Download NCM 109 MIDTERMS EVALUATION EXAM QUESTIONS AND ANSWERS 2024 WITH COMPLETE SOLUTION and more Exams Nursing in PDF only on Docsity!
NCM 109 MIDTERMS EVALUATION EXAM
QUESTIONS AND ANSWERS 2024 WITH
COMPLETE SOLUTION
You are a student nurse making their clinical rotation at the pediatric ward of Grey - Sloan Memorial Hospital. You have a 5 year old male patient diagnosed with bacterial meningitis, during your rounds, the patient's mother asked "How did my child acquire this illness?" As a bright student nurse, you know that your response is correct if you answered which of the following? A. "Bacterial meningitis is acquired through skin to skin contact from a person that is infected with the disease." B. "Bacterial meningitis can spread from person to person by respiratory droplets or throat secretions." C. "Bacterial meningitis can be acquired through contaminated food or water sources." D. "Bacterial meningitis is transmitted through fecal - oral route, especially in settings with poor sanitation such as those in low lying areas." Ans ✔👌 - B. "Bacterial meningitis can spread from person to person by respiratory droplets or throat secretions." RATIONALE:
- Bacterial meningitis is highly contagious and primarily transmitted through respiratory droplets expelled when an infected person coughs, sneezes, or talks. These droplets can be inhaled by others, leading to infection. Close contact with
an infected person, especially in crowded settings, increases the risk of transmission. As a student with vast knowledge of NCM 109 and Microbiology and Parasitology, you are correct with your understanding of Bacterial Meningitis if you knew that the following are the common causative agents of Bacterial Meningitis EXCEPT: A. Neisseria Meningitidis B. Streptococcus Pneumoniae C. Haemophilus Influenzae D. Trichinella Spiralis Ans ✔👌 - D. Trichinella Spiralis Rationale:
- Trichinella Spiralis is a parasitic infection caused by roundworms. Trichinella spiralis species is the common cause of human disease and infection occurs after the ingestion of raw or undercooked pork. A,B, and C are the common causative agents of bacterial meningitis. Which of the following Nursing Diagnosis regarding Bacterial Meningitis is the most priority? A. Risk for Infection B. Risk for Ineffective Cerebral Tissue Perfusion C. Risk for Physical Trauma D. Acute Pain Ans ✔👌 - B. Risk for Ineffective Cerebral Tissue Perfusion
Nurse Toni provides education to the mother of patient Paye diagnosed with bacterial meningitis. All of the following statements confirm that the patient understands her diagnosis EXCEPT: A. "Bacterial meningitis is the inflammation of the meninges, the protective membrane that surrounds the brain and spinal cord." B. "Bacterial meningitis can lead to serious complications including septic shock, cerebral edema and increased intracranial pressure." C. "There is no current treatment for bacterial meningitis and it should resolve within 7-10 days." D. "My headache and stiff neck pain are caused by irritability of the cervical and spinal nerves." Ans ✔👌 - C. "There is no current treatment for bacterial meningitis and it should resolve within 7-10 days." Rationale:
- Bacterial meningitis is a serious condition that requires prompt medical treatment with antibiotics. Option C is incorrect because it states that there is no current treatment for bacterial meningitis and suggests that it should resolve within 7-10 days, which is inaccurate and potentially dangerous misinformation. Monica, Rachel, and Phoebe are student nurses working in the pediatric neurology department and are reviewing the anatomy and physiology of the nervous system for their upcoming PNLE. The nurses are correct when they stated that the purpose of the blood brain barrier is:
A. Regulate perfusion and intracranial pressure in the brain B. Protect a fetus from contracting infections from the mother during pregnancy C. Protect the central nervous system from harmful substances and diseases D. Provide a pathway for medications to treat neurological conditions Ans ✔👌 - C. Protect the central nervous system from harmful substances and diseases Rationale:
- The blood-brain barrier (BBB) is a physiological mechanism that regulates the exchange of substances between the bloodstream and the central nervous system (CNS), including the brain and spinal cord. Its primary purpose is to protect the CNS from potentially harmful substances, such as toxins, pathogens, and large molecules, that may be present in the bloodstream. This selective permeability prevents many substances from freely crossing into the brain tissue, maintaining the homeostasis and integrity of the CNS. Mingyu Dimagiba Jr., a pediatric patient diagnosed with bacterial meningitis, is admitted to the medical floor at noon. Which health-care provider's order would have the highest priority? A. Administer an intravenous antibiotic. B. Obtain the client's lunch tray. C. Provide a quiet, calm, and dark room. D. Weigh the client in hospital attire. Ans ✔👌 - A. Administer an intravenous antibiotic.
