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COMMUNITY HEALTH NURSING

1. Which is the primary goal of community A. Type of occupation: agricultural, commercial,


health nursing? industrial
A. To support and supplement the efforts of the B. Location of the workplace in relation to health
medical profession in the promotion of health facilities
and prevention of illness C. Classification of the business enterprise
B. To enhance the capacity of individuals, based on net profit
families and communities to cope with their D. Sex and age composition of employees
health needs
C. To increase the productivity of the people by Answer: (B) Location of the workplace in
providing them with services that will increase relation to health facilities
their level of health Based on R.A. 1054, an occupational nurse
D. To contribute to national development must be employed when there are 30 to 100
through promotion of family welfare, focusing employees and the workplace is more than 1
particularly on mothers and children. km. away from the nearest health center.

Answer: (B) To enhance the capacity of 5. A business firm must employ an occupational
individuals, families and communities to cope health nurse when it has at least how many
with their health needs employees?
To contribute to national development through A. 21
promotion of family welfare, focusing particularly B. 101
on mothers and children. C. 201
D. 301
2. CHN is a community-based practice. Which
best explains this statement? Answer: (B) 101
A. The service is provided in the natural Again, this is based on R.A. 1054.
environment of people.
B. The nurse has to conduct community 6. When the occupational health nurse employs
diagnosis to determine nursing needs and ergonomic principles, she is performing which of
problems. her roles?
C. The services are based on the available A. Health care provider
resources within the community. B. Health educator
D. Priority setting is based on the magnitude of C. Health care coordinator
the health problems identified. D. Environmental manager

Answer: A. The service is provided in the natural Answer: (D) Environmental manager
environment of people. Ergonomics is improving efficiency of workers
Community-based practice means providing by improving the workers environment through
care to people in their own natural appropriately designed furniture, for example.
environments: the home, school and workplace,
for example. 7. A garment factory does not have an
occupational nurse. Who shall provide the
3. Population-focused nursing practice requires occupational health needs of the factory
which of the following processes? workers?
A. Community organizing A. Occupational health nurse at the Provincial
B. Nursing process Health Office
C. Community diagnosis B. Physician employed by the factory
D. Epidemiologic process C. Public health nurse of the RHU of their
municipality
Answer: (C) Community diagnosis D. Rural sanitary inspector of the RHU of their
Population-focused nursing care means municipality
providing care based on the greater need of the
majority of the population. The greater need is Answer: (C) Public health nurse of the RHU of
identified through community diagnosis. their municipality
Youre right! This question is based on
4. R.A. 1054 is also known as the Occupational R.A.1054.
Health Act. Aside from number of employees,
what other factor must be considered in 8. Public health services are given free of
determining the occupational health privileges to charge. Is this statement true or false?
which the workers will be entitled? A. The statement is true; it is the responsibility
of government to provide basic services.
COMMUNITY HEALTH NURSING

B. The statement is false; people pay indirectly The catchment area in PHN consists of a
for public health services. residential community, many of whom are well
C. The statement may be true or false, individuals who have greater need for
depending on the specific service required. preventive rather than curative services.
D. The statement may be true or false,
depending on policies of the government 12. According to Margaret Shetland, the
concerned. philosophy of public health nursing is based on
which of the following?
Answer: (B) The statement is false; people pay A. Health and longevity as birthrights
indirectly for public health services. B. The mandate of the state to protect the
Community health services, including public birthrights of its citizens
health services, are pre-paid services, though C. Public health nursing as a specialized field of
taxation, for example. nursing
D. The worth and dignity of man
9. According to C.E.Winslow, which of the
following is the goal of Public Health? Answer: (D) The worth and dignity of man
A. For people to attain their birthrights of health This is a direct quote from Dr. Margaret
and longevity Shetlands statements on Public Health Nursing.
B. For promotion of health and prevention of
disease 13. Which of the following is the mission of the
C. For people to have access to basic health Department of Health?
services A. Health for all Filipinos
D. For people to be organized in their health B. Ensure the accessibility and quality of health
efforts care
C. Improve the general health status of the
Answer: (A) For people to attain their birthrights population
of health and longevity D. Health in the hands of the Filipino people by
According to Winslow, all public health efforts the year 2020
are for people to realize their birthrights of
health and longevity. Answer: (B) Ensure the accessibility and quality
of health care
10. We say that a Filipino has attained longevity (none)
when he is able to reach the average lifespan of
Filipinos. What other statistic may be used to 14. Region IV Hospital is classified as what level
determine attainment of longevity? of facility?
A. Age-specific mortality rate A. Primary
B. Proportionate mortality rate B. Secondary
C. Swaroops index C. Intermediate
D. Case fatality rate D. Tertiary

