NCM 113: CHN Reviewer

1. An unknown epidemic has just been reported in Bray. Citie. People said that
affected resident’s manifests haemorrhagic fever.
Arrange accordingly the correct outline plan for epidemiological investigation.
1 Determine any unusual prevalence of the disease and its nature; is it epidemic,
sporadic, endemic or pandemic?
2 Determine if the disease is factual or real
3 Report the presence of dengue
4 Summarize data and conclude the final picture of epidemic
5 Relate the occurrence to the population group, facilities, food supply and
carriers
6 Determine onset and the geographical limitation of the disease

А. 1,2,6,3,4,5
B. 2,3,1,6,5,4
C. 2,3,1,6,5,4
D. 2,3,5,1,4,6

2. Which law requires registration of Births within 30 days from the day of birth?

A RA 3573
B PD 651
C RA 3753
D ACT 3573

3. Before reporting the presence of an epidemic, which of the following is of most

importance to determine?

A Is the disease tangible?

B Are the facts complete?
C Is the disease real?
D Is it epidemic or endemic?

4. The office in charge with registering vital facts in the Philippines is none other than
the:

A. NSO
B.PESO
C.PAGCOR
D. DOH

5. Jenny just gives birth to Justin, a healthy baby boy. Who are going to report the
birth of baby Justin?

A. Nurse
B. Midwife
C.OB Gyne
D. Birth attendant
6. It is a graphical representation of the age-sex composition of the population that
should also be examined during the assessment of the health status of the
community

A. Population pyramid
B. Papulation status
C. Graphical rate
D. Age-sex composition

7. Which of the following professionals can sign the birth certificate?

A. Municipal Health Officer

B. M Rural Midwife
С. Public Health Nurse
D. Any of these health professionals

8 In correcting misconception and myths about certain diseases and their

management, the health worker should first:

A. Identify the myths and health prevailing in the community

B. the source of myth
C. Explain how and why these myths came about
D. All of the above

9. All are characteristic of a point source epidemic, except.

A. The disease is usually caused by contaminated food

B. The spread of the disease is caused by a common vehicle
C. Epidemics are usually sudden
D. There is a gradual increase of cases

10. The following are notifiable diseases that needed tally sheets in data reporting,
except.

A. Bronchitis
B. Accidents
C. Chemical Poisoning
D. Hypertension

11. Is the best indicator of whether a condition is decreasing, increasing, or

remaining static?

A. Prevalence Indicators
B. Incidence Indicators
C. Prevalence
D. Incidence

12. If an outbreak of a Diarrheal disease occurs in 6-24 hours among people who
attended a party, the outbreak investigation usually determines
А. Outbreak rate
B. Attack rate
C. Short period of time rate
D. Incidence rate

13. The number of cases in Dengue fever usually increases towards the end of the
rainy season. This pattern of occurrence of Dengue Fever is best described as:

A. Epidemic occurrence
B. Cyclical variation
C. Sporadic occurrence
D. Secular occurrence

14. High infant mortality rate means low levels of health standards.

A. True
B. False

15. Epidemiology is an important tool that is applied by the members of the

community health management team which includes:

A. Public Health Physicians

B. Sanitary inspectors
C. Public health nurse
D. Epidemiology nurse

16. Allocation of manpower and financial resources, mechanisms for community

participation, collaboration between government and NGO's, equity in the distribution
of resources.

A. Health policy indicators

B. Disability policy indicators
C. Health status indicators
D. Interagency indicators

17. Type of health indicators that indicates the Age-sex structure, density, migration
and growth.

A. Health status indicators

B. Social and economic indicators
C. Population indicators
D. Socio economic indicators

18. Measures the total number of existing cases of disease at a particular point in
time divided by the number of people at the point in time.

A. Prevalence proportion
B. Incidence proportion
C. Point prevalence
D. Point incidence

19. Is the best indicator of whether a condition is decreasing, increasing, or

remaining static?

A. Socio-cultural behaviour
B. Community
С. Cohort
D. Norm

20. The point Prevalence is estimated by an obtained from cross-sectional studies,-

commonly known as:

A. Case study
B. Surveys
C. Statistics
D. Data analysis

21. In the investigation of an epidemic, you compare the present frequency on the
disease with the usual frequency at this time of the year. This is done during which
stage of the investigation?

