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Monday, July 30, 2007

Obstetrics-Maternal And Child Health Nursing Practice Test

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SITUATION : Aling Martha, 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 Martha's EDC?

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

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

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

3. With this pregnancy, Aling Martha is a

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

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

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

5. Aling Martha 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?

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

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

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

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

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

8. The best advise you can give to Aling Martha regarding prevention of varicosities is

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

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

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

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

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

11. In evaluating the weight gain of Aling Martha, you know the minimum weight gain during pregnancy is

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

12. The more accurate method of measuring fundal height is

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

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

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

14. Aling Martha 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

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

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

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

SITUATION : Maternal and child health is the program of the department of health created to lessen the death of infants and mother in the Philippines.

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

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

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

18. In maternal care, the PHN responsibility is

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

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

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

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

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

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?

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

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

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

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

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

24. Which hormone stimulates oocyte maturation?

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

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

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

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

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

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

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

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

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

29. Menstruation occurs because of which following mechanism?

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

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

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

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

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

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

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

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?

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

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

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

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

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

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

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

37. Which of the following mothers needs RHOGAM?

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

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

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

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

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

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

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

SITUATION : 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?

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

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

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

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

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

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

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

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

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.

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

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

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

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

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

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

49. What is the VISION of the RH?

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

SITUATION : 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?

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

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

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

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

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

SITUATION : Nurses should be aware of the different reproductive problems.

53. When is the best time to achieve pregnancy?

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

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:

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

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

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

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

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

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

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

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

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

59. When is the fetal weight gain greatest?

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

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

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

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

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

SITUATION : Cynthia, 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?

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

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

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

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

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

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

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

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

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

SITUATION : Helen, 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?

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

68. The nurse checks the perineum of Helen. Which of the following characteristic of the amniotic fluid would cause an alarm to the nurse?

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

69. Helen 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?

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

70. Helen wants to know how many fetal movements per hour is normal, the correct response is

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

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

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

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?

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

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

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?

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

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

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

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

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

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

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

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

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.

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

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

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

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

SITUATION : 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

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

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

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

83. The normal range of FHR is approximately

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

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

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

85. Which of the following is characteristics of false labor

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

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

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

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

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

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

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

SITUATION : Baby boy Jose 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?

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

90. The best way to position a newboarn during the first week of life is to lay him

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

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

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

92. Baby boy Jose must be carefully observed for the first 24 hours for

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

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

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

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

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

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

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

96. The major cause of maternal mortality in the Philippines is

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

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

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.

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

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?

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

100. A 40 year old mother in her third trimester should avoid?

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


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