SURIGAO EDUCATION CENTER

Km. 2, 8400 Surigao City, Philippines

CAMS- NURSING DEPT.

NUPC109 (LEC) FINAL EXAM 2023
NAME: Coleen Caluńa
DATE: June 23,2023
COURSE & YR: BSN-2 A
MULTIPLE CHOICE. WRITE YOUR ANSWER BEFORE THE NUMBER. STRICTLY NO
ERASURES ALLOWED!
C. 1. A 7-month-old infant arrives at the health center for a scheduled well-child visit. When the nurse approaches
the infant to obtain vital signs, the infant cries vigorously and clings fearfully to the mother. Which of the
following phenomena provides the best explanation for the infant's behavior?
A. Separation anxiety
B. Disassociation disorder
C. Stranger anxiety
D. Autism spectrum

D. 2. A 4-month-old infant boy is brought to the emergency department by his parents. He has been vomiting and
fussy for the past 24 hours. On exam there are circular bruises on his back. What priority assessment does the
nurse anticipate?
A. Chest x-ray examination
B. Ultrasonography of the head
C. Electroencephalography
D. Ophthalmologic examination

B. 3.Which action will the public health nurse take to have the most impact on the incidence of infectious diseases
in the school?
A. Make soap and water readily available in the classrooms.
B. Ensure that students are immunized according to national recommendations.
C. Provide written information about infection control to all parents.
D. Teach students how to cover their mouths when they cough or sneeze.

D. 4.The nurse is providing nursing care for a newborn infant with respiratory distress syndrome (RDS) who is
receiving nasal continuous positive airway pressure ventilation. Which assessment finding is most important to
report to the health care provider?
A. Apical pulse rate of 156 beats/min
B. Crackles audible in both lungs
C. Tracheal deviation to the right
D. Oxygen saturation of 93%

D. 5. The nurse obtains this information when assessing a 3-year-old patient with uncorrected tetralogy of Fallot
who is crying. Which finding requires immediate action?
A. The apical pulse rate is 118 beats/min.
B. A loud systolic murmur is heard in the pulmonic area.
C. There is marked clubbing of the child's nail beds.
D. The lips and oral mucosa are dusky in color.

C. 6. The nurse is observing a preschool classroom of children between the ages of 3 to 4 years of age. When
planning actions to ensure that each child meets normal developmental goals, which child will require the most
immediate intervention?
A. A 3-year-old boy who needs help dressing
B. A 4-year-old girl who has an imaginary friend
C. A 4-year-old girl who engages only in parallel play
D. A 3-year-old boy who draws stick figures

D. 7.A 6-year-old child arrives in the emergency department with active seizures. Which assessment is a priority
for the nurse to obtain?
A. Heart rate
B. Body mass index (BMI)
C. Blood pressure
D. Weight
A. 8. An excited mother calls the nurse for advice. “My child got cleaning solution in her eyes, and I rinsed her
eyes with water for a few minutes. What should I do? She is still screaming!” What does the nurse instruct the
caller to do first?
A. Comfort the child and check her vision.
B. Continue to irrigate the eyes with water.
C. Call the Poison Control Center.
D. Call 911 to request an ambulance.

B. 9. An adolescent who was hospitalized for anorexia nervosa is following the prescribed treatment plan. Her
self-esteem and weight have gradually improved, but she continues to refer to herself as “fatty.” She is able to
verbalize an appropriate diet and exercise plan. At this point, what is the priority concern?
A. Patient needs to continue to gain weight.
B. Patient has an unrealistic body image.
C. Patient needs more information about nutrition.
D. Patient lacks motivation to adhere to therapy.

D. 10.A parent calls the emergency department, saying, “I think my toddler might have swallowed a little toy. He
is breathing okay, but I don’t know what to do.” What is the most essential question to ask the caller?
A. “Has he vomited?”
B. “Have you been checking his stools?”
C. “What do you think he swallowed?”
D. “Has he been coughing?”

B. 11. A teenager arrives in the triage area alert and ambulatory, but his clothes are covered with blood. His
friends are yelling, “We were goofing around, and he got poked in the abdomen with a stick!” Which comment
would be of most concern?
A. “There was a lot of blood, and we used three bandages.”
B. “He pulled the stick out, just now, because it was hurting him.”
C. “The stick was really dirty and covered with mud.”
D. “He has diabetes, so he needs attention right away.”

