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Saturday, July 22, 2006

Leakage won't affect filipino nurses employment overseas - Herrera

RP nurses face rivals in US labor market

Indians, South Koreans, Canadians and Cubans have emerged as the chief rivals of Filipinos in the nursing labor market in the United States, former senator and labor leader Ernesto Herrera said.

Herrera, secretary-general of the Trade Union Congress of the Philippines, said that based on the statistics from the US National Council of State Boards of Nursing (NCSBN), the Philippines remains America’s number-one supplier of foreign nurses.

He said a total of 6,171 nurses educated in the Philippines took the National Council Licensure Examination (NCLEX) for the first time from January to June this year. They accounted for seven percent of the 89,140 first-time takers of the NCLEX during the period.

The NCLEX is the final step in the nurse licensure process in the US. The number of NCLEX examinees is "a good indicator" of how many US as well as foreign nursing graduates are trying to enter the profession in that country, according to Herrera.

The NCSBN data show that from January to June this year, a total of 1,864 nurses educated in India took the NCLEX, while a total of 948 nurses trained in South Korea took the test.

Completing the top five countries with the most NCLEX takers in the six-month period were Canada and Cuba, with 504 and 260 examinees, respectively.

Herrera said NCLEX statistics also indicate that the US is producing its own nurses by the thousands, except they are still not enough to cope with the growing healthcare needs of the aging US population.

Leakage won't affect filipino nurses employment overseas

He played down reports suggesting that the leakage in last month’s nursing licensure examination would affect the deployment of Filipino nurses abroad.

"That is not true. Hospitals abroad will keep on hiring qualified Filipino nurses as long as their services are needed. Besides, professional regulators overseas have their own means of determining the eligibility of foreign nurses, such as through the NCLEX in the case of the US," Herrera pointed out.

He was reacting to Philippine Overseas Employment Administration chief Rosalinda Baldoz’ statement that the leakage would adversely affect the Philippines’ ability to deploy nurses abroad.

"This is not to say that the our regulators should not take decisive corrective measures. Those responsible for the anomaly should be punished swiftly and adequate steps should be taken to prevent a repeat of the leakage," Herrera said.

From : ABS-CBN NEWS
http://www.abs-cbnnews.com/storypage.aspx?StoryId=45126

Posted by Budek at 6:15 PM | Permalink | Comments

PRC CHAIR SAYS NO GLARING LEAKAGE IN NURSING EXAM

PRC Chair Says No Glaring Leakage in Nursing Exam

by KATHLEEN ANNE H. JOHNSON

The controversy hounding the nursing board exams continues with Philippine Regulation Commission (PRC) chairperson Leonor T. Rosero declaring that there was "no glaring leakage" in the June 11 nursing licensure examination.

In a press forum at the Ambassador Hotel in Manila yesterday, Rosero said that while there were certain questions from Tests III and V that leaked, the PRC removed 25 items from Test III and reduced the rate in Test V from 100 percent to 10 percent which could have been covered by the "leakage" so that those who cheated would not benefit from it.

She said that the PRC did not actually void Test V in question, but only toned down some scores and eliminated some questions.

The claim was supported by Board of Nursing chairperson Eufemia Octaviano who also gave the same view as Rosero's on the leakage issue at the forum.

However, members of the Faculty Association of University of Santo Tomas College of Nursing said that in a resolution dated July 12, 2006, the PRC invalidated and excluded the 25 questions which were allegedly leaked from the test questions prepared by Virginia Mandeja, in Test III or the Nursing Practice III from the correction and computation of the scores of the examinees and nullified the results of the examination in Test V or The Nursing Practice V.

The group said the move brought concern to the UST College of Nursing community as it appealed to the PRC to suspend the scheduled oath-taking of successful examinees, while results of a full-scale and independent investigation are pending.

"We are fully aware that the PRC invalidated the 25 questions in Test III as well as all questions in Test V . The said tests measure the knowledge and competence of nursing graduates in two key subject-areas of the nursing curriculum: Medical Surgical Nursing (Test III) and Psychiatric Nursing (Test V). These subjects are major areas of competence of the profession, and deprived students who are good in those subjects," said Prof. Rene M. Tadle, president of the Faculty Association of UST College of Nursing.

Tadle said the move by the PRC also brought confusion on the basis of computation of grades of the examinees.

"We must insure that the medical profession is not infiltrated by incompetents to whom patients may unwarily entrust their lives and health," he said.

"Would the government allow the risking of patients’ life and limb under the care of nurses with doubtful competence?"

http://www.mb.com.ph/MTNN2006072269858.html

- brewed

Posted by brewed at 1:34 AM | Permalink | Comments

PRC files raps vs 2 nursing board members

PRC files raps vs 2 nursing board members
By Alcuin Papa
Inquirer
Last updated 06:01am (Mla time) 07/21/2006

Published on Page A5 of the July 21, 2006 issue of the Philippine Daily Inquirer

THE PROFESSIONAL Regulation Commission (PRC) said yesterday it had filed administrative charges against two members of the Board of Nursing who contributed questions to the nursing board exams on the suspicion that these were leaked to some examinees.

PRC Chair Leonor Rosero also told the Inquirer yesterday that the 17,000 nursing graduates who passed the board exams given in June could still lose their licenses later if it were found that there had been a “leakage” of exam questions.

“The more than 17,000 nurses who passed the recent board exam may take their oath on Aug. 22. But if the National Bureau of Investigation finds evidence of a leakage on the examiners’ part, their (nursing graduates) licenses could still be revoked or suspended,” Rosero said.

Rosero yesterday confirmed administrative charges had been filed against Board of Nursing members Anesia Dionisio and Virginia Madeja “for neglect of duty that gave rise to the leakage of test questions.”

If found guilty, Rosero said the two could lose their registration certificates and professional licenses.

Presidential appointees

Both were told to go on leave until the investigation was completed. The PRC does not have the authority to suspend or remove them from office since the two are presidential appointees, but the questions they contributed to the PRC’s Test Questions Data Bank for nursing were deleted.

The PRC has also asked the NBI and the Department of Justice to investigate the matter and determine the criminal liabilities of any party.

The filing of administrative charges against Dionisio and Madeja was based on the report of an independent fact-finding committee formed by Rosero on June 28.

“The committee did not establish how it (leakage) got to the examinees. That is why we gave it to the NBI. We would like to clarify that the leakage did not come from the PRC but outside it. It was beyond our control,” Rosero said.

The PRC excluded about 20 questions prepared by Madeja for Test III (Nursing Practice III) from the computation of the results. It also nullified the results of Test V (Nursing Practice V) after some examinees “may have benefited from the handwritten notes leaked from the test questions” prepared by Dionisio.

Rosero said the PRC decided not to nullify the entire exam -- given on June 11 and 12 -- because the questions from Madeja and Dionisio that were allegedly leaked did not affect the overall result of the exam. She said the integrity of the exam was intact.

Each of the five Board of Nursing examiners is assigned to submit 100 questions for a particular area of the exam. Of the 500 questions submitted, 100 are randomly picked to constitute the exam. The questions are then stored in a data bank for possible use in future exams.

“In the case of Test III, the remaining (80) questions were good enough to measure the students’ knowledge of the subject. In the case of Test V, the result would not have affected the grades of the examinees,” Rosero said.

No advantage

She said the PRC hired a statistician who came up with a formula that led the agency to decide on the outcome of the exam.

“There was a formula that was given in the computation of the results that would make invalid the effect of any leakage. We also found that if you had access to the leakage, it would not have favored you. The statistics and our methods will bear us out,” Rosero said.

She said she was able to question Dionisio and Madeja about the alleged leakage recently but both disavowed any knowledge of it. The PRC has refused to furnish the Inquirer contact numbers for the two.

Allegations of cheating surfaced in Baguio City after nursing graduates there complained of a leakage that allegedly emanated from the R. A. Gapuz Review Center in the city.

The review center has denied any involvement in the leakage. Ray Gapuz, company founder and chair, admitted, however, that he had received a faxed copy of an 18-page handwritten manuscript a day before the exams. The manuscript supposedly contained topics that came out in the board exams.

FROM: http://newsinfo.inq7.net/inquirerheadlines/nation/view_article.php?article_id=10968

Posted by sweet_periwinkle at 12:15 AM | Permalink | Comments

Friday, July 21, 2006

The nursing boards and the larger mess

found this column in the inq7 website... this is something to think about - kitchie

PASSION FOR REASON
The nursing boards and the larger mess
By Raul Pangalangan
Inquirer

Last updated 01:48am (Mla time) 07/21/2006
Published on Page A12 of the July 21, 2006 issue of the Philippine Daily Inquirer

IT IS nothing new for us to hear about another scandal, another leakage, in a government licensing examination. There are persistent causes for the obsession to pass -- if not "top" -- exams by the proverbial hook or crook. What is new is the setting: the OFW-funded surge in enrollment in higher education, and the overseas placement-driven demand for new, board-certified graduates. It is this setting that makes board exam safeguards even more urgent, and the place of good university-level schools even more strategic.

The eternal, ever-present reasons are in a way so typically, wonderfully Pinoy. We all love diplomas. We hang them on walls, together with, for the older folk, framed graduation photos in cap and gown. Next, we love those board exams. Abroad, people see them as licensing exams that attest merely that the candidate has the minimum competence, nothing less, but also nothing more. Hereabouts, we think they prove that the candidate is a genius (step aside, Einstein), all of a sudden licensed to talk in strangetechnical jargon meant to impress rather than enlighten.

On the loftier, more romantic side, for the Filipino Everyman, degrees and board exams are the dramatic escape from one's assigned place in life; they are his entrée into the finer classes. Believe it or not, the feudal attitude that each of us is born into a fixed station and immutable status -- something that most of the world began to chuck after the FrenchRevolution -- still lingers deep in the chest of the Filipino.

Commencement day and the oath-taking are tangible moments of release from that ordained pecking order. By token of parchment paper and ceremony, one's social and market worth is suddenly upgraded and, we proudly sermon the kids, that is an achievement that no one can take away from you (by which we imply that everything else that came before was given by others who, therefore, can also take them back).

Board and bar exams are even more special. They are "blind-graded" exams, where the "teacher" doesn't know if the paper he is checking belongs to the daughter of Doña Buding or the son of Buding's "labandera" [laundrywoman]. They stand on equal footing before the grader, and to be treated equally is, again, believe it or not, a rarity in Filipino life. Everywhere else, he is judged by his clothes, his titles, his pedigree, his accent. Before the government boards, he competes solely on his own talent and strength. Board and bar exams therefore embody the meritocratic ideal, the pride in besting others in a fair and equal contest, the democratic romance about the level playing field.

That is why the scandal in the nursing board exams riles us so. Whoever leaked out those handwritten notes shortchanged all those honest students who took the exam on their own. Yet, unless the actual culprits and individual cheaters are found, the only proper course of action is to set aside the results of the tainted examination altogether. Its integrity has been breached, its results are not reliable. To compel the honest to retake an exam they have already passed -- that makes them the innocent victims of other peoples' greed and cunning. That is sad, but that is a legitimate price to exact. To allow the cheaters to be board-certified and to profit from their crime -- that leaves the public unprotected from the incompetent and rewards the dishonest with honors undeserved.

The nursing board's decision to release the results prematurely, while the investigation is ongoing, is a vintage move to silence the critics. Politically, it creates a solid constituency -- all those who passed -- who will lobby that exam results be maintained. (I doubt if those who flunked will conversely have the incentive to either impugn the exam or testify on the leak. Even if they are thus "incentivized," certainly they wouldn't have as much credibility as those who passed.)

Legally, the nursing board announcement may have (perhaps on purpose) "vested" certain rights in every person on the list of passers, unless the board had expressly made reservations when they issued that list. Either way, the board's undue haste raises even more questions.

We are wasting away a golden opportunity by allowing nursing education to succumb to the enticements of the market, when in fact the market can be harnessed to benefit nursing education.

Who could have imagined the blossoming of private universities fueled by overseas Filipino workers' money? The Filipino family, long smitten by fancy diplomas, all of a sudden has disposable income. And guess where he chooses to spend it first? The most noble, most natural path is the road to a school for his children, and he thus invests in a dream that will outlive him. We must make the most of this sudden surge in enrollment.

But nursing schools are even more uniquely situated. Like the rest of the colleges, they have applicants knocking at their gates. But even better, they have interested employers visiting the dean's office.

The papers have lamented the loose accreditation of nursing schools and the Commission on Higher Education's feeble enforcement of academic standards to accommodate powerful lobbies. The nursing board leakage is just the latest scandal that undermines public trust in the nurses produced by Philippine schools. The Filipino public may be forgiving and cheap, but the foreign public is exacting and demanding. The nursingschool bonanza thrives because of the foreign public. To lose its trust just so shortsighted entrepreneurs can make a killing is to kill the goose that lays the golden egg.

FROM: http://opinion.inq7.net/inquireropinion/columns/view_article.php?article_id=10919

Posted by sweet_periwinkle at 11:53 PM | Permalink | Comments

Information for June 2006 NLE Passers

Hi Guys,

If you would want to get your grades in the recent board exams you could go to PRC and they would be giving it to you. You just get this piece of paper (1/4 size) and the records section fills it up for you. Also you can get a certificate of passing which basically certifies that you passed the NLE but this comes with a fee.

There are no requirements needed to be brought to be able to get this EXCEPT money for the fees and also an identification card.

The certification has 2 prices they have the EXPRESS which takes about an hour and half to process the document so you would be able to get it the same day but the document costs 200 pesos per document. For REGULAR process its 75 pesos per document and you can get it after 2 days. Added expense also include documentary stamp which cost around 21 pesos per document.

Lines are still quite manageable at PRC but it might grow in number these next few days with the release of oath taking tickets coming up... as announced in PRC tickets would start to be released on August 1, 2006. Please just check the site for any changes or development in the schedule.

Congratulations to us and god bless everyone!

Posted by Joan Gillen at 10:24 PM | Permalink | Comments

Thursday, July 20, 2006

Police remain fully committed in hunt for Debbie’s killer

Police remain fully committed in hunt for Debbie’s killer

MURDERED: Debbie Remorozo.

DETECTIVES have sent out a clear message to a murderer – the crime may have been four years ago but they remain fully committed to catching the killer.

Officers investigating the murder of Oldham nurse Debbie Reorozo recently travelled to a Filipino festival in London to make a fresh appeal for information about her death.

Debbie, a staff nurse who worked in the coronary care unit at Royal Oldham Hospital, was found stabbed to death in her flat at Summervale House, Vale Drive, Oldham, on December 8, 2002.

The 26-year-old, who had arrived in Britain from the Philippines in 2000, had left the hospital the previous afternoon wearing her nurses uniform and a distinctive orange bobble hat.

At 5.40pm the next day friends discovered her body inside her flat and a post-mortem examination revealed she had died from multiple stab wounds to the chest and neck.

No motive for the killing has ever been established and nothing was stolen.

Despite the time that has passed since the murder, the investigation remains not only open, but highly active.

As part of the inquiry, two officers from the Major Incident Team went to the annual Filipina Barrio Fiesta in Lampton Park, Hounslow, last week.

They handed out leaflets and posters in English and Tagalog, which is one of the main native languages of the Philippines.

