JULY 2011 PRE-BOARD RATIONALE , KEYWORD AND ANSWER Q UESTION 1 KEYWORD: CORRECT ANSWER: D RATIONALE : THIS ANSWER TYPICALLY

DESCRIBES THE CAUSE OF A DISSOCIATIVE DISORDER. AS A PROTECTIVE MEASURE , THE BRAIN DOESN T LET TRAUMATIC EVENTS TO BE REMEMBERED TO PROTECT THE PERSON FROM SEVERE STRESS. Q UESTION 2 KEYWORD: FETAL MOVEMENTS PER HOUR NORMAL ANSWER: B RATIONALE : GENERALLY, AT LEAST THREE MOVEMENTS IN ONE HOUR ARE CONSIDERED NORMAL. PROCEDURE VARIES WITH TIME OF THE DAY , REFERENCE TO MEALTIME , MATERNAL POSITION AND HYDRATION. OFTEN A BABY IS MORE ACTIVE AFTER A MEAL. Q UESTION 3 KEYWORD: THERAPEUTIC ANSWER: C RATIONALE : THE THERAPEUTIC SERUM LEVEL OF LITHIUM IS 0.6 TO 1.2 MEQ/L. SERUM LITHIUM LEVELS ABOVE THE THERAPEUTIC LEVEL WILL PRODUCE SIGNS OF TOXICITY . Q UESTION 4 KEYWORD: LEAST LIKELY ANSWER: B RATIONALE : MENINGITIS IS NOT A COMPLICATION OF BILHARIASIS. Q UESTION 5 KEYWORD: TREATMENT AND CONTROL; LEAST LIKELY ANSWER: C | RATIONALE : THERE IS NO KNOWN VACCINATION FOR DENGUE FEVER. Q UESTION 6 KEYWORD: FIRST ANSWER: D RATIONALE : ANY CLIENT WITH POTENTIAL COMPROMISE OF THE AIRWAY SHOULD BE DEALT WITH FIRST. Q UESTION 7 KEYWORD: LEAST LIKELY ANSWER: A RATIONALE : DYSTOCIA CAN BE CAUSED BY A DISPROPORTION BETWEEN FETAL PRESENTATION AND MATERNAL PELVIS SUCH AS IN CEPHALOPELVIC DISPROPORTION (CPD), PROBLEMS WITH PRESENTATION BREECH,SHOULDER, FACE , TRANSVERSE LIE , PROBLEMS WITH MATERNAL SOFT TISSUE FULL BLADDER, MYOMA UTERI, CERVICAL EDEMA, SCAR TISSUES AND CONGENITAL ABNORMALITIES AND DYSFUNCTIONAL UTERINE CONTRACTIONS SUCH AS TOO WEAK, TOO SHORT OR TOO FAR APART CONTRACTIONS.

Q UESTION 8 KEYWORD: EXCEPT ANSWER: B RATIONALE : PATIENTS HAVE THE RIGHT TO INDIVIDUALIZED NOT GENERALIZED TREATMENT PLAN AND TO PARTICIPATION IN THE DEVELOPMENT OF THAT PLAN AND TO AN EXPLANATION OF THE TREATMENT . Q UESTION 9 KEYWORD: GI BLEEDING USUALLY ASSOCIATED ANSWER: C RATIONALE : HEMORRHAGIC REACTIONS ARE DUE TO BANKED BLOOD THAT IS LOW IN PLATELETS AND COAGULATION FACTORS. Q UESTION 10 KEYWORD: OXYGEN TRANSPORT FROM THE LUNGS TO THE TISSUES ANSWER: C RATIONALE : A CLIENT WITH ANEMIA (DECREASE IN RED BLOOD CELLS) HAS PROBLEM IN TRANSPORTING OXYGEN FROM THE LUNGS TO THE TISSUE SINCE HEMOGLOBIN, WHICH IS RESPONSIBLE IN DISTRIBUTING OXYGEN TO THE DIFFERENT PARTS OF THE BODY , IS LOCATED INSIDE AN RBC. W ITH DECREASE NUMBER OF RBC, A DECREASE IN THE NUMBER OF OXYGEN-CARRYING HEMOGLOBIN ALSO OCCURS. Q UESTION 11 KEYWORD: PREVENT | ANSWER: A | RATIONALE : 80% OF GONOCCOCAL INFECTION PARTICULARLY IN FEMALES HAS NO SYMPTOMS. Q UESTION 12 KEYWORD: EFFECTIVE; POSTTRAUMATIC STRESS DISORDER. ANSWER: C RATIONALE : MAOIS ARE USED TO TREAT SLEEP PROBLEMS, NIGHTMARES AND INTRUSIVE DAYTIME THOUGHT IN INDIVIDUALS WITH POSTTRAUMATIC DISORDER. Q UESTION 13 KEYWORD: MOST APPROPRIATE ANSWER: C RATIONALE : THE MANAGEMENT FOR EARLY MORNING STIFFNESS IS PHYSICAL THERAPY TO KEEP THE JOINT MOBILE AS POSSIBLE AND THE HELP LESSEN THE SEVERITY OF MORNING STIFFNESS. Q UESTION 14 KEYWORD: MOST DETRIMENTAL ANSWER: B. RATIONALE : SYPHILIS MAY CROSS THE PLACENTA, CAUSING CONGENITAL SYPHILIS. IT USUALLY LEADS TO SPONTANEOUS ABORTION, AND IT INCREASES THE INCIDENCE OF MENTAL ABNORMALITY AND PHYSICAL DEFORMITIES IN FETUS. IN GONORRHEA, THE FETUS IS CONTAMINATED AT THE TIME OF DELIVERY . IT PLACES THE NEONATE AT RISK FOR OPHTHALMIA NEONATORUM, PNEUMONIA AND SEPSIS, BUT THESE CAN BE AVOIDED VIA CESAREAN DELIVERY .

