Health Care Expected To Help Fuel Job Growth Yet New Nurses Having Difficulties Finding Jobs

"Thousands more health-care workers, from doctors to nurses to physical therapists, will be needed in the coming decade in Florida and across the country to treat the increasing number of older Americans - particularly the enormous baby boom generation. According to the U.S. Bureau of Labor Statistics, health care is expected to generate 3.2 million new jobs through 2018, more than any other industry and mainly because of the increasing number of elderly. In Florida alone, U.S. Census data shows, the population of persons 65 and older is projected to increase by nearly 82 percent through 2020 to 5.1 million. Add to that scenario the game-changing effects of federal health-care reform and the rapid evolution of medical technology in diagnosing and treating disease and it's easy to see why job-growth projections in health care are so robust" (Zaragoza, 9/12).

Still, Nurse.com offers a different perspective on immediate job prospects for nursing students: "Despite a widely held belief that nursing was a 'recession-proof' profession, new graduates in many areas of the country report difficulty finding jobs. Surveys by the National Student Nurses Association of 2009 and 2010 new graduates show more than 40% of respondents had not found a nursing job by midsummer. The American Hospital Association reports an RN vacancy rate of 4% in March, down from 11.4% in 2006. Some nursing school deans say their students are having a much more difficult time finding jobs than in the past. ... Analysts say most of the hiring slowdown is because of the economy, with older RNs deciding to stay in the workforce because their retirement funds have not recovered from a stock-market drop in 2008, or a spouse was laid off, or they are just nervous about the economy" (Domrose, 9/12). Kaiser Health News: "One of the groups most affected by the changes in the new health law are medical school students. When they graduate - and complete the hospital residencies that follow - they will begin practice under a system that will be significantly different than when they began college. With millions more people expected to have health insurance, demand for primary care physicians is expected to go way up. Allison Fero, of Kaiser Health News, recently sat down individually with four medical students to discuss their career expectations, their concerns about the changing environment for doctors and their assessments of how the new law will affect the practice of medicine" (Fero, 9/13).

The Wall Street Journal: "Thirteen of Lenox Hill Hospital's doctors-in-training gather for one more class at the end of another long day of lectures and rounds: How to peel onions and chop garlic. It's a cooking class, and the organizers hope that it helps teach young doctors how to plan and cook nutritious meals so they can better advise patients on healthy eating. ... The program - which organizers say is the first of its kind in the city - includes six seminars on everything from nutrition, to weight management to exercise and a cooking class at the Institute of Culinary Education in Manhattan. It is based loosely on a joint project of the Culinary Institute of America and Harvard Medical School called Healthy Kitchens, Healthy Lives" (West, 9/11).

The Wall Street Journal, in a separate story: "There's a lot more to health care than doctors, lab results and complex reform bills. ... Dynamic and rapidly growing, the health care field offers young professionals the opportunity to explore emerging technologies while getting hands-on scientific and medical experience" (Cheney, 9/12).

The Boston Globe: "A new master's degree program at Dartmouth College is intended to bring more of the business of safety, cost-effectiveness, and efficiency into medicine. The program - launched by the college's new president, Dr. Jim Yong Kim, a longtime activist for better, less expensive medical care worldwide - is a response to the health care crisis. By training doctors and hospital administrators to think more strategically about the success rate of a particular type of surgery, for example, or ways to reduce waiting times in emergency rooms, medical care will get safer and more affordable, school officials say. The interdisciplinary master of health care delivery science program, which will be launched next summer, is a collaborative effort between the Tuck School of Business at Dartmouth and the Dartmouth Institute for Health Policy and Clinical Practice, the group that produces the Dartmouth Atlas of Health Care, which documents regional and hospital-by-hospital differences in how US medical resources are distributed and used" (Weintraub, 9/13).

Study Shows Local Standards Of Care Affect The Benefits Of Switching To New Treatement Alternatives

An analysis of a trial into how a new drug dabigatran was effective in preventing stroke in patients with atrial fibrillation has shown that local standards of care affect the benefits of switching to new treatments. This analysis of the RELY trial is reported in an Article Online First and in an upcoming Lancet, and is being presented at this week's European Society of Cardiology meeting in Stockholm, Sweden. The Article is by Professor Lars Wallentin, Uppsala University, Sweden, and colleagues.

The RELY study compared standard warfarin treatment with 110mg and 150mg twice daily doses of dabigatran. For warfarin treatment to be both safe and effective, blood tests are used to monitor its effects, which need to be kept within a very narrow window. This requires close monitoring and dose changes. As shown in the study there are large variations in standards of warfarin care between different centres and different countries. The standards of care can be estimated by averaging the time in the therapeutic range (TTR) for all warfarin treated patients in a centre (cTTR).This new analysis looked at whether or not the benefits shown by dabigatran in RELY were consistent even in centres that had poor INR quality control as estimated by cTTR.

The researchers showed there were fewer ischaemic strokes but not fewer occurrences of intracranial bleeding with increasing cTTR in the warfarin group. The value of cTTR had no effect influence on the the effect of dabigatran versus warfarin for preventing stroke. However, concerning cardiovascular mortality, bleeding and all cardiovascular events there risks were higher at centres with lower cTTR. Therefore concerning these events advantages of dabigatran versus warfarin were considerably larger at sites with poor standards of care.

The authors say: "Thus, these findings support the superiority of 150mg dabigatran twice daily and the non-inferiority of 110mg dabigatran twice daily versus warfarin for protection against stroke in atrial fibrillation irrespective of the quality of INR control that a centre can achieve."

But they add: "For secondary outcomes, such as non-haemorrhagic events and mortaility, advantages of dabigatran were reported for sites with poorer INR control, whereas results were comparable in sites with better INR control. Overall, these results show that local standards of care affect the benefits of switching to new treatment alternatives."

In a linked Comment, Dr Deirdre A Lane and Professor Gregory Y H Lip, University of Birmingham Centre for Cardiovascular Sciences, City Hospital, Birmingham, UK, says the findings mean oral anticoagulants would probably be advocated for an even greater proportion of patients with atrial fibrillation, in view of the future availability of the new oral anticoagulants, such as dabigatran, that overcome the disadvantages of warfarin.

They conclude: "Until the new oral anticoagulants become widely available (a positive advance), we should advocate tight INR control at conventional levels, for which there is a wealth of evidence for benefit, and promote strategies to improve the management of therapy with vitamin K antagonists [such as warfarin]."

Researchers Exploring 'Fusion Strategy' Against E-coli

South Dakota State University research is exploring a "fusion strategy" for making improved vaccines to protect pigs and humans against some strains of E. coli.

The SDSU researchers altered the toxins produced by a form of E. coli and genetically fused the non-poisonous "toxoid" to a protein known to cause an immune reaction. The resulting "fusion protein" could be used to develop a vaccine.

Assistant professor Weiping Zhang in SDSU's Veterinary and Biomedical Sciences Department studies a group of E. coli called enterotoxigenic Escherichia coli, or ETEC. Besides causing diarrheal illness in farm animals such as pigs, ETEC strains are the main source of bacterial-caused diarrhea in human populations in the developing world, and the chief cause of traveler's diarrhea. The World Health Organization estimates that ETEC causes approximately 210 million cases of illness in humans and 380,000 deaths, mostly in children in developing countries.

Enterotoxigenic E. coli produce enterotoxins that affect the tissues lining the intestine and cause the vomiting and diarrhea associated with ETEC.

The research is one of the ongoing projects in SDSU's Center for Infectious Disease Research and Vaccinology, which looks for new ways to diagnose and treat infectious disease in humans and domestic animals.

The ETEC project is innovative in that it uses as vaccine components, the toxins that scientists call "heat-stable enterotoxins," or STs, that are generally harmful to animals and humans and remain active even in a temperature of boiling water.

Zhang said heat-stable enterotoxins can't be used directly as a vaccine component because of their toxicity and because they are poor at causing an immune response unless coupled to a carrier protein. For that reason, many vaccine researchers working with ETEC focus their research on other disease-causing elements - the so-called heat-labile enterotoxins that are destroyed at high temperatures and the fimbriae, or appendages that help the bacteria hold on to the host and cause disease.

However, Zhang said not including STs as a vaccine component poses a problem because more than two-thirds of human ETEC diarrhea cases and more than one-fourth of ETEC diarrhea cases in pigs are caused by ETEC strains that produce a heat-stabile enterotoxin called STa.

"STa antigens must be included for developing broadly effective vaccines against ETEC infection," Zhang said.

The SDSU research explored an approach for using heat-stable enterotoxins.

"Since they are toxic, we cannot use them directly. So we mutated a gene. We only changed one amino acid for each toxin. And that change shifted them from toxic to non-toxic," Zhang said.

In the same way researchers mutated the gene that produces the heat-labile enterotoxin, which is known to produce an immune response. They then fused the two toxoids to produce a fusion protein.

mportantly, by tweaking only a few amino acids, the researchers left the protein structure of the bacterium largely intact. That is important, Zhang said, because just as the toxin has to bind to a receptor in the small intestine in order to cause the disease, the vaccine component must bind to that same receptor in order to cause an immune response.

Zhang and his colleagues published the study of their "fusion strategy" in January 2010 in the journal Infection and Immunity. Zhang's co-authors were Chengxian Zhang, David H. Francis, Ying Fang, and David Knudsen, all of SDSU; James Nataro of the University of Maryland School of Medicine; and Donald C. Robertson of Kansas State University.

In summer 2010 researchers began studying five possible vaccine components using a pig model. Once they select the best vaccine component, they'll move on to larger lab trials and field trials. The possibility of an improved swine vaccine is important because some estimates say swine producers lose $80 million a year because of illness in pigs in North America alone, Zhang said.

Meanwhile, since the toxins produced by ETEC in pigs and humans are nearly identical, Zhang and his colleagues are using the same system they've developed at SDSU for exploring a swine vaccine to explore a possible human vaccine.

Zhang has received $368,000 in grant funds for vaccine research against enterotoxigenic Escherichia coli-associated diarrhea in humans using a pig model that he and SDSU professor David Francis have developed. The research is sponsored by the U.S. Department of Health and Human Services' National Institutes of Health through its National Institute of Allergy and Infectious Diseases.

Zhang and his colleagues at three other institutions also have received about $1 million in support from the Bill & Melinda Gates Foundation for research into strategies for optimizing the vaccine for humans. Right now they have mutated only a single amino acid. The Gates Foundation wants to know if the vaccine components would be even more effective if researchers mutate other amino acids.

If the research leads to an improved vaccine either for pigs or humans, that entire process of developing the vaccine will take about 10 to 15 years, Zhang said.

Source:
South Dakota State University

July 2010 NLE result

Over 37,000 out of 91,008 passed the Nursing Licensure Examination that was given last July, According to a release by the Professional Regulatory Commission.

