuses to eat them after breastfeeding. The nurseshould suggest that the mother alter the feeding plan by…

a) Offering desert followed by vegetable and meat.b) Offering breast milk as long as the infant refuses to eat solid food.c) Mixing minced food with cow’s milk and feeding it to the infantthrough a large hole nipple.d) Giving the infant a few minutes of breast and then offering solidfood.

13. Which of the following abilities would a nurse expect a 4 month oldinfant to perform?

a) Sitting up without support.b) Responding to pleasure with smiles.c) Grasping a rattle when it is offered.d) Turning from either side to the back.

14. The nurse plans to administer the Denver DevelopmentalScreening Test (DDST) to a five month old infant. The nurse shouldexplain to the mother that the test measures the infants…

a) Intelligence quotient.b) Emotional development.c) Social and physical activities.d) Pre-disposition to genetic and allergic illnesses.

15. When discussing a seven month old infant’s mother regarding themotor skill development, the nurse should explain that by age sevenmonths, an infant most likely will be able to…

a) Walk with support.

b) Eat with a spoon.c) Stand while holding unto a furnitured) Sit alone using the hands for support.

16. A mother brings her one month old infant to the clinic for check-up.Which of the following developmental achievements would the nurseassess for?

a) Smiling and laughing out loud.b) Rolling from back to side.c) Holding a rattle briefly.d) Turning the head from side to side.



2

17. A two month old infant is brought to the clinic for the firstimmunization against DPT. The nurse should administer the vaccinevia what route?

a) Oral.b) Intramascular c) Subcutaneousd) Intradermal

18. The nurse teaches the client’s mother about the normal reactionthat the infant might experience 12 to 24 hours after the DPTimmunization, which of the following reactions would the nursediscuss?

a) Lethargy.b) Mild fever.c) Diarrhead) Nasal Congestion

19. An infant is observed to be competent in the followingdevelopmental skills: stares at an object, place her hands to the mouthand takes it off, coos and gargles when talk to and sustains part of her own weight when held to in a standing position. The nurse correctlyassessed infant’s age as…

a) Two months.b) Four monthsc) Six monthsd) Eight months.

20. The mother says, “the soft spot near the front of her baby’s head isstill big, when will it close?” Nurse Lilibeth’s correct response would beat…

a) 2 to 4 months.b) 5 to 8 months.c) 9 to 12 months.d) 13 to 18 months. prop

21. A mother states that she thinks her 9-month old is ‘developing

slowly’. When evaluating the infant’s development, the nurse would notexpect a normal 9-month old to be able to…

a) Creep and crawl.b) Begin to use imitative verbal expressions.c) Put an arm through a sleeve while being dressed.d) Hold a bottle with good hand – mouth coordination.

22. The mother of the 9-month old says, “it is difficult to add new foodsto his diet, he spits everything out”, she says. The nurse should teachthe mother to…

a) Mix new foods with formulab) Mix new foods with more familiar foods.c) Offer new foods one at a time.

d) Offer new foods after formula has been offered.

23. Which of the following tasks is typical for an 18-month old baby?

a) Copying a circleb) Pulling toysc) Playing toy with other childrend) Building a tower of eight blocks

24. Mother Riza brings her normally developed 3-year old to the clinicfor a check-up. The nurse would expect that the child would be at leastskilled in…

a) Riding a bicycle

b) Tying shoelacesc) Stringing large beadsd) Using blunt scissors

25. The mother tells the nurse that she is having problem toilet-trainingher 2-year old child. The nurse would tell the mother that the number one reason that toilet training in toddlers fails because the…

a) Rewards are too limitedb) Training equipment is inappropriatec) Parents ignore “accidents” that occur during trainingd) The child is not develop mentally ready to be trained

26. A child is not developmentally ready to be trained. A 2-1/2 year oldchild is brought to the clinic by his father who explains that the child isafraid of the dark and says “no” when asked to do something. Thenurse would explain that the negativism demonstrated by toddler isfrequently an expression of…

a) Quest for autonomyb) Hyperactivityc) Separation anxietyd) Sibling rivalry

27. The nurse would explain to the father which concept of Piaget’scognitive development as the basis for the child’s fear of darkness?