Answer: (C) Swaroops index Answer: (D) Tertiary


Swaroops index is the percentage of the deaths Regional hospitals are tertiary facilities because
aged 50 years or older. Its inverse represents they serve as training hospitals for the region.
the percentage of untimely deaths (those who
died younger than 50 years). 15. Which is true of primary facilities?
A. They are usually government-run.
11. Which of the following is the most prominent B. Their services are provided on an out-patient
feature of public health nursing? basis.
A. It involves providing home care to sick people C. They are training facilities for health
who are not confined in the hospital. professionals.
B. Services are provided free of charge to D. A community hospital is an example of this
people within the catchment area. level of health facilities.
C. The public health nurse functions as part of a
team providing a public health nursing services. Answer: (B) Their services are provided on an
D. Public health nursing focuses on preventive, out-patient basis.
not curative, services. Primary facilities government and non-
government facilities that provide basic out-
Answer: (D) Public health nursing focuses on patient services.
preventive, not curative, services.
COMMUNITY HEALTH NURSING

16. Which is an example of the school nurses 20. Who is the Chairman of the Municipal
health care provider functions? Health Board?
A. Requesting for BCG from the RHU for school A. Mayor
entrant immunization B. Municipal Health Officer
B. Conducting random classroom inspection C. Public Health Nurse
during a measles epidemic D. Any qualified physician
C. Taking remedial action on an accident hazard
in the school playground Answer: (A) Mayor
D. Observing places in the school where pupils The local executive serves as the chairman of
spend their free time the Municipal Health Board.

Answer: (B) Conducting random classroom 21. Which level of health facility is the usual
inspection during a measles epidemic point of entry of a client into the health care
Random classroom inspection is assessment of delivery system?
pupils/students and teachers for signs of a A. Primary
health problem prevalent in the community. B. Secondary
C. Intermediate
17. When the nurse determines whether D. Tertiary
resources were maximized in implementing
Ligtas Tigdas, she is evaluating Answer: (A) Primary
A. Effectiveness The entry of a person into the health care
B. Efficiency delivery system is usually through a consultation
C. Adequacy in out-patient services.
D. Appropriateness
22. The public health nurse is the supervisor of
Answer: (B) Efficiency rural health midwives. Which of the following is
Efficiency is determining whether the goals were a supervisory function of the public health
attained at the least possible cost. nurse?
A. Referring cases or patients to the midwife
18. You are a new B.S.N. graduate. You want to B. Providing technical guidance to the midwife
become a Public Health Nurse. Where will you C. Providing nursing care to cases referred by
apply? the midwife
A. Department of Health D. Formulating and implementing training
B. Provincial Health Office programs for midwives
C. Regional Health Office
D. Rural Health Unit Answer: (B) Providing technical guidance to the
midwife
Answer: (D) Rural Health Unit The nurse provides technical guidance to the
R.A. 7160 devolved basic health services to midwife in the care of clients, particularly in the
local government units (LGUs ). The public implementation of management guidelines, as
health nurse is an employee of the LGU. in Integrated Management of Childhood Illness.

19. R.A. 7160 mandates devolution of basic 23. One of the participants in a hilot training
services from the national government to local class asked you to whom she should refer a
government units. Which of the following is the patient in labor who develops a complication.
major goal of devolution? You will answer, to the
A. To strengthen local government units A. Public Health Nurse
B. To allow greater autonomy to local B. Rural Health Midwife
government units C. Municipal Health Officer
C. To empower the people and promote their D. Any of these health professionals
self-reliance
D. To make basic services more accessible to Answer: (C) Municipal Health Officer
the people A public health nurse and rural health midwife
can provide care during normal childbirth. A
Answer: (C) To empower the people and physician should attend to a woman with a
promote their self-reliance complication during labor.
People empowerment is the basic motivation
behind devolution of basic services to LGUs. 24. You are the public health nurse in a
municipality with a total population of about
20,000. There are 3 rural health midwives
COMMUNITY HEALTH NURSING

among the RHU personnel. How many more The community health nurse develops the
midwife items will the RHU need? health capability of people through health
A. 1 education and community organizing activities.
B. 2
C. 3 28. Which disease was declared through
D. The RHU does not need any more midwife Presidential Proclamation No. 4 as a target for
item. eradication in the Philippines?
A. Poliomyelitis
Answer: (A) 1 B. Measles
Each rural health midwife is given a population C. Rabies
assignment of about 5,000. D. Neonatal tetanus