A. Establishing the epidemic

B. Testing the hypothesis
C. Formulation of the hypothesis
D. Appraisal of facts

22. Number of registered live births in a year over midyear population of women 15-
44 years of age.

A. Growth rate
B. Population indicators
C. General fertility rate
D. Dynamic rate

23. Which statistic can give the most accurate reflection of the health status of a
community?

A. 1-4 year old age - specific mortality rate

B. Infant mortality rate
C. Swaroop's index
D. Crude Death rate

24. In the conduct of a census, the method of population assignment based on the
actual physical location of the people is termed;

A. De juce
B. De locus
C. De facto
D. De novo
25. The following are possible sources of Data except:
A. Experience
B. Census
C. Surveys
D. Research

26. In case of clerical errors in your birth corrected? certificate, where should you go
to have it

A. NSO
B. Court appeals
C. Municipal trial court
D. Local civil registrar

27. Monitoring is done while the intervention is still being implemented, why?

A. To provide feedback
B. To assess whether its objective were achieved
C. To identify problem
D. None of the above

28. If there are no losses to follow-up and the duration of follow up. It measures the
average risk or probability of developing the disease in a specified period of time.

Cumulative incidence
Attack rate
Incidence density
Cumulative density

29. This refers to systematic study of vital events such as births, illnesses,
marriages, divorces and deaths.

A. Epidemiology
B. Demographics
C. Vital statistics
D. Health statistics

30. Case example: A person who develops the disease within 2 years contributes 2
person-years to the denominator; who is lost to following up to 6 months contributes
half a year, what type of indicators?

A. Support from family

B. Health care providers
C. Peers/employers
D. None of the above

31. Include not only the population growth indicators but also other population
dynamics that can affect the age-sex structure of the population.
A. Growth indicators
B. Population indicators
C. Age-sex indicators
D. Dynamic indicators.

32. Health indicators are also used for, except:

A. Identifying public health problems and needs

B. Indicating priorities for resources allocation
C. Monitoring implementation of health programs
D. Determining factors that may not contribute to causation and control of
disease.

33. Which of the following is an epidemiologic function of the nurse during an

epidemic?

A. Conducting assessment of suspected cases to detect the communicable disease

B. Monitoring the condition of the cases affected by the communicable
C. Participating in the investigation to determine the source of epidemic.
D. Teaching the community on preventive measure against the disease.

34. Process the systematically and objectively assess compliance to the design of
the program?

A. Monitoring
B. Implementation
C. Evaluation
D. Hypothesis

35. In reporting the birth of baby Justin, where will he be registered?

A. At the local civil registrar

B. In the national statistics office
C. In the city health department
Đ. In the field health services and information system main office

36. What numerator is used in computing General Fertility rate?

A. Estimated midyear population

B. Number of registered live births
C. Number of pregnancies in the year
D. Number of females of reproductive year

37. Deaths among infants less than 28 days old are due mainly to nutritional factors
and environmental factors.

A. True
B. False
38. Include the entire biological, chemical, physical, social, cultural, economic,
genetic and behavioural factor that influences health.

A. Population
B. Determinants
C. Socio-Economic
D. Demography

39. Specific morbidity rates show disease rates in all population groups such as by
age, sex, occupation, education, exposure to risk factors, etc.

A. True
B. False

40. You will gather data of nutritional assessment of a purok. You will gather
information only from families with members who belong to the target population.
What method of data gathering is best for this purpose?

A. Census
B. Survey
C. Record review
D. Review of civil registry

41. Elucidation of the natural history of disease and provision of evidence for policy
formulation are also the practical applications of epidemiology.

A. True
B. False

42. A company Epidemiological Questions such as "Who is affected? Where do they

occur? When do they occur or increase? Can it be answered by?

A. Specific morbidity
B. Descriptive epidemiology
C. Specific mortality
D. Ecological studies

43. The following are all functions of the nurse in vital statistics, which of the following
is not?

A. Consolidate date
B. Collects data
C. Analyze data
D. Tabulate data

44. In order to control disease effectively, which of the following must be known?
1 The conditions surrounding its occurrence
2 Factors that do not favor its development
3 The condition that do not surround its occurrence
4 Factors that favors its development
A. 1 and 3
B. 1 and 4
C.2 and 3
D. 2 and 4

45. Access to health programs and facilities, availability of health resources are what
type of health indicators?

A. The provision of health care

B. Socio-economic indicators
C. Health status indicators
D. Environmental indicators

46. Number of deaths from a specified cause over number of cases of the same
disease x100

A. Case fatality rate

B. Maternal mortality rate
C. Infant mortality rate
D. Disease rate

47. Measures the number of new cases, episodes, or events occurring over a
specified place.

A. Prevalence
B. Incidence
C. Morbidity
D. Mortality

48. Prevalence incidence is example of morbidity indicators?

A. True
B. False

49. Later months which are more than 28 days old are influenced by genetic factors.

A. True
B. False

50. The rate of dying due to specific causes.

A. Specific mortality rate

B. Specific morbidity rate
C. Cause of death rate
D. None of the above

51. Which criteria in priority setting of health problems are used only in community
health care?
A. Modifiability of the problem
B. Nature of the health presented
C. Magnitude of the health problem
D. Preventive potential of the health problem

52. The study of the distribution and determinants of health-related health states or
events in specified populations and the application of this study to the prevention of
health problems and promotion.

