Free PNLE Exam Flashcards

The five-step systematic framework for nursing care: Assessment (collect and validate data), Diagnosis (analyze and name the problem), Planning (set goals and priorities), Implementation (carry out care), Evaluation (determine if goals were met). Assessment always precedes diagnosis and intervention.

A community-based approach making essential health care universally accessible through community participation, intersectoral collaboration, appropriate technology, and self-reliance. The barangay is the basic PHC unit in the Philippine health system.

Primary level: barangay health station (BHS) and rural health unit (RHU) provide first-contact care. Secondary level: district or provincial hospitals for specialist referral. Tertiary level: regional or specialized hospitals for complex or high-risk cases needing advanced technology.

The three interacting factors that determine disease occurrence: Host (the person or population at risk), Agent (the causative organism or factor), and Environment (physical, biological, and social conditions bringing host and agent together).

The proportion of an exposed group that develops disease during a specific outbreak: (number of new cases among exposed divided by total number exposed) x 100. Used to measure the intensity of a point-source outbreak, such as a foodborne illness event.

Number of deaths of infants under 1 year of age during a year, divided by the number of live births that year, multiplied by 1,000. A key indicator of maternal-child health, distinct from the neonatal mortality rate (deaths under 28 days) and the under-5 mortality rate.

The TB control strategy used in the Philippine National TB Program: a trained treatment partner directly observes the patient swallow every anti-TB dose for the full 6-month first-line regimen, preventing treatment interruption and drug resistance.

Mandatory Reporting of Notifiable Diseases and Health Events of Public Health Concern Act (2019). Requires health workers and facilities to report notifiable diseases and outbreaks to DOH surveillance systems within prescribed timeframes to enable a rapid public health response.

Verify the diagnosis and confirm that a true outbreak exists before launching control measures. Investigation then proceeds to defining and counting cases, building a line list and epidemic curve by person-place-time, testing hypotheses about the source, and implementing control measures.

The law governing nursing practice in the Philippines: defines the scope of nursing practice (independent and collaborative functions), qualifications for licensure, the Board of Nursing's powers, and grounds for suspension or revocation of a license.

Stage 1: onset of true labor to full cervical dilation (10 cm), the longest stage, with latent, active, and transition phases. Stage 2: full dilation to delivery of the baby. Stage 3: delivery of the baby to delivery of the placenta. Stage 4: first 1-2 hours postpartum, physiologic stabilization and hemorrhage monitoring.

Newborn assessment scored 0-2 on five signs: Appearance (color), Pulse (heart rate), Grimace (reflex irritability), Activity (muscle tone), Respiration (breathing effort), for a total of 0-10. Scored at 1 minute (tolerance of extrauterine life) and 5 minutes (response to resuscitation).

DOH-mandated protocol for a vigorous newborn: immediate and thorough drying, early skin-to-skin contact, properly timed (delayed) cord clamping at 1-3 minutes, and non-separation of mother and baby to support early breastfeeding initiation within the first hour.

The Philippine Newborn Screening Program collects a heel-prick blood sample ideally between 24 and 72 hours of life, not earlier than 24 hours, to detect metabolic, endocrine, and genetic disorders such as congenital hypothyroidism and PKU before symptoms appear.

At birth: BCG, a single dose that protects against severe forms of TB such as TB meningitis and miliary TB, and Hepatitis B vaccine given within 24 hours of birth to prevent perinatal transmission.

Pentavalent (DPT-HepB-Hib) and PCV are given at 6, 10, and 14 weeks; OPV/IPV follow the same schedule. MMR is given at 9 months, with a second dose at 12-15 months, per the DOH Expanded Program on Immunization.

Massage the fundus immediately and call for assistance. A boggy (soft), high uterus with heavy bleeding indicates uterine atony, the most common cause of early postpartum hemorrhage (blood loss over 500 mL for a vaginal birth); fundal massage restores uterine tone while help is summoned.

Postpartum perineal or episiotomy wound assessment: Redness, Edema, Ecchymosis, Discharge, Approximation (wound edges closed). Assessed at every postpartum check to detect infection or poor healing early.

Head control by 3-4 months; sits with support by 6 months; walks and says a few words by 12 months. Toddlers show parallel play and frequent tantrums (autonomy vs. shame/doubt). Preschoolers show associative play and magical/preoperational thinking (initiative vs. guilt).

Placenta previa: painless, bright-red vaginal bleeding; placenta covers or lies near the cervix; abdomen soft and non-tender; vaginal exam is contraindicated. Abruptio placentae: painful, dark-red bleeding from premature separation of a normally implanted placenta; abdomen rigid and tender.

Heart rate 60-100 bpm; respiratory rate 12-20 breaths/min; blood pressure below 120/80 mmHg; temperature 36.5-37.5 degrees C average; SpO2 95-100%. Deviations should be correlated with the client's baseline and clinical presentation.

Subjective data is what the patient states or reports and cannot be directly measured, such as pain level or nausea. Objective data is what the nurse observes or measures directly, such as vital signs, wound appearance, and laboratory results.

Infection-control practices applied to every patient, every time, regardless of diagnosis: hand hygiene, PPE when contact with blood or body fluids is anticipated, safe injection practices, and respiratory hygiene or cough etiquette. The foundation beneath all transmission-based precautions.

Used for pathogens that remain suspended in air and travel long distances: tuberculosis, measles, and varicella (chickenpox). Requires a negative-pressure room and an N95 or higher-level respirator for staff entering the room.

Used for pathogens spread by large respiratory droplets over short distances, generally within 3 feet (about 1 meter): influenza, mumps, pertussis, and rubella. A surgical mask worn within that distance of the patient is sufficient; a standard door and normal airflow are fine.