Q UESTION 15 KEYWORD: MOST BASIC QUESTION HEALTH SERVICE FAILS. ANSWER: A RATIONALE : IF A PARTICULAR HEALTH SERVICE FAILS, IT IS IMPORTANT TO REASSESS THE FELT NEEDS OF THE PEOPLE NOT THEIR DEMANDS. Q UESTION 16 KEYWORD: BEGIN. ANSWER: A RATIONALE : IN THE HEALTH CARE DELIVERY SYSTEM, IDEALLY, REHABILITATION SERVICES BEGIN UPON ADMISSION OF THE CLIENT IN THE HEALTH CARE SYSTEM. Q UESTION 17 KEYWORD: MOST APPROPRIATE . ANSWER: A. RATIONALE : ADMINISTRATION OF IMMUNE SERUM GLOBULIN WILL PROVIDE THE CHILD WITH PASSIVE IMMUNITY TO PREVENT A FULL-BLOWN CASE OF MEASLES OR REDUCE THE SEVERITY OF SYMPTOMS. ACTIVE IMMUNIZATION WITH MMR CAN BE GIVEN AT A LATER TIME . Q UESTION 18 :KEYWORD: EXCEPT. ANSWER: D RATIONALE : BLUISH DISCOLORATION OF THE UMBILICUS CULLEN S SIGN, RESULTS FROM FREE BLOOD PRESENT IN THE ABDOMEN. IT IS NOT A SIGN OF ASCITES. Q UESTION 19 KEYWORD: INFLUENCE THE NURSE S DECISION. ANSWER: A RATIONALE : THE CONDITION OF THE MUSCLE TISSUE IS AN IMPORTANT FACTOR THAT CAN INFLUENCE THE NURSE 'S DECISION IN ADMINISTERING INTRAMUSCULAR MEDICATIONS. MUSCLES CAN TAKE A LARGER VOLUME OF FLUID WITHOUT DISCOMFORT THAN SUBCUTANEOUS TISSUES CAN, ALTHOUGH THE AMOUNT VARIES AMONG INDIVIDUALS, CHIEFLY BASED ON THE MUSCLE SIZE AND CONDITION AND THE SITE USED. Q UESTION 20 KEYWORD: PRIMARY GOAL ANSWER: C RATIONALE : THE PRIMARY GOAL OF COMMUNITY HEALTH NURSING IS TO HELP COMMUNITIES AND FAMILIES TO
COPE WITH THE DISCONTINUITIES OF HEALTH AND THREATS IN SUCH A WAY AS TO MAXIMIZE THEIR POTENTIAL FOR HIGH LEVEL WELLNESS, AS WELL AS TO PROMOTE RECIPROCALLY SUPPORTIVE RELATIONSHIP BETWEEN PEOPLE AND THEIR PHYSICAL AND SOCIAL ENVIRONMENT.

Q UESTION 21 KEYWORD: RARE COMPLICATION. ANSWER: A RATIONALE : THE WORMS MAY LODGE AND BECOME TRAPPED IN THE APPENDIX AND CAUSE INFLAMMATION RESULTING IN APPENDICITIS.

Q UESTION 22 KEYWORD: MOST APPROPRIATE . ANSWER: D RATIONALE : ENEMAS ARE CONTRAINDICATED IN AN ACUTE ABDOMINAL CONDITION OF UNKNOWN ORIGIN SUCH AS SUSPECTED APPENDICITIS AS WELL AS AFTER RECENT COLON OR RECTAL SURGERY OR MYOCARDIAL INFARCTION. Q UESTION 23 KEYWORD: EMPHYSEMA; NOT EXCEED. ANSWER: A RATIONALE : OXYGEN IS USED CAUTIOUSLY IN A CLIENT WITH EMPHYSEMA AND SHOULD NOT EXCEED 3 LITERS PER MINUTE . BECAUSE OF THE LONG-STANDING HYPERCAPNIA THAT OCCURS IN THIS DISORDER, THE RESPIRATORY DRIVE IS TRIGGERED BY LOW OXYGEN LEVELS RATHER THAN INCREASED CARBON DIOXIDE LEVELS, WHICH IS THE CASE IN A NORMAL RESPIRATORY SYSTEM. Q UESTION 24 KEYWORD: EXCEPT ANSWER: A RATIONALE : PATIENTS WITH AIDS ARE IMMUNOCOMPROMISED. REVERSE ISOLATION IS REQUIRED. BUT THIS DOES NO PREVENT THE SPREAD OF AIDS. B, C AND D ARE UNIVERSAL PREVENTIVE MEASURES FOR AIDS. Q UESTION 25 KEYWORD: NOT. ANSWER: A RATIONALE : AMNIOCENTESIS IS AN EXAMINATION OF AMNIOTIC FLUID THAT IS USED TO SCREEN FOR SOME INBORN ERRORS OF METABOLISM. T HIS LABORATORY OR DIAGNOSTIC TEST CANNOT DETECT ALL INBORN ERRORS OF METABOLISM. Q UESTION 26 KEYWORD: PINWORMS ADVISABLE THAT THE SAME DRUG SHOULD ALSO BE ADMINISTERED. ANSWER: A. RATIONALE : ALL MEMBERS MUST BE TREATED ALSO BECAUSE ABSENCE OF SIGNS AND SYMPTOMS DOES NOT MEAN THEY DO NOT HAVE THE DISEASE . S OME PATIENTS ARE SYMPTOMATIC. Q UESTION 27 KEYWORD: EFFECTIVE ANSWER: D RATIONALE : THE PURPOSE OF ROM EXERCISES IS TO KEEP JOINT MOBILITY. IF THE CHILD CAN MOVE HER LEGS AND ARMS IN FULL RANGE OF MOTION AT ANYTIME WITHOUT EXPERIENCING PAIN, THEN, EXERCISES ARE EFFECTIVE . Q UESTION 28 KEYWORD: EXCEPT ANSWER: D RATIONALE : TORTS ARE LEGAL WRONG COMMITTED AGAINST A PERSON, HIS OR HER PROPERTY; INTENTIONAL, WILLFULLY COMMITTED WITHOUT A JUST CAUSE . EXAMPLES OF TORTS ARE : ASSAULT AND BATTERY FALSE IMPRISONMENT FRAUD NEGLIGENCE MALPRACTICE