Detectives know that many Filipino nurses move around the country working at different hospitals, and hoped to reach people who may have known or worked with Debbie.

Officers suspect Debbie knew her killer as there were no signs of forced entry, but the possibility it was a stranger has not been ruled out.

Police are also still keen to hear from Oldham residents who may have any information which may be useful.

There is even a £10,000 reward for anyone who provides information that leads to a conviction.
ANYONE with information should contact the incident room at Collyhurst Police Station on 0161 856 4025 or Crimestoppers, anonymously if they wish, on 0800 555 111.
--James Ferguson

i was browsing the net for the latest news on the board exam and came accross with this one. hndi ko na ni-post ung pic nya, visit the site nlng to catch a glimpse of what she looked like.. we may not know her, but she's a filipino nurse and nurses all over the world, registered or not, are connected to each other.. so, let's all pray for her soul and for her murderer to be found and jailed asap!
-kitchie

FROM: http://www.oldhamadvertiser.co.uk/news/s/215/215411_police_remain_fully_committed_in_hunt_for_debbies_killer.html

Posted by sweet_periwinkle at 11:31 PM | Permalink | Comments

Bed sharing 'drains men's brains'

Sharing a bed with someone could temporarily reduce your brain power - at least if you are a man - Austrian scientists suggest.

When men spend the night with a bed mate their sleep is disturbed, whether they make love or not, and this impairs their mental ability the next day.

The lack of sleep also increases a man's stress hormone levels.

According to the New Scientist study, women who share a bed fare better because they sleep more deeply.

Sleepless nights

"Sharing the bed space with someone who is making noises and

who you have to fight with for the duvet is not sensible"
- Professor Neil Stanley, a sleep expert at the University of Surrey

Professor Gerhard Kloesch and colleagues at the University of Vienna studied eight unmarried, childless couples in their 20s.

Each couple was asked to spend 10 nights sleeping together and 10 apart while the scientists assessed their rest patterns with questionnaires and wrist activity monitors.

The next day the couples were asked to perform simple cognitive tests and had their stress hormone levels checked.

Although the men reported they had slept better with a partner, they fared worse in the tests, with their results suggesting they actually had more disturbed sleep.

Both sexes had a more disturbed night's sleep when they shared their bed, Professor Kloesch told a meeting of the Forum of European Neuroscience.

But women apparently managed to sleep more deeply when they did eventually drop off, since they claimed to be more refreshed than their sleep time suggested.

Their stress hormone levels and mental scores did not suffer to the same extent as the men.

But the women still reported that they had the best sleep when they were alone in bed.

Bed sharing also affected dream recall. Women remembered more after sleeping alone and men recalled best after sex.

Separate beds

Dr Neil Stanley, a sleep expert at the University of Surrey, said: "It's not surprising that people are disturbed by sleeping together.

"Historically, we have never been meant to sleep in the same bed as each other. It is a bizarre thing to do.

"Sleep is the most selfish thing you can do and it's vital for good physical and mental health.

"Sharing the bed space with someone who is making noises and who you have to fight with for the duvet is not sensible.

"If you are happy sleeping together that's great, but if not there is no shame in separate beds."

He said there was a suggestion that women are pre-programmed to cope better with broken sleep.

"A lot of life events that women have disturb sleep - bringing up children, the menopause and even the menstrual cycle," he explained.

But Dr Stanley added people did get used to sharing a bed.

"If they have shared their bed with their partner for a long time they miss them and that will disturb sleep."

BBC NEWS/Health http://news.bbc.co.uk/2/hi/health/5197440.stm

-brewed

Posted by brewed at 11:29 PM | Permalink | Comments

PRC allows the year’s new batch of nurses to take oath

PRC allows the year’s new batch of nurses to take oath

THE Professional Regulation Commission said on Thursday that the successful examinees in the June 2006 nurse licensure examination will take their oath next month but warned that a National Bureau of Investigation finding that there was indeed a leakage may lead to the suspension or revocation of licenses.

PRC Chairman Leonor Rosero said that successful board candidates would be allowed to take their oath on August 22 as professionals.

She was quick to warn that in the event that the ongoing NBI investigation shows that a leakage took place, the commission would not hesitate to revoke or suspend their license.

Meanwhile, the two PRC employees who were identified as the source of the leakage were “inhibited” from performing their functions while under investigation.

“We instructed them to inhibit from their functions in the PRC,” Rosero said, referring to a certain Anesia Dionisio and Virginia Madeja, the alleged source of the leakage.

But tracing which schools and who among the board examinees who passed have benefited from the leakage is a tall order for the NBI.

“It’s now the job of the NBI to establish if there was really a leakage. The only evidence that we have is the manuscript of the 500 test questions. How this manuscript landed in the hands of the students, that we really don’t know,” Rosero said.

Bowing to pressures, the commission finally released the results of the June 11-12 nursing board examinations. More than 17,000 of the nearly 43,000 nurses who took the exams passed.

The board topnotcher came from the University of Pangasinan, with a 83.20-percent score. The second placer graduated from the University of the Philippines in Manila. Of the schools with more than 100 examinees, Saint Louis University in Baguio City was topnotcher.

It was earlier reported that the leak took place in Baguio.

On Tuesday, officials of the Ray A. Gapuz Review Center—alleged to be the source of the leak—denied any participation in the disclosure.

Prof. Ray Gapuz, founder and chairman of the company, however, admitted that he received a faxed copy of an 18-page handwritten manuscript a day before the exams containing questions on nursing terms in bullet points which allegedly came out in the examination sheet.

Gapuz even admitted that he allowed the circulation of the manuscript to students who had asked him if they can read it or share it with other students.

Meanwhile, Rosero dismissed criticisms that the integrity of the board exams had suffered because of the leak.

On Wednesday parents of the board examinees stormed the PRC office upon the release of test results.

“Di naman po lahat dahil yong apat na tests ay maayos naman po [I don’t think so because the four other tests were in order],” Rosero said.

She said that one of the tests had a 20-percent outcome from the leak. “But still 80 percent had been proven competent from that test.”

The parents criticized the PRC for releasing the results while the NBI probe is ongoing.

Rosero said that the contested questions were invalidated and taken out from the correction and computation of Tests 3 and 5.

“The investigation is with the NBI to pursue but we have to release the results so that the examinees will not have to wait one year to know the results,” Rosero said.
--Francis Earl A. Cueto

FROM: THE MANILA TIMES
http://www.manilatimes.net/national/2006/july/21/yehey/top_stories/20060721top6.html

Posted by sweet_periwinkle at 10:57 PM | Permalink | Comments

NBI joins probe on leakage at recent nursing board exams

NBI joins probe on leakage at recent nursing board exams
By Rizal S. Obanil

The National Bureau of Investigation (NBI) has stepped into the probe on the supposed leakage at the recent Nursing licensure exam conducted by the Philippine Regulatory Commission (PRC).

''We're focusing on the criminal aspect of the case. If there was someone from the government, review center or the board of nursing involved,'' NBI-Anti-Fraud and Computer Crimes Division (AFCCD) Chief Elfren Meneses said.

Meneses said that they recently received a letter of request from the PRC last July 18 to conduct an investigation on the supposed leakage at the June 11-12 board exam for nursing.

The AFCCD Chief has already assigned Supervising Agent Rodolfo Saniano and Special Investigator IV Martine Cruz to conduct an investigation.

Meneses said that they also received a pile of documents from the PRC, who has already conducted an initial investigation on the case.

The PRC has so far focused their investigation on the two examiners who allegedly distributed the leakage.

Meneses, however, said they will extend the conduct of the probe to the review centers, members of the board and the examinees themselves.

FROM: THE MANILA BULLETIN ONLINE
http://www.mb.com.ph/archive_pages.php?url=http://www.mb.com.ph/issues/2006/07/20/MTNN2006072069728.html

Posted by sweet_periwinkle at 10:17 PM | Permalink | Comments

Ched seeks curbs on review centers

Ched seeks curbs on review centers
By Florante S. Solmerin

An official of the Commission on Higher Education yesterday urged Congress to pass a law that would regulate the establishment and operation of review centers.

“It’s about time to regulate review centers. First, they should be reputable, financially capable and manned by reputable reviewers of high integrity,” said Julito Vitriolo, the agency’s executive secretary.

The appeal came on the heels of reports that a lot of review centers, particularly those that deal with nursing, were operating outside the bounds of law and immune to any charges for violating education standards.

Vitriolo cited the controversy over the recent nursing board examination, where some alleged that the Ray A. Gapuz Review Center was among the sources of a massive leakage.

“Leakage has since time immemorial been there. But at this point, we should tighten our policy to avoid such violations to occur time and again,” Vitriolo said.

“Apparently, if review centers are not regulated, they will remain a weak link in the entire process,” he added.

Vitriolo said that under the current setup, review centers are not under the supervision of the agency or the Philippine Regulatory Commission, or any other government office.

“Review centers should be part of the government system,” he said.

At present, these establishments are only accountable to the Securities and Exchange Commission and the government agency that issue business permits to them.

“If there’s a regime of regulation, review centers that may be found guilty of a violation should be investigated. Somebody must answer the allegation,” Vitriolo said.

But under the present setup, only estafa can be filed against erring review centers because there is no specific law penalizing the violation or action,” he added.

From : MANILA STANDARD TODAY
http://www.manilastandardtoday.com/?page=politics03_july20_2006

Posted by Budek at 7:34 PM | Permalink | Comments

PRC voids nurse test parts leaked to examinees

PRC voids nurse test parts leaked to examinees

The Professional Regulation Commission said portions of the June 2006 Nurse Licensure Examination leaked to the examinees were invalidated after their parents stormed the PRC office upon the releases of test results, ANC reported Thursday.

The parents scored PRC for releasing the results while the probe of the National Bureau of Investigation on the test leakage is ongoing.

Leonor Rosero, PRC chairwoman, said that the contested questions were invalidated and taken out from the correction and computation of Tests 3 and 5.

"The investigation is with NBI to pursue. Kawawa na naman ang iba kung maghihintay sila ng isang taon (The investigation is with the NBI to pursue [but we have to release the results] so that the examinees will not have to wait one year [to know the results] )," Rosero said.

The NBI is investigating the leakage confirmed by a PRC fact-finding committee. According to the committee report, the leakage came from the manuscripts of nursing board members Anesia Dionisio and Virginia Madeja. The two are facing administrative charges for neglect of duty.

More than 17,000 of the 42,000 examinees passed the board examinations held from June 11 to 12. The board top notcher came from the University of Pangasinan, with a 83.20 percent score. The second placer was from the University of the Philippines in Manila.

Of the schools with more than 100 examinees, Saint Louis University in Baguio City topped the performance list. It has been reported that the examination leakage took place in Baguio.

FROM : ABS-CBN News
http://www.abs-cbnnews.com/storypage.aspx?StoryID=44937

Posted by marisse at 10:47 AM | Permalink | Comments

Breastfeeding 'kills baby's pain'

Breastfeeding may be the ultimate natural painkiller for newborn babies.

A review of research found that breastfeeding newborns helps relieve the pain from a needle prick used to screen their blood for disease.

Breastfed babies appeared to experience less pain than those who were swaddled, given a pacifier, or a placebo. Comfort from a mother's presence may be key.

The Cochrane Library review, by Toronto's Mount Sinai Hospital, was based on data from over 1,000 babies.

The researchers say that breastfeeding could possibly help relieve pain for premature babies who need to undergo many painful intensive care procedures.
However, they stress that their study did not test the impact of breastfeeding on the pain associated with repeated procedures.
The Mount Sinai team assessed pain by measuring changes in heart and breathing rates, and the length of time a baby cried after receiving the needle prick.

COMFORT

The researchers say that the key to the effect of breastfeeding may be that an infant simply draws comfort from the close proximity of its mother.

Alternatively, breastfeeding may help to divert attention away from the pain of a needle prick.
They also suggest that the sweetness of breast milk may be a factor.

Another theory is that breast milk contains a high concentration of a chemical which could ultimately trigger the production of natural painkillers called endorphins.

The researchers also found that giving babies a sugar solution seemed to be effective.
But researcher Dr Prakeshkumar Shah said: "Based on this review we concluded that for a neonate undergoing painful procedure breastfeeding is superior to no treatment, placebo, or swaddling alone for relieving pain.

"As it is the most inexpensive, safe and advantageous from other perspectives, it should be offered to all neonates to relieve procedural pain when possible."

Dr Tony Williams, an expert in neonatal care at London's St George's Hospital, said: "Newborn babies are often given dummies soaked in concentrated glucose to help reduce distress during painful procedures.

"This study shows that babies would do just as well by being breastfed."

Posted by brewed at 12:48 AM | Permalink | Comments

Wednesday, July 19, 2006

Nursing license depends on NBI Investigation, We Will not think twice to revoke it - PRC

Nursing license depends on NBI Investigation, We Will not think twice to revoke it - PRC

http://www.pinoybsn.tk

Amidst the celebration of almost 17,000 newly licensed nurses as the Professionals Regulation Commission released the long awaited June 2006 National Licensure Examination for Nurses, There are no reasons to celebrate at all.

According to the recent statement of the Professionals Regulation Commission, Results are not yet FINAL and once an examinee has been proven cheating, They will not think twice to revoke their license and bar the ex-professional from practicing the profession.

NBI has now the case as forwarded by the commission, And depending on the investigation of the NBI, there is a possiblity to null the examination if the investigating body concludes that the leakage is non quantifiable, opening the possibility for a re-examination.

29 out of 70 topnotchers are from R.A Gapuz review center.

" It just fairs in comparison to the previous June 2003 board exams where we got 45 spots " In a statement made by Ray Gapuz.

According to PNA President George Cordero, The review center boast an unbelievably high passing rate.

" If they have such 98% passing rate, then why is the passing rate in the Nursing Licensure exam 42%? Isn't it supposed to be higher? " In a statement made by Mr. George Cordero.

The topnotchers, from 1 to 10 including Gringo De Guzman, the topnotcher, who got 83.20% in the recent board examination was from R.A.Gapuz Review Center that has been recently drag into the leakage issue.

" The commission will not think twice to revoke their licenses if proven that they've cheated " According to the PRC.

Yesterday, the review center "ADMITTED" that they distributed the "LEAKAGE" But they claim that they never knew that it was the exact manuscript that will be asked in the board exams because it was just faxed by a student. The review center admitted that they haven't carefully checked the source and they only asked the reviewees if they are intrested to get a copy.

Posted by Mahinhing Binata at 9:08 PM | Permalink | Comments

Nursing Licensure Exam Result now ready for DOWNLOAD in PDF and WORD format!

Click the widget below to download the recently concluded June 2006 National Licensure Examination for Nurses.

We congratulate all those who passed.

Congratulations to our blog admin JOAN, MARISSE and JEDDAH who are now officially RNs!

June 2006 NLE Resu...

Hosted by eSnips

June 2006 NLE Resu...

Hosted by eSnips

- Budek

Posted by Budek at 11:21 AM | Permalink | Comments

Nurse Licensure Examination Results Released

Nurse Licensure Examination Results Released
The Philippine Star 07/18/2006

The Professional Regulation Commission (PRC) announces that 17,821 out of 42,006 passed the Nurse Licensure Examination given by the Board of Nursing in the cities of Manila, Baguio, Cagayan de Oro, Cebu, Davao, Iloilo, Legazpi, Lucena, Tacloban, Tuguegarao and Zamboanga last June 2006. The results of examination with respect to eighteen (18) examinees were withheld pending final determination of their liabilities under the rules and regulations governing licensure examinations.