TOP 10

1. Rayan Abogado Oliva Ateneo de Naga 86.80%
2. Aileen Ancanan Austria De Los Santos-STI College, Inc.-(Delos Santos S.N.) 86.40%
3. Allyce Joana Toledo De Leon UST 86.00%
   Anna Vanessa Ang Gan UST 86.00% 
4. Alyssa Leonila Dela Silva Guiam CEU-Manila 85.80%
5. Charmaine Camacho Gauiran Remedios Trinidad Romualdez Memorial School 85.60%
   Vida Theresa Sibayan Gumangan Saint Louis University
   Abigail Diaz Icasiano Arellano University-Manila
   Weena Marie Bordeos Lim UST
   John Joseph Mayo Montalbo FEU-Manila
   Jan Michael Gabionza Ong Our Lady of Fatima University-Valenzuela
   Joan Dioquino Tejada Remedios Trinidad Romualdez Memorial School
6. Zyrus Ronn Samson Bernasor Our Lady of Fatima University-Valenzuela 85.40%
   Rouchel Anne Mañez Briones UP-Manila 85.40%
7. Peter James Bongolan Abad UP-Manila 85.20%
   Merjorie May Malicay Adolfo Cebu Normal University
   (Cebu State College)
   Clarence Joy Lozada Custodio Saint Joseph College-Cavite City
   Nico Paulo Maniago Dimal Angeles University Foundation
   Kris Ray Arcelo Dumaguin Velez College
   Stela Joy Ramirez Engada West Visayas State University-La Paz
   Jan Christian Gomez Feliciano UST
   Jose Paolo Julian Galeon Tarlac State University
   (Tarlac College of Tech.)
   Paulo Kristoffer Lumba Macasinag De La Salle University-Health Sciences Institute
   Joy Ann Acierto Tan Notre Dame of Dadiangas College
   Emer Joy Tapic Vale University of Bohol
8. Hana Kirstie San Miguel Abello UP-Manila 85.00%
   Kea Tena Capio UST
   Ana Francesca Caballero Centeno UST
   Grace Cecile We Co UP-Manila
   Michael Prince Notorio Del Rosario Lorma College
   Rouella Christina Martin Fajardo UST
   Joe Mari Abella Flores Cebu Normal University
   (Cebu State College)
   Donna May Sison Fronda Saint Joseph College-Cavite City
   Renan James Sace Lim UST
   Romina Tan Manaloto Our Lady of Fatima University-QC
   Marian Sheryl Flores Milo Saint Louis University
   Maria Kriselda Perez Rosales Lyceum of the Philippines University-Batangas,Inc
   Cristina Gan Satiada Chinese General Hospital Colleg of Nursing&Liberal Arts
   Laurence Lester Gamboa Tan UST
   Elise Cara Kaw Teng Trinity University of Asia (Trinity-QC)
   Marie Kathrina Torralba Tojong University of the Visayas-Mandaue City
   Jaylyn Gabrillo Villafania Saint Louis University
9. Jamela Montoya Arcilla FEU-Manila 84.80%
   Czarina Myrnelli Mamore Buenafe Northwestern University
   Arcel Tiatco Cabigting Angeles University Foundation
   Elaine Katrina Sigalat Cala UST
   Julie Ann Del Rosario Clarin UST
   Ancel Rivera De Guzman Holy Angel University
   Eleanor Deloeg Dela Paz Saint Louis University
   Ria Leah Oropesa Esporlas University of Perpetual Help System Dalta-Las Piñas
   Elaine Medina Lapaan Saint Louis University
   A Nico Nahar Idris Pajes Ateneo de Zamboanga
   Ana Jeska Sana Peñaranda West Visayas State University-La Pas
   Jan Roland Casinto Pomuceno Notre Dame of Dadiangas College
   Angeline Villarey Rempillo Our Lady of Guadalupe Colleges
   Nicael Dela Cruz Salazar Pamantasan ng Lungsod ng Pasig
   Ferie Angelica Yvan Soriano Silvino FEU-Manila
   Ivy Barrete Susvilla Cebu Normal University
   (Cebu State College)
   Kara Deneice Santos Tueres Our Lady of Fatima University-Valenzuela
   Ace Brian Samaniego Verallo Our Lady of Fatima University-Valenzuela
10. Abegael Panciles Bacol Manila Doctors College 84.60%
    Ramon Carlo Arpon Baring CEU-Manila
    Robert Iben Barit Medical College of Northern Philippines
    Livia Dedoroy Barrieses Riverside College
    Maria Virginia Cinco Cuayzon Our Lady of Fatima University-Valenzuela
    Kathleen Anne Palanca De Leon Chinese General Hospital College of Nursing&Liberal Arts
    Mark Anthony Santos De Luna Our Lady of Fatima University-Valenzuela
    Edwin Suarez Del Rosario II UST
    Eunice Pablico Empeño UST
    Greg Ely Cambaya Flores Our Lady of Fatima University-QC
    Marcius Antonius Balcita Gacayan Union Christian College
    April Joy Diane Garing Galicia Wesleyan University-Philippines-Cabanatuan City
    Mary Joy Sarrosa Garbanzos University of Saint La Salle
    Angeli Palisoc Garcia Trinity University of Asia (Trinity-QC)
    Sara Jane Jaide Labbay Ateneo De Zamboanga
    Micca Flores Lagleva UST
    Razel Mae Nacua Libot Cebu Normal University
    (Cebu State College)
    Alexandra Basañez Macalintal Ateneo De Zamboanga
    Kristine De La Cruz Macasero Cebu Normal University
    (Cebu State College)
    Celeste Imperial Madueño Manila Doctors College
    Sallie Ria Delos Santos Malayan Lyceum of the Philippines University-Manila
    Jan Paula Espiritu Martinez Universidad De Manila (City Coll. of Manila)
    Kimberly Chan Mendoza Saint Louis University
    Marie Paz Lacanlalay Nolasco Medical College of Northern Philippines
    Robelou Lizano Ong FEU-Manila
    Jodellene Fernandez Perocho CEU-Manila
    Clinton Rosita Rabadon Bicol University-Polangui
    Erika Genina David Ronquillo Holy Angel University
    Dioliza Montenegro Sacil Universidad De Santa Isabel (Col De Sta Isabel)
    Katherine Mejia Viacrusis Trinity University of Asia (Trinity-QC)

Top Performing Schools with 30-99 and more Examinees

Top-Performing-Schools-with-30-99-Examinees -


NURS0710se225.



Top Performing Schools

GSDMSFI 4th year student Nursing Research

Dear Sir/Madam:

We, a group of 4th year nursing students of GSDMSFI is presently conducting a study entitled “FACTORS AFFECTING THE NLE PERFORMANCES OF THE NURSING GRADUATES OF GENERAL SANTOS DOCTOR’S MEDICAL SCHOOL FOUNDATION INC.,”

In line with this, we humbly ask your permission to participate for this study. Data gathered will be considered confidential and will be respected.

Your cooperation and support will be deeply appreciated

NCLEX-RN Information: CHOOSING THE RIGHT STATE

Most of the people I met and honestly I also had my share of this "phase" which is having a problem of determining which state to apply to. But this is one of the most crucial part in terms of moving forward to your NCLEX-RN application process.

Choosing the right state can pose many questions to an applicant. But sometimes we need not complicate things really.

People tend to choose a state basing it on which state process papers fastest. Which is a not so bad idea considering that you really do not have a target state or you do not have relatives in the USA or basically really do not care what state you get in to as long as you are there in the US.

But if you have relatives or very close friends in certain US states then I think that is the best way to go. The effects of making this choice comes after actually when you already passed the NCLEX-RN exam and when you finally get your visas and work there. Life in the US can be pretty hard especially if you do not have someone to depend on too. It helps if you have relatives or friends atleast you can get advices, help or anything to get you started with your life.

What other people do is that they apply to a state that gives eligibility fast and then after passing the NCLEX-RN exam apply to their decided state this is what they call application by endorsement. This is okay esepecially if you have the resources financially and well it varies from state to state how their process. The length of this process vary from one state to the other since you would still have to fulfill the requirements of the state you intend to endorse to. There are also compact states which can affect the results of your endorsement.

So as an ending point in this article, please bear in mind that sometimes the fastest way isn't always the best option. But if you got nothing to lose then sometimes it doesn't hurt to take a risk. But whatever it is you decide on think it over a hundred times remember you cannot afford to commit mistakes.

Hopefully with this article we were able to make things easier for you and good luck on finding the right state that suits you best!

IELTS: Tips and Information

IELTS Examination is given here by 2 Companies, IDP Australia and the British Council. Here are some of the information about these 2 companies.

BRITISH COUNCIL
IELTS Administrator
10/F Taipan Place
Emerald Avenue
Ortigas Centre, Pasig City 1605

Tel: 632 9141011-14
Fax: 632 9141020
Email: ielts@britishcouncil.org.ph
Web: http://www.britishcouncil.org.ph

IDP AUSTRALIA
ELTS Administrator
2nd Floor Pioneer House Makati
108 Paseo de Roxas, Legaspi Village
Makati City, Metro Manila 1229(located accross Starbucks in the Old Greenbelt)

Tel: 632 816 0755
Fax: 632 815 9875
Office Hours: 9:30am to 4pm (Monday to Friday)
Saturdays: Half Day
Email: info@manila.idp.com

Test Fee: Php 8640.00M
More information with regards to IDP Australia

When you try to give them a call do not expect to be able to talk to an operator. All you can get is automated informations but most of the questions you have in mind would be found in one of the prompted message.

IDP Australia only accepts cash and manager's check as payments. If you are to make a manager's check please make it payable to IDP EDUCATION AUSTRALIA. Please be reminded to check their site or give them a call since prices may change without any prior notice.

It would also save you a lot of time if you download the application form from the website and accomplish it before proceeding to their office for submission.

Please bring additional pictures just in case though in your application you would already be submitting 2 passport size pictures.

DO NOT forget to bring your valid ID usually people bring their passport or their PRC License.

Upon submission and paying please wait for a few days to a week to receive a letter coming from them regarding the details of your exam such as the venue, time, date and even the location map of your exam venue.

Usually 2 weeks before the test date that you wish to schedule is sufficient to be rostered for that exam. This would still depend on the number of examinees applying for a certain date.

On the day of the exam, one thing that you should never forget is your IDENTIFICATION CARD you used when applying since this would be the only one that would be accepted as your reference and entry for the exam. Try not to bring many valuables on the day of the exam since all of your things would be deposited in one area without any numbers so anything can happen but so far no incidents but just for your own safety. Only cellphones are the ones wherein they give numbers when deposited but as for bags they just place it in one area.

California Board of Nursing Application Tips

Take note that these tips are for the FIRST TIME CALIFORNIA STATE BOARDS TEST TAKERS. If you are going to reexamine there will be a different form to accomplish.