a) Reversibilityb) Animismc) Conservation of matter d) Object permanence

28. Mother asks the nurse for advice about discipline. The nurse wouldsuggest that the mother would first use…

a) Structured interactionb) Spankingc) Reasoningd) Scolding

29. When a nurse assesses for pain in toddlers, which of the followingtechniques would be least effective?

a) Ask them about the painb) Observe them for restlessnessc) Watch their face for grimnessd) Listen for pain cues in their cries.

30. The mother reports that her child creates a quite scene every nightat bedtime and asks what she can do to make bedtime a little morepleasant. The nurse should suggest that the mother to…

a) Allow the child to stay up later one or two nights a week.b) Establish a set bedtime and follow a routinec) Let the child play toy just before bedtimed) Give the child a cookie if bedtime is pleasant.

31. The mother asks about dental care for her child. She says that shehelps brush the child’s teeth daily. Which of the following responses bythe nurse would be most appropriate?

a) “Since you help brush her teeth, there’s no need to see a dentistnow”b) “You should have begun dental appointments last year but it is nottoo late”c) “Your child does not need to see the dentist until she starts school”

d) “A dental check-up is a good idea, even if no noticeable problemsare present”

32. The mother says that she will be glad to let her child brush her teeth without help, but at what age should this begin? Nurse Roselynshould respond at…

a) 3 yearsb) 5 yearsc) 6 yearsd) 7 years

33. The mother tells the nurse that her other child, a 4-year old boy,has developed some “strange eating habits”, including not finishing her

meals and eating the same foods for several days in a row. She wouldlike to develop a plan to connect this situation. In developing such aplan, the nurse and mother should consider…

a) Deciding on a good reward for finishing a mealb) Allowing him to make some decisions about the foods he eatsc) Requiring him to eat the foods served at meal times.d) Not allowing him to play with friends until he eats all the food sheserved.



3

34. Nurse Bryan knows that one of the most effective strategies toteach a Four year old about safety is to…

a) Show him potential dangers to avoidb) Tell him he is bad when they do something dangerousc) Provide good examples of safety behavior d) Show him pictures of children who have involve with accidents

35. A 9 year old girl is brought to the pediatrician’s office for an annualphysical checkup. She has no history of significant health problems.When the nurse asks the girl about her best friend, the nurse isassessing…

a) Language developmentb) Motor developmentc) Neurological developmentd) Social development

36. The child probably tells the nurse that brushing and flossing her teeth is her responsibility. When responding to this information, thenurse should realize that the child…

a) Is too young to be given this responsibilityb) Is most likely quite capable of this responsibilityc) Should have assumed this responsibility much sooner d) Is probably just exaggerating the responsibility

37. The mother tells the nurse that the child is continually telling jokesand riddles to the point of driving the other family members crazy. Thenurse should explain that this behavior is a sign of…

a) Inadequately parental attentionb) Mastery of language ambiguitiesc) Inappropriate peer influenced) Excessive television watching

38. The mother relates that the child is beginning to identify behaviorsthat pleases others as “good behavior”. The child’s behavior ischaracteristics of which Kohlberg’s level of moral development?

a) Pre-conventional moralityb) Conventional moralityc) Post conventional moralityd) Autonomous morality

39. The mother asks the nurse about the child’s apparent need for between-meals snacks, especially after school. The nurse and mother develop a nutritional plan for the child, keeping in mind that the child..

a) Does not need to eat between mealsb) Should eat snacks his mother preparesc) Should help prepare own snacksd) Will instinctively select nutritional snacks

40. The mother is concerned about the child’s compulsion for collectingthings. The nurse explains that this behavior is related to the cognitiveability to perform.

a) Concrete operationsb) Formal operationsc) Coordination of d) Tertiary circular reactions