the brain, making them more sensitive to light and causing discomfort when exposed to bright light. You are studying the pathophysiology of Bacterial Meningitis, you have the correct understanding of its pathophysiology when you answered: A. Hydrocephalus is caused by an Increase in CSF outflow resistance B. Inflammation of the Brain Parenchyma causes meningeal irritation C. Meningeal irritation is possible even if the bacteria did not enter the blood brain barrier D. Cerebral Ischemia from an Increased cerebral blood flow causes necrosis Ans ✔👌 - A. Hydrocephalus is caused by an Increase in CSF outflow resistance Rationale:
- Hydrocephalus is a potential complication of bacterial meningitis. It occurs due to obstruction of the normal flow of cerebrospinal fluid (CSF) or a decrease in its absorption, leading to an accumulation of fluid within the brain's ventricles. This obstruction can result from inflammation of the meninges, scarring of the arachnoid villi (structures involved in CSF absorption), or blockage of the CSF pathways. An increase in CSF outflow resistance contributes to the development of hydrocephalus by impeding the normal drainage of CSF.
Patient CJ Tapan, a 4 year old male was diagnosed with Bacterial Meningitis and was given Penicillin G. As a bright student nurse, you know that Penicillin G causes which of the following? A. Penicillin G interferes with synthesis of cell-wall mucopeptide during active multiplication, resulting in bactericidal activity. B. Penicillin G specifically targets the cell wall and causes lysis causing a bacteriostatic activity C. Penicillin G interferes with synthesis of cell-wall mucopeptide during passive multiplication, resulting in bacteriostatic activity. Ans ✔👌 - A. Penicillin G interferes with synthesis of cell-wall mucopeptide during active multiplication, resulting in bactericidal activity. Rationale:
- Penicillin G is a beta-lactam antibiotic that works by inhibiting the synthesis of bacterial cell wall mucopeptide during active multiplication, leading to bacterial cell lysis and death. This mechanism of action makes it bactericidal rather than bacteriostatic. What is the main mode of transmission for influenza? a) Airborne droplets b) Direct contact with infected surfaces c) Ingestion of contaminated food or water d) Sexual contact with infected individuals Ans ✔👌 - Rationale: Option a) is correct. Influenza primarily spreads through airborne droplets when an
b) Washing hands frequently with soap and water c) Avoiding close contact with sick individuals d) Sharing personal items such as utensils and towels Ans ✔👌 - Rationale: Option d) is correct. Sharing personal items such as utensils and towels can increase the risk of spreading influenza, so it is not recommended. How long is the typical incubation period for influenza? a) 24-48 hours b) 1-3 days c) 1-2 weeks d) 2-4 weeks Ans ✔👌 - Rationale: Option b) is correct. The typical incubation period for influenza is 1-3 days, with symptoms usually appearing within this timeframe after exposure to the virus. Which influenza virus type is responsible for causing seasonal epidemics? a) Influenza A b) Influenza B c) Influenza C d) Influenza D Ans ✔👌 - Rationale: Option a) is correct. Influenza A virus is responsible for causing seasonal epidemics, as well as occasional pandemics. What is the primary treatment for influenza? a) Antibiotics b) Antiviral medications
c) Painkillers d) Intravenous fluids Ans ✔👌 - Rationale: Option b) is correct. Antiviral medications such as oseltamivir (Tamiflu) or zanamivir (Relenza) are commonly used to treat influenza by reducing the severity and duration of symptoms. What age group is recommended to receive annual influenza vaccinations? a) Children under 2 years old b) Adults over 65 years old c) Everyone aged 6 months and older d) Adolescents aged 13-18 years old Ans ✔👌 - Rationale: Option c) is correct. The Centers for Disease Control and Prevention (CDC) recommends annual influenza vaccination for everyone aged 6 months and older. Which of the following is a potential complication of influenza? a) Diabetes b) Pneumonia c) Hypertension d) Osteoporosis Ans ✔👌 - Rationale: Option b) is correct. Pneumonia is a common complication of influenza, especially in high-risk groups such as young children, the elderly, and individuals with underlying health conditions.