HOW TO OBTAIN THE APPLICATION FORM
First get a copy of the California Board of Registered Nursing Application Form. You will need ADOBE READER to view the file. The file is around 27 pages long including explanations and the actual forms needed.

APPLICATION FOR LICENSURE BY EXAMINATION
This is one of the first forms that you will need to accomplish basically it includes your personal information. Fill in the necessary information and here are some tips and frequently asked questions I encountered when filling up this form.

• 
  
  ADDRESS: If you have a relative or family member residing abroad whom you can trust and at the same time ask for little favors then if possible try using a US Address they say that it makes communication faster between you and the Board of Nursing just in case they need something from you. Also it is obvious that mailing time would be faster since letters are only transmitted to the same country as compared to having it mailed in another country. I also say ask for little favors because technically speaking when you mail your forms it would have to come from that US address too so what will happen is that if you are here in the Philippines you will mail the personal forms to your relatives address and they will be the one to mail it to the Board of Registered Nursing... sounds complicated but I hope you get what I mean. If you do not know anyone abroad then just use your address here in the Philippines.
• 
  
  Social Security Number: Most of us do not have this not unless you can legally work in the US so in most cases you just leave it blank.

• 
  
  Place your 2x2 picture on the second page beside the date on the lower part of the page using tape NOT glue.

The rest of the application are pretty much slef explanatory so this form has 2 pages. There is a part about an INTERIM PERMIT which basically says that they give you like a temporary permit to work while while waiting for the exam results which is valid for 6 months or until your results have been released. Personally, I did not avail of it since I won't be able to use it since I do not have papers to work in the US and most often than not they prioritize US nursing graduates for positions in hospitals. So I would rather keep the $35.

REQUEST FOR TRANSCRIPT

One of the forms for the California BON is the forms to be given to your school registrar and then they would be the one to submit it thru mail to the California BON. As for my tip just try to clarify everything with your school registrar so that less errors would be made in terms of processing.

BREAKDOWN OF EDUCATIONAL PROGRAM FOR INTERNATIONAL NURSING PROGRAMS and NURSING PROGRAM VERIFICATION

Just fill out the parts where it asks you to fill which is basically the personal information and the rest will be filled out by your nursing program. Usually they mail it together with your TOR which was filled by the school registrar.

LETTER OF EXPLANATION or COPY OF LOCAL LICENSE

If you do not have your local license yet just email them your board certification that you passed which you can request in PRC once you know you passed the exam. And well if you have your license already then just scan it and print it and attach it together with the other documents you will submit.

FINGERPRINT CARD

You would have to request for this separately you can request by going to this link:

So to summarize everything here are the forms that you will mail to the California BON: Fingerprint Request. Read thru the instuctions there and wait for it to arrive in your mail. Then you can accomplish the fingerprint in the NBI in Carriedo. I am not sure if it can be done in other NBI branches.

Once accomplished, mail it together with your other forms and DO NOT BEND the fingerprint card so if you can place it in a hard envelope the better. What I did was I improvised an envelope using a folder. They just need one copy but just in case the print is rejected provide them another copy so you would not have to mail it separately when they ask for another one.

Here are the things that YOU will mail to California BON:

• 
  
  Application for Licensure by Examination (2)
• 
  
  Letter of Explanation/ Copy of PRC License
• 
  
  Request for Disabilities Form (if applicable)
• 
  
  Fingerprint Card (2)

Things that the SCHOOL will mail to Cali BON:

• 
  
  Request for Transcript form + TOR and RLE Records
• 
  
  Breakdown of Educational Program for International Nursing Programs Form
• 
  
  Nursing Program Verification Form

As much as i am giving here tips and guidelines please refer and read the instructions that comes with the forms. There might have been changes in terms of fees and other instructions so it is important to refer to them still.

The processing of my application took about 2 months but then they requested for subject description so it took me another month to accomplish that. But I think the subject description is a case to case basis.

Last tip, oif you are to use Fed Ex or Special Couriers in mailing remember that they will not accept PO Box address that comes with the form so you can use this address instead:

Board of Registered Nursing

1625 North Market Blvd,

Suite N217 Sacramento, CA 95834-1924

Mastering ANTIEMETICS : A story towards mastery

This story will let you master all anti emetic drugs that are usually prescribed to the patients with nausea and vomiting.

I created this story because of frustration on how to retain those anti-emetics that are very very frequently asked in the local board exams and in NCLEX / CG Books. Also take note that TAGAMET and PEPCID are antacids used for heartburn that are also used to prevent nausea and vomiting. MAALOX has many many uses, but it is mainly an Antacid. The rest, are intended for nausea and vomiting. I did not include BENADRYL because it has variety of purpose, one is to prevent nausea, vomiting and dizziness specially for patients with Endolymphatic Hydrops [ Menieres Disease ]

Si Marinol At Penny

Inap na Inap [INAPRINE] na si marinol [MARINOL] sa kakaantay sa kanyang maal [MAALOX] na si penny. [PHENERGAN]

Dumating na si penny, [PHENERGAN] na Tagamet-ro [TAGAMET] manila pa.

Zofra ka na! [ZOFRAN] Sabay Compaz [COMPAZINE] ng kamay si marinol [MARINOL] para manampal.

Naubos ko na ang pepsi [PEPCID] dito sa tindahan, Ni regla [REGLAN] na ako kaantay bakit ngayon ka lang?

Honey, and drama drama [DRAMAMINE] mo naman.

Communicable Disease Nursing Study Bullets

Communicable Disease Nursing

DRUG OF CHOICE

Tetanus: PEN G Na; DIAZEPAM (Valium)
Meningitis: MANNITOL (osmotic diuretic); DEXAMETHASONE (anti-inflammatory); DILANTIN/PHENYTOIN (anti-convulsive); PYRETINOL/ENCEPHABO L (CNS stimulant)
Rabies Vaccines: LYSSAVAC, VERORAB
Immunoglobulins: ERIG or HRIg
 
DIAGNOSTIC TESTS
 

Tetanus: WOUND CULTUREMeningitis: LUMBAR PUNCTUREEncephalitis: EEGPolio: EMG; Muscle testing
Rabies: Brain biopsy (Negri bodies) Fluorescent rabies antibody test
Dengue: TOURNIQUET test (Rumpel lead)
Malaria: Malarial smear; QBC (Quantitative Buffy Coat)
Scarlet: DICK'S TEST; SCHULTZ-CHARLTON TESTDiphtheria: SCHICK'S TEST; Moloney's TestPertussis: Nasal swab; agar plateTuberculosis: MANTOUX testLeprosy: SLIT SKIN SMEAR
Pinworm: SCOTCH TAPE SWAB
Typhoid: WIDAL'S test
HIV/AIDS: ELISA; WESTERN BLOT; PCT: Polymerase Chain Reaction Test

CAUSATIVE AGENTS
 
Tetanus: CLOSTRIDIUM TETANIMeningococcemia: NEISSERIA MENINGITIDIS
Rabies: RHABDOVIRUS
Poliomyelitis: LEGIO DEBILITANS (Type I Brunhilde); (Type II Lansing); (Type III Leon)
Dengue Fever: ARBOVIRUSES (Chikunggunya); (Onyong-nyong); (West Nile); (Flaviviruses) (Common in the Phil.)Malaria: PLASMODIUM (protozoa) P. Falciparum (most fatal); P. Vivax P. Malariae; P. OvaleFilariasis: WUCHERERIA BANCROFTI; BRUGIA MALAYI
Leprosy: MYCOBACTERIUM LEPRAE
Measles: PARAMYXO VIRUSGerman measles: TOGA VIRUS
Chicken pox: VARICELLA ZOSTER VIRUSHerpes zoster: HERPES ZOSTER VIRUS
Scarlet fever: Group A HEMOLYTIC STREPTOCOCCUS
Scabies: SARCOPTES SCABIEI (itch mite)Bubonic plague: YERSINIA PESTIS
Diphtheria: KLEBS LOEFFLERPertussis: BORDETELLA PERTUSSIS
Tuberculosis: MYCOBACTERIUM TUBERCULOSISTyphoid: SALMONELLA TYPHICholera: VIBRIO CHOLERA
Amoebiasis: ENTAMOEBA HYSTOLITICA
Leptospirosis: LEPTOSPIRA Spirochete
Schistosomiasis: Schistosoma japonicum
Gonorrhea: N. GONORRHEAESyphilis: TREPONEMA PALLIDUMChlamydia: C. trachomatis, T. vaginalisGenital herpes: HERPES SIMPLEX 2

CD PHARMACOLOGY


Malaria: CHLOROQUINE
Schistosomiasis: PRAZIQUANTEL
Scabies: EURAX/ CROTAMITON
Chicken pox: ACYCLOVIR/ZOVIRAX
Tuberculosis: R.I.P.E.S.
Pneumonia: COTRIMOXAZOLE; Procaine PenicillinHelminths: MEBENDAZOLE; PYRANTEL PAMOATE

Anti Depressants : A Story Towards Mastery

The Psychiatric nursing part of the NLE always tend to ask you to classify drugs if they are antidepressants, major tranquilizer, anxiolytics, antiparkinsons, etc.

It is really hard to memorize these all. Remember the story of Marinol and Penny? How about Tranxene? This is our third story and hopefully, I can come out with the fourth one. I dont know if these things help you, but These are the things I used to memorize drugs that are impossible to memorize using traditional methods.

This is original and not copied from anywhere else. Post away and tell me if this help so I can know If the application of this strategy is universal, or only works with students who appreciate stories.

This is a very nice strategy for instructors who want to divert students' attention, fooling them that you are telling a story but in the real essence, you are teaching drugs and their classifications in a really unexpected way.

Si Nora, Ana at Ela.
By : Budek

Depressed ang magbarkadang si NORA, [ Norpramine ] ELA [ Elavil ] at ANA [ Anafranil ] At nagpunta ang tatlo sa AVENIDA [ Aventyl ] Para makilahok sa welga. Sila ay mga TOFnotchers [ Tofranil ] ng kanilang mga unibersidad at mga ASCENDERA [ Ascendin ] ng kanikanilang mga angkan.

" IMPRISON [ Imprin ] Dionisio and Madeja! Sunugin SINA KUAN! [ Sinequan ] VIVA [ Vivactyl ] Nursing Students! " Ang sinisigaw ng mga magkakabarkada at nakasulat sa kanilang rally banner.

Dumating SI LEX [ Celexa ] Ang pinaka FAVERITE [ Faverine ] na newscaster sa pinas.

Nora, Ana, Ela : " Mga PRO [ Prozac ] Retake kami! Di namin LUV [ Luvox ] ang mga PAXIL [ Paxil ] na Board examiners na yan! Mabuti pang mag ZOLO [ Zoloft ] Nalang kami at pupunta sa PANAMA[ Parnate, Nardil, Marplan ] at doon nalang kami mag nurse! Ang sagot ng mga magkakabarkada.

