Question 1 WRONG Situation 1: The Department of Health is strengthening its programs regarding maternal and child health nursing.

As a newly appointed community health nurse in town, you are oriented and well verse on these. 1. With regards to Womens Health and Safe Motherhood Project, the following strategies are included to prevent maternal mortality, except one: Establishment of BEmoNC and CEmoNC networks TBA facilitated home deliveries Improved Family Planning counselling Emphasis on Facility based deliveries Question 1 Explanation: *Rationale: Home deliveries are not recommended by the government even it is assisted by a health professional or a trained hilot nowadays. Maternal complications leading to maternal mortality has been found to be due to this. Question 2 WRONG The following qualifications reflect possible delivery in the Rural Health Unit, except for one: Cephalic presentation Adequate pelvis History of ceasarian section delivery Less than five pregnancies Question 2 Explanation: *Rationale: Rural health units do not have the capacity and the facilities to facilitate CS delivery. Aside from that women with history of CS deliveries usually have previous history of serious or potentially serious complications, thus they are usually advised to seek consult to the nearest hospital during their prenatal period to prepare them for their delivery. Question 3 WRONG You are assigned to provide baby care to the newly delivered healthy baby. What procedure are you going to do first? Examine the newborn and check for defects, deformities and birth injuries. Provide warmth to the newborn and have a quick check for breathing Clamp and cut the cord after cord pulsations have stopped. Facilitate the bonding between the mother and the newborn through early skin to - skin contact. Question 3 Explanation: *Rationale: Within the first 30 seconds, the objective of the nurse is to dry and provide warmth to the newborn to prevent from hypothermia. Question 4 WRONG The basis for the improvement in strategies in maternal and neonatal care is on Millennium Development Goals, which are: MDGs 1 & 2 MDGs 2 & 4 MDGs 3 & 5 MDGs 4 & 5 Question 4 Explanation: *Rationale: MDG 4 focuses on reducing child mortality and MDG 5 corresponds to the improvement of maternal health. Question 5 WRONG

The following are the intermediate results that can lower the risk for dying from pregnancy and childbirth with the integration of the MNCHN services in the community: Every delivery is facility- based and managed by skilled birth attendants Every pregnancy is adequately managed during pre and post partum courses Every pregnancy is wanted, planned and supported Only answers A & C Question 5 Explanation: *Rationale: Only A & C are correct; Every pregnancy is adequately managed throughout its course, not only during pre natal and post partum periods. Question 6 WRONG Situation II: You have observed that there are reports of dengue hemorrhagic fever in the barangay. You are to perform community awareness lecture about the said disease. 6. Which is the best preventive measure for dengue hemorrhagic fever? Frequent fogging in the vicinity to kill mosquitoes Use of mosquito nets and mosquito coils Use of mosquito repellent lotions Cleaning of surroundings and proper disposal of coconut shells, tires, and containers Question 6 Explanation: *Rationale: Fogging is not recommended for it only scares away mosquito and it even causes some respiratory consequences; use of mosquito nets, coils and repellants are options but the best preventive measure is through searching and destroying of breeding sites by cleaning the surroundings. Question 7 WRONG What are the signs and symptoms of DHF assessed as Grade II? Hermans signs, bone and joint pains, fever with headache, and abdominal pain Hypotension, anorexia, nausea and vomiting, fever, and rapid weak pulse Hermans signs, fever with headache, epistaxis, and melena Narrowing pulse pressure, restlessness, and cold clammy perspiration Question 7 Explanation: *Rationale: DHF Grade II includes the signs of Grade I plus spontaneous bleeding. Choice A refers only to signs and symptoms found in Grade I, while options B and D correspond to signs and symptoms of Grade III. Question 8 WRONG For planning and implementation during the course of DHF, the following are the necessary nursing considerations: Educate client to avoid dark colored foods and the use of hard bristled toothbrush, razor and other sharp objects Monitoring the intake and output of client Encouraging client to increase fluid intake All of the above Question 8 Explanation: *Rationale: All the above options should be included in plan of care for a client with DHF to easily identify and prevent bleeding, and to prevent the occurrence of dehydration. Question 9 WRONG What diagnostic procedure will confirm that the client is having DHF? Blood smear Urine and Stool examinations Cerebrospinal fluid examination Sputum examination

