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Mary Joyce Diaz BSN 3A1 1. Mr. Dela Rosa is suspected to have malaria after a business trip in Palawan.

The most important diagnostic test in malaria is: a. WBC count b. Urinalysis c. ELISA d. Peripheral blood smear Rationale: D. Peripheral blood smear 2. A prenatal nurse is providing instructions to a group of pregnant client regarding measures to prevent toxoplasmosis. Which statement if made by one of the clients indicates a need for further instructions? a. I need to cook meat thoroughly. b. I need to avoid touching mucous membranes of the mouth or eyes while handling raw meat. c. I need to drink unpasteurized milk only. d. I need to avoid contact with materials that are possibly contaminated with cat feces. Rationale: C. All pregnant women should be advised to do the following to prevent the development of toxoplasmosis. Women should be instructed to cook meats thoroughly, avoid touching mucous membranes and eyes while handling raw meat; thoroughly wash all kitchen surfaces that come into contact with uncooked meat, wash the hands thoroughly after handling raw meat; avoid uncooked eggs and unpasteurized milk; wash fruits and vegetables before consumption, and avoid contact with materials that possibly are contaminated with cat feces, such as cat litter boxes, sand boxes, and garden soil. 3. A nurse employed in a preschool agency is planning a staff education program to prevent the spread of an outbreak of an intestinal parasitic disease. The nurse include which priority prevention measure in the educational session? a. All food will be cooked before eating b. Only bottled water will be used for drinking c. All toileting will be cleansed daily with soap and water d. Staff will practice standard precautions when changing diapers and assisting children with toileting Rationale: D. The fecal-oral route is the mode of transmission of an intestinal parasitic disease. Standard precautions prevent the transmission of infection. Some fresh foods do not need to be cooked as long as they are washed well and were not grown in soil contaminated with human feces. Water and fresh foods can be vehicle for transmission, but municipal water sources are usually safe. Cleaning with soap and water is not effective as the use of bleach 4. When assisting with the plan of care for a client with intestinal parasites, the LVN/LPN should understand intestinal parasites are: a. Causes of rectal bleeding and anemia b. Contagious within the family unit c. Easily controlled by antibiotics d. A source of swollen abdomen from bloating

Rationale: B. Bleeding and bloating are not common symptoms of this disorder. Often weight loss has been present for some time. Antibiotics do not effectively remove parasites. 5. The following are preventive measures for Schistosomiasis EXCEPT: a. Use of safe water b. Avoid bathing and washing in infested waters c. Use of sanitary toilets d. Elimination of breeding sites of mosquitoes Rationale: D. This does not prevent transmission of gonorrhea. It prevents the occurrence of ophthalmia neonatorum. Situation 4: Endemic malaria occurs in the topic and subtopic areas where socioeconomic condition is very poor. 6. During your assessment, which among the following signs and symptoms need referral to a secondary or tertiary facility? a. Sweating and headache b. Icterus and shock c. Fever and chills d. Renal or liver failure Rationale: B. Malarial parasites invade and destroy red blood cells 7. Laboratory confirmation of malaria is done on a blood film. What do you expect to see in the film? a. Antibodies b. Malarial parasites c. Malarial purinates d. Antigen Rationale: B. As sporozoites from the salivary gland of a female Anopheles mosquito are injected under the skin, they travel into the bloodstream to the liver and mature within hepatocytes. Up to 30,000 parasites are then released into the bloodstream as merozoites and produce a symptomatic infection as they invade and destroy red blood cells. 8. The mode of transmission of this disease is through the bite of an infected female mosquito called: a. Aminophylline b. Aedes poecillus c. Anopheles d. Aedes egypti Rationale: C. Anopheles is the vector for malaria 9. Which of the following is NOT an anti-malarial drug? a. Sulfadoxine b. Amoxicillin c. Tetracycline d. Quinidine

Rationale: B. Amoxicillin is not a drug for malaria; A. Sulfadoxine (Sulfalene) 50 mg; C. Tetracycline hydrochloride 250mg/capsule D. Quinidine sulfate 300 mg table; Quinidine hydrochloride 300 mg/mL, 2 ML ampule