NOTE :

From NORPRAMINE up to VIVACTYL = TCAs
From CELEXA up to ZOLOFT = SSRI
Parnate, Nardil and Marplan are MAOI


Post away your comments and suggestions.

ABOUT BREAST FEEDING

ABOUT BREAST FEEDING

I. Physiology of Breast milk production

As soon as delivery of the placenta is over there will be an abrupt decrease on both Estrogen and Progesterone -----> this will stimulate the APG to secrete PROLACTIN.

note: Be aware that sucking also stimulates Prolactin secretion as this will stimuate the nerves and impulse will travel from the nipple to the Hypothalamus

PROLACTIN will act on the acini cells (alveolar cells) of the breast to produce milk. This milk is called FOREMILK and is stored in the lactiferous sinus. FOREMILK is contiously being produced.

What happens next?

When the baby sucks on the breast of the mother OXYTOCIN is stimulated and oxytocin will act on 2 organs.

1. Breast (Let down reflex)
2. Uterus (promotes Involutions)

OXYTOCIN will cause the mammary galnds to contract and push the milk forward making it available for the baby.

What will stimulate the Let Down reflex?
1. Sucking of the baby
2. Sound of the baby's cry

note: After the Let Down Reflex a new milk will be formed and this is called HINDMILK and this contains more FATS that is needed for the growing newborn

.STAGES OF BREASTMILK:
1. Colostrum - 2-4 days present
-content: decrease fats, increase IgA, dec CHO, dec CHON, inc minerals, -inc fat soluble minerals
2. Transitional milk- 4 – 14 days
-content: inc lactose, inc water soluble vit., inc minerals

3. Mature milk- 14 & up
-content: inc fats (linoleic acid) – resp for devt of brain & integrity of skin
-inc CHO- lactose – easily digested, baby not constipated.- esp of sour milk smelling odor of stool.

-Lactose intolerance- deficiency of enzyme LACTASE that digest LACTOSE
-Decrease CHON- lactalbumin

Difference with cow's milk

Cows milk
–inc fats -Dec CHO
-Inc CHON – casing- has curd that’s hard to digest.
-Inc minerals–traumatic effect on kidneys of babies. Can trigger stone formation.
-Inc phosphorusnote:

Note Baby who are breastfed are least likely to develop tetany. It is seen that botlle fed infants have more difficulty in regulating calcium and phosporus. Because cow's milk have more fat contents, this fatty acids may bind with calcium in the GIT causing more decrease in calcium.

Note: Breast feeding can be iniated
if had Cesarian Section- after 4 hours
if NSD, ASAP

Advantages of Breast feeding
1. Economical
2. Always available
3. Breastfed babies have higher IQ than bottle fed babies.
4. It facilitates rapid involution
5. Decrease incidence of breast cancer.
6. Has antibodiesI(gA), lactoferrin, lyzozymes and interferon (inhibit and/or destroy pathogenic bacteria and viruses)
7. Has lactobacillius bifidus- interferes with attack of pathogenic bacteria in GIT
8. Has macrophages
Store milk- plastic storage container
Store milk – good for 6 months from freezer- put rm temp. don’t heat

Disadvantages:
1. Possibility of transfer HEP B, HIV, cytomegalo virus.
2. No iron
3. Father can’t feed & bond as well

Proper breast feeding technique

1. Be in a comfortable position
(Most appropriate is Upright sitiing for this position avoids tension)
2. Entire body of teh baby should be turned towards the mother's breast.
3. Initiate feeding by stimulating the Rooting reflex- by touching the side of lips/cheeks then baby will turn to stimulus. Disappear by 6 weeks- by 6 weeks baby can focus. Reflex will be gone-
Purpose rooting- to look for food.

Sucking Mechanism (breast)
a. Lips of the infant should clamp a C-shape
b. The tounge thrusts forward to grasp nipple and areola
c. The nipple is brought against the ahrd palate as the tounge pulls the areola into the mouth
d. the gums compresses the areola, squezing milk at the back of the throat

Sucking mechanism (bottle)
The large rubber nipple strikes the soft palate and interferes with the action of the tounge. The tounge moves forwards against the gum to control overflow of milk in the espphagous (same reason why dental malocllusion is prone to bottle fed babies, because they thrust their tounge FORWARD causing problem in the formation od the dental arch)

4. Burp or Bubble the babyduring and after feeding to allow escape of air (preventing colic). Sit infant on lap, flexed forward, then rub or pat the back (note: avoid jarring the infant)

Criteria of Effective Sucking
a.) Baby’s mouth is hiked up to areola
b.) Mom experiences after pain.
c.) Other nipple is also flowing with milk.

NOTE: Make sure that the mother feeds the baby at the same breast she last feed her baby. THis is to facilitated complete emptying of the breast and thereby promote complete filling of milk.

Contra Indications in Breast Feeding:
a. Maternal Conditions:
1. HIV, CMV, Hepa B
2. Recieving Coumadin, Lithium or Methotrexate
3. has breast cancer
4. has herpes lesion on breast

b.Newborn Condition - Inborn errors of metabolism usch asErythrobastosis Fetalis – Rh incompatibility, Hydrops Fetalis, Phenylketonuria, Galactosemia, Tay Sachs disease

Problems experienced in Breastfeeding :

3RD day changes in breast post partuma.1
1)Engorged breast- feeling of fullness & tension in breast. - sometimes accompanied by fever known as MILK FEVER.
Mgt:Warm compress- for breastfeeding momCold compress
– for bottle feeding & wear supportive bra.
When is involution of breast- 4 weeks

b.) Sore nipple – cracked with painful nipple
Mgt: 1.) exposure to air – remove bra & wear dress, if not, expose to 20 Watt bulbavoid wearing plastic liner bra-will create moisture, cotton only

c.) Mastitis- inflammation of breast : staphylococcus aureus
Factors:
1. Improper breast emptying
2. Unhealthy sexual practices
- manually express inflamed breastfeed on unaffected breast- give antibiotics
– can still feed on unaffected breast

Type of stools with different milk products:

1. Transitional stool - - green loose & shiny, like diarrhea to the untrained eye
2. Breastfed stool
- golden yellow, soft, mushy with sour milk smell, frequently passed
- recur every feeding
3.. Bottlefed stool –
- pale yellow, formed hard with typical offensive odor, seldom passed, 2–3 x/day
- with food added -brown; odorous

PRC UPDATE

The results of the July, 2010 Licensure Examination will be released on the last week of August, 2010. 

BOARD OF NURSINGRESOLUTION 
NO. 2010- Series of 2010 
July 29, 2010

Oathaking Ceremony

The Oathaking Ceremony for the succesful examinees of july 2010 NLE is set to unleased on SEPTEMBER 20-21, 2010 with live video streaming. Further information will be posted soon.

Meanwhile, the result of the anticipated July 1010, NLE will be released on the LAST WEEK OF AUGUST 2010 per BON resolution No. 17. Series of 2010.

Tips On How To Get The Best Nursing Shoes

The purchase of shoes is an area that cannot be stressed enough in the nursing field. In the past nurses wore the traditional white shoes that set a nurse apart from other professions. Over time, this has changed, and there are several other styles available, with some nurses even choosing to wear either white or black sneakers instead of the traditional shoes.

The issue with shoes is that you must toss style for comfort when you are on your feet all day long. Many women, especially the younger ones, prefer style to comfort, but in the years to follow this line of thinking will take a toll on not only their backs but feet as well.
There is a great deal of controversy among health care professional about what shoes are the best for being on your feet eight to twelve hours a day, but the majority seem to feel that Nurse Mates are far from being the most comfortable. In fact, of the reviews published on this subject, many nurses and health care professionals complained that their feet actually hurt at the end of their shift.

Although in the past Nurse Mates seemed to be the industry standard, many are headed toward the New Balance walking shoe or the Naturalizer for comfort and durability. Another popular brand is Dansko, which is reported as being quite expensive but also very comfortable and durable.

A great many seem to also endorse the use of Dr. Scholl's gel insoles for taking the pressure off the back while working long shifts. Several professionals also endorse the use of custom made orthotics, but the cost at $150 a pair can be out of line for many people.
Since each person's feet adjust to different situations differently, the best thing you can do is go to a store at the end of your shift while your feet are tired and swollen from the day's work and try on several pair of shoes. Once you find the ones that feel the best on your feet, you may choose to go online and order them at a cheaper price than the shoe store has to offer.

The important thing to remember is that when you work on your feet, you must take care of them, no matter what the cost may be. Ill-fitting shoes will not only do damage to your feet but to your back as well because of the way you will walk to ease the pain in your feet from the shoes. Even if you buy a cheap uniform at the second hand store, buy the best shoes for your individual feet and don't give a second thought to the cost. After all, if you can't stand on your feet in the nursing profession, you can't do your job.

RE-SCHEDULING DECEMBER 2010 NLE

The scheduled Nurses Licensure Examination (NLE) on December 12 and 13, 2010 has been moved to DECEMBER 19 and 20, 2010 per Board of Nursing (BON) Resolution no. 2010. Furthermore, the Board also announces that the deadline of filing of applications for repeater applicants is moved from September 8, 2010 to SEPTEMBER 28, 2010.

Moreover, the results of the July, 2010 Licensure Examination will be released on the last week of August, 2010. 

BOARD OF NURSINGRESOLUTION 
NO. 2010- Series of 2010 
July 29, 2010

th Joseph Eribaren Memorial Nursing Lecture

We cordially invite you to the

6th Joseph Eribaren Memorial Nursing Lecture
"Effectiveness of Nursing Practice in Primary Health Care"
10 August 2010
1-3 PM
AVR 2, Notre Dame of Dadiangas University
Marist Avenue, General Santos City


The Mari Immaculees Batch 1993 has collaborated with the College of Nursing and the NDDU Nursing Alumni Association Inc. for the conduct of the 6th edition of the Joseph Eribaren Memorial Nursing Lecture. Mr. Eribaren was a public health nurse who died of leukemia in 2000. He belonged to the class of 1993. This event is memorialized by his 1993 classmates to heighten the involvement of alumni members in the school affairs as well as provide an opportunity for educational update from leading authorities in nursing and health related issues.

An integrated presentation will be made by Prof. Vito de Raya, RN, MPH of the College of Nursing, University of the East, and will be followed by reactions from guests.

We hope you can attend this enlightening discussion. This event is FREE of charge. The limited seats are available to registrants on a first-come, first-served basis.

Please confirm your attendance by sending a reply message on or before August 4, 2010.