Q UESTION 29 KEYWORD: NURSE DID NOT PUT UP THE SIDE RAILS; LIABILITY DOES THE NURSE HAVE. ANSWER: B RATIONALE : THE NURSE HAS BEEN NEGLIGENT. THE NURSE FAILED TO RAISE THE SIDERAILS, WHICH LED TO THE INJURY OF THE CLIENT. NEGLIGENCE REFERS TO THE COMMISSION OR OMISSION OF AN ACT , PURSUANT TO A DUTY , THAT A REASONABLY PRUDENT PERSON IN THE SAME OR SIMILAR CIRCUMSTANCE WOULD OR WOULD NOT DO , AND ACTING OR NON-ACTING OF WHICH IS THE PROXIMATE CAUSE OF INJURY TO ANOTHER PERSON OR HIS PROPERTY . Q UESTION 30 KEYWORD: INITIALLY; EXPECTED TO PERFORM. ANSWER: A RATIONALE : INFORMED CONSENT MEANS THE CLIENT MUST COMPREHEND THE SURGERY, THE ALTERNATIVES, AND THE CONSEQUENCES. W ITH LETTER B, THE EXPLANATION OF THE RISKS INVOLVED WITH THE SURGERY IS NOT WITHIN THE NURSE S DOMAIN. IN OPTION C, ALTHOUGH THIS IS TRUE , IT DOES NOT DETERMINE THE CLIENT'S ABILITY TO GIVE INFORMED CONSENT. Q UESTION 31 KEYWORD: SIGNIFICANT ANSWER: A RATIONALE : ATTENDING UNIT ACTIVITIES AND MEETINGS HELPS DECREASE THE CLIENT S SENSE OF ISOLATION. OFTEN, THE CLIENT CAN T RECALL EVENTS THAT TRIGGERED THE DISSOCIATIVE DISORDER, SO QUESTIONING HIM WOULD NOT BE HELPFUL. T HE CLIENT NEEDS TO BE ISOLATED FROM OTHERS ONLY IF HE IS UNABLE TO INTERACT APPROPRIATELY . A CLIENT WITH A DISSOCIATIVE DISORDER HAS TYPICALLY HAD FEW HEALTHY RELATIONSHIPS. FORMING FRIENDSHIPS WITH OTHERS IN THERAPY COULD BE SETTING THE CLIENT TO CONTINUE IN UNHEALTHY RELATIONSHIPS. Q UESTION 32 EXPLANATION:KEYWORD: EARLY SIGNS; AFTER CESSATION OR REDUCTION OF ALCOHOL INTAKE . | ANSWER: A | RATIONALE : EARLY SIGNS OF ALCOHOL WITHDRAWAL DEVELOP WITHIN A FEW HOURS AFTER CESSATION OR REDUCTION OF ALCOHOL AND PEAKS AFTER 24 TO 48 HOURS. Q UESTION 33 EXPLANATION:KEYWORD: MOST THERAPEUTIC. | ANSWER: C | RATIONALE: THE CLIENT IS EXPERIENCING LOSS AND IS FEELING HOPELESS. T HE MOST THERAPEUTIC RESPONSE BY THE NURSE IS THE ONE THAT ATTEMPTS TO TRANSLATE WORDS INTO FEELINGS. Q UESTION 34 EXPLANATION:KEYWORD: EXCEPT | ANSWER: C | RATIONALE: HAVING FEWER THAN 7 PATIENTS PROVIDES INADEQUATE INTERACTION AND MATERIAL FOR SUCCESSFUL GROUP PROCESS. HAVING MORE THAN 10 MEMBERS DOESN T ALLOW FOR ADEQUATE TIME FOR INDIVIDUAL PARTICIPATION. Q UESTION 35 EXPLANATION:ANSWER: B. | RATIONALE : IF RESULT OF CST IS EQUIVOCAL OR UNSATISFACTORY, THE TEST IS REPEATED WITHIN 24 HOURS OR 1 DAY . Q UESTION 36 EXPLANATION:KEYWORD: MAJOR DIETARY TREATMENT. | ANSWER: D. | RATIONALE : A MAJOR PROBLEM IN ASCITES IS FLUID RETENTION AND SODIUM RESTRICTION IS THE MAIN INTERVENTION FOR CONTROLLING IT . Q UESTION 37 EXPLANATION:KEYWORD: INITIAL | ANSWER: B | RATIONALE : ONCE THE DRAINAGE TUBE IS PATENT , THE FLUCTUATION IN THE WATER COLUMN WILL RESUME ; A LACK OF FLUCTUATION BECAUSE OF LUNG RE EXPANSION IS UNLIKELY 36 HOURS AFTER A TRAUMATIC OPEN CHEST INJURY . INFORMING THE PHYSICIAN IS

UNNECESSARY AT THIS TIME ; THE CHEST TUBE IS OCCLUDED AND NURSING INTERVENTION SHOULD BE ATTEMPTED FIRST .