10. As a preventive measure for malarias, you educate people living in malaria endemic areas to do which of the following? a. Avoid going out between 12nn to 3am b. Take chloroquine tablets once a day c. Apply insect repellant on house walls d. Use long sleeved shirts when going out at night e. Plant neem tree in their backyards f. Clear hanging branches nears rivers Rationale: A and B are not included. The vector's peak biting hours are 9pm to 3am. Chloroquine is taken at weekly intervals. Situation: A nurse is having her duty in a public health clinic. She encounters multiple cases of sexually transmitted diseases. 11. A nurse is collecting data from a prenatal client. The nurse determines that which of the following places the client into the high risk category for contracting human immunodeficiency virus? a. Living in an area where HIV infections are minimal b. A history of IV drug use in the past year c. A history of one sexual partner within the past 10 years d. A spouse who is heterosexual and had only 1 sexual partner in the past 10 years Rationale: B. Women who fall into the high-risk category for HIV infection include those with persistent and recurrent sexually transmitted diseases or a history of multiple sexual partners, and those who use or have used IV drugs. A, C and D do not contribute to the incidence of contracting HIV. 12. Which among the following informations is true of HIV? a. It can be transmitted via body fluids such as blood, semen, urine, and perspiration. b. Blood, semen, and breast milk have higher concentrations of HIV than urine, saliva, vomitus and stool c. A client who by history may be exposed to HIV but test negative for HIV antibodies can no longer infect others d. Enzyme-linked immunosorbent assay (ELISA) is the confirmatory test for HIV Rationale: B. This is true of HIV; A. Perspiration does not contain the virus; C. This is not always true for HIV. Clients may be infected with the virus, but has not yet produced antibodies, thereby testing negative, but being capable of infecting others. It usually takes 6 to 12 weeks (other books: 1 to 3 months) for a host to manufacture detectable HIV antibodies; D. Western blot is the confirmatory test for HIV.

13. Hepatitis B infection is established by the presence of hepatitis B antigen-antibody systems in the blood. Which of the following is NOT true? a. Presence of HBsAG is the serological marker to establish the diagnosis of hepatitis B. b. If the serological marker is present in the blood after 3 months, it indicates a carrier state or chronic hepatitis. c. The presence of anti-HBS indicates recovery and immunity to hepatitis B. d. Presence of HbeAG determines the infective state of the client Rationale: B. Presence of hepatitis B surface antigens (HBsAG) in the blood after 6 months indicates a carrier state or chronic hepatitis; A, C and D are true.Hepatitis B early antigen is detected in the blood about 1 week after the appearance of HBsAG. Its presence determines the infective state of the client 14. The nurse is talking to a young female client in the health clinic who is concerned she may have sexually transmitted disease. The nurse commends her for seeking medical care. The nurse explains that the major reason treatment of majority of STDs is delayed because: a. Client is embarrassed b. Symptoms are thought to be caused by something else c. Symptoms are ignored d. The client does not manifest signs and symptoms Rationale: A, Client is embarassed 15. The nurse is very active in contact tracing and epidemiologic treatment of all gonococcal identified contacts to prevent: a. Development of resistant strains b. Asymptomatic infections c. Non-venereal transmission d. Reinfection Rationale: B. 80% of gonoccocal infection, particularly in females have no symptoms. Situation : Filariasis is endemic in some parts of the Philippines. The disease often progresses to become chronic, debilitating and often unfamiliar to health workers. 16. Effective methods that the government would likely to pursue to eliminate filariasis in the country are all of the following EXCEPT: a. Pursue annual mass drug administration using two drugs in all endemic areas for at least five consecutive years b. Vaccination of all susceptible in high risk areas and high risk populations c. Intensify health information and advocacy campaigns in its prevention, control and elimination d. Halt progression of disease through disability prevention Rationale: B. There is no known vaccination for Filariasis. Diethycarbamezine Citrate (DEC) is given to patients with clinical manifestations and/or microfilariae. 17. The vector for Filariasis is:

a. Wuchereria bancrofti b. Aedes poecillus c. Anopheles d. Aedes egypti Rationale: B and A. This is the causative agent for filariasis. Other causative agents include Brugia malayi and Brugia timoril; C. This is the vector for Malaria; D. This is the vector for Dengue. 18. A long incubation period characterizes Filariasis that typically ranges from: a. 2-4 weeks b. 4-6 weeks c. 2-3 years d. 8-16 months Rationale: D. Incubation period ranges from 8-16 months. 19. A 36-year-old man is brought by his wife to a doctor's clinic to be tested for filariasis. The most likely diagnostic test that he will undergo is: a. Immunochromatographic test (ICT) b. Nocturnal Blood Examination c. Stool examination d. Urinalysis Rationale: A. The clinic is only open from 8am to 5pm. The ICT is an antigen test that can be done in daytime. Nocturnal blood smear is also a diagnostic test for Filariasis, but the patient's blood is taken at the patient's residence or in the hospital after 8pm. 20. A client in the acute stage of the disease will include which of the following clinical findings? a. Lymphangitis, lymphadenitis, epidydimitis b. Hydrocele, lymphedema, elephantiasis c. Orchitis, hydrocele, elephantiasis d. Lymphadenitis, lympedema and orchitis Rationale: A. Lymphangitis, lymphadenitis, epidydimitis, funiculitis and orchotis are acute clinical manifestations of Filariasis; B. Hydrocele, lymphedema, and elephantiasis are clinical manifestations of Chronic Filariasis.