A. Pandemic
B. Epidemiology
C. Epidemic
D. Epedemiology

53. Referred to parasites, protozoans, bacteria, viruses and other microbes?

A. Agent
B. Host
C. Environment
D. Model

54. Which Act declared that all communicable disease is reported to the nearest
health station?

A. 1082
B.1891
C.3573
D. 6675

55. Which of the following is a Natality rate?

A. Crude birth rate

B. Neonatal mortality rate
C. Infant mortality rate
D. General fertility rate

56. All of the following are uses of epidemiology except:

A. To study the history of health population and the rise and fall of disease
B. To diagnose the health of the community and the condition of the people
C. To provide summary data on health service delivery
D. To identify groups needing special attention.

57. The practical applications of epidemiology as implied by both the definition of

Epidemiology are listed below except:

A. Assessment of the health status of the Community

B. Determination of the disease causation
C. Monitoring and evaluation of health intervention
D. Treatment and control of disease
58. It is used as an approximation of the risk of dying in the 1* year of life.

A. Neonatal mortality rate

B. Post neonatal mortality rate
C. Infant mortality rate
D. Infant morbidity rate

59. The primary purpose of conducting an epidemiologic investigations, except:

A. Delineate the etiology of the epidemic

B. Identify the cause of the disease.
C. Identify groups who are at risk of contracting the disease.
D. Identify geographical location of cases of the disease in the community

60. Refers to analysis by time, places, and classes of people affected.

A. Distribution
B. Socio-economic
C. Determinants
D. Demography
 NCM 112

1. Nurse Anna was assigned to the Emergency Room with a night shift schedule.
During the endorsement the outgoing nurse endorsed her 4 patients with different
sicknesses. Bed #1 is a Patient with a calcium level of 8.9, Bed #2 is a Patient with
Cushing's syndrome taking Laxis 20 mg IV twice a day. Bed #3 is a Patient with a
potassium level of 3.8 and in Bed #4 is a Patient presenting with painful muscle
spasms and positive Trousseau's signs. If you were Nurse Anna, which Patient do
you think is at a potential risk for Digoxin toxicity?

A. Patient with a calcium level of 8.9

B. Patient with Cushing's syndrome taking Lasix 20 mg IV twice a day
C. Patient with a potassium level of 3.8
D. Patient presenting with painful muscle spasms and positive Trousseau's sign

2. Jam a nurse working in the emergency department of a hospital. A 65-year-old

male patient is brought in by ambulance with complaints of weakness, palpitations,
and muscle twitching. His medical history includes hypertension and chronic kidney
disease. As Jam assess the patient, Nurse Jam suspect’s hyperkalemia. What initial
intervention should Nurse Jam prioritize for his patient with suspected hyperkalemia?

A. Administer 1 gram of intravenous calcium gluconate.

B. Start continuous electrocardiogram (ECG) monitoring.
C. Initiate oral potassium supplements.
D. Administer loop diuretic (e.g., furosemide).

3. Mae a nurse working in a medical-surgical unit. Her patient is a 50-year-old

woman admitted with severe diarrhea for the past week. She also has a history of
alcohol abuse.During Nurse Mae's assessment, she suspected hypokalemia. What
is the most appropriate action should Nurse Mae address the potential hypokalemia
in this patient?

A. Administer an intravenous bolus of potassium chloride.

B Start oral potassium supplements immediately.
C. Encourage the patient to eat a banana.
D. Monitor vital signs and order a serum potassium level.

4. Lea, a patient with severe head trauma sustained in a car accident, has been
admitted to the intensive care unit (ICU) for close monitoring and care. The critical
condition necessitates vigilant observation, and after approximately 36 hours, a
significant change in his clinical status occurs. The nurse observes a sudden and
pronounced increase in Lea's urine output, exceeding 200 ml/hour, which raises
concerns regarding diabetes insipidus. Which laboratory findings support the nurse's
suspicion of diabetes insipidus?

A. Below-normal urine and serum osmolality levels

B. Above-normal urine and serum osmolality levels
C. Below-normal urine osmolality level, above-normal serum osmolality level
D. Above-normal urine osmolality level, below-normal serum osmolality level
5. A 42-year-old patient has been receiving treatment for Diabetes insipidus (DI)
under your careful supervision. It is time to prepare the patient for discharge from the
hospital, ensuring that they know how to manage their condition at home effectively.
You have spent time educating the patient on DI. You have emphasized the
significance of hydration, adherence to prescribed medications, and monitoring fluid
intake and output. Nonetheless, during your final discussion with the patient prior to
discharge, you encounter a statement that raises concerns about their understanding
of the condition and its management. Which statement indicates that the patient
needs additional teaching?