60 Item Pediatric Nursing

Situation 1: Raphael, a 6 year’s old prep pupil is seen at the school clinic for growth and development monitoring (Questions 1-5)

1. Which of the following is characterized the rate of growth during this period?
a. most rapid period of growth
b. a decline in growth rate
c. growth spurt
d. slow uniform growth rate

2. In assessing Raphael’s growth and development, the nurse is guided by principles of growth and development. Which is not included?
a. All individuals follow cephalo-caudal and proximo-distal
b. Different parts of the body grows at different rate
c. All individual follow standard growth rate
d. Rate and pattern of growth can be modified

3. What type of play will be ideal for Raphael at this period?
a. Make believe
b. Hide and seek
c. Peek-a-boo
d. Building blocks

4. Which of the following information indicate that Raphael is normal for his age?
a. Determine own sense self
b. Develop sense of whether he can trust the world
c. Has the ability to try new things
d. Learn basic skills within his culture

5. Based on Kohlberg’s theory, what is the stage of moral development of Raphael?
a. Punishment-obedience
b. “good boy-Nice girl”
c. naïve instrumental orientation
d. social contact

Situation 2 Baby boy Lacson delivered at 36 weeks gestation weighs 3,400 gm and height of 59 cm (6-10)

6. Baby boy Lacson’s height is
a. Long
b. Short
c. Average
d. Too short

7. Growth and development in a child progresses in the following ways EXCEPT
a. From cognitive to psychosexual
b. From trunk to the tip of the extremities
c. From head to toe
d. From general to specific

8. As described by Erikson, the major psychosexual conflict of the above situation is
a. Autonomy vs. Shame and doubt
b. Industry vs. Inferiority
c. Trust vs. mistrust
d. Initiation vs. guilt

9. Which of the following is true about Mongolian Spots?
a. Disappears in about a year
b. Are linked to pathologic conditions
c. Are managed by tropical steroids
d. Are indicative of parental abuse

10. Signs of cold stress that the nurse must be alert when caring for a Newborn is:
a. Hypothermia
b. Decreased activity level
c. Shaking
d. Increased RR

Situation 3 Nursing care after delivery has an important aspect in every stages of delivery

11. After the baby is delivered, the cord was cut between two clamps using a sterile scissors and blade, then the baby is placed at the:
a. Mother’s breast
b. Mother’s side
c. Give it to the grandmother
d. Baby’s own mat or bed

12. The baby’s mother is RH(-). Which of the following laboratory tests will probably be ordered for the newborn?
a. Direct Coomb’s
b. Indirect Coomb’s
c. Blood culture
d. Platelet count


13. Hypothermia is common in newborn because of their inability to control heat. The following would be an appropriate nursing intervention to prevent heat loss except
a. Place the crib beside the wall
b. Doing Kangaroo care
c. By using mechanical pressure
d. Drying and wrapping the baby

14. The following conditions are caused by cold stress except
a. Hypoglycemia
b. Increase ICP
c. Metabolic acidosis
d. Cerebral palsy

15. During the feto-placental circulation, the shunt between two atria is called
a. Ductus venosous
b. Foramen Magnum
c. Ductus arteriosus
d. Foramen Ovale

16. What would cause the closure of the Foramen ovale after the baby had been delivered?
a. Decreased blood flow
b. Shifting of pressures from right side to the left side of the heart
c. Increased PO2
d. Increased in oxygen saturation

17. Failure of the Foramen Ovale to close will cause what Congenital Heart Disease?
a. Total anomalous Pulmunary Artery
b. Atrial Septal defect
c. Transposition of great arteries
d. Pulmunary Stenosis


Situation 4 Children are vulnerable to some minor health problems or injuries hence the nurse should be able to teach mothers to give appropriate home care.

18. A mother brought her child to the clinic with nose bleeding. The nurse showed the mother the most appropriate position for the child which is:
a. Sitting up
b. With low back rest
c. With moderate back rest
d. Lying semi flat

19. A common problem in children is the inflammation of the middle ear. This is related to the malfunctioning of the:
a. Tympanic membrane
b. Eustachian tube
c. Adenoid
d. Nasopharynx


20. For acute otitis media, the treatment is prompt antibiotic therapy. Delayed treatment may result in complications of:
a. Tonsillitis
b. Eardrum Problems
c. Brain damage
d. Diabetes mellitus


21. When assessing gross motor development in a 3 year old, which of the following activities would the nurse expect to finds?
a. Riding a tricycle
b. Hopping on one foot
c. Catching a ball
d. Skipping on alternate foot.

22. When assessing the weight of a 5-month old, which of the following indicates healthy growth?
a. Doubling of birth weight
b. Tripling of birth weight
c. Quadrupling of birth weight
d. Stabilizing of birth weight


23. An appropriate toy for a 4 year old child is:
a. Push-pull toys
b. Card games
c. Doctor and nurse kits
d. Books and Crafts

24. Which of the following statements would the nurse expects a 5-year old boy to say whose pet gerbil just died
a. “The boogieman (kamatayan- the man with the scythe) got him”
b. “He’s just a bit dead”
c. “Ill be good from now own so I wont die like my gerbil”
d. “Did you hear the joke about…”


25. When assessing the fluid and electrolyte balance in an infant, which of the following would be important to remember?
a. Infant can concentrate urine at an adult level
b. The metabolic rate of an infant is slower than in adults
c. Infants have more intracellular water that adult do
d. Infant have greater body surface area than adults


26. When assessing a child with aspirin overdose, which of the following will be expected?
a. Metabolic alkalosis
b. Respiratory alkalosis
c. Metabolic acidosis
d. Respiratory acidosis

27. Which of the following is not a possible systemic clinical manifestation of severe burns?
a. Growth retardation
b. Hypermetabolism
c. Sepsis
d. Blisters and edema

28. When assessing a family for potential child abuse risks, the nurse would observe for which of the following?
a. Periodic exposure to stress
b. Low socio-economic status
c. High level of self esteem
d. Problematic pregnancies


29. Which of the following is a possible indicator of Munchausen syndrome by proxy type of child abuse?
a. Bruises found at odd locations, with different stages of healing
b. STD’s and genital discharges
c. Unexplained symptoms of diarrhea, vomiting and apnea with no organic basis
d. Constant hunger and poor hygiene

30. Which of the following is an inappropriate interventions when caring for a child with HIV?
a. Teaching family about disease transmission
b. Offering large amount of fresh fruits and vegetables
c. Encouraging child to perform at optimal level
d. Teach proper hand washing technique

Situation 5 Agata, 2 years old is rushed to the ER due to cyanosis precipitated by crying. Her mother observed that after playing she gets tired. She was diagnosed with Tetralogy of Fallot.

31. The goal of nursing care fro Agata is to:
a. Prevent infection
b. Promote normal growth and development
c. Decrease hypoxic spells
d. Hydrate adequately

32. The immediate nursing intervention for cyanosis of Agata is:
a. Call up the pediatrician
b. Place her in knee chest position
c. Administer oxygen inhalation
d. Transfer her to the PICU

33. Agata was scheduled for a palliative surgery, which creates anastomosis of the subclavian artery to the pulmonary artery. This procedure is:
a. Waterston-Cooley
b. Raskkind Procedure
c. Coronary artery bypass
d. Blalock-Taussig

34. Which of the following is not an indicator that Agata experiences separation anxiety brought about her hospitalization?
a. Friendly with the nurse
b. Prolonged loud crying, consoled only by mother
c. Occasional temper tantrums and always says NO
d. Repeatedly verbalizes desire to go home

35. When Agata was brought to the OR, her parents where crying. What would be the most appropriate nursing diagnosis?
a. Infective family coping r/t situational crisis
b. Anxiety r/t powerlessness
c. Fear r/t uncertain prognosis
d. Anticipatory grieving r/t gravity of child’s physical status


36. Which of the following respiratory condition is always considered a medical emergency?
a. Laryngeotracheobronchitis (LTB)
b. Epiglottitis
c. Asthma
d. Cystic Fibrosis



37. Which of the following statements by the family of a child with asthma indicates a need for additional teaching?
a. “We need to identify what things triggers his attacks”
b. “He is to use bronchodilator inhaler before steroid inhaler”
c. “We’ll make sure he avoids exercise to prevent asthma attacks”
d. “he should increase his fluid intake regularly to thin secretions”

38. Which of the following would require careful monitoring in the child with ADHD who is receiving Methylphenidate (Ritalin)?
a. Dental health
b. Mouth dryness
c. Height and weight
d. Excessive appetite

Situation 6 Laura is assigned as the Team Leader during the immunization day at the RHU

39. What program for the DOH is launched at 1976 in cooperation with WHO and UNICEF to reduce morbidity and mortality among infants caused by immunizable disease?
a. Patak day
b. Immunization day on Wednesday
c. Expanded program on immunization
d. Bakuna ng kabtaan

40. One important principle of the immunization program is based on?
a. Statistical occurrence
b. Epidemiologic situation
c. Cold chain management
d. Surveillance study

41. The main element of immunization program is one of the following?
a. Information, education and communication
b. Assessment and evaluation of the program
c. Research studies
d. Target setting

42. What does herd immunity means?
a. Interruption of transmission
b. All to be vaccinated
c. Selected group for vaccination
d. Shorter incubation

43. Measles vaccine can be given simultaneously. What is the combined vaccine to be given to children starting at 15 months?
a. MCG
b. MMR
c. BCG
d. BBR

Situation 7: Braguda brought her 5-month old daughter in the nearest RHU because her baby sleeps most of the time, with decreased appetite, has colds and fever for more than a week. The physician diagnosed pneumonia.

44. Based on this data given by Braguda, you can classify Braguda’s daughter to have:
a. Pneumonia: cough and colds
b. Severe pneumonia
c. Very severe pneumonia
d. Pneumonia moderate

45. For a 3-month old child to be classified to have Pneumonia (not severe), you would expect to find RR of:
a. 60 bpm
b. 40 bpm
c. 70 bpm
d. 50 pbm

46. You asked Braguda if her baby received all vaccines under EPI. What legal basis is used in implementing the UN’s goal on Universal Child Immunization?
a. PD no. 996
b. PD no. 6
c. PD no. 46
d. RA 9173


47. Braguda asks you about Vitamin A supplementation. You responded that giving Vitamin A starts when the infant reaches 6 months and the first dose is”
a. 200,000 “IU”
b. 100,000 “IU”
c. 500,000 “IU”
d. 10,000 “IU”


48. As part of CARI program, assessment of the child is your main responsibility. You could ask the following question to the mother except:
a. “How old is the child?”
b. “IS the child coughing? For how long?”
c. “Did the child have chest indrawing?”
d. “Did the child have fever? For how long?”