Q UESTION 38 EXPLANATION:KEYWORD: PRIORITY NURSING DIAGNOSIS. | ANSWER: D | RATIONALE : GENITAL HERPES IS CHARACTERIZED BY PAINFUL VESICLES AFFECTING THE EXTERNAL GENITALIA, VAGINA AND CERVIX. Q UESTION 39 EXPLANATION:KEYWORD: WHILE GETTING OUT OF BED NAUSEA AND LIGHTHEADED-NESS; NURSE SHOULD. | ANSWER: D. | RATIONALE: THE NURSE SHOULD TAKE THE BP OF THE CLIENT TO VALIDATE ORTHOSTATIC HYPOTENSION. A BODY TEMPERATURE READING OR CHEMISTRY PROFILE WILL NOT YIELD USEFUL INFORMATION ABOUT HYPOTENSION. T HE VALSALVA MANEUVER IS PERFORMED TO LOWER THE HEART RATE AND ISN T AN APPROPRIATE INTERVENTION. Q UESTION 40 EXPLANATION:KEYWORD: PRINCIPLE OF WHICH THERAPY DISULFIRAM (ANTABUSE ) . | ANSWER: B | RATIONALE: AVERSION THERAPY, ALSO KNOWN AS AVERSION CONDITIONING OR NEGATIVE REINFORCEMENT, IS A TECHNIQUE USED TO CHANGE BEHAVIOR. IN THIS THERAPY , A STIMULUS (ALCOHOL) ATTRACTIVE TO THE CLIENT IS PAIRED WITH AN UNPLEASANT EVENT IN HOPES OF INSTITUTING THE STIMULUS WITH NEGATIVE PROPERTIES. Q UESTION 41 EXPLANATION:KEYWORD: NOT ALLOWED TO DEVELOP APPROPRIATE INDEPENDENCE . | ANSWER: D | RATIONALE: ACCORDING TO ERIKSON, TODDLERS EXPERIENCE A SENSE OF SHAME WHEN THEY ARE NOT ALLOWED TO DEVELOP APPROPRIATE INDEPENDENCE AND AUTONOMY . Q UESTION 42 EXPLANATION:KEYWORD: RESULT OF LIVER FAILURE; EXPECTS. | ANSWER: C. | RATIONALE : INCREASED AMMONIA LEVELS OCCUR IN PATIENTS WITH LIVER DAMAGE AS A RESULT OF THE BREAKDOWN OF BLOOD PROTEIN IN INTESTINAL TRACT. Q UESTION 43 EXPLANATION:KEYWORD: MOST APPROPRIATE NEEDLE GAUGE . | ANSWER: B | RATIONALE: A 25- TO 27-GAUGE NEEDLE MEASURING A HALF-INCH IN LENGTH IS COMMONLY USED WHEN ADMINISTERING AN INTRADERMAL INJECTION. Q UESTION 44 EXPLANATION:KEYWORD: HYPOTHERMIA DECREASED; PERFORMS. | ANSWER: D | RATIONALE: HYPOTHERMIA WITH CARDIAC ARRHYTHMIAS MAY OCCUR WHEN INFUSING THE LARGE QUANTITIES OF BLOOD THAT ARE REQUIRED IN GI BLEEDING. B LOOD-WARMING EQUIPMENT SHOULD BE USED TO PREVENT THUS PROBLEM. Q UESTION 45 EXPLANATION:KEYWORD: BEST ACTIVITY | ANSWER: A | RATIONALE : A PERSON WHO IS EXPERIENCING MANIA IS OVERACTIVE, FULL OF ENERGY , LACKS CONCENTRATION AND HAS POOR IMPULSE CONTROL. THE CLIENT NEEDS AN ACTIVITY THAT WILL ALLOW HER TO USE EXCESS ENERGY, YET NOT ENDANGER OTHERS DURING THE PROCESS. TETHERBALL IS AN EXERCISE THAT USES THE LARGE MUSCLE GROUPS OF THE BODY AND IS A GREAT WAY TO EXPEND THE INCREASED ENERGY THIS CLIENT IS EXPERIENCING. Q UESTION 46 EXPLANATION:KEYWORD: BASED ON THE NURSE 'S EVALUATION. | ANSWER: D | RATIONALE : THE CONTEXT OF COMMUNITY HEALTH NURSING IS BASED ON THE NURSE ' S EVALUATION ABOUT THE EXISTING HEALTH PROBLEMS AND NEEDS OF THE PEOPLE . ONE OF THE PRINCIPLES OF CHN STATES THAT COMMUNITY HEALTH NURSING IS BASED ON THE RECOGNIZED NEEDS OF INDIVIDUALS, FAMILIES, COMMUNITIES AND GROUPS. Q UESTION 47 EXPLANATION:KEYWORD: CONSIDERED. | ANSWER: C. | RATIONALE : AN INCREASE OF MORE THAN 30 SYSTOLIC BP AND 15 DIASTOLIC BP AT ANYTIME DURING PREGNANCY IS CONSIDERED HYPERTENSION.

Q UESTION 48 EXPLANATION:KEYWORD: REDUCED OXYGEN IN THE BLOOD. | ANSWER: B | RATIONALE : HYPOXEMIA REFERS TO REDUCED OXYGEN IN THE BLOOD. CYANOSIS IS THE BLUISH DISCOLORATION OF THE SKIN, NAIL BEDS AND MUCOUS MEMBRANES DUE TO REDUCED HEMOGLOBIN-OXYGEN SATURATION. HYPOXIA IS A CONDITION OF INSUFFICIENT OXYGEN ANYWHERE IN THE BODY , FROM THE INSPIRED GAS TO THE TISSUES. ANEMIA
IS A DECREASE IN RED BLOOD CELLS