A. "I will drink fluids equal to the amount of my urine output."

B. "I will weigh myself daily using the same scale."
C. " will always wear my medical alert bracelet."
D. "I no longer have to keep track of how much urine I make or how much fluid
I drink. The medicine will take care of everything."

6. A male client has recently been diagnosed with diabetes insipidus (Di), and Nurse
Lina is tasked with developing an extensive education plan for him. The middle-aged
client is eager to learn more about his condition and how to manage it effectively. As
Nurse Lina prepares the teaching plan, he considers the DI fundamentals that the
client must comprehend. The nurse shouldinclude information about which hormone
is lacking in clients with diabetes insipidus.

A. Antidiuretic Hormone (ADH)

B. Thyroid-stimulating Hormone (TSH):
C. Follicie-stimulating Hormone (FSH)
D Luteinizing Hormone (LH)

7. Nurse Britney is working in the ICU, and a postoperative patient exhibits extreme
thirst, dry skin, and a rising serum sodium level. The patient's family is concerned
and asks you for an explanation. How would Nurse Britney respond?

A. "This is a normal response to surgery; it should improve soon."

B. "Your loved one might be dehydrated; I'll bring some water."
C. "The patient's sodium levels are too high, and we need to address it."
D. "This could be a side effect of the pain medication."

8. Liza is the incharge nurse in a busy medical-surgical unit, and she receive a call
from a nurse reporting that a patient is experiencing confusion, nausea, and swelling.
The lab results confirm hyponatremia. What should Nurse Liza prioritize?

A. Increasing the patient's sodium intake

B. Administering hypertonic saline immediately
C. Restricting the patient's fluid intake
D. Ordering a complete blood count (CBC)

9. This is a requisite for any metabolic processes. It was absorbed from foods in the
presence of normal gastric acidity and vitamin D. major cation in the composition of
bones and teeth. This also vital in the function for blood clotting, transmission of
nerve impulses, myocardial contraction, and muscle contraction. An essential in
activating enzymes that stimulate essential chemical reactions in the body. If there is
a high or low level of this electrolyte, you will be diagnosed with excess or deficit.

A. Magnesium
B. Potassium
c. Calcium
D. Phosphate

10. Mina 37 years old, came into the hospital for check-up. The client is positive for
Trousseau's sign and Chostek's sign. She says that she feels tingling in his finger.
Nina, a 3rd year student nurse, studying Medsurg to assess the patient and to add
on that when she performs the tendon reflex the result is 0 or no response. Nina
knew that this is a type of which electrolyte imbalance?

A. Hyponatremia
B. Hypocalcaemia
C. Hypernatremia
D. Hypercalcemia

11. What should be included in the nursing care for a client with DI?

A. Blood pressure every hour

B. Strict intake and output
C. Urine for ketone bodies
D. Glucose monitoring four times a day

12. A client who has hypokalaemia asks the nurse lo dietary advice on what foods
would help this problem. What should the nurse tell the client?

A. Eggs and cheese

B. Fruits, especially oranges, bananas and prunes
C. Green leafy vegetables
D. Breads and cereals

13. Following cardiac surgery, a client's urine output for the last is 20mL. The nurse
understands that this indicates which of the following?

A. Possible hyperkalaemia
B. Insufficient cardiac output
C. Inadequate fluid replacements
D. Diuresis is occurring

14. The nurse is caring for a client who had a total thyroidectomy. What should the
nurse plan to observe the client for immediately after his return to the nursing care
unit?

A. Hoarseness
B. Signs of hypercalcemia
C. Loss of reflexes
D. Mental confusion

Situation 1: After suffering head trauma, a client develops signs and

symptoms of Diabetes Insipidus.

15. Which characteristic symptom of the client's disorder would the nurse expect to
find during an assessment?

A Polyphagia
B Polyuria
C Glycosuria
D Hyperglycemia

16. How does the nurse expect the urine that is collected for a routine urinalysis to
appear?

A. Tea-colored
B. Pale Yellow
C. Colorless
D. Light pink pil

17. Which nursing intervention is essential for monitoring the client's condition?

A. Measuring intake and output

B. Analyzing blood glucose levels
C. Inserting a Foley catheter
D. Sending urine samples to the laboratory

18. Melissa visited her OB-GYN for her prenatal visit. It was the usual check-up
comprised of physical exams, blood and urine test. The doctor was asking for any
unusualities and she replied "Is frequent urination a common symptom during third
trimester?" The doctor nodded yes. " If so, then none" she added. "But what if it's
painful during urination?" she asked again. The doctor looked at her concerned and
said assuringly "T Think we need to analyse your urine test, wait just a sec." What
does this story tell you?

