Nursing Practice Test II – Set A

Normally, the top of the ear aligns with an imaginary line drawn across the inner and outer canthus of the eye. Ears set below this line are associated with renal anomalies or mental retardation. Low-set ears don't accompany otogenous tetanus, tracheoesophageal fistula, or congenital heart defects.

Dry peeling skin is related to decreased vernix and prolonged immersion in amniotic fluid.

Bone marrow depression is most likely to occur 10 days after methotrexate is administered.

There is an increased risk of ectopic pregnancy with IVF-ET.

RhoGAM should be given within 72 hours after delivery to have an impact on future pregnancies.

Friends become very important at this age. Children usually begin having an interest in the opposite sex around this age, although they aren't always willing to admit it. Her physical development towards maturity continues, but it isn't as rapid at this stage as in previous years. Although independence increases at this stage, children continue to need parental supervision. Growth and development slow down but gradual changes continue to occur.

In a young child, the eustachian tube is relatively short, wide, and horizontal, promoting drainage of secretions from the nasopharynx into the middle ear. If the child takes a bottle to bed and drinks while lying down, fluids may pool in the pharyngeal cavity, increasing the risk of otitis media. Cerumen in the external ear canal doesn't promote the development of otitis media. However, during shampooing, water may become trapped in the external ear canal by large amounts of cerumen, possibly causing otitis externa (external ear inflammation). Persistent fluid in the middle ear may impair language development and hearing; however, a 10-month-old child isn't expected to combine two words when speaking.

To sustain them until active erythropoiesis begins, neonates have Hb concentrations higher than those of older children. The normal value of Hb for neonates is 18 to 27 g/dl. Disease as well as such nonpathologic conditions as age, sex, altitude, and the degree of fluid retention or dehydration can affect Hb values. The values for a 3-month-old, a 3-year-old, and a 10-year-old are correct as stated above.

The battlecry of the rabies control program of the DOH is “SUMUNOD SA BATAS RABIES”. All agencies involved are gearing up their efforts towards the goal of declaring the Philippines as Rabies Free by the 2020.

Meningococcemia is also called meningococcal meningitis or cerebrospinal fever.

Mother’s with type O blood have anti-A and anti-b antibodies that are transferred across the placenta; this is the most common incompatability because the mother is type O in 20% of all pregnancies.

Hemorrhage can result from a ruptured tubal pregnancy and shock can ensue.

If hemorrhage is associated with a head injury and it goes undetected, a child may experience hypovolemic shock because a large portion of a child's blood volume goes to the head. In children, cerebral tissues are softer, thinner, and more flexible — conditions that permit diffusion of the impact. Because a child's skull can expand more than an adult's can, a greater amount of posttraumatic edema can occur without evidence of neurologic deficits. Subdural, epidural, and intracerebral hematomas are the different types of head injury that can occur in children and adults.

The abnormal facies associated with fetal alcohol syndrome includes a small, upturned nose, which is distinctive in these infants.

The bartolin glands are located beneath the vaginal vestibule; if cysts form and they become infected they cause labial, vaginal, or pelvic pain particularly during or after intercourse (dyspareunia).

A bulb syringe with a rubber tip is a safe, effective feeding device for a neonate with a cleft lip. I.V. fluids are required only during the immediate postoperative period, until the neonate can tolerate oral fluids. Thickened formula and gastric gavage rarely are necessary for a neonate with a cleft lip.

The cricoid cartilage in the toddler is the narrowest part of larynx and provides a natural seal. This keeps the endotracheal tube in place without requiring a cuff. The vocal cords are narrower in an adult. The trachea is shorter and the larynx is anterior and cephalad, but these aren't reasons to choose an uncuffed tube.

Calcium gluconate will reverse the central nervous system depressant action of magnesium sulfate.

When measles is given to 9 months, it provides 85% protection. When given at 1 year, it provides 95% protection.

As the term “hysterectomy” implies, only the uterus is removed, therefore, the client will eventually have a physiologic menopause.

First, the nurse must clamp the catheter to prevent air entry, which could lead to air embolism. If an air embolism occurs, the nurse should position the child on the side after clamping the catheter. The nurse may turn off the infusion pump after ensuring the child's safety. If blood has backed up in the catheter, the nurse may need to flush the catheter with heparin; however, this isn't the initial priority.

Heparin can be used during pregnancy because it does not cross the placental barrier and will not cause hemorrhage.

An amiocentesis is done at this time because a therapeutic abortion can be legally and safety performed if desired by the parents.

The lotion applied to the skin and left for 8-12 hours to be effective.

A clients who have cancer of one breast are at risk for development of cancer in the other breast.