Q UESTION 49 EXPLANATION:KEYWORD: SHOULD NOT EXPECT. | ANSWER: C | RATIONALE : THERE SHOULD BE NO OR ONLY VERY MINIMAL CHANGES IN BP DURING PREGNANCY . A DECLINE IN THE SECOND TRIMESTER IS EXPECTED BUT IT USUALLY RETURNS TO BASELINE AT 3RD TRIMESTER. BP SHOULD BE TAKEN AT EVERY CLINIC VISIT TO DETERMINE DEVELOPING PIH. AN INCREASE OF MORE THAN 30 SYSTOLIC BP AND 15 DIASTOLIC BP AT ANYTIME DURING PREGNANCY IS CONSIDERED HYPERTENSION. Q UESTION 50 EXPLANATION:KEYWORD: BEST DESCRIBED. | ANSWER: D | RATIONALE: MILIEU THERAPY PROVIDES A SAFE ENVIRONMENT THAT IS ADAPTED TO THE INDIVIDUAL CLIENT' S NEEDS AND ALSO PROVIDES GREATER COMFORT AND FREEDOM OF EXPRESSION THAT HAS BEEN EXPERIENCED IN THE PAST BY THE CLIENT. ALL MEMBERS CONTRIBUTE TO THE PLANNING AND FUNCTIONING OF THE SETTING. Q UESTION 51 EXPLANATION:KEYWORD: NOT ADVISABLE | ANSWER: B | RATIONALE : IT IS NOT ADVISABLE FOR CHILDREN WITH RHEUMATOID ARTHRITIS TO SIT OR STAND FOR PROLONGED PERIODS OF TIME , SUCH AS WHEN THEY WATCH TV, AS PROLONGED IMMOBILITY RESULTS IN STIFFNESS AND POSSIBLE CONTRACTURES. Q UESTION 52 EXPLANATION:KEYWORD: NOT. | ANSWER: C | RATIONALE: BEHAVIORAL INFLUENCES REFER TO THE FACTOR IN THE ECOSYSTEM AFFECTING THE INDIVIDUAL S HEALTH THROUGH CERTAIN HABITS THAT A PERSON HAS. THESE MAY BE IN THE FORM OF SMOKING, INTAKE OF ALCOHOLIC DRINKS, SUBSTANCE ABUSE OR LACK OF EXERCISE . T HE PEOPLE' S LIFESTYLE , HEALTH CARE AND CHILD REARING PRACTICES ARE SHAPED, TO A LARGE EXTENT , BY THEIR CULTURE AND ETHNIC HERITAGE . OPTION C IS NOT A BEHAVIORAL INFLUENCE , IT IS AN ENVIRONMENTAL INFLUENCE . Q UESTION 52 EXPLANATION:KEYWORD: NOT. | ANSWER: C | RATIONALE: BEHAVIORAL INFLUENCES REFER TO THE FACTOR IN THE ECOSYSTEM AFFECTING THE INDIVIDUAL S HEALTH THROUGH CERTAIN HABITS THAT A PERSON HAS. THESE MAY BE IN THE FORM OF SMOKING, INTAKE OF ALCOHOLIC DRINKS, SUBSTANCE ABUSE OR LACK OF EXERCISE . T HE PEOPLE' S LIFESTYLE , HEALTH CARE AND CHILD REARING PRACTICES ARE SHAPED, TO A LARGE EXTENT , BY THEIR CULTURE AND ETHNIC HERITAGE . OPTION C IS NOT A BEHAVIORAL INFLUENCE , IT IS AN ENVIRONMENTAL INFLUENCE . Q UESTION 53 EXPLANATION:KEYWORD: DISCUSSING AND IDENTIFYING TASKS AND BOUNDARIES. | ANSWER: A | RATIONALE : IN THE FORMING OR INITIAL STAGE , THE MEMBERS ARE IDENTIFYING TASKS AND BOUNDARIES. Q UESTION 54 EXPLANATION:KEYWORD: DRUG OF CHOICE . | ANSWER: B | RATIONALE : PRAZIQUANTEL (BILTRICIDE ) IS THE DRUG OF CHOICE FOR SCHISTOSOMIASIS. Q UESTION 55 EXPLANATION:KEYWORD: EXCEPT | ANSWER: D | RATIONALE : MEBENDAZOLE (VERMOX): 100 MG 2X/DAY X 3 DAYS. SIDE EFFECTS: DIARRHEA, ABDOMINAL PAIN, LEUCOPENIA Q UESTION 56 EXPLANATION:KEYWORD: COMBED YOUR HAIR THIS MORNING. | ANSWER: C | RATIONALE: GIVING RECOGNITION IS INDICATING TO THE CLIENT THE NURSE S AWARENESS OF HIM AND HIS BEHAVIORS AS EXEMPLIFIED BY THE NURSE TELLING THE CLIENT THAT HE COMBED HIS HAIR THIS MORNING. A.) MAKING OBSERVATIONS VERBALIZE WHAT YOU PERCEIVE SUCH AS THE NURSE TELLING THE CLIENT , I NOTICE THAT YOU CAN T SIT STILL. B.) ENCOURAGING DESCRIPTION ASKING THE CLIENT TO VERBALIZE HIS PERCEPTION. E.G WHAT IS HAPPENING TO YOU NOW? Q UESTION 57 EXPLANATION:KEYWORD: LEAST. | ANSWER: C | RATIONALE : IF THE NURSE HAS TO DELIVER THE BABY HERSELF MEMBRANES SHOULD BE RUPTURED MANUALLY (IF NECESSARY ) FOR BIRTH OR DELIVERY TO TAKE PLACE .

Q UESTION 58 EXPLANATION:KEYWORD: HOLDS CERTAIN INFORMATION MIGHT PUT PATIENT S CONDITION IN A CRITICAL STATE . | ANSWER: A | RATIONALE : PATERNALISM IS A MORAL PRINCIPLE OF DECIDING WHAT IS BEST FOR THE CLIENT AND ACTING WITHOUT CONSULTING THE INDIVIDUAL. AT TIMES, A PHYSICIAN CAN INTENTIONALLY WITHHOLD INFORMATION ACCORDING TOO HIS/ HER SOUND JUDGMENT WHEN SUCH REVELATION WOULD DO MORE HARM TO AN EMOTIONALLY UNSTABLE OR DEPRESSED PERSON. (B ENEVOLENT DECEPTION). BENEFICENCE REFERS TO DOING ACTS OF KINDNESS AND MERCY THAT DIRECTLY BENEFIT THE PATIENT. NONMALEFICENCE MEANS TO DO NO HARM. Q UESTION 59 EXPLANATION:KEYWORD: APPROPRIATE TOY - TODDLER. | ANSWER: C | RATIONALE: YOUNG TODDLERS ARE STILL SENSORIMOTOR LEARNERS AND THEY ENJOY THE EXPERIENCE OF FEELING DIFFERENT TEXTURES. THUS, FINGER PAINTS WOULD BE AN APPROPRIATE TOY CHOICE . Q UESTION 60 EXPLANATION:KEYWORD: DRUG OF CHOICE . | ANSWER: D | RATIONALE : HETRAZAN IS THE DRUG OF CHOICE FOR FILIARISIS. Q UESTION 61 EXPLANATION:KEYWORD: AVOID TRAUMA | ANSWER: D. | RATIONALE : WHILE DOING NASOPHARYNGEAL SUCTIONING, SUCTION SHOULD ONLY BE APPLIED WHILE REMOVING THE CATHETER, NOT WHILE INSERTING IT, IN ORDER TO