The members of the Board of Nursing are Eufemia F. Octaviano, Chairman; Remedios L. Fernandez, Letty G. Kuan and Estelita T. Galutira, Members. The two (2) other members of the Board namely Anesia B. Dionisio and Virginia D. Madeja were advised to inhibit themselves from participating in the official functions of the Board of Nursing. Due to the increase on the number of examinees and after a thorough scientific statistical treatment to the report of irregularity, the results were released in twenty-seven (27) working days from the last day of examination.

Registration for the issuance of Professional Identification Card (ID) and Certificate of Registration will start on Monday, May 29, 2006 but not later than June 19, 2006. Those who will register are required to bring the following: duly accomplished Oath Form or Panunumpa ng Propesyonal, current Community Tax Certificate (cedula), 2 pieces passport size picture (colored with white background and complete nametag), 1 piece 1" x 1" picture (colored with white background and complete nametag), 2 sets of metered documentary stamps, and 1 short brown envelope with name and profession; and to pay the Initial Registration Fee of P600 and Annual Registration Fee of P450 for 2006-2009. Successful examinees should personally register and sign in the Roster of Registered Professionals. Registration of successful examinees will start on Tuesday, August 15, 2006.

The schedule of registration in alphabetical order will be announced later. The oathtaking ceremony of the successful examinees in the said examination as well as the previous ones who have not taken their Oath of Professional will be held before the Board on Tuesday, August 22, 2006 at 8:00 o'clock in the morning at the Araneta Coliseum, Araneta Center, Cubao, Quezon City; on August 23, 2006 in Cebu; on August 26, 2006 in Zamboanga; on August 29, 2006 in Iloilo; on August 30, 2006 in Tuguegarao; on August 31, 2006 in Legazpi and Davao; on September 3, 2006 in Baguio; on September 6, 2006 in Tacloban; and on September 7, 2006 in Cagayan De Oro. Please contact the Accredited Professional Organization (Philippine Nurses Association) local chapter for further details. All must come in their white gala uniform, nurses cap, white duty shoes, without earrings, hair not touching the collar and without corsage.

No oathtaking will be allowed before the August 22, 2006 schedule in Manila. Oathtaking will be administered by the Board of Nursing as per RA 9173. Tickets will be available starting Tuesday, August 1, 2006 at the Ground Floor of PRC - Main Building, Sampaloc, Manila.

Phil Star
http://www.philstar.com/philstar/dailydose200607190202.htm

Joan's Notes: Click on the link to see the list of passers. I attempted to post it but they were so many to edit I would do my best to post an actual list here. Finally I can call myself an RN. :) Congrats to everyone who passed the exams. God bless everyone!

Posted by Joan Gillen at 12:36 AM | Permalink | Comments

Tuesday, July 18, 2006

Faxed paper holds key

Faxed paper holds key
by Francis Earl A. Cueto, Researcher

The owner of a review center where test questions for the nursing board examinations were allegedly leaked admitted on Tuesday that the center allowed the circulation of an 18-page manuscript to its students a day before the exams in June.

In a press briefing, Prof. Ray Gapuz, founder of the R.A. Gapuz review center, said he approved the dissemination of the manuscript faxed to his office by a student.

Gapuz said that as a policy, the center allows students to volunteer new materials to be included in the review as long as they get his permission first.

He recalled a time when similar material was submitted, but the students only got “sidetracked” because it was not included in the exams.

The Professional Regulation Commission (PRC) admitted last week that test questions had indeed been leaked and announced that two members of the Nursing Board were facing an inquiry.

Gapuz said students get review materials from friends in other centers.
“The thing is, other students enroll in different review centers and they share materials. Here we have a policy that they should first ask permission if the materials can be read or distributed or not,” he said.

Stressing that his center never engaged in any cheating, Gapuz said it was possible the leaked questions could have come from rival review centers.

He said, however, that he merely browsed through the bullet points in the faxed manuscript and did not bother to make a thorough evaluation before approving it.

“I did not go through the nitty-gritty of things, because I was having my class on the tenth of June in Manila when I received a fax coursed through my staff asking me to evaluate the paper if it is worth being read by the students in Baguio,” Gapuz said.

“I browsed through it [manuscript] and asked if the students wanted a copy they could go ahead and read it and use it for reference. So this is a choice of the students who want to have a copy or not,” he said.

Ninety-two examinees first filed a complaint about the leakage with the PRC. A total of 425 members of the Philippine Nurses’ Association have since joined them, asking the PRC to hold the release of the results of the examination until a thorough investigation has been made.

The results of the exams, held on June 11 and 12, have not been released. Last week the complainants said the review center distributed answers to exam questions called “emergency drills” the night before the exams.

Gapuz has 16 review centers nationwide.

Last week the PRC said it was considering annulling the results and holding new exams.
But a ranking officer of the Commission on Higher Education (CHED) said on Tuesday that letting the examinees retake the tests will “not be a logical thing to do.”

CHED Commissioner Dr. Nona Ricaforte said the PRC should simply think of the questionnaires as a “bonus” to the examinees.

“The students and the parents should not be penalized for the leakage. If the test is retaken, you can just imagine the cost and the effort of the students. This will also cost the government a huge sum,’’ said Ricaforte, adding that her statement is not the position of the entire commission.

“I sympathize with the students because some of them have already schedules of going abroad,’’ she added.

Ricaforte said, however, she is not preempting the PRC investigation.

“These are just my personal views. Once they are able to pinpoint the three questionnaires and who the culprit is—they can stop and learn from there rather than jeopardize the parents and the students. This will also help even the schools,’’ she noted.

Gapuz echoed the sentiments of Ricaforte. “It would be burdensome for the parents to spend anew for tuition and allowances and for the graduates for time they will have to redo,” he said.
Jose Dino, president of the Philippine National Association of School Security Organization, said the students should not be blamed for the errors committed by the PRC officials.

“It’s most unfair for the PRC to order nursing students to repeat the exam out of security lapses on their part. Government authorities like the National Bureau of Investigation must conduct and put to jail the PRC employees responsible,’’ Dino said.

He said that while the CHED has nothing to do with the controversy, it must also investigate higher education officials involved in the leakage.

The Philippine Overseas Employment Agency also expressed fear that the issue will affect not just Filipino nurses going abroad but other skilled workers in the country.

From: The Manila Times
http://www.manilatimes.net/national/2006/july/19/yehey/top_stories/20060719top4.html

Posted by sweet_periwinkle at 11:05 PM | Permalink | Comments

Gapuz talks about the leakage, Review center NOT AFFECTED.

Gapuz talks about the leakage
By : Budek
http://www.pinoybsn.tk

For the first time, the head reviewer of R.A Gapuz review center talked publicly answering the alleged leakage issue in the last month's exam.

He said that his review center has nothing to do with the alleged leakage and that it is merely brought about by people that are trying to tarnish the review center's consistent and phenomenal track record.

Gapuz supporters told the media that the PRC did not include the review center in the list of individuals and organizations to be investigated by the national bureau of investigation. This only proves that the review center has nothing to do with the "leak" they said.

Gapuz publicly state that he is determined to find and brought to justice those individuals that started linking the review center with the alleged leak and will try to cooperate in anyway they can to the investigating body.

Gapuz emphasized that those given the night before the examination are all reading materials that will help the student's focus their studies to the most common board questions. It is not a leakage according to him.

WE ARE NOT AFFECTED

In preparation for the June and December board exams, The review center used the help of elite web designers to create an all new and dynamic website. They are not in anyway affected by the issue and will still expect numerous reviewees for the december boards.

The review center also introduced an innovation called T.I.P.S

" The center offers a comprehensive review for the local board examination. This features a refresher type of review, which discusses the major concepts integrated in the local board examination. The center utilized the T.I.P.S. (Total Innovative Personalized Supplemental Review) which shortened the traditional three-month nursing review course into 10-12 days. The T.I.P.S. review is the most innovative and a totally new review course to be introduced for the first time in the history of Local RN review. This course includes lectures and practice tests which simulate the actual Local-RN examinations and test taking techniques. Delivered in a totally innovative way, Mr. Gapuz makes every student enjoy every concept, and at the same time learn “the easy way”." - RA Gapuz Review Center

This only proves that the review center is not in anyway affected by the recent nursing mess.

The review center is ready and onset for the start of the review season for the december batch, which will officially start this october 01, 2006.

-Budek
http://www.pinoybsn.tk

Posted by Budek at 9:39 PM | Permalink | Comments

CRITICAL THINKING: Asthma and Wheezes

Q. Can you always hear Wheezes during and asthma attack?

A. Well, not necessarily. When a patient experiences severe bronchospasm, there wouldn’t be enough air movement to create turbulence that causes the wheezing sound. So when you hear greatly diminished breath sounds and no adventitious breath sounds, this indicates an emergency because the patient might be in acute hypoventilation, which can result in hypercapnia, hypoxemia thereby Respiratory Acidosis o Respiratory Arrest if uncorrected.

When wheezing stops……

If all other assessment criteria- labored breathing prolonged expiratory time and accessory muscle use — point to acute bronchial obstruction, act to maintain patients airway and give oxygen as ordered. The patient may begin to wheeze again when the airways open more.

Q. Then How can I Intervene if my patient who is having asthmatic episodes suddenly stops wheezing?

A. Immediately, ask your patient to cough, minsan kasi mucous plug lang yan (loka? nag tagalog?). Also ask him to do pursed-lip breathing to improve his oxygenation. If these measures fail, consider this a medical emergency. Check your patient’s vital signs for tachycardia, pulsus paradoxus (remember eto ung decreased BP during inspiration) and hypotension. Give Bronchodilators by nebulizer, IV, steroids or sub-q epinephrine, as ordered, and prepare to intubate him.

Also urge asthmatic patients to call the doctor if he needs to use bronchodilator more often than every 4 hours to help prevent acute asthma attacks. Such need indicates increasing inflammation that’s unresponsive to bronchodilators, and patient may need to add or increase steroid therapy.

Dagdag lang dun sa post ni Budek. Ang taray diba? lol

Posted by Jeddah at 9:24 PM | Permalink | Comments

Red Cross Training: Standard First Aid and Basic Life Support (BLS)

Red Cross Training: Standard First Aid and Basic Life Support (BLS)

Red Cross Quezon City Chapter is conducting a Training Course for Standard First Aid management and Basic Life Support. It caters to any person (lay person or health care provider) who wants to learn how save lives especially when out of the Hospital Setting.

The whole training will take 6 days (Monday to Saturday) from 8am-5pm. Curriculum includes Treating patient in with Shock, Patient/Casualty Handling, Soft Tissue Injury, Musculo-skeletal Injury, Poisoning, Basic Extrication, some common Emergency situations such us CVA, MI, DM, Seizures and Emergency Delivery and Proper CPR for infant, children and adult. Teaching includes both didactic teaching and return demonstration (much like our previous RLE). Oh, quizzes will also be given. (Utang na loob, sawa na kami dyan.. I know.. I know…)

Advantages from taking the training:

Well except that you will gain knowledge and skills, after completing the whole training and passing the written and practical exams you will receive *2 or 3 certificates. Now, why is it 2 or 3. As I told you, written and practical exams will be given, If you will pass it (at least 75%, oo! parang board exams), you will receive a Certificate of Attendance and Certificate of Completion of the training plus you ID as a Licensed First-Aider. But if you excel in the training and you got a grade of 80% and above both in the written and practical (First Aid and BLS) you will get another certificate which is the Certificate of Proficiency.

Plus, you will receive a free manual for Standard first aid and a Triangular bandage. (Sorry, no T-shirts lol)

So that’s a certificate and license, but when will my license expire?

Expiration of the license will take a year. So after the expiration and you want to still be a First aider, you have to renew the license by taking another written and practical exam.

Requirements and Process of application:

As I’ve said everyone is invited to join, you just need to:
Pay 1,500 pesos at the Red Cross at QC City hall. Then you will be scheduled. Training takes place every week.
If you have already paid, on your first day of training you will need to present a Medical Certificate and a picture (either 1x1 or 2x2)
Orientation and Registration will occur at the first day of training
Training is done at CP. Garcia at UP Diliman.

If you still have questions just e-mail it to me at jedz_boi18@yahoo.com and Ill try to ask them and give you the anser ASAP.
*Certificate of Proficiency is only given at Red Cross QC chapter.

Posted by Jeddah at 8:38 PM | Permalink | Comments

THINK ! # 1

Think ! # 1

A client with asthma was brought to the E.R because of dyspnea, wheezing and coughing. Client appears restless, air hungry with sternal retraction. The physician ordered both oxygen and theophylline.

What should be your first intervention?

1. Administer theophylline as ordered
2. Relax the client
3. Reassure the client that he will be fine
4. Administer oxygen as ordered

YOU ANSWERED : 4

CORRECT ANSWER : 1

Rationale : Airway patency is the utmost priority. The client is having a severe asthmatic attack, Oxygen will be almost useless because there is a severe bronchoconstriction, Impairing perfusion. Maintaining airway patency takes precedence over AIR itself. Bronchodilators are given first before giving oxygen.

http://www.pinoybsn.tk
- Budek

Posted by Budek at 10:32 AM | Permalink | Comments

Stop the deterioration of quality nursing education

Stop the deterioration of quality nursing education (LETTER)
July 16, 2006, Manila Times

I read your editorial in the July 12 issue of the Manila Times on the “two depressing” events that affected the country’s nursing education. I refer to the mass resignation of members of the Technical Committee on Nursing Education of CHED and the “leakage” of test questions in the June 11-12 nurses examination.

I agree with your editorial that unless something is done to stop the deterioration of quality nursing education, we will be producing incompetent and unskilled nurses. This will have an adverse effect on countries where Filipino nurses are in demand.

In other words, the demand for our nurses in the US, Europe, Canada, Australia and the Middle East, particularly Saudi Arabia and the United Arab Emirates, will drastically fall.

Something must be done by the government to avert this consequence for the benefit of our nurses who have dreams of working abroad.

Felicitas Domingo Novaliches, Quezon City

MANILA TIMES
http://www.manilatimes.net/national/2006/july/16/yehey/opinion/20060716opi8.html

Posted by Joan Gillen at 12:31 AM | Permalink | Comments

Monday, July 17, 2006

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.

------

Easy lang to remember no? Hayyyy... atleast wala ng magkakamali. Tinanong sa exam yang Zofran na yan pati yang Reglan madalas tanungin. Kala ko pampa regla ang reglan, yung zofran naman, kala ko yung nilalagay sa fried chicken. Jufran pala iyon.

http://www.pinoybsn.tk
- Budek

Posted by Budek at 11:47 AM | Permalink | Comments

Leak mars credibility of nursing exam

Leak mars credibility of nursing exam

By Florante S. Solmerin

The alleged leakage of questions in the recent nursing licensure examination has tainted the credibility of Filipino nurses and may have put their chances of landing a job abroad at risk, the Philippine Overseas Employment Administration said yesterday.