41. The nurse explained to the mother that according to Erickson’sframework of psychosocial development, play as a vehicle of development can help the school age child develop a sense of…

a) Initiativeb) Industry

c) Identityd) Intimacy

42. The school nurse is planning a series of safety and accidentprevention classes for a group of third grades. What preventivemeasures should the nurse stress during the first class, knowing theleading cause of incidental injury and death in this age?

a) Flame-retardant clothingb) Life preservesc) Protective eyewear d) Auto seat belts

43. The mother of a 10-year old boy expresses concern that he isoverweight. When developing a plan of care with the mother, NurseKatrina should encourage her to…a) Limit child’s between-,meal snacksb) Prohibit the child from playing outside if he eat snacksc) Include the child in meal planning and preparationd) Limit the child’s calories intake to 1,200kCal/day

44. When assessing an 18-month old, the nurse notes a characteristicsprotruding abdomen. Which of the following would explain the rationalefor this findings?

a) Increased food intake owing to ageb) Underdeveloped abdominal musclesc) Bowlegged postured) Linear growth curve

45. If parents keep a toddler dependent in areas where he is capableof using skills, the toddler will develop a sense of which of thefollowing?

a) Mistrustb) Shamec) Guiltd) Inferiority

46. Which of the following fears would the nurse typically associatewith toddlerhood?

a) Mutilationb) The darkc) Ghostsd) Going to sleep

47. A mother of a 2 year old has just left the hospital to check on her other children. Which of the following would best help the 2 year oldwho is now crying inconsolably?

a) Taking a napb) Peer play group

c) Large cuddly dogd) Favorite blanket

48. Which of the following is an appropriate toy for an 18 month old?

a) Multiple-piece puzzleb) Miniature Carsc) Finger paintsd) Comic Book

49. When teaching parents about typical toddler eating patterns, whichof the following should be included?

a) Food “jags”

b) Preference to eat alonec) Consistent table mannersd) Increase in appetite

50. Which of the following toys should the nurse recommend for a 5-month old?

a) A big red balloonb) A teddy bear with button eyesc) A push-pull wooden truckd) A colorful busy box

51. Postpartum Period:The fundus of the uterus is expected to go down normally postpartally

about __ cm per day.

A.1.0 cmB.2.0 cmC.2.5 cmD.3.0 cm

52. The lochia on the first few days after delivery is characterized as

A.Pinkish with some blood clotsB.Whitish with some mucusC.Reddish with some mucusD.Serous with some brown tinged mucus



4

53. Lochia normally disappears after how many days postpartum? A.5 daysB.7-10 daysC.18-21 daysD.28-30 days

54. The nursing intervention to relieve pain in breast engorgementwhile the mother continues to breastfeed is

A.Apply cold compress on the engorged breastB.Apply warm compress on the engorged breastC.Massage the breastD.Apply analgesic ointment

55. A woman who delivered normally per vagina is expected to voidwithin ___ hours after delivery.

A.3 hrsB.4 hrs.C.6-8 hrsD.12-24 hours

56. According to Rubin’s theory of maternal role adaptation, the mother will go through 3 stages during the post partum period. These stagesare:

A.Going through, adjustment period, adaptation periodB.Taking-in, taking-hold and letting-goC.Attachment phase, adjustment phase, adaptation phaseD.Taking-hold, letting-go, attachment phase

57. The uterine fundus right after delivery of placenta is palpable at

A.Level of Xyphoid processB.Level of umbilicusC.Level of symphysis pubisD.Midway between umbilicus and symphysis pubis

58. In a woman who is not breastfeeding, menstruation usually occursafter how many weeks?

A.2-4 weeksB.6-8 weeksC.6 monthsD.12 months

59. The following are nursing measures to stimulate lactation EXCEPT

A.Frequent regular breast feedingB.Breast pumpingC.Breast massageD.Application of cold compress on the breast

60. The following are interventions to make the fundus contractpostpartally EXCEPT

A.Make the baby suck the breast regularlyB.Apply ice cap on fundusC.Massage the fundus vigorously for 15 minutes until contractedD.Give oxytocin as ordered