25. If the RHU needs additional midwife items, Answer: (B) Measles
you will submit the request for additional Presidential Proclamation No. 4 is on the Ligtas
midwife items for approval to the Tigdas Program.
A. Rural Health Unit
B. District Health Office 29. The public health nurse is responsible for
C. Provincial Health Office presenting the municipal health statistics using
D. Municipal Health Board graphs and tables. To compare the frequency of
the leading causes of mortality in the
Answer: (D) Municipal Health Board municipality, which graph will you prepare?
As mandated by R.A. 7160, basic health A. Line
services have been devolved from the national B. Bar
government to local government units. C. Pie
D. Scatter diagram
26. As an epidemiologist, the nurse is
responsible for reporting cases of notifiable Answer: (B) Bar
diseases. What law mandates reporting of A bar graph is used to present comparison of
cases of notifiable diseases? values, a line graph for trends over time or age,
A. Act 3573 a pie graph for population composition or
B. R.A. 3753 distribution, and a scatter diagram for
C. R.A. 1054 correlation of two variables.
D. R.A. 1082
30. Which step in community organizing
Answer: (A) Act 3573 involves training of potential leaders in the
Act 3573, the Law on Reporting of community?
Communicable Diseases, enacted in 1929, A. Integration
mandated the reporting of diseases listed in the B. Community organization
law to the nearest health station. C. Community study
D. Core group formation
27. According to Freeman and Heinrich,
community health nursing is a developmental Answer: (D) Core group formation
service. Which of the following best illustrates In core group formation, the nurse is able to
this statement? transfer the technology of community organizing
A. The community health nurse continuously to the potential or informal community leaders
develops himself personally and professionally. through a training program.
B. Health education and community organizing
are necessary in providing community health 31. In which step are plans formulated for
services. solving community problems?
C. Community health nursing is intended A. Mobilization
primarily for health promotion and prevention B. Community organization
and treatment of disease. C. Follow-up/extension
D. The goal of community health nursing is to D. Core group formation
provide nursing services to people in their own
places of residence. Answer: (B) Community organization
Community organization is the step when
Answer: (B) Health education and community community assemblies take place. During the
organizing are necessary in providing community assembly, the people may opt to
community health services. formalize the community organization and make
COMMUNITY HEALTH NURSING

plans for community action to resolve a


community health problem. Answer: (A) Primary
The purpose of isolating a client with a
32. The public health nurse takes an active role communicable disease is to protect those who
in community participation. What is the primary are not sick (specific disease prevention).
goal of community organizing?
A. To educate the people regarding community 36. On the other hand, Operation Timbang is
health problems _____ prevention.
B. To mobilize the people to resolve community A. Primary
health problems B. Secondary
C. To maximize the communitys resources in C. Intermediate
dealing with health problems D. Tertiary
D. To maximize the communitys resources in
dealing with health problems Answer: (B) Secondary
Operation Timbang is done to identify members
Answer: (D) To maximize the communitys of the susceptible population who are
resources in dealing with health problems malnourished. Its purpose is early diagnosis
Community organizing is a developmental and, subsequently, prompt treatment.
service, with the goal of developing the peoples
self-reliance in dealing with community health 37. Which type of family-nurse contact will
problems. A, B and C are objectives of provide you with the best opportunity to observe
contributory objectives to this goal. family dynamics?
A. Clinic consultation
33. An indicator of success in community B. Group conference
organizing is when people are able to C. Home visit
A. Participate in community activities for the D. Written communication
solution of a community problem
B. Implement activities for the solution of the Answer: (C) Home visit
community problem Dynamics of family relationships can best be
C. Plan activities for the solution of the observed in the familys natural environment,
community problem which is the home.
D. Identify the health problem as a common
concern 38. The typology of family nursing problems is
used in the statement of nursing diagnosis in
Answer: (A) Participate in community activities the care of families. The youngest child of the
for the solution of a community problem de los Reyes family has been diagnosed as
Participation in community activities in resolving mentally retarded. This is classified as a
a community problem may be in any of the A. Health threat
processes mentioned in the other choices. B. Health deficit
C. Foreseeable crisis
34. Tertiary prevention is needed in which stage D. Stress point
of the natural history of disease?
A. Pre-pathogenesis Answer: (B) Health deficit
B. Pathogenesis Failure of a family member to develop according
C. Prodromal to what is expected, as in mental retardation, is
D. Terminal a health deficit.