Question 9 Explanation: *Rationale: By testing through blood smear DHF will be confirmed. The rest diagnostic procedures are not relevant to the confirmation process of this said disease. Question 10 WRONG Dengue hemorrhagic fever can be fatal. The following manifestations are present in DHF, except for one. Thrombocytosis Prolonged bleeding time Thrombocytopenia Positive Rumpel Leade test Question 10 Explanation: *Rationale: Thrombocytosis is not a manifestation of DHF instead there is depletion of thrombocytes in the system referring to as thrombocytopenia; which can be evidenced by prolonged bleeding time and petechial rashes. Question 11 WRONG Situation III: IMCI or the Integrated Management for Childhood Illnesses is an important tool for public health nurses for managing cases of children seeking health care. 11. What should you look for in assessing the childs condition? Does the child vomit everything? Is the child able to breastfeed or drink? Is the child lethargic or unconscious? Is the child having some breathing difficulties? Question 11 Explanation: *Rationale: Options A and B refers to what you should ask for during assessment, but what you really need to look for is if the child is lethargic which is a danger sign. It also refers to as objective data instead of subjective one as verbalized by mother. Option D is asked if you are querying the child to have pneumonia or not. Question 12 WRONG If the child is having fever for 9 days everyday and has stiff neck but without runny nose, what color health management will it suggest? Green Yellow Pink Violet Question 12 Explanation: *Rationale: Pink, since the child is suggested to be having very severe febrile disease under the high malaria risk management. Question 13 WRONG In a child reported to having diarrhea, assessment is an essential guide for knowing if the child is experiencing dehydration. What body part should you assess? Buttocks Abdomen Eyelids Arms Question 13 Explanation: *Rationale: Abdomen is assessed for signs of dehydration in children; the rest do not give hints of dehydration. Question 14 WRONG Child Isabel is already 12 weeks old. What immunizations should Isabel have received?

BCG, OPV-0, DPT+HIB-1, Hepatitis B1, and OPV-1 BCG, OPV-0, DPT+HIB-1, Hepatitis B1, DPT+HIB-2, Hepatitis B2, OPV-1 and OPV-2 BCG, OPV-0, DPT+HIB-1, Hepatitis B1, OPV-1, and BCG, OPV-0, DPT+HIB-1, and OPV-1 Question 14 Explanation: *Rationale: At birth the child should have received BCG and OPV-0; at 6 weeks, the child can receive DPT+HIB-1, Hepatitis B1, OPV-1 already; and at 10 weeks, DPT+HIB-2, Hepatitis B2 and OPV-2 can be given to the child. The next immunization is when the child reached the age of 14 weeks. Question 15 WRONG In preparing sugar water for the treatment of low blood sugar in a child, includes the following proportion: 200 ml of clean water plus 2 level tbsp. of sugar 400 ml of clean water plus 4 level tsp of sugar 200 ml of clean water plus 4 level tsp of sugar 200 ml of clean water plus 4 level tbsp of sugar Question 15 Explanation: *Rationale: The right proportion in making sugar water is 200 ml of clean water with 4 tsp of sugar. Question 16 WRONG Situation IV: The Aquino Health Agenda (AHA) is focusing on the achievement of Universal Health Care for All Filipinos. 16. The AHA strategic thrusts are the keys for ensuring that all Filipinos especially the poor will receive the benefits of the health reform. These involve: Attainment of Millennium Development Goals 2 and 3. Financial risk protection through expansion in National Health Insurance Program enrolment and benefit Improved service delivery for health care needs through upgraded quality health care facilities B & C only Question 16 Explanation: *Rationale: There are three strategic thrusts involving financial risk protection, improved ac care delivery, and attainment of health related MDGs which are MDGs 4 and 5. Question 17 WRONG Last April 2011, the Department of Health together with the LGUs conducted a nationwide campaign on: Reproductive Health Bill Disaster and Preparedness Measles- Rubella Isang Milyong Sepilyo Question 17 Explanation: *Rationale: Measles Rubella Campaign was conducted last 2011 to decrease the incidence of MR in the country and to coincide with the MDGs goal of reducing child mortality Question 18 WRONG Which is incorrect regarding the training and deployment of unemployed nurses as RNHeals to the rural area? To supply the needs of poor Filipino people in far flung areas To contribute to the eradication of poverty and hunger To assist in the promotion of gender and equality To address the proliferation of volunteer nurses Question 18 Explanation: *Rationale: It is only to improve the access of poor communities to quality healthcare and services, not to supply their needs; Take note also that community health nursing is focusing on the development of self- reliance of the community. cess to health