PREVENT TRAUMA TO THE TRACHEA. Q UESTION 62 EXPLANATION:KEYWORD: MOST LIKELY. | ANSWER: A | RATIONALE : HYPNOSIS IS ONE OF THE MAIN THERAPIES FOR CLIENTS WHO DISSOCIATE . IT IS NOT A TREATMENT OF CHOICE FOR CLIENTS WITH ADDICTIVE DISORDERS OF HALLUCINATIONS. CONFABULATION ISN T A SYMPTOM OF POST -TRAUMATIC STRESS DISORDER. Q UESTION 63 EXPLANATION:KEYWORD: MOST LIKELY. | ANSWER: A | RATIONALE : BENEDICT S TEST IS A URINE TEST FOR SUGAR. A PREGNANT WOMAN TESTED POSITIVE FOR B ENEDICT S TEST IS MOST LIKELY TO BE DIABETIC. Q UESTION 64 EXPLANATION:KEYWORD: MOST APPROPRIATE . | ANSWER: A | RATIONALE : CORRECTING A CLEFT PALATE PRIOR TO DEVELOPMENT OF SPEECH ALLOWS FOR FORMATION OF MORE NORMAL SPEECH PATTERN. Q UESTION 65 EXPLANATION:KEYWORD: PRECISE OXYGEN CONCENTRATION | ANSWER: C | RATIONALE: THE VENTURI MASK DELIVERS THE MOST ACCURATE OXYGEN CONCENTRATION. IT IS THE BEST OXYGEN DELIVERY SYSTEM FOR A CLIENT WITH EMPHYSEMA, ONE OF THE CHRONIC OBSTRUCTIVE PULMONARY DISEASES (COPD), BECAUSE IT DELIVERS A PRECISE OXYGEN CONCENTRATION. Q UESTION 66 EXPLANATION:KEYWORD: BREATHS EFFECTIVELY AND COMFORTABLE WHEN SITTING UPRIGHT; SHOULD BE DOCUMENTED. | ANSWER: B | RATIONALE : ORTHOPNEA IS THE INABILITY TO BREATHE EXCEPT IN AN UPRIGHT OR STANDING POSITION. APNEA IS THE CESSATION OF BREATHING. DYSPNEA IS THE DIFFICULTY OR UNCOMFORTABLE BREATHING. T ACHYPNEA IS AN ABNORMALLY RAPID RESPIRATORY RATE . Q UESTION 67 EXPLANATION:KEYWORD: IDEAL NUMBER OF MEMBERS | ANSWER: C | RATIONALE: THE IDEAL NUMBER OF MEMBERS IN AN INPATIENT GROUP IS 7 TO 10. Q UESTION 68 EXPLANATION:KEYWORD: SUBCUTANEOUS ROUTE ; CORRECT AMOUNT INSULIN. | ANSWER: A | RATIONALE : AMONG THE MANY KINDS OF DRUGS ADMINISTERED SUBCUTANEOUSLY (JUST BENEATH THE SKIN) ARE VACCINES, INSULIN AND HEPARIN. ONLY SMALL DOSES (0.5 TO 1 ML) OF MEDICATION ARE USUALLY INJECTED VIA THE SUBCUTANEOUS ROUTE . Q UESTION 69 EXPLANATION:KEYWORD: ONE OR TWO MOVEMENTS PER HOUR; TEST USUALLY CONDUCTED. | ANSWER: A | RATIONALE : A NON-STRESS TEST (NST) IS USUALLY CONDUCTED IF THE WOMAN REPORTS ONLY ONE OR TWO MOVEMENTS PER HOUR. IF THE NST RESULT IS NONREACTIVE , A BIOPHYSICAL PROFILE OR CONTRACTION STRESS TEST IS CONDUCTED TO FURTHER ASSESS THE CONDITION OF THE FETUS. Q UESTION 70 EXPLANATION:KEYWORD: TYPICAL EATING PATTERN TODDLER. | ANSWER: B | RATIONALE: TODDLERS BECOME PICKY EATERS, EXPERIENCING FOOD JAGS AND EATING LARGE AMOUNTS ONE DAY AND VERY LITTLE THE NEXT. A TODDLER S FOOD JAGS EXPRESS A PREFERENCE FOR THE RITUALISM OF EATING ONE TYPE OF FOOD FOR SEVERAL DAYS AT A TIME . Q UESTION 71 EXPLANATION:KEYWORD: CHART (LEGAL OWNER) | ANSWER: B | RATIONALE : THE LEGAL OWNER OF THE CHART IS THE HOSPITAL. ON THE OTHER HAND, THE PATIENT IS THE LEGAL OWNER OF DATA IN THE CHART.

Q UESTION 72 EXPLANATION:KEYWORD: BEFORE STARTING A CONTINUOUS FEEDING. | ANSWER: C | RATIONALE : TO PREVENT ASPIRATION OF STOMACH CONTENTS, THE NURSE SHOULD PLACE THE CLIENT IN SEMI-FOWLER S POSITION. THE SUPINE AND REVERSE TRENDELENBURG POSITIONS MAY CAUSE ASPIRATION. HIGH-FOWLER S POSITION ISN T NECESSARY AND MAY NOT BE TOLERATED AS WELL AS SEMI-FOWLER S. Q UESTION 73 EXPLANATION:KEYWORD: NOT A LEGAL RESPONSIBILITY. | ANSWER: B | RATIONALE : THE NURSE
CAN ONLY REVEAL CONFIDENTIAL INFORMATION ABOUT THE PATIENT TO APPROPRIATE PERSONS SUCH AS THE PHYSICIAN OR HEALTH STAFF OR THE NEXT NURSE WHO WILL CARE FOR THE SAME PATIENT . REVEALING INFORMATION TO THE CHURCH MINISTER SHOULD NEVER BE PRACTICED BY NURSES. Q UESTION 74 EXPLANATION:KEYWORD: SUCCESSFUL FLUID RESUSCITATION IN A CLIENT WITH DIARRHEA. | ANSWER: B | RATIONALE : BECAUSE OF THE CRITERIA IN THE QUESTION, FLUID RESUSCITATION, THE DIAGNOSIS FOR DIARRHEA IN THIS CASE IS NARROWED TO DEFICIENT FLUID VOLUME RELATED TO EXCESSIVE FLUID LOSS IN STOOL. THUS, FLUID RESUSCITATION IS NEEDED AND EXPECTED OUTCOMES OF SUCCESSFUL INTERVENTION INCLUDE: FIRM SKIN TURGOR, MOIST MUCOUS MEMBRANES, URINE OUTPUT OF AT LEAST 30 ML/HR. THE CLIENT