A. The patient was about to give birth.

B. It means she has Chronic Pyelonephritis.
C. The patient may be experiencing pregnancy induced Kidney infection.
D. This is a normal conversation between a doctor and a patient.

19. An out-patient with acute pyelonephritis complained about headaches and

fatigue during her follow up appointment. The doctor asked if she is also
experiencing excessive thirst and poor appetite. She answered dumb foundedly
"Yes! My husband even noticed my sudden weight loss because of it ". The doctor
immediately ordered the patient for an IVU test to be done. What does these
symptoms usually mean?

А. The patient is experiencing pregnancy induced Kidney infection.

B. The patient was dehydrated.
C. It means she has Chronic Pyelonephritis.
D. These are observations of Vesicoureteral Reflux.

20. Education is important for patients with acute pyelonephritis. It helps promote
patient participation in mitigating the disease and hasten progress to recovery.
Habitual practices such as proper hygiene and consuming adequate amounts of
fluids a day, are one of the few easy steps to do. Along with any other advices, the
real main goal is to take action in order to prevent chances of the disease developing
into its worst form, chronic pyelonephritis. What patient education is the most crucial
among the rest?

A. Prevention of infection
B. Attending follow up check-ups
C. Strict adherence to prescribed medicine.
D. Bed rest

21. It is a bacterial infection of the renal pelvis, tubules and interstitial tissue of one or
both kidneys. Causes involve either upward spread of bacteria from the bladder or
systeric sources reaching the kidney. Manifested with symptoms of low back pain,
nausea and painful urination. If not treated, can, eventually lead to end stage kidney
disease. What do you call this disease?

A. Pyurianephritis
B. Phylonepritis:
C. Pilonephritis
D. Pyelonephritis

22. Gina, 32, is a mother of two children. Gina's kidneys are losing their ability to
function. Her lower sides and back were also bothering her. She also mentioned that
she has a fullness in her abdomen and that there is some sort of blood in her urine.
Gina made the decision to go see his doctor for a checkup as a result. What disease
would Gina have based on her symptors and experiences?

A. Gina has Polycystic Kidney Disease.

B. Gina has a Urinary Tract Infection
C. Gina suffers from polycystic ovary syndrome
D. Gina has cancer

23. Patient Pablo was admitted to the Davao del Sur Provincial Hospital at 2 a.m.
and transferred to the ward at 9:35 a.m. He is 36 years old and was helped by the
on-duty nurse, nurse Dino, who read the patient's paperwork.She noticed that
Pablo's diagnosis was polycystic kidney disease on the chart. Which condition is
typically diagnosed in adults?

A. Autosomal Dominant Polycystic Kidney Disease

B. Hypocalcaemia
C. Chronic Kidney Disease
D. Aneurysms in the brain
24. In addition to kidney cysts, PKD can result in a wide range of medical conditions.
Which of the following medical conditions is present in at least 50% of PKD patients
when PKD is initially diagnosed?

A. Abdominal hernia (weakness or opening in the abdominal wall)

B. High blood pressure
C. Elevated cholesterol
D. Chronic Kidney Disease

25. A patient diagnose with CKD and have low production of EPO (Erythropoietin)
and hematuria. You checked that the patient is also deficient of iron, folic acid and
Vit. B12. You are assessing this patient, what signs and symptoms do you expect
the patient is having?

A. Pale, tired, Shortness of breath, confused

B. Pale, Vomiting, shallow breathing, nosebleed
C. Pale, Chest pain, severe headache, buzzing in ear

26. Sarah is a 55-year-old woman who has recently been diagnosed with stage 3
chronic kidney disease. She is concerned about the progression of her condition and
asks you what she can do to slow it down. As a nurse on duty. What advice can you
give her?

A. Advise Sarah to make lifestyle changes, following a healthy diet low in salt
and protein, exercising regularly, quitting smoking, and limiting alcohol
consumption.
B. Recommend irregular monitoring of her kidney function,taking medications That
prescribed and stop smoking and abstain from alcohol.
C. Visit folk healer and take herbalize medicine and ensure blood glucose level under
control.
D. Encourage Sarah to exercise daily and take highprotein dietwhich may slow the
Progression of CKD and potassium containing foods.

27. Josh, 62 years old, was admitted and diagnosed with stage 4 CKD. He is a
smoker, and his family has a history of kidney disease. In assessing him, you note
that his left leg is swelling and that he is feeling tiredness, chest pain, shortness of
breath, unusually pale skin, dizziness, headaches, and sleep problems.
This finding means that Josh developed anemia. What medication is appropriate to
give to Josh?

A. thyroid hormone replacement therapy (THRT) with L-thyroxine

B. Sodium polystyrene sulfonate
C. Erythropoiesis-stimulating agents
D. Lymphati-polyetistic

Situation 2: A client with type 1 DM consuls a physician regarding urinary

problems.