Question 19 WRONG According to the AHA, the following instruments are vital in implementing the three strategic thrusts. Which one refers to the access to professional health providers capable in the provision of their health needs at the appropriate level of care? Service Delivery Governance for Health Human Resources for Health Health Information Question 19 Explanation: *Rationale: Human Resources for Health refer to health professionals such as midwives, nurses and the like which could provide their needs in the community. They will be skilfully trained to be competent in the provision of health care in every familys door steps as much as possible. Question 20 WRONG Encouragement of community integration and self- reliance enhancement in the community is valued, too in this health agenda. Which of these statements indicate the correct meaning of community health team? It is a group of people composed of NGOs and private organizations It is led by the midwife in the priority population areas The rural health physician is the one who directly tracks the eligible population None of the above Question 20 Explanation: *Rationale: It is a group of health volunteers led by the midwife in the barangay. The midwife tracks the eligible population for health care services while the rural health physician only supervises the community health team. familys door steps as much as possible. Question 21 WRONG It refers to the description of disease occurrence which is constantly present in a given area. Pandemic Sporadic Endemic Epidemic Question 21 Explanation: *Rationale: The constant presence of an infectious agent within a specific area is called endemic. Pandemic refers to an epidemic which has widely spread in different places; epidemic is the occurrence of a disease condition more than as expected; and sporadic is defined as occurrence of disease in occasional periods only. Question 22 WRONG Mang Ernie came to the RHU because he was bitten by their dog. What nursing consideration is your priority? Administration of Anti- rabies vaccine Provision of dim, quiet and non- stimulating room for the client Assessment of wound for classification, severity, and other signs and symptoms Provision of isolation precautions Question 22 Explanation: *Rationale: Assessment is always prioritized in doing nursing care. There are guidelines from which the assessment of type, size, and appearance of bite is classified prior to referral to Animal Bite Center. This classification is the basis for the treatment of anti- rabies vaccine as indicated by the physician. Provision of dim and non- stimulating room and isolation precautions are only given during the later stages of rabies virus invasion in the system. Question 23

WRONG You are about to provide health teachings about pulmonary tuberculosis in your area of assignment. What diagnostic procedure is usually done early in the morning to confirm PTB? Chest X- ray Sputum Examination Bronchoscopy All of the above Question 23 Explanation: *Rationale: Sputum Examination is usually done early in the morning to detect presence of Mycobacterium Tuberculosis. Chest X- ray is another confirmatory procedure but could be done anytime of the day. On the other hand, bronchoscopy is an invasive procedure that confirms the extent of PTB. Question 24 WRONG Scarlet fever is a febrile contagious condition. Which laboratory procedure is not included in confirming scarlet fever? ASO titer Sputum Examination Throat culture Differential count of white blood cells Question 24 Explanation: *Rationale: An elevated ASO titer, positive throat culture for strep, and an increase in WBC differential count especially the eosinophils conclude the presence of scarlet fever in the system. Question 25 WRONG What skin manifestation can be observed to a child having the 3- day measle? Generalized flushing of the skin Rashes that appears on chest spreading gradually upward and downward Macupapular rashes on the cheeks (slightly elevated) Rose- red papules on the face Question 25 Explanation: *Rationale: Option A refers to DHF, B for Scarlet fever, and C for Measles.