Used for pathogens spread by direct or indirect contact: MRSA, C. difficile, and scabies. Requires a gown and gloves for all patient contact plus dedicated or disinfected equipment; C. difficile specifically requires soap-and-water hand hygiene because alcohol rub does not kill spores.

Right patient (verify two identifiers), right drug, right dose, right route, right time, and right documentation, plus right reason, right response, right education, and right to refuse. High-alert medications require an independent double-check of the dose.

Tachycardia, dry mucous membranes, poor skin turgor, thirst, and concentrated or decreased urine output, with possible hypotension. Reflects loss of extracellular fluid faster than intake; the nurse anticipates fluid replacement and monitors for worsening perfusion.

Serum potassium above 5.0 mEq/L. The classic ECG change is tall, peaked T waves, which can progress to a widened QRS and lethal dysrhythmias. Common causes include renal failure, tissue damage, and acidosis; requires prompt recognition and cardiac monitoring.

The physician or surgeon performing the procedure is responsible for explaining the procedure, risks, benefits, and alternatives and for obtaining consent. The nurse's role is to witness the signature, verify the client's understanding, and notify the provider if questions remain unanswered, not to give the primary explanation.

Diabetic Ketoacidosis (DKA): usually type 1 diabetes, ketones present with metabolic acidosis, rapid onset, Kussmaul breathing, fruity breath odor. Hyperosmolar Hyperglycemic State (HHS): usually type 2 diabetes, no significant ketones, slower onset, extreme hyperglycemia, more common in older adults.

Deep, rapid, labored respirations that are the body's compensatory mechanism to blow off CO2 and correct metabolic acidosis. Classically seen in diabetic ketoacidosis; a key assessment finding that helps distinguish DKA from HHS.

Blood glucose below 70 mg/dL, with shakiness, diaphoresis, confusion, tachycardia, and hunger. For a conscious client, give 15-20 g of fast-acting oral glucose and recheck in 15 minutes. For an unconscious client, give IV dextrose or IM/intranasal glucagon per protocol; never give oral intake to an unresponsive client.

A life-threatening exacerbation of hyperthyroidism: high fever, severe tachycardia, agitation or delirium, and hypertension that can progress to cardiovascular collapse if untreated. Requires immediate treatment with antithyroid drugs, beta-blockers, and cooling measures.

Avoid late or large meals and lying down within 2-3 hours of eating; elevate the head of the bed; avoid trigger foods such as fatty, spicy, caffeinated, alcoholic, chocolate, or mint items. Weight management reduces reflux by lowering intra-abdominal pressure.

Severe epigastric pain radiating to the back, elevated serum amylase and lipase, and nausea or vomiting. Priority nursing care includes NPO status to rest the pancreas, IV fluids, pain management, and monitoring for hypocalcemia and systemic complications.

Chronic liver damage presenting with ascites, jaundice, and increased bleeding risk from impaired clotting-factor synthesis. The nurse monitors for hepatic encephalopathy (rising ammonia), esophageal varices, and fluid or electrolyte imbalance.

Face drooping, Arm weakness, Speech difficulty, Time to call for emergency help. Sudden onset of any of these signs is a medical emergency; document the last-known-well time because it determines eligibility for time-sensitive treatment such as thrombolytics.

A standardized neurologic assessment scoring three responses: Eye opening (1-4), Verbal response (1-5), Motor response (1-6), for a total of 3-15. A lower score indicates a more depressed level of consciousness; a drop of 2 or more points signals significant neurologic deterioration.

Early signs: severe headache, vomiting (often without nausea), and altered level of consciousness, the earliest and most sensitive indicator, plus pupillary changes. Cushing's triad (widening pulse pressure, bradycardia, irregular respirations) is a late, preterminal sign requiring immediate intervention.

Unconscious refusal to accept a painful reality or fact, acting as if it does not exist. Common in early stages of grief, a terminal diagnosis, or substance use disorder; the nurse acknowledges the client's feelings without reinforcing the denial.

Unconsciously attributing one's own unacceptable thoughts, feelings, or impulses to another person. Example: a client who is angry at self instead accuses the nurse of being angry at them.

Redirecting emotions, often anger, from the original threatening source to a safer or less threatening substitute target. Example: a client yells at a family member after a frustrating encounter with a physician.

Rationalization: justifying unacceptable behavior or feelings with logical-sounding but self-serving excuses. Regression: reverting to behaviors typical of an earlier developmental stage under stress, such as a hospitalized child reverting to thumb-sucking or bedwetting.

Reaction formation: expressing the opposite of one's true, unacceptable feeling, such as excessive kindness masking resentment. Sublimation: channeling an unacceptable impulse into a socially acceptable and often constructive activity, such as aggression redirected into competitive sports.

Open-ended questions invite a full response; reflecting mirrors the client's stated feeling back to them; silence allows the client time to process; active listening confirms understanding. These techniques keep the focus on the client's own thoughts and feelings.

False reassurance ('everything will be fine'), giving unsolicited advice, asking 'why' questions that sound accusatory, changing the subject, and approving or disapproving of the client's behavior all block therapeutic communication and should be avoided.

Airway compromise is addressed first, then Breathing problems once the airway is open, then Circulation problems once A and B are adequate. This ABC order takes priority over Maslow's hierarchy of needs when a client has an immediate physiologic threat to life.

Tachycardia, hypotension, cool and clammy pale skin, a weak or thready pulse, delayed capillary refill, and decreased urine output, reflecting the body's compensatory response to significant blood or fluid loss. Priority action is to control any active bleeding source and support circulation with IV fluids or blood products per protocol.

Ask directly and non-judgmentally whether the client is thinking of harming or killing themselves; direct questioning does not increase risk and is required for accurate assessment. Ensure immediate environmental safety by removing means, and arrange continuous observation for a client with an active plan and means.