ALSO HAS A NURSING DIAGNOSIS OF DIARRHEA WITH THE FOLLOWING EXPECTED OUTCOMES: PASSAGE OF FORMED STOOLS AT REGULAR INTERVALS, DECREASE IN STOOL FREQUENCY AND LIQUIDITY. HOWEVER, SINCE THE QUESTION IS FOCUSED ON THE EXPECTED OUTCOME OF FLUID RESUSCITATION, THUS THE CORRECT ANSWER IS A FIRM SKIN TURGOR. Q UESTION 75 EXPLANATION:KEYWORD: BECOMES PESSIMISTIC ABOUT TREATMENT. | ANSWER: A | RATIONALE: CLIENTS WITHDRAWING FROM DRUGS SUCH AS COCAINE FREQUENTLY EXPERIENCE DEPRESSION. IT IS COMMON FOR DRUG-ADDICTED CLIENTS TO EXPERIENCE FATIGUE WITHOUT BECOMING PESSIMISTIC. Q UESTION 76 EXPLANATION:KEYWORD: GLUTEN-INDUCED ENTEROPATHY ELIMINATE FROM HER DIET PERMANENTLY. | ANSWER: A | RATIONALE: TO MANAGE GLUTEN-INDUCED ENTEROPATHY, THE CLIENT MUST ELIMINATE GLUTEN, WHICH MEANS AVOIDING ALL CEREAL GRAINS EXCEPT RICE AND CORN. Q UESTION 77 EXPLANATION:KEYWORD: MOST APPROPRIATE . | ANSWER: B | RATIONALE : THE CLIENT IS EXPERIENCING SYMPTOMS OF HYPOGLYCEMIA. CHECKING THE BLOOD GLUCOSE LEVEL AND ADMINISTERING CARBOHYDRATES WILL ELEVATE BLOOD GLUCOSE . Q UESTION 78 EXPLANATION:KEYWORD: PRIORITY. | ANSWER: B | RATIONALE: CARE SHOULD BE TAKEN NOT TO PUT ANYTHING IN THE MOUTH THAT SHOULD DAMAGE THE SUTURE LINE . T HE MOTHER CAN FEED THE BABY WITH A WIDE -BOWL SPOON THAT CANNOT ENTER THE MOUTH. Q UESTION 79 EXPLANATION:KEYWORD: MANAGES ANXIETY ANOREXIA NERVOSA | ANSWER: C | RATIONALE: CLIENTS WITH ANOREXIA NERVOSA HAVE THE DESIRE TO PLEASE OTHERS. THEIR NEED TO BE CORRECT OR PERFECT INTERFERES WITH RATIONAL DECISION-MAKING PROCESSES. T HESE CLIENTS ARE MORALISTIC. RULES AND RITUALS HELP THESE CLIENTS MANAGE THEIR ANXIETY. Q UESTION 80 EXPLANATION:KEYWORD: MOST LIKELY | ANSWER: C | RATIONALE : DISSOCIATIVE AMNESIA TYPICALLY OCCURS AFTER THE PERSON HAS EXPERIENCED A VERY STRESSFUL TRAUMATIC SITUATION. B INGE EATING DOESN T CAUSE DISSOCIATIVE AMNESIA. CLOSE -HEAD INJURY COULD RESULT IN PHYSIOLOGIC NOT DISSOCIATIVE AMNESIA. FIGHT WITH A FAMILY MEMBER WOULDN T BE STRESSFUL ENOUGH TO CAUSE DISSOCIATIVE AMNESIA. Q UESTION 81 EXPLANATION:KEYWORD: ETHICAL DILEMMA. | ANSWER: C | RATIONALE: ETHICAL DILEMMA IS A PROBLEM IN DECISION MAKING BECAUSE THERE IS NO CLEARLY CORRECT OR RIGHT CHOICE . THIS MAY RESULT IN HAVING TO CHOOSE AN ACTION THAT VIOLATES ONE PRINCIPLE OR VALUE IN ORDER TO PROMOTE ANOTHER. Q UESTION 82 EXPLANATION:KEYWORD: EXCEPT | ANSWER: A | RATIONALE : THIS DOES NOT PREVENT TRANSMISSION OF GONORRHEA. IT PREVENTS THE OCCURRENCE OF OPHTHALMIA NEONATORUM. Q UESTION 83 EXPLANATION:KEYWORD: EXCEPT | ANSWER: B | RATIONALE : IN INITIAL DISEASE MANAGEMENT, CLIENTS EAT A HIGH-CALORIE , HIGH PROTEIN WITH MINERAL AND VITAMIN SUPPLEMENTS TO HELP NORMALIZE THE NUTRITIONAL STATUS. Q UESTION 84 EXPLANATION:KEYWORD: ORIGINALLY MADE TO AVOID PLAGIARISM | ANSWER: C | RATIONALE: CHARACTERISTICS OF GOOD PROBLEM IN NURSING RESEARCH. G GENERAL APPLICABILITY RESULT SHOULD BE HELPFUL OR APPLICABLE TO ALL. A.) BASIC/ PRE FOR PERSONAL KNOWLEDGE B.) APPLIED FOCUS IS SOLVING

PROBLEMS OF OTHERS; RE RESEARCHABLE COLLECTABLE & ABUNDANT DATA, F FEASIBLE OR MEASURABLE A.) TIME , B.) MONEY / COST , C.) PARTICIPANTS, D.) INSTRUMENTS, E .) EXPERIENCE , F.) PROPER ETHICS OF GOOD RESEARCHER; I IMPORTANT , N NOVELTY ORIGINAL TO AVOID PLAGIARISM, S SIGNIFICANT. Q UESTION 85 EXPLANATION:KEYWORD: CORRECTLY STATED. | ANSWER: A | RATIONALE : IN MOTHERS WITH GENITAL HERPES, THE FETUS CAN BE CONTAMINATED AFTER MEMBRANES RUPTURE OR WITH VAGINAL DELIVERY . THEREFORE , FOR WOMEN WITH ACTIVE LESIONS, EITHER RECURRENT OR PRIMARY AT THE TIME OF LABOR, DELIVERY SHOULD BE BY CESAREAN TO PREVENT THE FETUS FROM COMING INTO CONTACT WITH THE GENITAL HERPES. Q UESTION 86 EXPLANATION:KEYWORD: VAGUE CONNECTIONS TO EACH OTHER | ANSWER: A | RATIONALE : THE TERM LOOSE ASSOCIATIONS REFER TO SENTENCES THAT HAVE VAGUE CONNECTIONS TO EACH OTHER. LETTER B IS DEFINED AS BELIEF THAT OTHERS INTEND TO HARM THE CLIENT IN SOME WAY . DEPERSONALIZATION IS A STATE IN