61. The following are nursing interventions to relieve episiotomy woundpain EXCEPT

A.Giving analgesic as orderedB.Sitz bathC.Perineal heat

D.Perineal care

62. Postpartum blues is said to be normal provided that the followingcharacteristics are present. These are1. Within 3-10 days only;2. Woman exhibits the following symptoms- episodic tearfulness,fatigue, oversensitivity, poor appetite;3. Maybe more severe symptoms in primpara

A.All of the aboveB.1 and 2C.2 onlyD.2 and 3

63. The neonatal circulation differs from the fetal circulation because

A.The fetal lungs are non-functioning as an organ and most of theblood in the fetal circulation is mixed blood.B.The blood at the left atrium of the fetal heart is shunted to the rightatrium to facilitate its passage to the lungs

C.The blood in left side of the fetal heart contains oxygenated bloodwhile the blood in the right side contains unoxygenated blood.D.None of the above

64. The anterior fontanelle is characterized as:

A.3-4 cm antero-posterior diameter and 2-3 cm transverse diameter,diamond shapeB.2-3 cm antero-posterior diameter and 3-4 cm transverse diameter and diamond shapeC.2-3 cm in both antero-posterior and transverse diameter anddiamond shapeD.none of the above

65. The ideal site for vitamin K injection in the newborn is:

A.Right upper armB.Left upper armC.Either right or left buttocksD.Middle third of the thigh

66. At what APGAR score at 5 minutes after birth should resuscitationbe initiated?

A.1-3B.7-8C.9-10D.6-7

67. Right after birth, when the skin of the baby’s trunk is pinkish but thesoles of the feet and palm of the hands are bluish this is called:

A.SyndactylyB.AcrocyanosisC.Peripheral cyanosisD.Cephalo-caudal cyanosis

68. The minimum birth weight for full term babies to be considerednormal is:

A.2,000gmsB.1,500gmsC.2,500gms

D.3,000gms

69. The procedure done to prevent ophthalmia neonatorum is:

A.Marmet’s techniqueB.Crede’s methodC.Ritgen’s methodD.Ophthalmic wash

70. Which of the following is a TRUE statement about normalovulation?

A.It occurs on the 14th day of every cycleB.It may occur between 14-16 days before next menstruationC.Every menstrual period is always preceded by ovulationD.The most fertile period of a woman is 2 days after ovulation



5

51. Answer: (A) 1.0 cmThe uterus will begin involution right after delivery. It is expected to regress/go down by 1 cm. per day and becomes no longer palpable about 1 week after delivery.

52. Answer: (C) Reddish with some mucusRight after delivery, the vaginal discharge called lochia will be reddish because there is some blood, endometrial tissue and mucus. Since it is not pure blood it isnon-clotting.

53. Answer: (B) 7-10 daysNormally, lochia disappears after 10 days postpartum. What’s important to remember is that the color of lochia gets to be lighter (from reddish to whitish) andscantier everyday.

54. Answer: (B) Apply warm compress on the engorged breastWarm compress is applied if the purpose is to relieve pain but ensure lactation to continue. If the purpose is to relieve pain as well as suppress lactation, thecompress applied is cold.

55. Answer: (C) 6-8 hrs A woman who has had normal delivery is expected to void within 6-8 hrs. If she is unable to do so after 8 hours, the nurse should stimulate the woman to void. If nursing interventions to stimulate spontaneous voiding don’t work, the nurse may decide to catheterize the woman.

56. Answer: (B) Taking-in, taking-hold and letting-goRubin’s theory states that the 3 stages that a mother goes through for maternal adaptation are: taking-in, taking-hold and letting-go. In the taking-in stage, themother is more passive and dependent on others for care. In taking-hold, the mother begins to assume a more active role in the care of the child and in letting-go,the mother has become adapted to her maternal role.