49. A newborn’s failure to pass meconium within 24 hours after birth may indicate which of the following?
a. Aganglionic Mega colon
b. Celiac disease
c. Intussusception
d. Abdominal wall defect

50. The nurse understands that a good snack for a 2 year old with a diagnosis of acute asthma would be:
a. Grapes
b. Apple slices
c. A glass of milk
d. A glass of cola


51. Which of the following immunizations would the nurse expect to administer to a child who is HIV (+) and severely immunocomromised?
a. Varicella
b. Rotavirus
c. MMR
d. IPV

52. When assessing a newborn for developmental dysplasia of the hip, the nurse would expect to assess which of the following?
a. Symmetrical gluteal folds
b. Trendelemburg sign
c. Ortolani’s sign
d. Characteristic limp

53. While assessing a male neonate whose mother desires him to be circumcised, the nurse observes that the neonate’s urinary meatus appears to be located on the ventral surface of the penis. The physician is notified because the nurse would suspect which of the following?
a. Phimosis
b. Hydrocele
c. Epispadias
d. Hypospadias

54. When teaching a group of parents about seat belt use, when would the nurse state that the child be safely restrained in a regular automobile seatbelt?
a. 30 lb and 30 in
b. 35 lb and 3 y/o
c. 40 lb and 40 in
d. 60 lb and 6 y/o

55. When assessing a newborn with cleft lip, the nurse would be alert which of the following will most likely be compromised?
a. Sucking ability
b. Respiratory status
c. Locomotion
d. GI function

56. For a child with recurring nephritic syndrome, which of the following areas of potential disturbances should be a prime consideration when planning ongoing nursing care?
a. Muscle coordination
b. Sexual maturation
c. Intellectual development
d. Body image


57. An inborn error of metabolism that causes premature destruction of RBC?
a. G6PD
b. Hemocystinuria
c. Phenylketonuria
d. Celiac Disease

58. Which of the following would be a diagnostic test for Phenylketonuria which uses fresh urine mixed with ferric chloride?
a. Guthrie Test
b. Phenestix test
c. Beutler’s test
d. Coomb’s test

59. Dietary restriction in a child who has Hemocystenuria will include which of the following amino acid?
a. Lysine
b. Methionine
c. Isolensine tryptophase
d. Valine

60. A milk formula that you can suggest for a child with Galactosemia:
a. Lofenalac
b. Lactum
c. Neutramigen
d. Sustagen




CLICK HERE FOR THE CORRECT ANSWERS AND RATIONALE

60 Items pediatric Nursing questions with Rationale

Situation 1: Raphael, a 6 year’s old prep pupil is seen at the school clinic for growth and development monitoring (Questions 1-5)

1. Which of the following is characterized the rate of growth during this period?
a. most rapid period of growth

b. a decline in growth rate
c. growth spurt
d. slow uniform growth rate

Correct answer is letter B. During the Preschooler stage growth is very minimal. Weight gain is only 4.5lbs (2kgs) per year and Height is 3.5in (6-8cm) per year.
Review:
Most rapid growth and development- Infancy
Slow growth- Toddler hood and Preschooler
Slower growth- School age
Rapid growth- Adolescence

2. In assessing Raphael’s growth and development, the nurse is guided by principles of growth and development. Which is not included?
a. All individuals follow cephalo-caudal and proximo-distal
b. Different parts of the body grows at different rate
c. All individual follow standard growth rate

d. Rate and pattern of growth can be modified

Growth and development occurs in cephalo-caudal meaning development occurs through out the body’s axis. Example: the child must be able to lift the head before he is able to lift his chest. Proximo-distal is development that progresses from center of the body to the extremities. Example: a child first develops arm movement before fine-finger movement. Different parts of the body grows at different range because some body tissue mature faster than the other such as the neurologic tissues peaks its growth during the first years of life while the genital tissue doesn’t till puberty. Also G&D is predictable in the sequence which a child normally precedes such as motor skills and behavior. Lastly G&D can never be modified “Haller? (Pwede mo bang turuan mag basa ang Infant? Or patayuin sya bago pa nakakagapang?)

3. What type of play will be ideal for Raphael at this period?

a. Make believe
b. Hide and seek
c. Peek-a-boo
d. Building blocks

Correct answer is Letter A, make believe is most appropriate because it enhances the imitative play and imagination of the preschooler. C and D are for infants while letter A is B is recommended for schoolers because it enhances competitive play.

4. Which of the following information indicate that Raphael is normal for his age?
a. Determine own sense self
b. Develop sense of whether he can trust the world

c. Has the ability to try new things

d. Learn basic skills within his culture

The correct answer is letter C; because Erickson defines the developmental task of a preschool period is learning Initiative vs. Guilt. Children can initiate motor activities of various sorts on their own and no longer responds to or imitate the actions of other children or of their parents. Letter A and B is.. for you!!

5. Based on Kohlberg’s theory, what is the stage of moral development of Raphael?
a. Punishment-obedience
b. “good boy-Nice girl”

c. naïve instrumental orientation
d. social contact

Correct answer is letter C: According to Kohlber, a preschooler is under Pre-conventional where a child learns about instrumental purpose and exchange, that is they will something do for another if that that person does something with the child in return. Letter A is applicable for Toddlers and letter B is for a School age child.

Situation 2 Baby boy Lacson delivered at 36 weeks gestation weighs 3,400 gm and height of 59 cm (6-10)

6. Baby boy Lacson’s height is

a. Long
b. Short
c. Average
d. Too short

Correct answer is Letter A because the normal length of a newborn is 47.5-53.75 cm (19.5-21in) with an average of 50cm (Filipino standards po ito, pag kay Pilliteri nyo tinignan, 53cm for female and 54cm for male)

7. Growth and development in a child progresses in the following ways EXCEPT

a. From cognitive to psychosexual
b. From trunk to the tip of the extremities
c. From head to toe
d. From general to specific

Growth and development occurs in cephalo-caudal (head to toe), proximo-distal (trunk to tips of the extremities and general to specific, but it doesn’t occurs in cognitive to psychosexual because they can develop at the same time.

8. As described by Erikson, the major psychosexual conflict of the above situation is
a. Autonomy vs. Shame and doubt
b. Industry vs. Inferiority

c. Trust vs. mistrust
d. Initiation vs. guilt

According to Erikson, children 0-18 months are under the developmental task of Trust vs. Mistrust.

9. Which of the following is true about Mongolian Spots?

a. Disappears in about a year
b. Are linked to pathologic conditions
c. Are managed by tropical steroids
d. Are indicative of parental abuse

Mongolian spots are stale grey or bluish patches of discoloration commonly seen across the sacrum or buttocks due to accumulation of melanocytes and they disappears in 1 year. They are not linked to steroid use and pathologic conditions.

10. Signs of cold stress that the nurse must be alert when caring for a Newborn is:
a. Hypothermia
b. Decreased activity level
c. Shaking

d. Increased RR

Correct answer is letter D. Hypothermia is inaccurate cause normally, temperature of a newborn drop, Also a child under cold stress will kick and cry to increase the metabolic rate thereby increasing heat so B isn’t a good choice. A newborn doesn’t have the ability to shiver (Pag ikaw ay nag pa anak at ang beybe ay nanga-ngatog, naku itapon mo yan..di yan beybe itik yan.. hehe). So letter B and C is wrong. A newborn will increase its RR because the NB will need more oxygen because of too much activity.

Situation 3 Nursing care after delivery has an important aspect in every stages of delivery

11. After the baby is delivered, the cord was cut between two clamps using a sterile scissors and blade, then the baby is placed at the:

a. Mother’s breast
b. Mother’s side
c. Give it to the grandmother
d. Baby’s own mat or bed

Of course, place it at the mother’s breast for latch-on. (Note: for NSD breast feed ASAP while for CS delivery, breast feed after 4 hours) Lol, syempre d naman pwede sa grandma dba? Kasi naman hindi gatas ang ipapadede nyan, yogurt na sosyal. ewwww. LOL

12. The baby’s mother is RH(-). Which of the following laboratory tests will probably be ordered for the newborn?

a. Direct Coomb’s
b. Indirect Coomb’s
c. Blood culture
d. Platelet count

Coomb’s test is the test to determine if RH antibodies are present. Indirect Coomb’s is done to the mother and Direct Coomb’s is the one don’t to the baby. Blood culture and Platelet count doesn’t help detect RH antibodies.


13. Hypothermia is common in newborn because of their inability to control heat. The following would be an appropriate nursing intervention to prevent heat loss except

a. Place the crib beside the wall
b. Doing Kangaroo care
c. By using mechanical pressure
d. Drying and wrapping the baby

Placing the crib beside the wall is un-appropriate because it can provide heat loss by radiation. Doing Kangaroo care or hugging the baby, mechanical pressure or incubators and drying and wrapping the baby will help conserve heat,


14. The following conditions are caused by cold stress except
a. Hypoglycemia

b. Increase ICP

c. Metabolic acidosis
d. Cerebral palsy


Hypoglycemia may occur due to increase metabolic rate, And because of newborns are born slightly acidic, and they catabolize brownfat which will produce ketones which is an acid will cause metabolic acidosis. Also a NB with severe hypothermia is in high risk for kernicterus (too much bilirubin in the brain) can lead to Cerebral palsy. There is no connection in the increase of ICP with hypothermia.
(NOTE: pathognomonic sign of Kernicterus in adult- asterexis, or involuntary flapping of the hand.)


15. During the feto-placental circulation, the shunt between two atria is called
a. Ductus venosous
b. Foramen Magnum
c. Ductus arteriosus

d. Foramen Ovale


Foramen ovale is opening between two atria, Ductus venosus is the shunt from liver to the inferior vena cava, and your Ductus Arteriosus is the shunt from the pulmonary artery to the aorta. (hindi kasali sa feto-placental circulation ang Foramen Magnum, sa skull un!)


16. What would cause the closure of the Foramen ovale after the baby had been delivered?
a. Decreased blood flow

b. Shifting of pressures from right side to the left side of the heart
c. Increased PO2
d. Increased in oxygen saturation


During feto-placental circulation, the pressure in the heart is much higher in the right side, but once breathing/crying is established, the pressure will shift from the R to the L side, and will facilitate the closure of Foramen Ovale. (Note: that is why you should position the NB in R side lying position to increase pressure in the L side of the heart.)
Review:
Increase PO2-> closure of ductus arteriosus
Decreased bloodflow -> closure of the ductus venosus
Circulation in the lungs is initiated by -> lung expansion and pulmonary ventilation
What will sustain 1st breath-> decreased artery pressure
What will complete circulation-> cutting of the cord

17. Failure of the Foramen Ovale to close will cause what Congenital Heart Disease?
a. Total anomalous Pulmunary Artery

b. Atrial Septal defect
c. Transposition of great arteries
d. Pulmunary Stenosis

Foramen ovale is the opening between two Atria so, if its will not close Atrial Septal defect can occur.

Situation 4 Children are vulnerable to some minor health problems or injuries hence the nurse should be able to teach mothers to give appropriate home care.