“We are not being favorably considered to host the National Council Licensure Examination for Practical Nurses due to alleged forgeries and fraud in the licensure examinations,” Rosalinda Baldoz, the agency’s administrator, told the general assembly of the Federated Association of Manpower Exporters Inc. over the weekend.

“This [leakage] has trained the credibility of our nursing [board] exams,” she added.

The Philippines has been lobbying to host the NCLEX for the past two years, Baldoz said.

Baldoz said the controversy was making it hard to deploy nurses not only in the United States but other parts of the world as well. Even other skilled workers may be affected, she added.

To date, the country has deployed more than 100,000 nurses abroad, particularly to the Middle East, the United States and Europe, where Filipino medical workers are preferred.

The Philippines has 460 nursing schools, 40 of which have a zero passing rate in the board examination.

In the recent nursing licensure test, 23 of these schools failed to hurdle the minimum passing rate of 8 percent.

“If questions remain and doubts concerning our examination system persist, all Filipino professionals going abroad may be affected since their credentials would be subject to further scrutiny,” Baldoz said.

To avoid another leakage, Baldoz said the Professional Regulatory Commission should computerize the licensure examinations and install fool-proof security measures.

In a separate interview, the commission’s chief, Leonor Tripon-Rosero, said the more than 42,000 aspiring nurses who took the examination last month may have to retake it.

“That is an option,” she said.

Earlier, the agency confirmed that test questions had been leaked to students of a review center in Baguio City.

The commission said two members of its Board of Nursing had been implicated in the leakage and that charges were being prepared against them by a fact-finding panel.

FROM : MANILA STANDARD TODAY
http://www.manilastandardtoday.com/?page=politics06_july17_2006

Posted by Budek at 11:06 AM | Permalink | Comments

English Exams

As promised I would be placing here informations on the other exams Filipino nurses are taking especially when they go to the US or anywhere abroad. Like what Budek has mentioned in the side bar I would first deal with the 2nd exam that we should all pass... THE ENGLISH EXAMS.

There are different companies who offer these english exams so let me enumerate them to you and share whatever information I have learned about them from other people and references.

IELTS- International English Language Testing System

As mentioned the IELTS exam has four areas the listening, reading, writing and speaking subjects. The exam has 2 types of modules the Academic and the General Training Module. For Nurses, they usually take the Academic module. Academic module is usually taken by people who have intentions in studying abroad while the General Training Module are for those who are looking to migrate or skilled workers. The Academic Module carries more weight as compared to the General Training Module. I think the reason why nurses take the academic module is because at least if they have intentions of furthering their education later on abroad they would not need to take the exam again plus this is more readily available in the IELTS testing centers here in the Philippines. But it is up to you to decide which module suits your requirement.

The IELTS is usually a pen and paper exam though in other countries they are already starting to also make the exam computer based but so far here in the Philippines the exam is still pen and paper based.

The exam is taken for 2 days your listening, reading and writing test are taken in one day and the speaking test is scheduled on another day. The require score for nurses is an overall band score of 6.5 but for the speaking part if you intend on applying in the US you should get a band score of 7 and 6 for UK. You should not get a grade lower than 5.5 in listening and speaking areas.

Well thats about it... I would post more detailed information about this exam in my upcoming posts and well if you have questions feel free to post them up in the comments section.

Hope this information helps :D

Joan's Notes: Guys these information I presented to you are based on what I have read in different resources (Kaplan, Scott's English, Forums etc.) it would also help if you get verification from others. We aim to just at least give you guidelines and a little background. Have a good day everyone!

Posted by Joan Gillen at 10:49 AM | Permalink | Comments

Need Your Help

Hi Guys,

Well first of all we would like to thank you for your continuous patronage to PINOY BSN. In our efforts to make the site more interesting and informative I would like to ask help from you guys.

Nars Budek does a great job of placing the latest news and helpful reviews for the different nursing subject areas so I could leave that to her and maybe just add if I see something.

I was thinking if you guys actually wanted me to place an area or post helpful informations in terms of applying abroad or basically just giving out infomations about the different international requirements and informations on the different exams. I think this can be my main contribution for the site.

Let me know guys if I should go on with this idea by placing comments.

I would like to hear from you and God Bless!

Posted by Joan Gillen at 12:12 AM | Permalink | Comments

Sunday, July 16, 2006

Don’t blame us, say Baguio nursing deans

Don’t blame us, say Baguio nursing deans

By Vincent Cabreza
Inquirer
07/16/2006

BAGUIO CITY—The deans of Baguio’s nursing schools said they should not be blamed if the exposé about cheating in the 2006 Nursing Licensure Examination would reduce the number of Filipino nurses being employed abroad.

Maria Grace Lacanaria, dean of the St. Louis University College of Nursing, said they were apprised about the potential backlash on migrating nurses of their campaign against anomalies in the annual licensing tests of the Professional Regulation Commission.

“[The 91 complainants and the city’s nursing schools] will work to cleanse Philippine nursing [community] of professionals who cheated to get their licenses, but this should not be the reason for us to be condemned if the world’s medical community starts distrusting our nurses,” said Lacanaria.

At a rally on Tuesday, Lacanaria said cleaning up the licensure examinations would guarantee that foreign employers would be getting competent and efficient nurses.

The country sends 15,000 nurses annually to the United States, according to the Department of Labor and Employment.

The Philippine Overseas Employment Administration expressed fears this number would be cut due to the scandal.

Lawyer Kisaak Gabaen, who represents the nursing school deans, said they were initially blamed for the United Kingdom’s decision to suspend its quota of migrating Filipino nurses last month.

But the UK cut was a consequence of its new health laws that restrict the number of foreign medical employees it could hire, Gabaen said.

The school deans said they would sue next week a top official of the Philippine Nurses Association who tried to pressure them into suppressing the expose because of ongoing negotiations to host the US National Council Licensure Examination for nurses in Manila.

On Thursday, PRC chair Leonor Tripon-Lucero confirmed there were leakages of test questions and answers that circulated among clients of a review center during the June 11 and 12 licensing exams here. A PRC fact-finding body traced the leak to the test manuscripts of two members of the PRC board of nursing.

But Lucero did not say whether PRC would void the exam results as a consequence.

Ninety-one of the examinees complained to PRC about the cheating, and had asked for the suspension of both the test results and the two members of the nursing board.

Members of PNA in the city and the Association of Deans of Philippine Colleges of Nursing (ADPCN) also filed their complaints.

The R.A. Gapuz Review Center which was implicated in the leakages yesterday said it would fully cooperate with PRC’s investigation of the incident.

The RAGRC noted that the PRC fact-finding committee did not find the review center to have been involved in the leakage.

“RAGRC is confident that its name will soon be finally cleared and vindicated of any suspicion thus proving its earlier consistent assertions that it had absolutely no participation in any leakage,” it said in a statement.

RAGRC said it supported the PRC’s recommendations that administrative charges be filed against those involved and that some questions in Test III and Test V be excluded and invalidated. With a report from Jerome Aning .

PHILIPPINE DAILY INQUIRER
http://globalnation.inq7.net/news/news/view_article.php?article_id=10074

Posted by Budek at 9:45 PM | Permalink | Comments

Baguio Examinees Fear ‘Whitewash’ on Nursing Board Scam

Baguio Examinees Fear ‘Whitewash’ on Nursing Board Scam

The attempt to cover up the truth about the leakage on the June nursing board exam, and the “inaction” by the Professional Regulatory Board (PRC) are meant to prevent the issue from tarnishing the image of the Philippines. The alleged reason: a top official of the Philippine Nurses Association (PNA) is allegedly lobbying for the country to become a testing center for the U.S. National Council Licensure Examination for Registered Nurses (NCLEX-RN), an examination for nurses who seek employment in the U.S.

BY ARTHUR L. ALLAD-IW
Northern Dispatch
Posted by Bulatlat

BAGUIO CITY (246 kms north of Manila) – The attempt to cover up the truth about the leakage on the June nursing board exam, and the “inaction” by the Professional Regulatory Board (PRC) are meant to prevent the issue from tarnishing the image of the Philippines. The alleged reason: a top official of the Philippine Nurses Association (PNA) is allegedly lobbying for the country to become a testing center for the U.S. National Council Licensure Examination for Registered Nurses (NCLEX-RN), an examination for nurses who seek employment in the U.S.

Despite the move to suppress the complaint, however, professional health workers, examinees of the latest board exam, nursing students and their supporters held a rally here on July 11, braving rains down Session Road. In a program at the People’s Park here after the rally, the speakers reiterated their main call for the PRC to establish an independent fact-finding body to investigate the scam and to suspend members of the Board of Nursing (BON)who are suspected of being involved in the alleged leakage while the probe is going on.

The ralliers said in a statement that they “express disappointment with the PRC for its failure to act on the complaint expeditiously,” as they also expressed fear that the PRC is doing a “whitewash.”

NCLEX-RN testing center

The ralliers said that PNA national president George Cordero told the heads of the PNA-Cordillera and the Cordillera Association of Deans of Philippine Colleges of Nursing (ADPCN) to slow down in their expose on the leakage scam as it will affect the Philippines’ chances of becoming an NCLEX-RN testing center.

The ralliers’ statement revealed that on June 17, Cordero called PNA-Cordillera governor Ruth Thelma Tingda “to suppress the complaint.”

They added that on June 19, Cordero also called Dr. Mary Grace Lacanaria, urging the latter “to suppress the complaint” and to resort to “damage control” instead of carrying on with it.” Cordero, they said in the statement, warned that the issue of the board examination leakage may – and certainly will – damage the PNA’s lobbying to make the country an NCLEX-RN testing center.

Lacanaria is the dean of the College of Nursing at St. Louis University (SLU) and the president of the ADPCN. Cordero allegedly offered her a position in his nursing school, but she turned it down.

Lacanaria and Tingda are among those who joined as intervenors in the complaint against the leakage that was filed before the PRC.

Move to whitewash complaint

Standing on their grounds against the leakage, 92 board examinees in this city filed their complaint at the PRC-CAR office on June 21. They claimed that leakage on Sets III and V of their examinations, numbering “more or less 50 questions” benefited examinees/reviewees from the Gapuz review center but 119 leaked questions benefited another review school.

On June 28, 425 professional nurses joined the complainants through an intervention they filed at the PRC national office.

It was learned that the common calls of the complainants and intervenors are the immediate convening of an independent fact finding committee (IFFC) to investigate the leakage; to file the necessary administrative and criminal charges against those who are responsible; and put on preventive suspension all members of the Board of Nursing (BON) while the investigation is going on.

The intervenors and their counsels found out, when they filed their intervention on June 28, that the PRC national legal and records divisions have no records on the complaint filed on June 21.

They also found out that the PRC national and its regional office issued contradicting statements as to the creation of the committee. They claimed that lawyer Senando Esteban of PRC-CAR told them on June 30 that the committee would be created, to be headed by lawyer Renato Valdecantos, a PRC Commissioner.

In their talk with Valdecantos on July 3, he allegedly admitted to them that he is the head of the committee with all members from the PRC; and that there is an on-going investigation with the Board of Nursing not related to the leakage. He also retracted his earlier statement to them that there was a committee created to investigate the leakage, as the complaint is still with the Legal Division.

These contradictory statements from PRC officials “give enough reason for them to claim that the PRC’s actions are tainted with intentions to railroad and whitewash the complaint,” the intervenors and complainants said in their July 11 statement.

They are pushing for an independent committee. The members of the committee should not be from the PRC, as they allegedly showed their bias. Nordis learned from the lawyers of the complainants/intervenors that the committee was already created composed by members coming from the PRC.

Independent members of the committee should be reputable members of the ADPCN, a nurse, representative of health non-government organization, and from the National Bureau of Investigation, PRC and Commission on Higher Education, said Cheryll Daytec-Yangot, a counsel of the complainants/intervenors in an interview.

“Suspend BON!”

Lacanaria and Tingda, in an earlier press conference, said that the Board of Nursing prepares the questions for, and administers the nursing licensure examination.

The Board, they said, has “all the privileges related to the exam,” including access to the questionnaires. And two of its members were allegedly involved in the scam.

The ralliers alleged that before the nursing board exams were given on June 11 to 12, two members of the Board and Cordero traveled to Switzerland.

Reliable sources said that the travel was irregular under the circumstances. Not only because the examinations were then approaching but also because Cordero operates a nursing school and a review center, aside from the fact that one of his children was set to take the board examinations.

Twenty-two deans and examinees met with Cordero on June 10. In that meeting, Cordero allegedly leaked board examination questions, the complainants said in their statement.

While they call for the suspension of the Board to prevent it from influencing the investigation, they wonder why Valdecantos conducts back-door talks with the body – two of whose members are alleged to have been involved in the scam.

“Is there a conspiracy between these offices?” asked one examinee in the July 11 rally.

In an earlier update from the PRC, insiders said they will be filing administrative cases against the two Board members whom they declined to name for now.

Uncovering, remedying

The interested parties are also pushing for a congressional inquiry – particularly a Senate investigation – in aid of legislation.

Kissack Gabaen, counsel for the complainants and intervenors, said the legislative inquiry will serve as a venue not only to unmask the extent of the scam but also to come up with appropriate legislation to determine which agency should have jurisdiction over scams like the alleged leakage.

He explained that there is a gray area as to what office has jurisdiction over the scam. He clarified that the Commission on Higher Education (CHEd) has jurisdiction over nursing students and the PRC over professional nurses. “How about in between these stages?” he asked. This could be addressed by the inquiry to come-up with appropriate legislation, he said.

He believes however, that those linked to the scam would do everything to suppress the revelation of the truth.

Nordis tried to interview Cordero to get his side on the issue, but he could not be reached. In an interview over ABS-CBN, however, he denied the allegations against him.

Northern Dispatch / Posted by Bulatlat

Posted by Budek at 4:02 PM | Permalink | Comments

100 Item Obstetrics-Maternal And Child Health Nursing Examination Answers and Rationale

100 Item Obstetrics-Maternal And Child Health Nursing Examination

Budek
http://www.pinoybsn.tk

Question Pool

DISCLAIMER: Care has been taken to verify that all answers and rationale below are accurate. Please comment up if you noticed any errors or contradictions to maintain accuracy and precision of the answers as not to mislead the readers.

-Budek

DEGREE OF QUESTION DIFFICULTY

4 – Very hard question, 25% Chance of answering correctly
3 – Hard question, 50% Chance of answering correctly
2 – Moderately hard question, 75% of answering correctly
1 – Easy question, 99% will answer the question correctly

Introduction: The questions are coded according to their sources and will only be for my personal reference. RED questions are original questions I created. FATIMA students READ and DIGEST each of these questions carefully. Goodluck.

SITUATION : [ND89] Aling Julia, a 32 year old fish vendor from baranggay matahimik came to see you at the prenatal clinic. She brought with her all her three children. Maye, 1 year 6 months; Joy, 3 and Dan, 7 years old. She mentioned that she stopped taking oral contraceptives several months ago and now suspects she is pregnant. She cannot remember her LMP.

1. Which of the following would be useful in calculating Aling Julia's EDC? [3]

A. Appearance of linea negra
B. First FHT by fetoscope
C. Increase pulse rate
D. Presence of edema

* The answer of some people is A because they say linea negra appears at 2nd trimester. Appearance of Linea negra is not the same with all women. Some will have it as early as first trimester while other on the 2nd trimester. It is very subjective and non normative.