57. Answer: (B) Level of umbilicusImmediately after the delivery of the placenta, the fundus of the uterus is expected to be at the level of the umbilicus because the contents of the pregnancy havealready been expelled. The fundus is expected to recede by 1 fingerbreadths (1cm) everyday until it becomes no longer palpable above the symphysis pubis.

58. Answer: (B) 6-8 weeks

When the mother does not breastfeed, the normal menstruation resumes about 6-8 weeks after delivery. This is due to the fact that after delivery, the hormonesestrogen and progesterone gradually decrease thus triggering negative feedback to the anterior pituitary to release the Folicle-Stimulating Hormone (FSH) whichin turn stimulates the ovary to again mature a graafian follicle and the menstrual cycle post pregnancy resumes.

59. Answer: (D) Application of cold compress on the breastTo stimulate lactation, warm compress is applied on the breast. Cold application will cause vasoconstriction thus reducing the blood supply consequently theproduction of milk.

60. Answer: (C) Massage the fundus vigorously for 15 minutes until contractedMassaging the fundus of the uterus should not be vigorous and should only be done until the uterus feel firm and contracted. If massaging is vigorous andprolonged, the uterus will relax due to over stimulation.

61. Answer: (D) Perineal carePerineal care is primarily done for personal hygiene regardless of whether there is pain or not; episiotomy wound or not.

62. Answer: (A) All of the above All the symptoms 1-3 are characteristic of postpartal blues. It will resolve by itself because it is transient and is due to a number of reasons like changes inhormonal levels and adjustment to motherhood. If symptoms lasts more than 2 weeks, this could be a sign of abnormality like postpartum depression and needstreatment.

63. Answer: (A) The fetal lungs are non-functioning as an organ and most of the blood in the fetal circulation is mixed blood.The fetal lungs is fluid-filled while in utero and is still not functioning. It only begins to function in extra uterine life. Except for the blood as it enters the fetusimmediately from the placenta, most of the fetal blood is mixed blood.

64. Answer: (A) 3-4 cm antero-posterior diameter and 2-3 cm transverse diameter, diamond shapeThe anterior fontanelle is diamond shape with the antero-posterior diameter being longer than the transverse diameter. The posterior fontanelle is triangular shape.

65. Answer: (D) Middle third of the thighNeonates do not have well developed muscles of the arm. Since Vitamin K is given intramuscular, the site must have sufficient muscles like the middle third of thethigh.

66. Answer: (A) 1-3 An APGAR of 1-3 is a sign of fetal distress which requires resuscitation. The baby is alright if the score is 8-10.

67. Answer: (B) Acrocyanosis Acrocyanosis is the term used to describe the baby’s skin color at birth when the soles and palms are bluish but the trunk is pinkish.

68. Answer: (C) 2,500gms According to the WHO standard, the minimum normal birth weight of a full term baby is 2,500 gms or 2.5 Kg.

69. Answer: (B) Crede’s methodCrede’s method/prophylaxis is the procedure done to prevent ophthalmia neonatorum which the baby can acquire as it passes through the birth canal of the

mother. Usually, an ophthalmic ointment is used.

70. Answer: (B) It may occur between 14-16 days before next menstruationNot all menstrual cycles are ovulatory. Normal ovulation in a woman occurs between the 14th to the 16th day before the NEXT menstruation. A common

misconception is that ovulation occurs on the 14th day of the cycle. This is a misconception because ovulation is determined NOT from the first day of the cyclebut rather 14-16 days BEFORE the next menstruation.

1. C

2. C

3. C

4. B

5. B

6. A

7. B

8. B

9. B

10. C

11. C

12. D

13. A

14. C

15. D

16. D

17. B

18. B

19. B

20. D

21. C

22. C

23. B

24. B

25. D

26. A

27. B

28. A

29. A

30. B

31. D

32. C

33. B

34. C

35. D

36. B

37. B

38. B

39. C

40. A

41. B

42. D

43. C

44. B

45. B

46. D

47. D

48. C

49. A

50. D

A.dock,glgui

Documents

Transcript of A.dock,glgui