28. When the nurse interviews the client, which symptoms will the client most likely
report if a bladder infection has been acquired?
1Sharp flank pain
2Urethral discharge
3Strong-smelling urine
4Burning on urination
5Urgency
6Frequency

A. 1, 2, 4
B. 1, 3, 4,5
C. 4, 5, 6
D. 1, 4, 5, 6

29. When the nurse reviews the result of the client urinalysis, which substance on
the urine is most suggestive of a bladder infection?

A. Glucose
B. Blood
C. Bilirubin
D. Protein

Situation 3: Several clients come to the urology clinic with signs and
symptoms related to urinary tract infection.

30. In evaluating multiple clients with UTIs, the OPD nurse would anticipate which
client to be at least risk for developing UTI?

A client with urethral mucosa damage

B. client with an altered mental condition
C. client with an altered metabolic state
Đ. An immunocompromised client

31. Which statements made by a diabetic client at the OPD strongly suggest that the
client has a UTI?
1 "I need to urinate frequently"
2 "I can't hold my urine"
3 "I have a burning sensation when I urinate"
4 "I have itching in my perineal area"
5 "I pass a large quantity of urine"
6 "My urine is foul smelling"

A. 1, 2, 3
B. 1, 2, 4, 5
C. 1, 3, 6
D. 1, 3, 4, 5

32. Because the client has DM, which statement by the nurse best explains why that
client is at higher risk for acquiring a bladder infection?

A. Glucose in urine supports bacterial growth

B. Diabetes suppresses white blood cell activity
C. Diabetic clients urinate more frequently
D. The urine is more concentrated in DM clients

Situation 4: The physician prescribes the combination urinary anti-infective

medication trimethoprim and sulfamethoxazole twice a day for the client who
is diagnosed with pyelonephritis.

33. Which nursing instruction is most appropriate for preventing crystal formation in
this client’s urine?

A. Eat more acidic citrus fruits

B. Avoid carbonated soft drinks
C. Drink 3 quarts of water daily
D. Take the medication with food

Situation 5: A middle-aged client comes to the clinic with vague symptoms of

malaise and headache. Even though these symptoms are rather unremarkable,
the client is diagnosed with acute glomerulonephritis.

34. When the nurse reviews the client medical history, which findings most likely
precipitated the present illness?

A. Trauma to the lower abdomen

B. An upper respiratory infection
C. Treatment with an antibiotic
D. An allergic reaction to Xray dye

35. If this client is typical of others with glomerulonephritis, which finding would the
nurse expect to observe when conducting a head-to-toe. Physical assessment?

A. Skin hemorrhages
B. Absence of body hair
C. Flushed appearance
D. Peripheral edema

36. Coughing, sneezing, exercising, laughing, moving heavy objects, and other
activities that put strain on the bladder cause leakage. In women, this is the most
prevalent type of incontinence. It is frequently caused by bodily changes associated
with pregnancy, childbirth, and breastfeeding.as well as menopause. It is treatable
and, in some cases, curable. What is the nature of this incontinence?

A. Stress Incontinence
B. Urge Incontinence
C. Functional Incontinence
D. Urinary Retention

37. Patient Thumbook, a 78 years old, has a history of Alzheimer's disease. Due to
his disease he developed a functional urine incontinence. Her daughter stated that
her father is unable to reach the toilet when urinating. Also the client is having
difficulty in removing his garments before voiding due to his condition. Which nursing
actions will be implemented into the care plan?

A. Place a bedside commode near the patient's bed.

B. Demonstrate the use of the Crede maneuver the to patient.
C. Use an ultrasound scanner to check postvoiding residuals.
D. Teach the use of Kegel exercises to strengthen the pelvic floor

38. Harry is a 40-year-old patient. With a history of hypertension and a blood

pressure reading of 190/100 mmHg. Dr. Masakitin, prescribed Hytrin, an alpha-
adrenergic antagonist. Mr. Harry returned to the doctor after a week of taking the
alpha-adrenergic medicine to complain about his frequent urinating. The nurse says
that in certain persons with an intact urinary system, the drug has an undesirable
effect on the alpha receptors, which are responsible for bladder neck closing
pressure, causing urine incontinence. Mr. Harry has what kind of urine incontinence?

A. Latrogenic incontinence
B. Mixed Incontinence
C. Naka inom rag RH
D. Functional incontinence

39. Vina a 31-year-old female, who is living in Mabini Extension Street Digos City.
Vina came to the clinic to report her burning experience when peeing. She also told
the nurse that she only voids at least once a day. She also like to drink soft drinks
instead of water. The patient keeps on saying she's in pain while urinating. What
would be your best response to the patient?