18. A mother brought her child to the clinic with nose bleeding. The nurse showed the mother the most appropriate position for the child which is:

a. Sitting up
b. With low back rest
c. With moderate back rest
d. Lying semi flat

The correct position is making the child having an upright sitting position with the head slightly tilted forward. This position will minimize the amount of blood pressure in nasal vessels and keep blood moving forward not back into the nasopharynx, which will have the choking sensation and increase risk of aspiration. Choices b, c, d, are inappropriate cause they can cause blood to enter the nasopharynx.


19. A common problem in children is the inflammation of the middle ear. This is related to the malfunctioning of the:
a. Tympanic membrane

b. Eustachian tube
c. Adenoid
d. Nasopharynx

This is because children has short, horizontal Eustachian tubes. The dysfunction in the Eustachian tube enables bacterial invasion of the middle ear and obstructs drainage of secretions.


20. For acute otitis media, the treatment is prompt antibiotic therapy. Delayed treatment may result in complications of:
a. Tonsillitis
b. Eardrum Problems

c. Brain damage
d. Diabetes mellitus

One of the complication of recurring acute otitis media is risk for having Meningitis, thereby causing possible brain damage. That is why patient must follow a complete treatment regimen and follow up care. A and B are not complications of AOM, (lalo na ung D!!)

21. When assessing gross motor development in a 3 year old, which of the following activities would the nurse expect to finds?

a. Riding a tricycle
b. Hopping on one foot
c. Catching a ball
d. Skipping on alternate foot.

Answer is A, riding a tricycle is appropriate for a 3 y/o child. Hopping on one foot can be done by a 4 y/o child, as well as catching and throwing a ball over hand. Skipping can be done by a 5 y/o.

22. When assessing the weight of a 5-month old, which of the following indicates healthy growth?

a. Doubling of birth weight
b. Tripling of birth weight
c. Quadrupling of birth weight
d. Stabilizing of birth weight

During the first 6 months of life the weight from birth will be doubled and as soon as the baby reaches 1 year, its birth weight is tripled.


23. An appropriate toy for a 4 year old child is:
a. Push-pull toys
b. Card games

c. Doctor and nurse kits
d. Books and Crafts

Letter C is appropriate because it will enhance the creativity and imagination of a pre-school child. Letter B and D are inappropriate because they are too complex for a 4 y/o. Push-pull toys are recommended for infants.


24. Which of the following statements would the nurse expects a 5-year old boy to say whose pet gerbil just died
a. “The boogieman (kamatayan- the man with the scythe) got him”

b. “He’s just a bit dead”
c. “Ill be good from now own so I wont die like my gerbil”
d. “Did you hear the joke about…”


A 5 y/o views death in “degrees”, so the child most likely will say that “he is just a bit dead”. Personification of death like boogeyman or “kamatayan” occurs in ages 7 to 9 as well as denying death can if they will be good. Denying death using jokes and attributing life qualities to death occurs during age 3-5.

25. When assessing the fluid and electrolyte balance in an infant, which of the following would be important to remember?
a. Infant can concentrate urine at an adult level
b. The metabolic rate of an infant is slower than in adults
c. Infants have more intracellular water that adult do

d. Infant have greater body surface area than adults

Infants have greater body surface area than adult, increasing their risk to F&E imbalances. Also infants cant concentrate a urine at an adult level and their metabolic rate, also called water turnover, is 2 to 3 times higher than adult. Plus more fluids of the infants are at the ECF spaces not in the ICF spaces.

26. When assessing a child with aspirin overdose, which of the following will be expected?
a. Metabolic alkalosis
b. Respiratory alkalosis

c. Metabolic acidosis

d. Respiratory acidosis

Remember that Aspirin is acid (Acetylsalicylic ACID), so what do you expect? (ang taray LOL) UN NA!
Review:
Pag galling sa bibig: alkalosis (hyper-emesis)
Pag galling sap wet: acidosis (diarrhea)


27. Which of the following is not a possible systemic clinical manifestation of severe burns?
a. Growth retardation
b. Hypermetabolism
c. Sepsis

d. Blisters and edema

The question was asking for a SYSTEMIC clinical manifestation, Letters A,B and C are systemic manifestations while Blisters and Edema weren’t.

28. When assessing a family for potential child abuse risks, the nurse would observe for which of the following?
a. Periodic exposure to stress
b. Low socio-economic status
c. High level of self esteem

d. Problematic pregnancies

Answer is D, Typical factors that may be risk for Child abuse are problematic pregnancies, chronic exposure to stress not periodic, low level of self esteem not high level. Also child abuse can happen in all socio-economic status not just on low socio-economic status.


29. Which of the following is a possible indicator of Munchausen syndrome by proxy type of child abuse?
a. Bruises found at odd locations, with different stages of healing
b. STD’s and genital discharges

c. Unexplained symptoms of diarrhea, vomiting and apnea with no organic basis
d. Constant hunger and poor hygiene

Munchausen syndrome by Proxy is the fabrication or inducement of an illness by one person to another person, usually mother to child. It is characterized by symptoms such as apnea and siezures, which may be due to suffocation, drugs or poisoning, vomiting which can be induced with poisons and diarrhea with the use of laxatives. Letter A can be seen in a Physical abuse, Letter B for sexual abuse and Letter C is for Physical Neglect.

30. Which of the following is an inappropriate intervention when caring for a child with HIV?
a. Teaching family about disease transmission

b. Offering large amount of fresh fruits and vegetables
c. Encouraging child to perform at optimal level
d. Teach proper hand washing technique

A child with HIV is immunocompromised. Fresh fruits and vegetables, which may be contaminated with organisms and pesticides can be harmful, if not fatal to the child, therefore these items should be avoided.

Situation 5 Agata, 2 years old is rushed to the ER due to cyanosis precipitated by crying. Her mother observed that after playing she gets tired. She was diagnosed with Tetralogy of Fallot.

31. The goal of nursing care fro Agata is to:
a. Prevent infection
b. Promote normal growth and development

c. Decrease hypoxic spells
d. Hydrate adequately

The correct answer is letter C. Though letter B would be a good answer too, this goal is too vague and not specific. Nursing interventions will not solely promote normal G&D unless he will undergo surgical repair. So decreasing Hypoxic Spells is more SMART. (alam nyo na kung ano yun! Specific, measurable, attainable, realistic and time bounded). Letter A and D are inappropriate.
REVIEW! REVIEW! REVIEW!
Tetralogy of Fallot is a cyanotic Congenital Heart disease. Kaya sa tinawag na Tetralogy cause it has 4 anomalies;
1. VSD- ventricular septal defect
2. Pulmunary Stenosis
3. Over-riding of the Aorta- the aorta overrides both ventricles
4. Right ventricular hypertrophy

We have 14 congenital heart defects. 8 acyanotic and 6 cyanoyic.
8 Acyanotice includes: ASD, VSD, PDA, endocardial cushion defect, pulmonary stenosis, doupling of the aorta, Aortic stenosis and Coarctation of the Aorta
6 Cyanotic includes: Tetralogy of fallot, Total anomalous pulmonary artery, Transposition of the great arteries, Truncus arteriousus, Hypoplastic Left heart syndrome.
(Acyanotic causes L->R shunting while cyanotic cause R->L shunting. Para madaling matandaan lahat ng may “T” eh cyanotic OK?

32. The immediate nursing intervention for cyanosis of Agata is:
a. Call up the pediatrician

b. Place her in knee chest position
c. Administer oxygen inhalation
d. Transfer her to the PICU

The immediate intervention would be to place her on knee-chest or “squatting” position because it traps blood into the lower extremities. Though also letter C would be a good choice but the question is asking for “Immediate” so letter B is more appropriate. Letter A and D are incorrect because its normal for a child who have ToF to have hypoxic or “tets” spells so there is no need to transfer her to the NICU or to alert the Pediatrician.

33. Agata was scheduled for a palliative surgery, which creates anastomosis of the subclavian artery to the pulmonary artery. This procedure is:
a. Waterston-Cooley
b. Raskkind Procedure
c. Coronary artery bypass

d. Blalock-Taussig


Correct answer is Blalock-Taussig procedure its just a temporary or palliative surgery which creates a shunt between the aorta and pulmonary artery (oist parang ductus arteriosus) so that the blood can leave the aorta and enter the pulmonary artery and thus oxygenating the lungs and return to the left side of the heart, then to the aorta then to the body. This procedure also makes use of the subclavian vein so pulse is not palpable at the right arm.
The full repair for ToF is called the Brock procedure. Raskkind is a palliative surgery for TOGA.

34. Which of the following is not an indicator that Agata experiences separation anxiety brought about her hospitalization?

a. Friendly with the nurse
b. Prolonged loud crying, consoled only by mother
c. Occasional temper tantrums and always says NO
d. Repeatedly verbalizes desire to go home

Because toddlers views hospitalization is abandonment, separation anxiety is common. Its has 3 phases: PDD (parang c puff daddy LOL)
1. Protest 2. despair 3. detachment (or denial). Choices B, C, D are usually seen in a child with separation anxiety (usually in the protest stage).
REVIEW:
Separation anxiety begin at: 9 months
Peaks: 18 months

35. When Agata was brought to the OR, her parents where crying. What would be the most appropriate nursing diagnosis?
a. Infective family coping r/t situational crisis
b. Anxiety r/t powerlessness
c. Fear r/t uncertain prognosis

d. Anticipatory grieving r/t gravity of child’s physical status


In this item letter A and be are inappropriate response so remove them. The possible answers are C and D. Fear defined as the perceived threat (real or imagined) that is consciously recognized as danger (NANDA) is applicable in the situation but its defining characteristics are not applicable. Crying per se can not be a subjective cue to signify fear, and most of the symptoms of fear in NANDA are physiological. Anticipatory grieving on the other hand are intellectual and EMOTIONAL responses based on a potential loss. And remember that procedures like this cannot assure total recovery. So letter D is a more appropriate Nursing diagnosis.
NOTE: GANATO NA PO ANG PATTERN NG NLE, LAGING MAY HALONG THERAPUETIC COMMUNICATION AT NURSING DIAGNOSIS.


36. Which of the following respiratory condition is always considered a medical emergency?
a. Laryngeotracheobronchitis (LTB)

b. Epiglottitis
c. Asthma
d. Cystic Fibrosis

Correct answer is letter B, because acute and sever inflammation of the epiglottis can cause life threatening airway obstruction, that is why its always treated as a medical emergency. NSG intervention : Prepare tracheostomy set at bed side.
LTB, can also cause airway obstruction but its not an emergency. Asthma is also not an emergency (ung status asthmaticus ang kaylangan ng prompt treatment). CF is a chronic disease, so its not a medical emergency.
REVIEW: Medical emergency of GI: peritonitis

37. Which of the following statements by the family of a child with asthma indicates a need for additional teaching?
a. “We need to identify what things triggers his attacks”
b. “He is to use bronchodilator inhaler before steroid inhaler”

c. “We’ll make sure he avoids exercise to prevent asthma attacks”

d. “he should increase his fluid intake regularly to thin secretions”

Asthmatic children don’t have to avoid exercise. They can participate on physical activities as tolerated. Using a bronchodilator before administering steroids is correct because steroids are just anti-inflammatory and they don’t have effects on the dilation of the bronchioles. OF course letters A and B are obviously correct.