Prolactine is a hormone that is produced and secreted by the anterior pituitary; a pituitary tumor is the most probable cause of elevated prolactin levels the result in lactation not associated with childbirth.

After closure, spinal fluid may accumulate and back up into the brain, increasing intracranial pressure and causing the fontanels to bulge.

Infants from birth to 20 lb (9.1 kg) and under age 1 must be in a rear-facing infant or convertible seat in the backseat, preferably in the middle. Infants and small children should never be placed in the front seat because of the risk of injuries from a breaking front windshield and an expanding airbag. The position next to the window isn't preferred.

If rescue breathing is unsuccessful in a child under age 1, the nurse should deliver four back blows, followed by four chest thrusts, to try to expel the object from the obstructed airway. The nurse shouldn't perform chest compressions because the infant has a pulse and because chest compressions are ineffective without a patent airway for ventilation. The nurse shouldn't use abdominal thrusts for a child under age 1 because they can injure the abdominal organs.

Community-based groups called Barangay Health Emergency Response Teams (BHERT) were organized and trained to respond to any situation similar to that of a SARS threat.

The lack of completion of fatal bladder development may interfere with the development of the pelvis.

All the immunizing agents are in liquid form except BCG and measles which are in powder form.

Heart failure may cause a gallop rhythm in a child. Bounding peripheral pulses, widened pulse pressure, and bradycardia aren't associated with heart failure.

Using the formula systolic blood pressure = 80 + (age in years × 2), the estimated blood pressure for a 3-year-old child is 80 + (3 × 2) = 86.

The causative agent of scabies is the male and female itch mite Sarcoptes scabiei. The female itch mite burrows under the epidermis to lay eggs and the male itch mite resides on the surface of the skin.

DOH data on seropositive cases of HIV point out that 85 percent who tested positive were males from 19 to 49 years old.

The Department of Health (DOH) just recently uncovered a parasitic disease affecting lungs of people who are fond of eating raw or insufficiently cooked crabs or crustaceans in many parts of the country called Paragonimiasis, it has similar manifestations as pulmonary tuberculosis that frequently it is misdiagnosed as such.

This is a description of a chancre, which is the initial sign of syphilis.

Once cervical dilation has begun, the abortion is classified as inevitable.

Because the infant weighs 17 lb (7.7 kg), the safe dosage range is 385 to 578 mg daily. The ordered dose, 540 mg daily, is safe. To calculate the amount to administer, the nurse may use the following fraction method: 500 mg/2 ml = 270 mg/X ml 500X = 270 × 2 500X = 540 X = 540/500 X = 1.08 ml

Right to left shunts result in inadequate perfusion of blood, not enough blood flows to the lungs for oxygenation.

The maintenance phase of Category I is extended from 4 months to 7 months in patients with this type TB or complication.

If an infant has mild diarrhea, his mother should be advised to continue his normal diet and to call back if the diarrhea doesn't stop or if he shows signs of dehydration. Notifying the day care about the infant's illness is important but doesn't take priority.

The Hib vaccine provides protection against serious childhood infections caused by H. influenzae type B virus, such as meningitis and bacterial pneumonia. The influenza virus vaccine provides immunity to various strains of the influenza virus. The Heptavax vaccine prevents infection by the hepatitis B virus. Chickenpox is caused by the varicella virus; a chickenpox vaccine is now available.

Tetracycline should be avoided in children under age 8 because it may cause enamel hypoplasia and permanent yellowish gray to brownish tooth discoloration. Penicillin, erythromycin, and amoxicillin don't discolor the teeth.

A pudendal block provides anesthesia to the perineum.

For the most accurate measurement, the nurse should place the infant in a supine position and then measure recumbent height. Measuring recumbent height with the infant lying on the side would yield an inaccurate result. Measuring recumbent height with the infant prone would yield an inaccurately long result because it includes the length of the foot. Measuring standing height with the infant held upright would yield an inaccurate result until the child no longer needs assistance to stand up straight.

Cerebral hyperemia (excess blood in the brain) causes an initial increase in intracranial pressure in the head of an injured child. The brain is less myelinated in a child and more easily injured than an adult brain. Intracranial hypertension — not hypotension — places the child at greater risk for secondary brain injury. A child's cranium is thinner and more pliable, causing the child to receive a more severe injury.

The anterior fontanel is open in a healthy, 6-month-old infant. Normally, it closes between ages 9 and 18 months. It should feel flat and firm. A sunken fontanel indicates dehydration. Although coughing or crying may cause temporary bulging, persistent bulging and tenseness of the fontanel signals increased intracranial pressure.

RhIg is given to prevent active formation of antibodies when an Rh-negative individual is at risk for sensitization; if given to an Rh-positive person, an injection of the RhIg would cause hemolysis of RBC.