A. Tell the patient "That is what you get for not drinking water."
B. Give Antibiotic to the patient.
C. Tell the patient that she needs to drink water every day and void at least 3-5
times a day.
D. Tell the patient that it is OK

40. You are assigned to join a health teaching program for your barangay. A lot of
people attend the program. Some are children and adults. You are excited to ask
and answer questions of the topic that you teach. After the program someone ask
you that" Why do we need to urinate after having sexual intercourse? " What would
be your response?

A. "We need to pee after sexual intercourse to not be pregnant."

B. "We need to pee after sexual intercourse to help flush the bacteria that was
introduced during intercourse away from the urethra."
C. "We need to pee after intercourse because it will help fight the bacteria in the
genital area."
D. "We need to pee after intercourse because it is mandatory"

41. Patient Dragona i 19 years oid, and she is a bartender She is the only one who
provides for her family. Her mother is sick and cannot work anymore.
And his dad passed away three yoars ago.she is complaining that her right lower
quadrant is in pain overy time she pees, and she was recently diagnosed with a UTI.
As the nurse practitioner, you are assessing whether the patient has made any
improvement with their symptom of hematuria. What question would you ask the
patient?

A "Do you have pain when you urinate?"

B "Do you feel like you need to urinate more often than usual?-
C "Does your urine look cloudy?"
D "Is there blood in your urine?"

42 Kyle wakes up when he notices that he is late for his class today. When he
arrives, he is already late for the first subject. But he still chooses to go inside, and
the teacher instructs them to answer the questions given on the board about the
topic. The topic is about Urinary Tract Infection. The first question is "what are the
signs and symptoms of UTI? Except:

A Dizziness
B Vomiting
C Frequent Urinating
D Bloody Urine

43. Patient Hilda has been eating a lot due to stress. This is a result of his recent
break up. Doctor Jakara advices Hilda that it will lead to complications if he does not
stop eating unhealthy foods. Now Hilda has been excreting too much calcium in her
urine (hypercalciuria). Which of these dietary measures should she follow?

A Try to eliminate calcium in the diet.

B Consume a low-sodium, high-potassium diet.
C Consume a low-calcium, high-sodium diet.
D Decrease water consumption to conserve calcium.

44. Miko wasdiagnosed with nephrolithiasis. This condition is causing the patient to
experience periodic pain that is less cramp-like in nature. Additionally, Miko has
reported experiencing sharp pain in the lower abdomen, typically on one side of the
body. Diagnosing nephrolithiasis requires a physical exam and a medical history to
be taken by a physician. There will be a lot of tests to undergone in order to
diagnose Nephrolithiasis. But what is the most accurate diagnostic test for
nephrolithiasis?

A. Computed Tomography
B. Urinalysis
C. Ultrasound
D. Abdominal X-ray

45. Bebe is a 25 years old female who live in purok experiencing abdominal
bommitung. She went to the hospital and asses byte nurse. Nurse Sarah gives
advice to a patient who i diagnosed with a urolithiasis. Nurse Sarah wants to give the
best intervention for the patient to recover and gain the normal stage of the patient.
What will nurse Sarah focus on and how will Nurse Sarah give the best assessment?

A. Encourage ambulation as a means of moving the stone through the urinary tract.
B. Crush any blood clots passed in urine, and inspect sides of urinal and bedpan for
clinging, stones.
C. Instruct patient to report decreased urine volume, bloody or cloudy urine, fever,
and pain. Instruct patient to report any increase in pain.
D. All of the above.

Situation 5: Mario is a 56-year-old man who has been diagnosed with stable angina.
He experiences chest pain during physical exertion, which usually subsides with rest
or nitro-glycerine. He has been managing his condition with medication and lifestyle
changes.

46. What is the typical cause of Mario's chest pain?

A. Emotional stress
B. Resting after physical activity
C. Physical exertion
D. Cold weather

47. Mario is planning to take a long walk in him neighborhood. What should he do
before starting him walk?

A. Skip his nitroglycerin medication to avoid side effects.

B. Ensure she has his nitroglycerin medication with him
C. Avoid drinking water to reduce the risk of dehydration.
D. Carry a heavy backpack to increase the intensity of his exercise.

48. During her walk, Mario starts to experience chest pain. What should be his initial
response?

A. Continue walking to finish his exercise routine.

B. Stop, sit down, and take his prescribed nitroglycerin.
C. Ignore the pain and finish his walk.
D. Cali 911 immediately.