However, First FHT by fetoscope is UNIVERSAL and it is arbitrarily accepted that it starts at the 4th month of gestation. Therefore, If I heard the First FHT by fetoscope, I can say that Aling Julia's EDC is at 4th month and the EDC will be around 5 months from now.Pulse rate and Edema will never suggest the estimated date of confinement nor age of gestation.

2. Which hormone is necessary for a positive pregnancy test? [1]

A. Progesterone
B. HCG
C. Estrogen
D. Placental Lactogen

* HCG is responsible for positive pregnancy test. But it is NOT a positive sign of pregnancy. Only PROBABLE. Purpose of HCG is to maintain the secretion of progestrone by the corpus luteum. It will deteriorate by 2nd trimester as the placenta resumes its funciton. HCG is also use to stimulate descend of the testes in case of cryptorchidism or undescended testes. HCG peaks at 10 weeks then decline for the rest of the pregnancy. Non pregnant females will have less than 5 mIU/ml and can reach up to 100,000 mIU/ml in pregnant women. By the way, undescended testes repair is done when the child is 1 year old according to Lippinncots, the doctor will try to wait baka kasi bumaba pa before they do surgery.

3. With this pregnancy, Aling Julia is a [1]

A. P3 G3
B. Primigravida
C. P3 G4
D. P0 G3

* She has 3 children, so para 3. Since she is pregnant, this is her 4th gravida. Remember that even if the pregancy is beyond the age of viability [ >7 months ] consider it as PARA and not GRAVIDA as long as the baby is still inside the uterus. A common error of the old nurses in a puericulture center where I dutied in is that they count the child inside the mother's womb as GRAVIDA when it is greater than 7 months! [ kawawang nanay, mali na ang home based mothers record mo ] I tried to correct it but they still INSISTED. I read pillitteri thinking that I might be wrong nakakahiya naman... but I was right.

4. In explaining the development of her baby, you identified in chronological order of growth of the fetus as it occurs in pregnancy as [1]

A. Ovum, embryo, zygote, fetus, infant
B. Zygote, ovum, embryo, fetus, infant
C. Ovum, zygote, embryo, fetus, infant
D. Zygote, ovum, fetus, embryo, infant

* The Ovum is the egg cell from the mother, the sperm will fertilize it to form a zygote. This usually happens in the AMPULLA or the distal third of the fallopian tube. Hyalorunidase is secreted by the sperm to dissolve the outer memberane of the ovum. The zygote now containes 46 chromosomes. 23 from each germ cell. The zygote is now termed as an embryo once it has been implanted. Implantation takes 3-4 days. When the embryo reach 8th weeks, it is now termed as a FETUS until it has been delivered and then, neonate then infant.

5. Aling Julia states she is happy to be pregnant. Which behavior is elicited by her during your assessment that would lead you to think she is stressed? [3]

A. She told you about her drunk husband
B. She states she has very meager income from selling
C. She laughs at every advise you give even when its not funny
D. She has difficulty following instructions

* Stressed is manifested in different ways and one of them, is difficulty following instructions. Telling you that her husband is drunk and has meager income from selling is not enough for you to conclude she is stressed. Assessment is always based on factual and specific manifestations. A diagnosis is made from either ACTUAL or POTENTIAL/RISK problems. A and B are both potential problems, but not actual like D. C is automatically eliminated first because laughing is not indicative of stress.

6. When teaching Aling Julia about her pregnancy, you should include personal common discomforts. Which of the following is an indication for prompt professional supervision? [2]

A. Constipation and hemorrhoids
B. Backache
C. Facial edema
D. frequent urination

*Facial edema is NOT NORMAL. Facial edema is one sign of MILD PRE ECLAMPSIA and prompt professional supervision is needed to lower down the client's blood pressure. Blood pressure in Mild Pre Eclampsia is around 140/90 and 160/110 in severe. Treatment involves bed rest, Magnesium sulfate, Hydralazine, Diazoxide and Diazepam [ usually a combination of Magsul + Apresoline [ Hydralazine ] ] Calcium gluconate is always at the client's bed side when magnesium toxicity occurs. It works by exchanging Calcium ions for magnesium ions. A,B and D are all physiologic change in pregnancy that do not need prompt professional supervision. Frequent urination will disappear as soon as the pressure of the uterus is released against the bladder and as soon as the client's blood volume has returned to normal. Backache is a common complaint of women with an OCCIPUT POSTERIOR presentation due to pressure on the back. Intervention includes pelvic rocking or running a tennis ball at the client's back. Constipation and hemorrhoids are relieved by increasing fluid intake and hot sitz bath.

7. Which of the following statements would be appropriate for you to include in Aling Julia's prenatal teaching plan? [1]

A. Exercise is very tiresome, it should be avoided
B. Limit your food intake
C. Smoking has no harmful effect on the growth and development of fetus
D. Avoid unnecessary fatigue, rest periods should be included in you schedule

* Exercise is not avoided in pregnancy, therfore eliminate A. Food is never limited in pregnancy. Calories are even increased by around 300 cal a day as well as vitamins and minerals. Smoking, alcohol and drug use are avoided for the rest of the pregnancy because of their harmful effects on the growth and development of the fetus. Rest period and avoiding unecessary fatigue is one of the pillars in health teaching of the pregnant client.

8. The best advise you can give to Aling Julia regarding prevention of varicosities is [3]

A. Raise the legs while in upright position and put it against the wall several times a day
B. Lay flat for most hours of the day
C. Use garters with nylon stocking
D. Wear support hose

* A thigh high stocking or a support hose WORN BEFORE GETTING UP in the morning is effective in prevention of varicosities. Stocking should have NO GARTERS because it impedes blood flow, they should be made of COTTON not nylon to allow the skin to breathe. Lying flat most of the day WILL PREVENT VARICOSITIES but will not be helpful for the client's overall health and function. Raising the legs and putting it against the wall will still create pressure in the legs.

9. In a 32 day menstrual cycle, ovulation usually occurs on the [2]

A. 14th day after menstruation
B. 18th day after menstruation
C. 20th day after menstruation
D. 24th day after menstruation

* To get the day of ovulation, A diary is made for around 6 months to determine the number of days of menstrual cycle [ from onset of mens to the next onset of mens ] and the average is taken from that cycles. 14 days are subtracted from the total days of the menstrual cycle. This signifies the ovulation day. A couple would abstain having sex 5 days before and 5 days after the ovulation day. Therefore, a 32 day cycle minus 14 days equals 18, hence... ovulation occurs at the 18th day.

10. Placenta is the organ that provides exchange of nutrients and waste products between mother and fetus. This develops by [4]

A. First month
B. Third month
C. Fifth month
D. Seventh month

* The placenta is formed at around 3 months. It is a latin word for PANCAKE because of it's appearance. It arises from the trophoblast from the chorionic villi and decidua basalis. It functions as the fetal lungs, kidney, GI tract and an endocrine organ.

11. In evaluating the weight gain of Aling Julia, you know the minimum weight gain during pregnancy is [3]

A. 2 lbs/wk
B. 5 lbs/wk
C. 7 lbs/wk
D. 10 lbs/wk

* Weight gain should be 1 to 2 lbs per week during the 2nd and 3rd trimester and 3 to 5 lbs gain during the first trimester for a total of 25-35 lbs recommended weight gain during the gravida state.

12. The more accurate method of measuring fundal height is [2]

A. Millimeter
B. Centimeter
C. Inches
D. Fingerbreadths

* Fundal height is measured in cm not mm. centimeters is the more accurate method of measuring fundic height than inches or fingerbreadths.

13. To determine fetal position using Leopold's maneuvers, the first maneuver is to [1]

A. Determine degree of cephalic flexion and engagement
B. Determine part of fetus presenting into pelvis
C. Locate the back,arms and legs
D. Determine what part of fetus is in the fundus

* Leopold's one determines what is it in the fundus. This determines whether the fetal head or breech is in the fundus. A head is round and hard. Breech is less well defined.

14. Aling julia has encouraged her husband to attend prenatal classes with her. During the prenatal class, the couple expressed fear of pain during labor and delivery. The use of touch and soothing voice often promotes comfort to the laboring patient. This physical intervention is effective because [2]

A. Pain perception is interrupted
B. Gate control fibers are open
C. It distracts the client away from the pain
D. Empathy is communicated by a caring person

* Touch and soothing voice promotes pain distraction. Instead of thinking too much of the pain in labor, The mother is diverted away from the pain sensation by the use of touch and voice. Pain perception is not interrupted, pain is still present. When gate control fibers are open, Pain is felt according to the gate control theory of pain. Although empathy is communicated by the caring person, this is not the reason why touch and voice promotes comfort to a laboring patient.

15. Which of the following could be considered as a positive sign of pregnancy ? [1]

A. Amenorrhea, nausea, vomiting
B. Frequency of urination
C. Braxton hicks contraction
D. Fetal outline by sonography

* Fetal outline by sonography or other imaging devices is considered a positive sign of pregnancy along with the presence of fetal heart rate and movement felt by a qualified examiner. All those signs with the discoverer's name on them [ chadwick, hegars, braxton hicks, goodells ] are considered probable and All the physiologic changes brought about by pregnancy like hyperpigmentation, fatgiue, uterine enlargement, nausea, vomiting, breast changes, frequent urination are considered presumptive.

Sonographic evidence of the gestational sac is not POSITIVE sign but rather, PROBABLE.

SITUATION : [FFC] Maternal and child health is the program of the department of health created to lessen the death of infants and mother in the philippines. [2]

16. What is the goal of this program?

A. Promote mother and infant health especially during the gravida stage
B. Training of local hilots
C. Direct supervision of midwives during home delivery
D. Health teaching to mother regarding proper newborn care

* The goal of the MCHN program of the DOH is the PROMOTION AND MAINTENANCE OF OPTIMUM HEALTH OF WOMAN AND THEIR NEWBORN. To achieve this goal, B,C and D are all carried out. Even without the knowledge of the MCHN goal you SHOULD answer this question correctly. Remember that GOALS are your plans or things you MUST ATTAIN while STRATEGIES are those that must be done [ ACTIONS ] to attain your goal.

Looking at B,C and D they are all ACTIONS. Only A correctly followed the definition of a goal.

17. One philosophy of the maternal and child health nursing is [1]

A. All pregnancy experiences are the same for all woman
B. Culture and religious practices have little effect on pregnancy of a woman
C. Pregnancy is a part of the life cycle but provides no meaning
D. The father is as important as the mother

* Knowing that not all individuals and pregnancy are the same for all women, you can safely eliminate letter A. Personal, culture and religious attitudes influence the meaning of pregnancy and that makes pregnancy unique for each individual. Culture and religious practice have a great impact on pregnancy, eliminate B. Pregnancy is meaningful to each individuals, not only the mother but also the father and the family and the father of the child is as important as the mother. MATERNAL AND CHILD HEALTH IS FAMILY CENTERED and thid will guide you in correctly answering D.

18. In maternal care, the PHN responsibility is [2]

A. To secure all information that would be needing in birth certificate
B. To protect the baby against tetanus neonatorum by immunizing the mother with DPT
C. To reach all pregnant woman
D. To assess nutritional status of existing children

* The sole objective of the MCHN of the DOH is to REACH ALL PREGNANT WOMEN AND GIVE SUFFICIENT CARE TO ENSURE A HEALTHY PREGNANCY AND THE BIRTH OF A FULL TERM HEALTH BABY. As not to confuse this with the GOAL of the MCHN, The OBJECTIVE should answer the GOAL, they are different. GOAL : to promote and maintain optimum health for women and their newborn HOW? OBJECTIVE : By reaching all pregnant women to give sufficient care ensuring healthy pregnancy and baby.

19. This is use when rendering prenatal care in the rural health unit. It serves as a guide in Identification of risk factors [1]

A. Underfive clinic chart
B. Home based mother's record
C. Client list of mother under prenatal care
D. Target list of woman under TT vaccination

* The HBMR is used in rendring prenatal care as guide in identifying risk factors. It contains health promotion message and information on the danger signs of pregnancy.

20. The schedule of prenatal visit in the RHU unit is [4]

A. Once from 1st up to 8th month, weekly on the 9th month
B. Twice in 1st and second trimester, weekly on third trimester
C. Once in each trimester, more frequent for those at risk
D. Frequent as possible to determine the presence of FHT each week

* Visit to the RHU should be ONCE each trimester and more frequent for those who are high risks. The visit to the BHS or health center should be ONCE for 1st to 6th months of pregnancy, TWICE for the 7th to 8th month and weekly during the 9th month. They are different and are not to be confused with.

SITUATION : Knowledge of the menstrual cycle is important in maternal health nursing. The following questions pertains to the process of menstruation

21. Menarche occurs during the pubertal period, Which of the following occurs first in the development of female sex characteristics? [2]

A. Menarche
B. Accelerated Linear Growth
C. Breast development
D. Growth of pubic hair

* Remember TAMO or THELARCHE, ADRENARCHE, MENARCHE and OVULATION. Telarche is the beginning of the breast development which is influenced by the increase in estrogen level during puberty. Adrenarche is the development of axillary and pubic hair due to androgen stimulation. Menarche is the onset of first menstruation that averagely occurs at around 12 to 13 years old. Ovulation then occurs last. However, prior to TAMO, Accelerated LINEAR GROWTH will occur first in GIRLS while WEIGHT INCREASE is the first one to occur in boys.

22. Which gland is responsible for initiating the menstrual cycle? [3]

A. Ovaries
B. APG
C. PPG
D. Hypothalamus

* Hypothalamus secretes many different hormones and one of them is the FSHRF or the FOLLICLE STIMULATING HORMONE RELEASING FACTOR. This will instruct the ANTERIOR PITUITARY GLAND to secrete FSH that will stimulate the ovary to release egg and initiate the menstrual cycle.

The PPG or the posterior pituitary only secretes two hormones : OXYTOCIN and ADH. It plays an important factor in labor as well as in the pathophysiology of diabetes insipidus.

23. The hormone that stimulates the ovaries to produce estrogen is [1]

A. GnRH
B. LH
C. LHRF
D. FSH

* FSH stimulates the ovaries to secrete estrogen. This hormone is a 3 substance compounds known as estrone [e1], estradiol [2] and estriol [3] responsible for the development of female secondary sex characteristics. It also stimulates the OOCYTES to mature. During pregnancy, Estrogen is secreted by the placenta that stimulates uterine growth to accomodate the fetus.

24. Which hormone stimulates oocyte maturation? [2]

A. GnRH
B. LH
C. LHRF
D. FSH

* Refer to #23

25. When is the serum estrogen level highest in the menstrual cycle? [4]

A. 3rd day
B. 13th day
C. 14th day
D. End of menstrual cycle

* There are only 3 days to remember in terms of hormonal heights during pregnancy. 3,13 and 14. During the 3rd day, Serum estrogen is the lowest. During the 13th day, Serum estrogen is at it's peak while progestrone is at it's lowest and this signifies that a mature oocyte is ready for release. At 14th day, Progesterone will surge and this is the reason why there is a sudden increase of temperature during the ovulation day and sudden drop during the previous day. This will not stimulate the release of the mature egg or what we call, OVULATION.