A. 12. A 10-year-old girl has completed a course of amoxicillin for a urinary tract infection (UTI). This is the
second UTI the child has had this year. The child is in the 95th percentile for weight and has a history of
constipation. Her parents ask the nurse for preventive strategies for UTIs. Which of the following preventive
strategies is best for the nurse to recommend?
A. Increase fiber in the diet.
B. Drink cranberry juice.
C. Increased vitamin C in a diet.
D. Limit fluids at bedtime.

D 13. A toddler is brought to the health center for a fever of 102°F (39°C) and a sore throat. As the nurse places
a toddler and his parents in the exam room, the child experiences a tonic-clonic seizure. Which nursing action is
a priority?
A. Assess the child's level of consciousness.
B. Obtain an oxygen saturation.
C. Loosen the child's clothing.
D. Position the child in side-lying position.

B 14. Which of the following would most likely alert the nurse to the possibility that a preschooler is experiencing
moderate dehydration?
A. Deep, rapid respirations.
B. Diaphoresis.
C. Absence of tear formation.
D. Decreased urine specific gravity

D 15. Which of the following would be an important assessment finding for an 8-month-old infant admitted with
severe diarrhea?
A. Bowel sounds every 5 seconds.
B. Pale yellow urine.
C. Normal skin elasticity.
D. Depressed anterior fontanel.

B 16. Which of the following would be the best activity for the nurse to include in the plan of care for an infant
experiencing severe diarrhea?
A. Monitoring the total 8-hour formula intake.
B. Weighing the infant each day.
C. Checking the anterior fontanel every shift.
D. Monitoring abdominal skin turgor every shift.
D 17. On finding a child who is not breathing, the nurse has someone activate the emergency medical system and
then does which of the following first?
A. Clear the airway.
B. Begin mouth-to-mouth resuscitation.
C. Initiate oxygen therapy.
D. Start chest compressions.
A 18. A father brings his 3-month-old infant to the clinic, reporting that the infant has a cold, is having trouble
breathing, and “just doesn't seem to be acting right.” Which of the following actions should the nurse do first?
A. Check the infant's heart rate.
B. Weigh the infant.
C. Assess the infant's oxygen saturation.
D. Obtain more information from the father.
A 19. The triage nurse in the emergency room must prioritize the children waiting to be seen. Which of the
following children is in the greatest need of emergency medical treatment?
A. A 6-year-old with a fever of 104°F (40°C), a muffled voice, no spontaneous cough, and drooling.
B. A 3-year-old with a fever of 100°F (37.8°C), a barky cough, and mild intercostal retractions.
C. A 4-year-old with a fever of 101°F (38.3°C), a hoarse cough, inspiratory stridor, and restlessness.
D. A 13-year-old with a fever of 104°F (40°C), chills, and a cough with thick yellow secretions.
C 20. An 11-year-old is admitted for treatment of an asthma attack. Which of the following indicates immediate
intervention is needed?
A. Thin, copious mucous secretions.
B. Productive cough.
C. Intercostal retractions.
D. Respiratory rate of 20 breaths/minute.
B 21. A 12-year-old with asthma wants to exercise. Which of the following activities should the nurse suggest to
improve breathing?
A. Soccer.
B. Swimming.
C. Track.
D. Gymnastics.
C 22. When preparing the teaching plan for the mother of a child with asthma, which of the following should the
nurse include as signs to alert the mother that her child is having an asthma attack?
A. Secretion of thin, copious mucus.
B. Tight, productive cough.
C. Wheezing on expiration.
D. Temperature of 99.4°F (37.4°C).
C 23. A 7-year-old child with a history of asthma controlled without medications is referred to the school nurse
by the teacher because of persistent coughing. Which of the following should the nurse do first?

A. Obtain the child's heart rate.

B. Give the child a nebulizer treatment.
C. Call a parent to obtain more information.
D. Have a parent come and pick up the child.
D 24. An 8-year-old child with asthma states, “I want to play some sports like my friends. What can I do?” The
nurse responds to the child based on the understanding of which of the following?
a. Physical activities are inappropriate for children with asthma.
b. Children with asthma must be excluded from team sports.
c. Vigorous physical exercise frequently precipitates an asthmatic episode.
d. Most children with asthma can participate in sports if the asthma is controlled.