38. Which of the following would require careful monitoring in the child with ADHD who is receiving Methylphenidate (Ritalin)?
a. Dental health
b. Mouth dryness

c. Height and weight
d. Excessive appetite

Dental problems are more likely to occur in children under going TCA therapy. Mouth dryness is a expected side effects of Ritalin since it activates the SNS. Also loss of appetite is more likely to happen, not increase in appetite. The correct answer is letter C, because Ritalin can affect the child’s G&D. Intervention: medication “holidays or vacation”. (This means na.. during weekends or holidays or school vacations, where the child wont be in school, the drug can be withheld.)

Situation 6 Laura is assigned as the Team Leader during the immunization day at the RHU

39. What program for the DOH is launched at 1976 in cooperation with WHO and UNICEF to reduce morbidity and mortality among infants caused by immunizable disease?
a. Patak day
b. Immunization day on Wednesday

c. Expanded program on immunization

d. Bakuna ng kabtaan

SUS me! Dapat pa bang I-rationalize? Ang di nakakuha ng tamang sagot… hala… JOKE.. hehehe

40. One important principle of the immunization program is based on?
a. Statistical occurrence

b. Epidemiologic situation

c. Cold chain management
d. Surveillance study

Letters A, C and D are not included in the principles of EPI.
The principle of EPI are the following:
1. Its is based on epidemiological situation
2. Mass approach utilization- the whole community is to be protected rather than the individual
3. Immunization is a basic health service, and should be provided by the RHU

41. The main element of immunization program is one of the following?
a. Information, education and communication
b. Assessment and evaluation of the program
c. Research studies

d. Target setting

Correct answer is D.
The following are the elements of EPI:
• Target seting
• Cold chain logistic management
• Information, education and communication
• Assessment and evaluation of the program’s over all performance
• Surveillance, studies and research

42. What does herd immunity means?

a. Interruption of transmission
b. All to be vaccinated
c. Selected group for vaccination
d. Shorter incubation

43. Measles vaccine can be given simultaneously. What is the combined vaccine to be given to children starting at 15 months?
a. MCG

b. MMR
c. BCG
d. BBR

MMR or Measles, Mumps, Rubella is a vaccine furnished in one vial and is routinely given in one injection (Sub-Q). It can be given at 15 months but can also be given as early as 12th month.

Situation 7: Braguda brought her 5-month old daughter in the nearest RHU because her baby sleeps most of the time, with decreased appetite, has colds and fever for more than a week. The physician diagnosed pneumonia.

44. Based on this data given by Braguda, you can classify Braguda’s daughter to have:
a. Pneumonia: cough and colds

b. Severe pneumonia
c. Very severe pneumonia
d. Pneumonia moderate

For a child aging 2months up to 5 years old can be classified to have sever pneumonia when he have any of the following danger signs:
• Not able to drink
• Convulsions
• Abnormally sleepy or difficult to wake
• Stridor in calm child or
• Severe under-nutrition

45. For a 3-month old child to be classified to have Pneumonia (not severe), you would expect to find RR of:
a. 60 bpm
b. 40 bpm
c. 70 bpm

d. 50 pbm

Correct answer is letter D. A child can be classified to have Pneumonia (not severe) if:
• the young infant is less than 2 months- 60 bpm or more
• if the child is 2 months up to less than 12 months- 50 bpm or more
• if the child is 12 months to 4 y/o- 40 bpm or more

46. You asked Braguda if her baby received all vaccines under EPI. What legal basis is used in implementing the UN’s goal on Universal Child Immunization?
a. PD no. 996

b. PD no. 6
c. PD no. 46
d. RA 9173

Correct answer is letter B. Presidential Proclamation no. 6 (April 3, 1986) is the “Implementing a United Nations goal on Universal Child Immunization by 1990”. PD 996 (September 16, 1976) is “providing for compulsory basic immunization for infants and children below 8 years of age. PD no. 46 (September 16, 1992) is the “Reaffirming the commitment of the Philippines to the universal Child and Mother goal of the World Health Assembly. RA 9173 is of course the “Nursing act of 2002”

47. Braguda asks you about Vitamin A supplementation. You responded that giving Vitamin A starts when the infant reaches 6 months and the first dose is”
a. 200,000 “IU”

b. 100,000 “IU”
c. 500,000 “IU”
d. 10,000 “IU”

An infant aging 6-11 months will be given Vitamin supplementation of 100, 000 IU and for Preschoolers ages 12-83 months 200,000 “IU” will be given.

48. As part of CARI program, assessment of the child is your main responsibility. You could ask the following question to the mother except:
a. “How old is the child?”
b. “IS the child coughing? For how long?”

c. “Did the child have chest indrawing?”
d. “Did the child have fever? For how long?”

The CARI program of the DOH includes the “ASK” and “LOOK, LISTEN” as part of the assessment of the child who has suspected Pneumonia. Choices A, B and D are included in the “ASK” assessment while Chest indrawings is included in the “LOOK, LISTEN” and should not be asked to the mother.


49. A newborn’s failure to pass meconium within 24 hours after birth may indicate which of the following?

a. Aganglionic Mega colon
b. Celiac disease
c. Intussusception
d. Abdominal wall defect

Failure to pass meconium of Newborn during the first 24 hours of life may indicate Hirschsprung disease or Congenital Aganglionic Megacolon, an anomaly resulting in mechanical obstruction due to inadequate motility in an intestinal segment. B, C, and D are not associated in the failure to pass meconium of the newborn.


50. The nurse understands that a good snack for a 2 year old with a diagnosis of acute asthma would be:
a. Grapes

b. Apple slices
c. A glass of milk
d. A glass of cola


Correct answer is B, apple slices. Grapes is in appropriate because of its “balat” that can cause choking. A glass of milk is not a good snack because it’s the most common cause of Iron-deficiency anemia in children (milk contains few iron), A glass of cola is also not appropriate cause it contains complex sugar. (walang kinalaman ang asthma dahil ala naman itong diatery restricted foods na nasa choices.)

51. Which of the following immunizations would the nurse expect to administer to a child who is HIV (+) and severely immunocomromised?
a. Varicella
b. Rotavirus
c. MMR

d. IPV


IPV or Inactivated polio vaccine does not contain live micro organisms which can be harmful to an immunocompromised child. Unlike OPV, IPV is administered via IM route.


52. When assessing a newborn for developmental dysplasia of the hip, the nurse would expect to assess which of the following/
a. Symmetrical gluteal folds
b. Trendelemburg sign

c. Ortolani’s sign
d. Characteristic limp


Correct answer is Ortolani’s sign; it is the abnormal clicking sound when the hips are abducted. The sound is produced when the femoral head enters the acetabulum. Letter A is wrong because its should be “asymmetrical gluteal fold”. Letter B and C are not applicable for newborns because they are seen in older children.

53. While assessing a male neonate whose mother desires him to be circumcised, the nurse observes that the neonate’s urinary meatus appears to be located on the ventral surface of the penis. The physician is notified because the nurse would suspect which of the following?
a. Phimosis
b. Hydrocele
c. Epispadias

d. Hypospadias


Hypospadias is a c condition in which the urethral opening is located below the glans penis or anywhere along the ventral surface of the penile shaft. Epispadias, the urethral meatus is located at the dorsal surface of the penile shaft. (Para di ka malilto, I-alphabetesize mo Dorsal, (Above) eh mauuna sa Ventral (Below) , Epis mauuna sa Hypo.)

54. When teaching a group of parents about seat belt use, when would the nurse state that the child be safely restrained in a regular automobile seatbelt?
a. 30 lb and 30 in
b. 35 lb and 3 y/o

c. 40 lb and 40 in

d. 60 lb and 6 y/o

Basta tandaan ang rule of 4! 4 years old, 40 lbs and 40 in.

55. When assessing a newborn with cleft lip, the nurse would be alert which of the following will most likely be compromised?

a. Sucking ability

b. Respiratory status
c. Locomotion
d. GI function

Because of the defect, the child will be unable to form the mouth adequately arounf the nipple thereby requiring special devices to allow feeding and sucking gratification. Respiratory status may be compromised when the child is fed improperly or during post op period.
REVIEW!
Repair of cleft lip-cheiloplasty-should be done within 1-3 months- to save sucking reflex- position post-op side lying
Repair of cleft palate- Uranoplasty- should be done within 4-6 months-to preserve speech- position post-op is prone.

56. For a child with recurring nephritic syndrome, which of the following areas of potential disturbances should be a prime consideration when planning ongoing nursing care?
a. Muscle coordination
b. Sexual maturation
c. Intellectual development

d. Body image

Because of edema, associated with nephroitic syndrome, potential self concept and body image disturbance related to changes in appearance and social isolation should be considered.

HEY! NARARAMDAMAN KO NA LALABAS ULIT ANG MGA SAKIT RELATED SA NEW BORN SCREENING KAYA ARALIN NA ITO. I WILL POST A SIMPLE LECTURE DITO. (LATER…. Kasi tamad ako,,, hehehe)


57. An inborn error of metabolism that causes premature destruction of RBC?

a. G6PD
b. Hemocystinuria
c. Phenylketonuria
d. Celiac Disease

G6PD is the premature destruction of RBC when the blood is exposed to antioxidants, ASA (ano un? Aspirin), legumes and flava beans.


58. Which of the following would be a diagnostic test for Phenylketonuria which uses fresh urine mixed with ferric chloride?
a. Guthrie Test

b. Phenestix test
c. Beutler’s test
d. Coomb’s test


Phenestix test is a diagnostic test which uses a fresh urine sample (diapers) and mixed with ferric chloride. If positive, there will be a presence of green spots at the diapers. Guthrie test is another test for PKU and is the one that mostly used. The specimen used is the blood and it tests if CHON is converted to amino acid.


59. Dietary restriction in a child who has Hemocystenuria will include which of the following amino acid?
a. Lysine

b. Methionine

c. Isolensine tryptophase
d. Valine

Hemocystenuria is the elevated excretion of the amino acid hemocystiene, and there is inability to convert the amino acid methionine or cystiene. So dietary restriction of this amino acids is advised. This disease can lead to mental retardation.


60. A milk formula that you can suggest for a child with Galactosemia:
a. Lofenalac
b. Lactum

c. Neutramigen

d. Sustagen

Neutramigen is suggested for a child with Galactosemia. Lofenalac is suggested for a child with PKU. Sustagen is for Susy and Geno, Lactum.. lactum.. inom ka ng inom!