26. To correctly determine the day of ovulation, the nurse must [2]

A. Deduct 14 days at the mid of the cycle
B. Subtract two weeks at cycle's end
C. Add 7 days from mid of the cycle
D. Add 14 days from the end of the cycle

* Refer to # 9

Big thanks to marisse for the correction in this number.

27. The serum progesterone is lowest during what day of the menstrual cycle? [4]

A. 3rd day
B. 13th day
C. 14th day
D. End of menstrual cycle

* At 3rd day, The serum estrogen is at it's lowest. At the 13th day, serum estrogen is at it's peak while progesterone is at it's lowest. At the 13th day of the cycle, An available matured ovum is ready for fertilization and implantation. The slight sharp drop of temperature occurs during this time due to the very low progestrone level. The next day, 14th day, The serum progestrone sharply rises and this causes the release of the matured ovum. Temperature also rises at this point because of the sudden increase in the progestrone level.

28. How much blood is loss on the average during menstrual period? [4]

A. Half cup
B. 4 tablespoon
C. 3 ounces
D. 1/3 cup

* The average blood loss during pregnancy is 60 cc. A, half cup is equivalent to 120 cc. C, is equivalent to 90 cc while D, is equivalent to 80 cc. 1 tablespoon is equal to 15 ml. 4 tablespoon is exactly 60 cc.

29. Menstruation occurs because of which following mechanism? [2]

A. Increase level of estrogen and progesterone level
B. Degeneration of the corpus luteum
C. Increase vascularity of the endothelium
D. Surge of hormone progesterone

* Degeneration of the corpus luteum is the cause of menstruation. Menstruation occurs because of the decrease of both estrogen and progestrone. This is caused by the regression of the corpus luteum inside the ovary 8 to 10 days in absence of fertilization after an ovum was released. With the absence of progestrone, the endometrium degenerates and therefore, vascularity will decrease at approximately 25th day of the cycle which causes the external manifestation of menstruation.

30. If the menstrual cycle of a woman is 35 day cycle, she will approximately [2]

A. Ovulate on the 21st day with fertile days beginning on the 16th day to the 26th day of her cycle
B. Ovulate on the 21st day with fertile days beginning on the 16th day to the 21th day of her cycle
C. Ovulate on the 22st day with fertile days beginning on the 16th day to the 26th day of her cycle
D. Ovulate on the 22st day with fertile days beginning on the 14th day to the 30th day of her cycle

* Formula for getting the fertile days and ovulation day is : Number of days of cycle MINUS 14 [ Ovulation day ] Minus 5 Plus 5 [ Possible fertile days ].

Since the client has a 35 day cycle, we subtract 14 days to get the ovulation day which is 21. Minus 5 days is equal to [21 - 5 = 16 ] 16 , Plus 5 days [ 21 + 5 = 26 ] is equal to 26. Therefore, Client is fertile during the 16th to the 26th day of her cycle. This is the same principle and formula used in the calendar / rhythm method.

SITUATION : Wide knowledge about different diagnostic tests during pregnancy is an essential arsenal for a nurse to be successful.

31. The Biparietal diameter of a fetus is considered matured if it is atleast [4]

A. 9.8 cm
B. 8.5 cm
C. 7.5 cm
D. 6 cm

* BPD is considered matured at 8.5 cm and at term when it reaches 9.6 cm.

32. Quickening is experienced first by multigravida clients. At what week of gestation do they start to experience quickening? [4]

A. 16th
B. 20th
C. 24th
D. 28th

* Multigravid clients experience quickening at around 16 weeks or 4 months. Primigravid clients experience this 1 month later, at the 5th month or 20th week.

33. Before the start of a non stress test, The FHR is 120 BPM. The mother ate the snack and the practitioner noticed an increase from 120 BPM to 135 BPM for 15 seconds. How would you read the result? [3]

A. Abnormal
B. Non reactive
C. Reactive
D. Inconclusive, needs repeat

* Normal non stress test result is REACTIVE. Non stress test is a diagnostic procedure in which the FHR is compared with the child's movement. A normal result is an increase of 15 BPM sustained for 15 seconds at every fetal movement. The mother is told to eat a light snack during the procedure while the examiner carefully monitors the FHR. The mother will tell the examiner that she felt a movement as soon as she feels it while the examiner take note of the time and the FHR of the fetus.

34. When should the nurse expect to hear the FHR using a fetoscope? [4]

A. 2nd week
B. 8th week
C. 2nd month
D. 4th month

* The FHR is heard at about 4 months using a fetoscope. Remember the word FeFOUR to relate fetoscope to four.

35. When should the nurse expect to hear FHR using doppler Ultrasound? [4]

A. 8th week
B. 8th month
C. 2nd week
D. 4th month

* The FHR is heard as early as 8th week [ some books, 12 to 14 weeks ] using doppler ultrasound. Remember the word DOPPLE RATE, [ DOPPLER 8 ] to relate dopple ultrasound to the number 8.

36. The mother asks, What does it means if her maternal serum alpha feto protein is 35 ng/ml? The nurse should answer [4]

A. It is normal
B. It is not normal
C. 35 ng/ml indicates chromosomal abberation
D. 35 ng/ml indicates neural tube defect

* The normal maternal alpha feto protein is 38-45 ng/ml. Less 38 than this indicates CHROMOSOMAL ABBERATION [Down,Klinefelters] and more than 45 means NEURAL TUBE DEFECTS [Spina Bifida]. Remember the word CLINICAL NURSE. C for chromosomal abberation for <38>N for neural tube defect for >45. C<38>45 Clinic Nurse.

CLINIC NURSE is also an important mnemonics to differentiate COUNTER TRANSFERENCE from TRANSFERENCE. Counter transference is the special feeling of the CLINIC NURSE or CLINICIAN to the patient while transference is the development of personal feelings of the patient to the nurse.

37. Which of the following mothers needs RHOGAM? [1]

A. RH + mother who delivered an RH - fetus
B. RH - mother who delivered an RH + fetus
C. RH + mother who delivered an RH + fetus
D. RH - mother who delivered an RH - fetus

* Rhogam is given to RH - Mothers That delivers an RH + Fetus. Rhogam prevents ISOIMMUNIZATION or the development of maternal antibodies against the fetal blood due to RH incompatibility. Once the mother already develops an antibody against the fetus, Rhogam will not anymore be benificial and the mother is advised no to have anymore pregnancies. Rhogam is given within 72 hours after delivery.

38. Which family planning method is recommended by the department of health more than any other means of contraception? [4]

A. Fertility Awareness Method
B. Condom
C. Tubal Ligation
D. Abstinence

* Abstinence is never advocated as a family planning method. Though, It is probably the BEST METHOD to prevent STD and pregnancy, it is inhumane and supresses the reproductive rights of the people. It is also unrealistic. FAM is advocated by the DOH more than any other kind of contraception. It is a combination of symptothermal and billings method. CALENDAR method is the only method advocated by the catholic church.

39. How much booster dose does tetanus toxoid vaccination for pregnant women has? [4]

A. 2
B. 5
C. 3
D. 4

* TT1 and TT2 are both primary dosages. While TT3 up to TT5 represents the booster dosages.

40. Baranggay pinoybsn.tk has 70,000 population. How much nurse is needed to service this population? [4]

A. 5
B. 7
C. 50
D. 70

* For every 10,000 population , 1 nurse is needed. therefore, a population of 70,000 people needs a service of 7 nurses.

SITUATION : [ND2I246] Reproductive health is the exercise of reproductive right with responsibility. A married couple has the responsibility to reproduce and procreate.

41. Which of the following is ONE of the goals of the reproductive health concept? [3]

A. To achieve healthy sexual development and maturation
B. To prevent specific RH problem through counseling
C. Provide care, treatment and rehabilitation
D. To practice RH as a way of life of every man and woman

* EVERY ACHIEVER AVOIDS RECEIVER : Remember this mnemonics and it will guide you in differentiating which is which from the goals, visions and strategies. If a sentence begins with these words, it is automatically a GOAL. Usually, The trend in the board is that they will mix up the vision, strategies and goals to confuse you. D is the only vision of the RH program. Anything else aside from the vision and goals are more likely strategies. [ B and C ]

Strategies, even without knowing them or memorizing them can easily be seperated as they convey ACTIONS and ACTUAL INTERVENTIONS. This is universal and also applies to other DOH programs. Notice that B and C convey actions and interventions.

42. Which of the following is NOT an element of the reproductive health? [4]

A. Maternal and child health and nutrition
B. Family planning
C. Prevention and management of abortion complication
D. Healthy sexual development and nutrition

* Achieving healthy sexual development and nutrition is a GOAL of the RH. Knowledge of the elements, goals, strategies and vision of RH are important in answering this question. I removed the word ACHIEVE to let you know that it is possible for the board of nursing not to include those keywords [ although it never happened as of yet ].

43. In the international framework of RH, which one of the following is the ultimate goal? [3]

A. Women's health in reproduction
B. Attainment of optimum health
C. Achievement of women's status
D. Quality of life

* Quality of life is the ultimate goal of the RH in the international framework. Way of life is the ultimate goal of RH in the local framework.

44. Which one of the following is a determinant of RH affecting woman's ability to participate in social affairs? [3]

A. Gender issues
B. Socio-Economic condition
C. Cultural and psychosocial factors
D. Status of women

* This is an actual board question, Gender issues affects the women participation in the social affairs. Socio economic condition is the determinant for education, employment, poverty, nutrition, living condition and family environment. Status of women evolves in women's rights. Cultural and psychosocial factors refers to the norms, behaviors, orientation, values and culture. Refer to your DOH manual to read more about this.

45. In the philippine RH Framework. which major factor affects RH status? [4]

A. Women's lower level of literacy
B. Health service delivery mechanism
C. Poor living conditions lead to illness
D. Commercial sex workers are exposed to AIDS/STD.

* Health services delivery mechanism is the major factor that affect RH status. Other factors are women's behavior, Sanitation and water supply, Employment and working conditions etc.

46. Which determinant of reproductive health advocates nutrition for better health promotion and maintain a healthful life? [4]

A. Socio-Economic conditions
B. Status of women
C. Social and gender issues
D. Biological, Cultural and Psychosocial factors

* Refer to # 44

47. Which of the following is NOT a strategy of RH? [3]

A. Increase and improve contraceptive methods
B. Achieve reproductive intentions
C. Care provision focused on people with RH problems
D. Prevent specific RH problem through information dessemination

* Refer to #41

48. Which of the following is NOT a goal of RH? [3]

A. Achieve healthy sexual development and maturation
B. Avoid illness/diseases, injuries, disabilities related to sexuality and reproduction
C. Receive appropriate counseling and care of RH problems
D. Strengthen outreach activities and the referral system

* Refer to #41

49. What is the VISION of the RH? [2]

A. Attain QUALITY OF LIFE
B. Practice RH as a WAY OF LIFE
C. Prevent specific RH problem
D. Health in the hands of the filipino

* Refer to #43

SITUATION : [SORANGE19] Baby G, a 6 hours old newborn is admitted to the NICU because of low APGAR Score. His mother had a prolonged second stage of labor

50. Which of the following is the most important concept associated with all high risk newborn? [1]

A. Support the high-risk newborn's cardiopulmonary adaptation by maintaining adequate airway
B. Identify complications with early intervention in the high risk newborn to reduce morbidity and mortality
C. Assess the high risk newborn for any physical complications that will assist the parent with bonding
D. Support mother and significant others in their request toward adaptation to the high risk newborn

* The 3 major and initial and immediate needs of newborns both normal and high risks are AIR/BREATHING, CIRCULATION and TEMPERATURE. C and D are both eliminated because they do not address the immediate newborn needs. Identifying complication with early intervention is important, however, this does not address the IMMEDIATE and MOST IMPORTANT newborn needs.

51. Which of the following would the nurse expect to find in a newborn with birth asphyxia? [1]

A. Hyperoxemia
B. Acidosis
C. Hypocapnia
D. Ketosis

* Birth Asphyxia is a term used to describe the inability of an infant to maintain an adequate respiration within 1 minute after birth that leads so acidosis, hypoxia, hypoxemia and tissue anoxia. This results to Hypercapnia not Hypocapnia due to the increase in carbonic acid concentration in the fetal circulation because the carbon dioxide fails to get eliminated from the infant's lungs because of inadequate respiration. Ketosis is the presence of ketones in the body because of excessive fat metabolism. This is seen in diabetic ketoacidosis.

52. When planning and implementing care for the newborn that has been successfully resuscitated, which of the following would be important to assess? [1]

A. Muscle flaccidity
B. Hypoglycemia
C. Decreased intracranial pressure
D. Spontaneous respiration

* There is no need to assess for spontaneous respiration because OF the word SUCCESSFULLY RESUSCITATED. What is it to assess is the quality and quantity of respiration. Infants who undergone tremendous physical challenges during birth like asphyxia, prolonged labor, RDS are all high risk for developing hypoglycemia because of the severe depletion of glucose stores to sustain the demands of the body during those demanding times.

SITUATION : [P-I/46] Nurses should be aware of the different reproductive problems.

53. When is the best time to achieve pregnancy? [2]

A. Midway between periods
B. Immediately after menses end
C. 14 days before the next period is expected
D. 14 days after the beginning of the next period

* The best time to achieve pregnancy is during the ovulation period which is about 14 days before the next period is expected. A Menstrual cycle is defined as the number of days from the start of the menstruation period, up to the start of another menstrual period. To obtain the ovulation day, Subtract 14 days from the end of each cycle.

Example, The start of the menstrual flow was July 12, 2006. The next flow was experienced August 11, 2006. The length of the menstrual cycle is then 30 days [ August 11 minus July 12 ]. We then subtract 14 days from that total length of the cycle and that will give us 16 days [ 30 minus 14 ] Count 16 days from July 12, 2006 and that will give us July 28, 2006 as the day of ovulation. [ July 12 + 16 days ] This is the best time for coitus if the intention is getting pregnant, worst time if not.

54. A factor in infertility maybe related to the PH of the vaginal canal. A medication that is ordered to alter the vaginal PH is: [2]

A. Estrogen therapy
B. Sulfur insufflations
C. Lactic acid douches
D. Na HCO3 Douches

* Sperm is innately ALKALINE. Too much acidity is the only PH alteration in the vagina that can kill sperm cells. Knowing this will direct you to answering letter D. Sodium Bicarbonate douches will make the vagina less acidic because of it's alkaline property, making the vagina's environment more conducive and tolerating to the sperm cells. Estrogen therapy will not alter the PH of the vaginal canal. HRT [ Hormone replacement therapy ] is now feared by many women because of the high risk in acquiring breast, uterine and cervical cancer. Research on this was even halted because of the significant risk on the sample population. Lactic acid douches will make the vagina more acidic, further making the environment hostile to the alkaline sperm. Sulfur insufflation is a procedure used to treat vaginal infections. A tube is inserted in the vagina and sulfur is introduced to the body. The yeasts, fungi and other microorganisms that are sensitive to sulfur are all immediately killed by it on contact.