d. Cough, conjunctivitis, cirrhosis Ans ✔👌 - Answer: A. The 3'cs of measles are Cough, Conjunctivitis, Coryza
An infant whose mother has immunity to measles receives antibodies transplacentally; these antibodies are protective for a period of time. At what age should infants be vaccinated? a. Birth to 2 months b. 4 months c. 12-15 months d. 18-24 months Ans ✔👌 - Answer: C. 12 to 15 mo. The first dose is recommended at age 12 to 15 mo but can be given as young as age 6 mo during a measles outbreak or before international travel.The mother's antibodies are protective for most of the first 6 to 12 mo of life. Infants immunized at < 1 yr of age still require 2 further doses given after the first birthday. Measles is highly contagious. Communicability begins several days before and continues until several days after the rash appears. Transmission is typically by large respiratory droplets that are discharged by cough and briefly remain airborne for a short distance. Which of the following is another means of disease transmission? a. Animal vectors
b. Small aerosolized droplets c. Transmission by fomites on surfaces d. Contact with a vaccinated person living with an infected child Ans ✔👌 - Answer: B. Small aerosolized droplets. Transmission may also occur by small aerosolized droplets that can remain airborne (and thus be inhaled) for up to 2 h in closed areas (eg, in an office examination room). A: Measles has no known animal reservoir or asymptomatic carrier state. C: Transmission by fomites seems less likely than airborne transmission because the measles virus is thought to survive only for a short time on dry surfaces. D: In the US, almost all measles cases are imported by travelers or immigrants, with subsequent indigenous transmission occurring primarily among unvaccinated people. Which of the following helps differentiate a drug rash from typical measles? a. The patient has enlarged, tender lymph nodes. b. Cephalocaudal progression is absent. c. drug rash seldom occurs in children > 3 yr d. A drug rash does not resemble measles. Ans ✔👌 - Answer: B. There is no cephalocaudal progression or cough, and there is usually a history of recent drug exposure. A: Enlarged, usually tender postauricular and suboccipital lymph nodes help distinguish rubella from measles. C: Roseola infantum differs from measles in that it
through the prodromal and exanthem phase. True or False a. True b. False Ans ✔👌 - Answer: False People who are infected with Measles are contagious from the final day of incubation period through the prodromal and exanthem phase. The age for the first MMR dose is 4-6 years old. a. True b. False Ans ✔👌 - Answer: False 12-15 months 1st dose. 4-6 years old second dose Which of the following is the most common causative agent of bacterial pneumonia? A. Influenza virus B. Streptococcus pneumoniae C. Aspergillus fumigatus D. Respiratory syncytial virus Ans ✔👌 - B. Streptococcus pneumoniae Rationale: Streptococcus pneumoniae is the most common causative agent of bacterial pneumonia, responsible for a significant portion of cases. The nurse is providing discharge teaching to the parents of a child recovering from
pneumonia. Which statement by the parents indicates understanding of home care instructions? A. "We will keep our child indoors and avoid fresh air." B. "We will ensure our child completes the full course of antibiotics." C. "We will encourage our child to engage in vigorous physical activity." D. "We will provide our child with a high-fat diet to promote healing." Ans ✔👌 - B. "We will ensure our child completes the full course of antibiotics." Rationale: Completing the full course of antibiotics is essential to ensure the infection is fully treated and prevent recurrence or antibiotic resistance. Which of the following diagnostic tests is commonly used to confirm the diagnosis of pneumonia in children? A. Electrocardiogram (ECG) B. Magnetic resonance imaging (MRI) C. Complete blood count (CBC) D. Chest X-ray Ans ✔👌 - D. Chest X-ray Rationale: Chest X-ray is often used to diagnose pneumonia by revealing areas of the lungs that are filled with fluid and infected.
immediately? A. Respiratory rate of 24 breaths per minute B. Oxygen saturation of 92% C. Low-grade fever D. Crackles on auscultation Ans ✔👌 - D. Crackles on auscultation Rationale: Crackles indicate fluid in the lungs, which can worsen respiratory status and may require immediate intervention. Which of the following nursing interventions is most appropriate for promoting effective airway clearance in a child with pneumonia? a) Encouraging the child to drink plenty of fluids b) Administering antipyretics to reduce fever c) Limiting the child's physical activity d) Encouraging shallow breathing exercises Ans ✔👌 - a) Encouraging the child to drink plenty of fluids Rationale: Adequate hydration helps thin respiratory secretions and promotes effective airway clearance.
A child with pneumonia is experiencing difficulty breathing. Which of the following actions should the nurse prioritize? a) Administering pain medication b) Encouraging deep breathing exercises c) Placing the child in a supine position d) Administering supplemental oxygen as prescribed Ans ✔👌 - d) Administering supplemental oxygen as prescribed Rationale: Supplemental oxygen helps alleviate hypoxemia and improve oxygenation in children with pneumonia experiencing difficulty breathing. Which assessment finding indicates a potential complication of bacterial pneumonia? A) Decreased breath sounds on auscultation B) Increased oxygen saturation C) Decreased white blood cell count D) Increased urinary output Ans ✔👌 - A) Decreased breath sounds on auscultation Rationale: Decreased breath sounds suggest consolidation or fluid accumulation in the affected lung area, indicating a potential complication of bacterial pneumonia.