C 25. The nurse is observing a student nurse administer eye drops, as shown in the figure. What should the nurse
instruct the student to do?
A. Move the dropper to the inner canthus.
B. Have the client raise the eyebrows.
C. Administer the drops in the center of the lower lid.
D. Have the client squeeze both eyes after administering the drops.
B 26. The client with a cataract tells the nurse about being afraid of being awake during eye surgery. Which of
the following responses by the nurse would be the most appropriate?
A. “Have you ever had any reactions to local anesthetics in the past?”
B. “What is it that disturbs you about the idea of being awake?”
C. “By using a local anesthetic, you won't have nausea and vomiting after the surgery.”
D. “There's really nothing to fear about being awake. You'll be given a medication that will help you relax.”
C 27. The nurse judges that the mother understands the term cerebral palsy when she describes it as a term applied
to impaired movement resulting from which of the following?
A. Injury to the cerebrum caused by viral infection.
B. Malformed blood vessels in the ventricles caused by inheritance.
C. Nonprogressive brain damage caused by injury.
D. Inflammatory brain disease caused by metabolic imbalances.
A 28. The nurse assesses the family's ability to cope with the child's cerebral palsy. Which action should alert the
nurse to the possibility of their inability to cope with the disease?
A. Limiting interaction with extended family and friends.
B. Learning measures to meet the child's physical needs.
C. Requesting teaching about cerebral palsy in general.
D. Seeking advice on coping on social media.
A 29. When assessing a female adolescent for scoliosis, what should the nurse ask the client to do?
a. Bend forward at the waist with arms hanging freely.
b. Lie flat on the floor and extend her legs straight from the trunk.
c. Sit in a chair while lifting her feet and legs to a right angle with the trunk.
d. Stand against a wall while pressing the length of her back against the wall.
D 30. An overweight adolescent has been diagnosed with type 2 diabetes. To increase the client's self-efficacy to
manage their disease, the nurse should:

A. Provide the client with a written daily food and exercise plan.
B. Discuss eliminating junk food in the home with the parents.
C. Arrange for the school nurse to weigh the child weekly.
D. Utilize a peer with type 2 diabetes to role model lifestyle changes.
C 31. After 6 months of treatment with diet and exercise, a 12-year-old with type 2 diabetes still has a fasting
blood glucose level of 140 mg/dL (7.8mmol/L). The primary care provider has decided to begin metformin
(Glucophage). The adolescent asks how the medication works. The nurse should tell the client that the medicine
decreases the glucose production and:
A. Replaces natural insulin.
B. Helps the body make more insulin.
C. Increases insulin sensitivity.
D. Decreases carbohydrate adsorption.
C 32. A nurse is teaching an 8-year-old with diabetes and her parents about managing diabetes during illness. The
nurse determines the parents understand the instruction when they indicate that, when the child is ill, they will
provide:

A. More calories.
B. More insulin.
C. Less insulin.
D. Less protein and fat.
A, B, F 33. A nurse is assessing an 8-year-old with diabetes who is experiencing hyperglycemia. Which
symptom(s) indicate(s) that the hyperglycemia requires immediate intervention? Select all that apply.
A. Weakness.
B. Thirst.
C. Shakiness.
D. Hunger.
E. Headache.
F. Dizziness.
B 34. The nurse talks to an adolescent about how she can tell her friends about her new diagnosis of diabetes.
Which of the following behaviors by the adolescent indicates that the adolescent has responded positively to the
discussion?
A. She asks the nurse for material on diabetes for a school paper.
B. She introduces the nurse to her friends as “the one who taught me all about my diabetes.”
C. She says, “I'll try to tell my friends, but they'll probably quit hanging out with me.”
D. She asks her friends what they think about someone who has a lifelong illness.
D 35. The mother of an 8-year-old with diabetes tells the nurse that she does not want the school to know about
her daughter's condition. The nurse should reply:
A. “I think that would be a good idea.”
B. “What is it that concerns you about having the school know about your daughter's condition?”
C. “It would be fine not to tell your daughter's friends, but the teacher must know.”
D. “In order to keep your daughter safe, it is necessary for all adults in the school to know her condition.”