55. A diagnostic test used to evaluate fertility is the postcoital test. It is best timed [2]

A. 1 week after ovulation
B. Immediately after menses
C. Just before the next menstrual period
D. Within 1 to 2 days of presumed ovulation

* A poscoital test evaluates both ovulation detection and sperm analysis. When the woman ovulates [ by using the FAM method or commercial ovulation detection kits, woman should know she ovulates ] The couple should have coitus and then, the woman will go to the clinic within 2 to 8 hours after coitus. The woman is put on a lithotomy position. A specimen for cervical mucus is taken and examined for spinnbarkeit [ ability to stretch 15 cm before breaking ] and sperm count. Postcoital test is now considered obsolete because a single sperm and cervical mucus analysis provides more accurate data.

56. A tubal insufflation test is done to determine whether there is a tubal obstruction. Infertility caused by a defect in the tube is most often related to a [3]

A. Past infection
B. Fibroid Tumor
C. Congenital Anomaly
D. Previous injury to a tube

* PID [ Most common cause of tubal obstruction ] due to untreated gonorrhea, chlamydia or other infections that leads to chronic salphingitis often leads to scarring of the fallopian tube thereby causing tubal obstuction. This one of the common cause of infertility, the most common is Anovulation in female and low sperm count in males. A ruptured appendix, peritonitis and abdominal surgery that leads to infection and adhesion of the fallopian tube can also lead to tubal obstruction.

57. Which test is commonly used to determine the number, motility and activity of sperm is the [2]

A. Rubin test
B. Huhner test
C. Friedman test
D. Papanicolau test

* Huhner test is synonymous to postcoital test. This test evaluates the number, motility and status of the sperm cells in the cervical mucus. refer to # 55 for more information. Rubin test is a test to determine the tubal patency by introducing carbon dioxide gas via a cannula to the client's cervix. The sound is then auscultated in the client's abdomen at the point where the outer end of the fallopian tube is located, near the fimbriae. Absent of sound means that the tube is not patent. Friedman test involves a FROG to determine pregnancy that is why it is also called as FROG TEST. Papanicolaou test [Correct spelling], discovered by Dr. George Papanicolaou during the 1930's is a cytolgic examination of the epithelial lining of the cervix. It is important in diagnosis cervical cancer.

58. In the female, Evaluation of the pelvic organs of reproduction is accomplished by [2]

A. Biopsy
B. Cystoscopy
C. Culdoscopy
D. Hysterosalpingogram

* Biopsy is acquiring a sample tissue for cytological examination. Usually done in cancer grading or detecting atypical, abnormal and neoplastic cells. Cystoscopy is the visualization of the bladder using a cystoscope. This is inserted via the urethra. TURP or the transurethral resection of the prostate is frequently done via cystoscopy to remove the need for incision in resecting the enlarged prostate in BPH. Culdoscopy is the insertion of the culdoscope through the posterior vaginal wall between the rectum and uterus to visualize the douglas cul de sac. This is an important landmark because this is the lowest point in the pelvis, fluid or blood tends to collect in this place. Hysterosalpingogram is the injection of a blue dye, or any radio opaque material through the cervix under pressure. X ray is then taken to visualize the pelvic organs. This is done only after menstruation to prevent reflux of the menstrual discharge up into the fallopian tube and to prevent an accidental irradiation of the zygote. As usual, as with all other procedures that ends in GRAM, assess for iodine allergy.

59. When is the fetal weight gain greatest? [3]

A. 1st trimester
B. 2nd trimester
C. 3rd trimester
D. from 4th week up to 16th week of pregnancy

* Vital organs are formed during the first trimester, The greatest LENGTH gain occurs during the second trimester while the greatest weight gain occurs during the last trimester. This is the time when brown fats starts to be deposited in preparation for the upcoming delivery.

60. In fetal blood vessel, where is the oxygen content highest? [3]

A. Umbilical artery
B. Ductus Venosus
C. Ductus areteriosus
D. Pulmonary artery

* Ductus venosus is directly connected to the umbilical vein, Which is directly connected to the highly oxygenated placenta. This vessel supplies blood to the fetal liver. Umbilical arteries carries UNOXYGENATED BLOOD, they carry the blood away from the fetal body. Ductus arteriosus shunts the blood away from the fetal lungs, this carries an oxygenated blood but not as concentrated as the blood in the ductus venosus who have not yet service any of the fetal organ for oxygen except the liver. Knowing that the fetal lungs is not yet functional and expanded will guide you to automatically eliminate the pulmonary artery which is responsible for carrying UNOXYGENATED BLOOD away from the lungs.

61. The nurse is caring for a woman in labor. The woman is irritable, complains of nausea and vomits and has heavier show. The membranes rupture. The nurse understands that this indicates [1]

A. The woman is in transition stage of labor
B. The woman is having a complication and the doctor should be notified
C. Labor is slowing down and the woman may need oxytocin
D. The woman is emotionally distraught and needs assistance in dealing with labor

* The clue to the answer is MEMBRANES RUPTURE. Membranes, as a rule, rupture at full dilation [ 10 cm ] unless ruptured by amniotomy or ruptured at an earlier time. The last of the mucus plug from the cervix is also released during the transition phase of labor. We call that the OPERCULUM as signaled by a HEAVIER SHOW. During the transition phase, Cervix is dilated at around 8 to 10 cm and contractions reaches their peak of intensity occuring every 2 to 3 minutes with a 60 to 90 second duration.

At the transition phase, woman also experiences nausea and vomiting with intense pain. This question is LIFTED from the previous board and the question was patterned EXACTLY WORD PER WORD from pillitteri.

SITUATION : [J2I246] Katherine, a 32 year old primigravida at 39-40 weeks AOG was admitted to the labor room due to hypogastric and lumbo-sacral pains. IE revealed a fully dilated, fully effaced cervix. Station 0.

62. She is immediately transferred to the DR table. Which of the following conditions signify that delivery is near? [2]

I - A desire to defecate
II - Begins to bear down with uterine contraction
III - Perineum bulges
IV - Uterine contraction occur 2-3 minutes intervals at 50 seconds duration

A. I,II,III
B. I,II,III,IV
C. I,III,IV
D. II,III,IV

* Again, lifted word per word from Pillitteri and this is from the NLE. A is the right answer. A woman near labor experiences desire to defecate because of the pressure of the fetal head that forces the stool out from the anus. She cannot help but bear down with each of the contractions and as crowning occurs, The perineum bulges. A woman with a 50 second contraction is still at the ACTIVE PHASE labor [ 40 to 60 seconds duration, 3 to 5 minutes interval ] Women who are about to give birth experience 60-90 seconds contraction occuring at 2-3 minutes interval.

63. Artificial rupture of the membrane is done. Which of the following nursing diagnoses is the priority? [2]

A. High risk for infection related to membrane rupture
B. Potential for injury related to prolapse cord
C. Alteration in comfort related to increasing strength of uterine contraction
D. Anxiety related to unfamiliar procedure

* Nursing diagnosis is frequently ask. In any case that INFECTION was one of the choices, remove it as soon as you see it in ALL CASES during the intra and pre operative nursing care. Infection will only occur after 48 hours of operation or event. B is much more immediate and more likely to occur than A, and is much more FATAL. Prioritization and Appropriateness is the key in correctly answering this question. High risk for infection is an appropriate nursing diagnosis, but as I said, Infection will occur in much later time and not as immediate as B. Readily remove D and C because physiologic needs of the mother and fetus take precedence over comfort measures and psychosocial needs.

64. Katherine complains of severe abdominal pain and back pain during contraction. Which two of the following measures will be MOST effective in reducing pain? [4]

I - Rubbing the back with a tennis ball
II- Effleurage
III-Imagery
IV-Breathing techniques

A. II,IV
B. II,III
C. I,IV
D. I,II

* Remove B. Imagery is not used in severe pain. This is a labor pain and the mother will never try to imagine a nice and beautiful scenery with you at this point because the pain is all encompassing and severe during the transition phase of labor. Remove A and C Because breathing techniques is not a method to ELIMINATE PAIN but a method to reduce anxiety, improve pushing and prevent rapid expulsion of the fetus during crowning [ By PANTING ]

Back pain is so severe during labor in cases of Posterior presentations [ ROP,LOP,RMP,LSaP, etc... ] Mother is asked to pull her knees towards her chest and rock her back. [ As in a rocking chair ] A Tennis ball rubbed at the client's back can relieve the pain due to the pressure of the presenting part on the posterior part of the birth canal. Also, rubbing a tennis ball to the client's back OPENS THE LARGE FIBER NERVE GATE. Effleurage or a simple rotational massage on the abdomen simply relieves the client's pain by opening the large fiber nerve gate and closing the the small fiber nerve gate. [ Please read about Gate control theory by Mezack and Wall ].

65. Lumbar epidural anesthesia is administered. Which of the following nursing responsibilities should be done immediately following procedure? [1]

A. Reposition from side to side
B. Administer oxygen
C. Increase IV fluid as indicated
D. Assess for maternal hypotension

* Hypotension is one of the side effects of an epidural anesthesia. An epidural anesthesia is injected on the L3 - L4 or L4 - L5 area. The injection lies just above the dura and must not cross the dura [ spinal anesthesia crosses the dura ]. Nursing intervention revolves in assesing RR, BP and other vital signs for possible complication and side effects. There is no need to position the client from side to side, The preferred position during the transition phase of labor is LITHOTOMY. Oxygen is not specific after administration of an epidural anesthesia. IV fluid is not increased without doctor's order. AS INDICATED is different from AS ORDERED.

66. Which is NOT the drug of choice for epidural anesthesia? [4]

A. Sensorcaine
B. Xylocaine
C. Ephedrine
D. Marcaine

* A,B and D are all drugs of choice for epidural anesthesia. Ephedrine is the drug use to reverse the symptom of hypotension caused by epidural anesthesia. It is a sympathomimetic agent that causes vasoconstriction, bronchodilation [ in asthma ] and can increase the amount of energy and alertness. Ephedrine is somewhat similar to epinephrine in terms of action as well as it's adverse effects of urinary retention, tremor, hypersalivation, dyspnea, tachycardia, hypertension.

SITUATION : [SORANGE217] Alpha, a 24 year old G4P3 at full term gestation is brought to the ER after a gush of fluid passes through here vagina while doing her holiday shopping.

67. She is brought to the triage unit. The FHT is noted to be 114 bpm. Which of the following actions should the nurse do first? [2]

A. Monitor FHT ever 15 minutes
B. Administer oxygen inhalation
C. Ask the charge nurse to notify the Obstetrician
D. Place her on the left lateral position

* Remove A. A FHR of 114 bpm is 6 beats below normal. Though monitoring is continuous and appropriate, This is not your immediate action. B, Oxygen inhalation needs doctor's order and therefore, is a DEPENDENT nursing action and won't be your first option. Although administration of oxygen by the nurse is allowed when given at the lowest setting during emergency situation. C is appropriate, but should not be your IMMEDIATE action. The best action is to place the client on the LEFT LATERAL POSITION to decrease the pressure in the inferior vena cava [ by the gravid uterus ] thereby increasing venus return and giving an adequate perfusion to the fetus. Your next action is to call and notify the obstetrician. Remember to look for an independent nursing action first before trying to call the physician.

68. The nurse checks the perineum of alpha. Which of the following characteristic of the amniotic fluid would cause an alarm to the nurse? [1]

A. Greenish
B. Scantly
C. Colorless
D. Blood tinged

* A greenish amniotic fluid heralds fetal distress not unless the fetus is in breech presentation and pressure is present on the bowel. Other color that a nurse should thoroughly evaluate are : Tea colored or strong yellow color that indicates hemolytic anemia , as in RH incompatibility.

69. Alpha asks the nurse. "Why do I have to be on complete bed rest? I am not comfortable in this position." Which of the following response of the nurse is most appropriate? [3]

A. Keeping you on bed rest will prevent possible cord prolapse
B. Completed bed rest will prevent more amniotic fluid to escape
C. You need to save your energy so you will be strong enough to push later
D. Let us ask your obstetrician when she returns to check on you

* Once the membrane ruptures, as in the situation of alpha, The immediate and most appropriate nursing diagnosis is risk for injury related to cord prolapse. Keeping the client on bed rest is one of the best intervention in preventing cord prolapse. Other interventions are putting the client in a modified T position or Kneed chest position. Once the amniotic fluid escapes, It is allowed to escape. Although bed rest does saves energy, It is not the most appropriate response why bed rest is prescribed after membranes have ruptured. Not answering the client's question now will promote distrust and increase client's anxiety. It will also make the client think that the nurse is incompetent for not knowing the answer.

70. Alpha wants to know how many fetal movements per hour is normal, the correct response is [4]

A. Twice
B. Thrice
C. Four times
D. 10-12 times

* According to Sandovsky, To count for the fetal movement, Mother is put on her LEFT SIDE to decrease placental insufficiency. This is usually done after meals. The mother is asked to record the number of fetal movements per hour. A fetus moves Twice every 10 minutes and 10 to 12 times times an hour.

In SIA'S Book, She answered this question with letter B. But according to Pillitteri, A movement fewer than 5 in an hour is to be reported to the health care provider. The Board examiners uses Pillitteri as their reference and WORD PER WORD, Their question are answered directly from the Pillitteri book. 10-12 times according to Pillitteri, is the normal fetal movement per minute.

71. Upon examination by the obstetrician, he charted that Alpha is in the early stage of labor. Which of the following is true in this state? [1]

A. Self-focused
B. Effacement is 100%
C. Last for 2 hours
D. Cervical dilation 1-3 cm

* The earliest phase of labor is the first stage of labor : latent phase characterized by a cervical dilation of 0-3 cm, Mild contraction lasting for 20 to 40 seconds. This lasts approximately 6 hours in primis and 4.5 hours in multis. C is the characteristic of ACTIVE PHASE of labor, Characterized by a cervical dilation of 4-7 cm and contractions of 40 to 60 seconds. This phase lasts at around 3 hours in primis and 2 hours in multis. Effacement of 100% is a characteristic of the TRANSITION PHASE as well as being self focused.

SITUATION : Maternal and child health nursing a core concept of providing health in the community. Mastery of MCH Nursing is a quality all nurse should possess.

72. When should be the 2nd visit of a pregnant mother to the RHU? [2]

A. Before getting pregnant
B. As early in pregnancy
C. Second trimester
D. Third trimester

* Visit to the RHU are once every trimester and more frequent for those women at risk. Visit to the health center is once during the 0-6th month of pregnancy, twice during the 7th-8th month and weekly at the last trimester.

73. Which of the following is NOT a standard prenatal physical examination? [1]

A. Neck examination for goiter
B. Examination of the palms of the hands for pallor
C. Edema examination of the face hands, and lower extremeties
D. Examination of the legs for varicosities

74. Which of the following is NOT a basic prenatal service delivery done in the BHS? [2]

A. Oral / Dental check up
B. Laboratory examination
C. Treatment of diseases
D. Iron supplementation

* A is done at the RHU not in BHS.

75. How many days and how much dosage will the IRON supplementation be taken? [4]

A. 365 days / 300 mg
B. 210 days / 200 mg
C. 100 days/ 100mg
D. 50 days / 50 mg

* Iron supplementation is taken for 210 days starting at the 5th month of pregnancy up to 2nd month post partum. Dosage can range from 100 to 200 mg.