49. What the primary purpose of nitroglycerin for apin uke Mario with angina
pectoris?

A. To reduce blood pressure

B. To relieve chest pain by dilating coronary arteries
C. To increase heart rate
D. To treaties cholesterol levels

50. So in addition to medication, what lifestyle changes can help manage Mario's
angina symptoms?

A. Smoking more to alleviate stress

B. Regular exercise to build stamina.
C. A diet high in saturated fats.
D. Stress management techniques and a heart-healthy diet.
51. Lenny is a 58-year-old woman with a history of stable angina. She's been
managing her condition with medication and lifestyle changes. Lenny's doctor
recently adjusted her medication regimen, and she is diligent about following the
prescribed treatment plan she is also working with cardiac rehabilitation program to
improve her overall cardiovascular health Lenny is planning to go on a family
vacation that includes a long haul flight and a cruise. As she prepares for her trip,
she has several concerns related to her angina. Which of the following actions
considerations would be most appropriate for Jennifer in this situation?

A. Discontinue all medication for the duration of the trip.

B. Carry her nitro-glycerine tablets and medical records in her checked luggage.
C. Consult with her healthcare provider before the trip to discuss any
necessary adjustments to her treatment plan.
D. Avoid discussing her medical history with the cruise staff to maintain privacy.

52. A 56-year-old male patient has been admitted with acute chest pain and
diagnosed with myocardial infarction. He is anxious, diaphoretic, and his vital signs
are stable. The physician has ordered aspirin. What should the nurse do first?

A. Administer the aspirin as ordered

B. Draw blood for cardiac enzyme levels
C. Initiate nitro-glycerine therapy
D. Start oxygen therapy

53. A post-MI patient is being prepared for discharge. The nurse is providing
education on medications. The patient is prescribed dual antiplatelet therapy, statins,
and a beta-blocker. Which statement by the patient indicates the need for further
education?

A "I’ll take the aspirin with a full glass of water"

B. "I'll stop taking the statin if I experience muscle pain."
C. "I need to monitor my heart rate while on the beta-blocker."
D. “should report any unusual bleeding or bruising

54. A patient with a history of Mi presents with chest pain. The ECG shows ST-
segment elevation the physician has ordered thrombolytic therapy what is the
nurse's priority action before administering the thrombolytic agent?

A. Administer sublingual nitro-glycerine

B. Draw blood for coagulation studies
C. Assess for signs of heart failure
D. Confirm the diagnosis with a second ECG

55. A patient who had a Mi a week ago is in cardiac rehabilitation, Reports chest
discomfort that lasts for several minutes. What should the nurse do first?

A. Stop the exercise and have the patient rest

B. Ignore the discomfort, as It's common after
C. Administer nitroglycerin to relieve the pain
D. Continue to push the patient, through the exercise routine
56. A MI patient with a significant cardiac history is in the intensive care unit. The
patient's cardiac output is decreased, and there are signs of low tissue perfusion.
Which nursing intervention is the highest priority?

A. Administering pain medication

B. Elevating the head of the bed
C. Administering intravenous fluids
D. Starting vasoactive medications

57. A patient is diagnosed with a non-ST-segment elevation MI (NSTEMI). Which

assessment finding is typical for NSTEMI?

A ST-segment elevation on the ECG

B Substernal chest pain radiating to the arm
C Elevated cardiac enzymes
D Severe hypertension

58. A patient recovering from an Ml is discharged home. The nurse should provide
Education on recognizing warning signs of recurrent Mi. Which symptom should be
emphasized?

A. Diaphoresis
B. Nausea and vomiting
C. Shortness of breath
D. Headache

59. Mateo, a 45-year-old man, has several risk factors for coronary artery disease
(CAD), including a family history of heart disease, hypertension, and a sedentary
lifestyle. He has been experiencing occasional angina (chest pain) during physical
activity. He presents to his healthcare provider for an evaluation.
During Mateo's evaluation, the healthcare provider explains the pathophysiology of
myocardial infarction (MI) related to CAD. Which of the following sequences best
represents the pathophysiological events that lead to an MI in a patient like John?

A. Atheroscierosis →Plaque rupture → Thrombus formation → Myocardial

ischemia→ Myocardial infarction
B. Hypertension → Myocardial ischemia → Atherosclerosis → Thrombus formation
→ Myocardial infarction
C. Myocardial infarction → Atherosclerosis → Plaque rupture → Thrombus formation
→Myocardial ischemia
D.Thrombus formation→ Myocardial infarction → Atherosclerosis → Plaque rupture
→ Myocardial ischemia

60. Honey, a 60-year-old woman, is at her annual check-up with her primary care
physician. She has several risk factors for coronary artery disease (CAD), including a
family history of heart disease, obesity, and diabetes.She's worried about her heart
health and is seeking information. To further educate Honey, her physician mentions
thrombus formation. What should the physician emphasize about thrombus
formation in the context of MI?
A. "Thrombus formation is the thickening of the blood due to elevated cholesterol
levels."
B. "It's the result of excessive sweating, causing dehydration and blood clotting."
C. "Thrombus formation is the formation of fatty deposits within the heart muscle."
D. "This occurs when a blood clot forms at the site of plaque rupture and
further obstructs blood flow."