WHICH THE CLIENT FEELS UNREAL OR BELIEVES PARTS OF THE BODY ARE BEING DISTORTED. Q UESTION 87 EXPLANATION:KEYWORD: PRIORITY INTERVENTION; WORKING TO DEVELOP HIS COPING SKILLS. | ANSWER: B | RATIONALE : TO HELP THE CLIENT DEVELOP EFFECTIVE COPING SKILLS THE NURSE MUST KNOW THE CLIENT S BASELINE FUNCTIONING. DETERMINING WHETHER THE CLIENT HAS FEARS OR OBSESSIVE THINKING, MONITORING FOR SIGNS OF ANXIETY , AND TEACHING ABOUT EFFECTIVE COMMUNICATION SKILLS ARE LATER PRIORITIES, NOT INITIAL ONES. Q UESTION 88 EXPLANATION:KEYWORD: CORRECTLY. | ANSWER: D | RATIONALE : MERIT IS USED AS A CRITERION FOR TRANSPLANT RECIPIENTS AND IT A FORM OF DISTRIBUTIVE JUSTICE WHERE SERVICES GO TO MORE DESERVING INDIVIDUAL. Q UESTION 89 EXPLANATION:KEYWORD: FIRST | ANSWER: B. | RATIONALE : AN ADVERSE REACTION TO ANY DRUG CAN BE LIFE -THREATENING AND SHOULD BE DEALT WITH FIRST. MORPHINE IS A RESPIRATORY DEPRESSANT. Q UESTION 90 EXPLANATION:KEYWORD: BEST TIME . | ANSWER: C | RATIONALE : PINWORN IS ENTEROBIASIS AND THE MODE OF TRANSMISSION IS FECAL-ORAL ROUTE . BECAUSE THE EGGS ARE DEPOSITED TO THE ANUS AT NIGHT, THE BEST TIME TO PERFORM A CELLOPHANE TEST WOULD BE IN THE MORNING UPON AWAKENING OF THE CHILD. Q UESTION 91 EXPLANATION:KEYWORD: EXCEPT | ANSWER: C | RATIONALE: SOURCES OF GOOD PROBLEM C CONCEPTS, L LITERATURES, I ISSUES, E ESSAYS, N NURSING PROBLEMS, T THEORIES Q UESTION 92 EXPLANATION:KEYWORD: CONSENTS TO HIS OWN HOSPITAL ADMISSION. | ANSWER: C | RATIONALE : VOLUNTARY COMMITMENT TAKES PLACE WHEN A CLIENT CONSENTS TO HIS OWN HOSPITAL ADMISSION IN A PSYCHIATRIC FACILITY . IN THIS CASE THE CLIENT HAS THE RIGHT TO REFUSE TREATMENT AND MUST BE RELEASED WHEN HE OR SHE NO LONGER CHOOSES TO REMAIN IN THE HOSPITAL. LETTERS A AND B ARE APPLICABLE FOR CLIENTS WHO ARE HOSPITALIZED INVOLUNTARILY . Q UESTION 93 EXPLANATION:KEYWORD: CORRECT | ANSWER: C | RATIONALE : WHEN COUNTING FETAL MOVEMENTS, THE WOMAN SHOULD EMPTY HER BLADDER FIRST . T HEN ASSIST HER TO LIE DOWN OR SIT, BE RELAXED AND QUIET AND INSTRUCT HER TO PLACE HER HANDS OVER HER ABDOMEN. SHE THEN OBSERVES AND COUNTS THE NUMBER OF TIMES THE BABY MOVES. T HE PATIENT IS INSTRUCTED TO REPORT FEWER THAN NORMAL FETAL MOVEMENTS. Q UESTION 94 EXPLANATION:KEYWORD: MOST APPROPRIATE | ANSWER: D | RATIONALE : THIS PROVIDES A SIMPLE EXPLANATION FOR THE CLIENT. T HE USE OF WHY CAN PUT SOMEONE ON THE DEFENSIVE . T HE SECOND CHOICE TAKES FOCUS OFF THE CLIENT . Q UESTION 95 EXPLANATION:KEYWORD: APPROPRIATE SUCTION TUBE LENGTH; ADULT PATIENT. | ANSWER: D | RATIONALE : IN PERFORMING NASOPHARYNGEAL SUCTIONING, THE LENGTH OF INSERTION OF THE TUBING FOR AN ADULT WOULD BE THE DISTANCE FROM THE TIP OF THE NOSE TO THE TIP OF THE EAR LOBE . Q UESTION 96 EXPLANATION:KEYWORD: NOT TRUE .ANSWER: CRATIONALE : IN IRRESISTIBLE IMPULSE INSANITY DEFENSE , THE ACCUSE , BECAUSE OF MENTAL HEALTH DID NOT HAVE THE WILL TO RESIST AN IMPULSE TO COMMIT THE ACT , EVEN THOUGH ABLE TO DIFFERENTIATE BETWEEN RIGHT AND WRONG. Q UESTION 97 EXPLANATION:KEYWORD: PRIMARY PURPOSE | ANSWER: B | RATIONALE: EACH STATE OR PROVINCE PROTECTS THE HEALTH AND WELFARE OF ITS POPULACE BY REGULATING NURSING PRACTICE .

Q UESTION 98 EXPLANATION:KEYWORD: EFFECTIVELY PREVENT PINWORM TRANSMISSION. | ANSWER: A | RATIONALE : THE BEST PREVENTIVE MEASURE IS THOROUGH HAND WASHING BEFORE AND AFTER EATING AND AFTER DEFECATION BECAUSE PINWORM IS TRANSMITTED BY ORAL-FECAL ROUTE . Q UESTION 99 EXPLANATION:KEYWORD: CONTRACTION STRESS TEST NEGATIVE; SHOULD INSTRUCT NEXT CLINIC VISIT. | ANSWER: C | RATIONALE : A NEGATIVE CONTRACTION STRESS TEST (CST) GIVES AN ASSURANCE OF FETAL HEATH WITHIN THE FOLLOWING WEEK AND THE TEST IS REPEATED AFTER ONE WEEK . CST IS INDICATED FOR HIGH RISK PREGNANCIES. Q UESTION 100 EXPLANATION:KEYWORD: SAME INDIVIDUAL TWO OR MORE GENOTYPICALLY DIFFERENT CELL LINES. | ANSWER: C | RATIONALE : MOSIACISM IS THE PRESENCE OF CHROMOSOME IN THE SAME INDIVIDUAL OF TWO OR MORE GENOTYPICALLY DIFFERENT CELL LINES.