76. When should the iron supplementation starts and when should it ends? [4]

A. 5th month of pregnancy to 2nd month post partum
B. 1st month of pregnancy to 5th month post partum
C. As early in pregnancy up to 9th month of pregnancy
D. From 1st trimester up to 6 weeks post partum

* Refer to #75

77. In malaria infested area, how is chloroquine given to pregnant women? [4]

A. 300 mg / twice a month for 9 months
B. 200 mg / once a week for 5 months
C. 150 mg / twice a week for the duration of pregnancy
D. 100 mg / twice a week for the last trimester of pregnancy

* Always remember that chloroquine is given twice a week for the whole duration of pregnancy. This knowledge alone will lead you to correctly identifying letter C.

78. Which of the following mothers are qualified for home delivery? [2]

A. Pre term
B. 6th pregnancy
C. Has a history of hemorrhage last pregnancy
D. 2nd pregnancy, Has a history of 20 hours of labor last pregnancy.

* Knowing that a preterm mother is not qualified for home delivery will help you eliminate A. History of complications like bleeding, CPD, Eclampsia and diseases like TB, CVD, Anemia also nulls this qualification. A qualified woman for home delivery should only had less than 5 pregnancies. More than 5 disqualifies her from home delivery. High risk length of labor for primigravidas ls more than 24 hours and for multigravidas, it is more than 12 hours. Knowing this will allow you to choose D.

79. Which of the following is not included on the 3 Cs of delivery? [2]

A. Clean Surface
B. Clean Hands
C. Clean Equipments
D. Clean Cord

* 3 Cs of delivery are CLEAN SURFACE,HANDS AND CORD. " Kinamay ni Cordapya ang labada gamit ang Surf - Budek "

80. Which of the following is unnecessary equipment to be included in the home delivery kit? [4]

A. Boiled razor blade
B. 70% Isopropyl Alcohol
C. Flashlight
D. Rectal and oral thermometer

* Home delivery kit should contain the following : Clamps, Scissors, Blade, Antiseptic, Soap and hand brush, Bp app, Clean towel or cloth and Flashlight.

Optional equipments include : Plastic sheet, Suction bulb, Weighing scale, Ophthalmic ointment, Nail cutter, Sterile gloves, Rectal and oral thermometers.

SITUATION : [NBLUE166] Pillar is admitted to the hospital with the following signs : Contractions coming every 10 minutes, lasting 30 seconds and causing little discomfort. Intact membranes without any bloody shows. Stable vital signs. FHR = 130bpm. Examination reveals cervix is 3 cm dilated with vertex presenting at minus 1 station.

81. On the basis of the data provided above, You can conclude the pillar is in the [1]

A. In false labor
B. In the active phase of labor
C. In the latent phase of labor
D. In the transitional phase of labor

* Refer to #71

82. Pitocin drip is started on Pilar. Possible side effects of pitocin administration include all of the following except [3]

A. Diuresis
B. Hypertension
C. Water intoxication
D. Cerebral hemorrhage

* Oxytocin [ Pitocin ] is a synthetic form of hormone naturally released by the PPG. It is used to augment labor and delivery. Dosage is about 1 to 2 milli units per minute and this can be doubled until the desired contraction is met. Side effects are Water intoxication, Diuresis, Hypertonicity of the uterus, Uterine rupture, Precipitated labor, Walang kamatayang Nausea and Vomiting and Fetal bradycardia. Diuresis occurs because of water intoxication, The kidney will try to compensate to balance the fluid in the body.

NEVER give pitocin when FHR is below 120. Even without knowing anything about Pitocin, A cerebral hemorrhage is LETHAL and DAMAGE IS IRREVERSIBLE and if this is a side effect of a drug, I do not think that FDA or BFAD will approve it.

83. The normal range of FHR is approximately [3]

A. 90 to 140 bpm
B. 120 to 160 bpm
C. 100 to 140 bpm
D. 140 to 180 bpm

* A normal fetal heart rate is 120-160 bpm.

84. A negative 1 [-1] station means that [1]

A. Fetus is crowning
B. Fetus is floating
C. Fetus is engaged
D. Fetus is at the ischial spine

* At the negative station, The fetus is not yet engaged and floating. At 0 station, it means that the fetus is engaged to the ischial spine. Crowning occurs when the fetus is at the +3,+4 Station. Stations signifies distance of the presensting part below or above ischial spine. + denoted below while - denotes above. The number after the sign denotes length in cm. +1 station therefore means that the presenting part is 1 cm below the ischial spine.

85. Which of the following is characteristics of false labor [1]

A. Bloody show
B. Contraction that are regular and increase in frequency and duration
C. Contraction are felt in the back and radiates towards the abdomen
D. None of the above

* A,B and C are all charactertistics of a true labor. True labor is heralded by LIGHTENING. This makes the uterus lower and more anterior. This occrs 2 weeks prior to labor. At the morning of labor, women experiences BURST OF ENERGY because of adrenaline rush induced by the decrease progestrone secretion of the deteriorating placenta. The pain in labor is felt at the back and radiates towards the abdomen and becomes regular, increasing frequency and duration. As the cervix softens and dilates, The OPERCULUM or the mucus plug is expelled.

False labor is characterized by Irregular uterine contraction that is relieved by walking, Pain felt at the abdomen and confined there and in the groin, The cervix do not achieve dilation and Pain that is relieved by sleep and do not increase in intensity and duration.

86. Who's Theory of labor pain that states that PAIN in labor is cause by FEAR [4]

A. Bradley
B. Simpson
C. Lamaze
D. Dick-Read

* Believe it or not, this is an actual board question. Grantley Dick-Read is just one person. Usually a two name theory means two theorist. He published a book in 1933 "CHILDBIRTH WITHOUT FEAR". He believes that PAIN in labor is caused by FEAR that causes muscle tension, thereby halting the blood towards the uterus and causing decreased oxygenation which causes the PAIN.

1950s French obstetrician, Dr. Ferdinand Lamaze perhaps is the most popular theorist when it comes to labor. The theory behind Lamaze is that birth is a normal, natural and healthy event that should occur without unnecessary medical intervention. Rather than resorting to pain medication, different breathing techniques are used for each stage of labor to control pain. Fathers are assigned the role of labor coach, and are responsible for monitoring and adjusting their partner's breathing pattern throughout childbirth.

In 1965, obstetrician Robert A. Bradley, MD wrote "Husband Coached Childbirth." The Bradley method perhaps is the easiest to remember, BRAD ley necessitates the presence of the FATHER during labor. Bradley Method views birth as a natural process. This method also emphasizes the importance of actively involving fathers in the labor process. Fathers are taught ways to help ease their partner's pain during childbirth through guided relaxation and slow abdominal breathing.

James Young Simpson is an english doctor and the first to apply anesthesia during labor and child birth. He uses ETHER to alleviate labor pain. He then discovered the effects of chloroform as an anesthetic agent. Because of his works, He was recognized by Queen Victoria because the queen herself uses Simpson's chloroform in alleviating labor pain when she gave birth to prince leopold.

87. Which sign would alert the nurse that Pillar is entering the second stage of labor? [1]

A. Increase frequency and intensity of contraction
B. Perineum bulges and anal orifice dilates
C. Effacement of internal OS is 100%
D. Vulva encircles the largest diameter of presenting part

* The second stage of labor begins as the cervical internal os is 100% effaced and fully dilated. It ends after the fetus has been delivered. Crowning, as in letter B and D is too late of a sign to alert the nurse that Pillar is entering the second stage of labor. A occurs during the first stage of labor.

88. Nursing care during the second stage of labor should include [1]

A. Careful evaluation of prenatal history
B. Coach breathing, Bear down with each contraction and encourage patient.
C. Shave the perineum
D. Administer enema to the patient

* The second stage of labor begins with a full cervical dilation and effacement and finishes when the baby is fully delivered. Careful evaluation of prenatal history is done on admission and check ups and is never done in the second stage of labor. Shaving the perineum and enema are done during the first stage of labor in preparation for delivery or before labor begins when client is admitted. Enema is not a routine procedure before delivery, but can be done to prevent defecation during labor. B is appropriate during the second stage of labor when the client's contraction is at it's peak and dilation and effacement are at maximum to help client accomplish the task of giving birth.

SITUATION : [NBLUE170] Baby boy perez was delivered spontaneously following a term pregnancy. Apgar scores are 8 and 9 respectively. Routine procedures are carried out.

89. When is the APGAR Score taken? [1]

A. Immediately after birth and at 30 minutes after birth
B. At 5 minutes after birth and at 30 minutes after birth
C. At 1 minute after birth and at 5 minutes after birth
D. Immediately after birth and at 5 minutes after birth

* APGAR score taken 1 minute after birth determines the initial status of the newborn while the 5 minute assessment after birth determines how well the newborn is adjusting to the extrauterine life.

90. The best way to position a newborn during the first week of life is to lay him [3]

A. Prone with head slightly elevated
B. On his back, flat
C. On his side with his head flat on bed
D. On his back with head slightly elevated

* Sudden infant death syndrome occurs when the fetus is in prone position. Knowing this will allow you to eliminate A first. During the first week of life, The fetus has an immature cardiac sphincter and musculature for swallowing, Knowing this will let you eliminate B and D. Side lying position is the best position for a neonate during the first few weeks of life. This will decrease the risk of aspiration of secretion.

91. Baby boy perez has a large sebaceous glands on his nose, chin, and forehead. These are known as [1]

A. Milia
B. Lanugo
C. Hemangiomas
D. Mongolian spots

* Newborn sebaceous glands are sometimes unopened or plugged. They are called MILIA. They will disappear once the gland opens at around 2 weeks after delivery. They are characterized by a pinpoint white papule. Lanugo is the fine hair that covers the newborn. It disappears starting 2 weeks after birth. A premature infant has more lanugo than a post mature infant. Hemangiomas are vascular tumors of the skin. Mongolian spots are patches that are gray in color and are often found in sacrum or buttocks. They disappear as the child grows older.

92. Baby boy perez must be carefully observed for the first 24 hours for [2]

A. Respiratory distress
B. Duration of cry
C. Frequency of voiding
D. Range in body temperature

* Range in body temperature needs to be observed and carefully monitored for the first 24 hours after delivery. A newborn has an inadequate and immature temperature regulating mechanism. RDS is observed immediately after delivery, not in a continuous 24 hour observation. Once the fetus establish a normal breathing pattern it is not anymore of a concern. RDS occurs when the Surfactants are absent or insufficient. The adequacy of these surfactants is measured by the L:S ratio [ Lecithin : Spingomyelin ] An L:S ratio of 2:1 is considered, mature and adequate to sustain fetal lung expansion and ventilation. Therefore, A child born without RDS is unlikely to have RDS in 24 hours.

Another thing that is carefully observed during the first 24 hours is the meconium. Absent of meconium during the first 24 hours after birth warrants further investigation by the attending physician.

93. According to the WHO , when should the mother starts breastfeeding the infant? [4]

A. Within 30 minutes after birth
B. Within 12 hours after birth
C. Within a day after birth
D. After infant's condition stabilizes

* According to the world health organization, The mother should start breastfeeding her infant within 30 minutes after birth.

94. What is the BEST and most accurate method of measuring the medication dosage for infants and children? [3]

A. Weight
B. Height
C. Nomogram
D. Weight and Height

* A nomogram is the most accurate method for measuring medication dosage for infants and children. It estimates the body surface area by drawing a line in the first column [ child's height ] towards the third column [ child's weight ]. The point in which it crosses the middle column [ BSA ] is the child's surface area.

95. The first postpartum visit should be done by the mother within [4]

A. 24 hours
B. 3 days
C. a week
D. a month

* Mother should visit the health facility 4 weeks to 6 weeks after delivery. The first post partum visit by the birth attendant is done within 24 hours after delivery, the next visit will be at 1 week after delivery and the third visit is done 2 to 4 weeks after delivery.

96. The major cause of maternal mortality in the philippines is [3]

A. Infection
B. Hemorrhage
C. Hypertension
D. Other complications related to labor,delivery and puerperium

* Refer to the latest survey of FHSIS in the DOH website.

97. According to the WHO, what should be the composition of a commercialized Oral rehydration salt solution? [4]

A. Potassium : 1.5 g. ; Sodium Bicarbonate 2.5g ; Sodium Chloride 3.5g; Glucose 20 g.
A. Potassium : 1.5 g. ; Sodium Bicarbonate 2.5g ; Sodium Chloride 3.5g; Glucose 10 g.
A. Potassium : 2.5 g. ; Sodium Bicarbonate 3.5g ; Sodium Chloride 4.5g; Glucose 20 g.
A. Potassium : 2.5 g. ; Sodium Bicarbonate 3.5g ; Sodium Chloride 4.5g; Glucose 10 g.

* This is the WHO ORESOL formula for the commercialized ORS. Remember PA BCG Which stands for POTASSIUM [ Pa ] SODIUM BICARBONATE [ B ] SODIUM CHLORIDE [ C ] GLUCOSE [ G ]. The numbers are easy to remember because they are just increased by 1.0 g increment starting from 1.5. Glucose however is at 20 g. So the MNEMONIC is PA BCG 1.5 2.5 3.5 20. This is the mnemonic I use and it is easy to remember that way. It is original by the way.

98. In preparing ORESOL at home, The correct composition recommnded by the DOH is [4]

A. 1 glass of water, 1 pinch of salt and 2 tsp of sugar
B. 1 glass of water, 2 pinch of salt and 2 tsp of sugar
C. 1 glass of water, 3 pinch of salt and 4 tsp of sugar
D. 1 glass of water, 1 pinch of salt and 1 tsp of sugar

99. Milk code is a law that prohibits milk commercialization or artificial feeding for up to 2 years. Which law provides its legal basis? [4]

A. Senate bill 1044
B. RA 7600
C. Presidential Proclamation 147
D. EO 51

* Executive order # 51 prohibits milk commercialization or artificial feeding up to 2 years. That is why the milk commercials in the country has " BREAST MILK IS STILL BEST FOR BABIES UP TO 2 YEARS " After their presentation in accordance with EO 51. RA 7600 is the ROOMING IN / BREAST FEEDING ACT which requires the heatlh professionals to bring the baby to the mother for breastfeeding as early as possible. Senate bill # 1044 was created to implement RA 7600. Presidential Proclamation # 147 made WEDNESDAY as the national immunization day.

100. A 40 year old mother in her third trimester should avoid [4]

A. Traveling
B. Climbing
C. Smoking
D. Exercising

* Mother's are not prohibited to travel, climb or exercise. If long travels are expected, Mother should have a 30 minute rest period for every 2 hours of travel [ LIPPINCOTT ]. Climbing is a very vague term used by the board examiners though I assume they are referring to climbing a flight of stairs. Anyhow, SMOKING is detrimental for both mother and child no question about it and so is ALCOHOL. In thousands of questions I answered, it never fails that HANDWASHING, AVOID SMOKING, AVOID ALCOHOL are always the answer. It still depends on the question so THINK.

DISCLAIMER: Care has been taken to verify that all answers and rationale below are accurate. Please comment up if you noticed any errors or contradictions to maintain accuracy and precision of the answers as not to mislead the readers.

Budek
http://www.pinoybsn.tk

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