Answer: (D) Terminal 39. The de los Reyes couple have a 6-year old
Tertiary prevention involves rehabilitation, child entering school for the first time. The de
prevention of permanent disability and disability los Reyes family has a
limitation appropriate for convalescents, the A. Health threat
disabled, complicated cases and the terminally B. Health deficit
ill (those in the terminal stage of a disease) C. Foreseeable crisis
D. Stress point
35. Isolation of a child with measles belongs to
what level of prevention? Answer: (C) Foreseeable crisis
A. Primary Entry of the 6-year old into school is an
B. Secondary anticipated period of unusual demand on the
C. Intermediate family.
D. Tertiary
COMMUNITY HEALTH NURSING

40. Which of the following is an advantage of a B. In the care of family members, as much as
home visit? possible, use only articles taken from the bag.
A. It allows the nurse to provide nursing care to C. Put on an apron to protect her uniform and
a greater number of people. fold it with the right side out before putting it
B. It provides an opportunity to do first hand back into the bag.
appraisal of the home situation. D. At the end of the visit, fold the lining on which
C. It allows sharing of experiences among the bag was placed, ensuring that the
people with similar health problems. contaminated side is on the outside.
D. It develops the familys initiative in providing
for health needs of its members. Answer: (A) Wash his/her hands before and
after providing nursing care to the family
Answer: (B) It provides an opportunity to do first members.
hand appraisal of the home situation. Choice B goes against the idea of utilizing the
Choice A is not correct since a home visit familys resources, which is encouraged in
requires that the nurse spend so much time with CHN. Choices C and D goes against the
the family. Choice C is an advantage of a group principle of asepsis of confining the
conference, while choice D is true of a clinic contaminated surface of objects.
consultation.
44. The public health nurse conducts a study on
41. Which is CONTRARY to the principles in the factors contributing to the high mortality rate
planning a home visit? due to heart disease in the municipality where
A. A home visit should have a purpose or she works. Which branch of epidemiology does
objective. the nurse practice in this situation?
B. The plan should revolve around family health A. Descriptive
needs. B. Analytical
C. A home visit should be conducted in the C. Therapeutic
manner prescribed by the RHU. D. Evaluation
D. Planning of continuing care should involve a
responsible family member. Answer: (B) Analytical
Analytical epidemiology is the study of factors or
Answer: (C) A home visit should be conducted determinants affecting the patterns of
in the manner prescribed by the RHU. occurrence and distribution of disease in a
The home visit plan should be flexible and community.
practical, depending on factors, such as the
familys needs and the resources available to 45. Which of the following is a function of
the nurse and the family. epidemiology?
A. Identifying the disease condition based on
42. The PHN bag is an important tool in manifestations presented by a client
providing nursing care during a home visit. The B. Determining factors that contributed to the
most important principle of bag technique states occurrence of pneumonia in a 3 year old
that it C. Determining the efficacy of the antibiotic
A. Should save time and effort. used in the treatment of the 3 year old client
B. Should minimize if not totally prevent the with pneumonia
spread of infection. D. Evaluating the effectiveness of the
C. Should not overshadow concern for the implementation of the Integrated Management
patient and his family. of Childhood Illness
D. May be done in a variety of ways depending
on the home situation, etc. Answer: (D) Evaluating the effectiveness of the
implementation of the Integrated Management
Answer: (B) Should minimize if not totally of Childhood Illness
prevent the spread of infection. Epidemiology is used in the assessment of a
Bag technique is performed before and after community or evaluation of interventions in
handling a client in the home to prevent community health practice.
transmission of infection to and from the client.
46. Which of the following is an epidemiologic
43. To maintain the cleanliness of the bag and function of the nurse during an epidemic?
its contents, which of the following must the A. Conducting assessment of suspected cases
nurse do? to detect the communicable disease
A. Wash his/her hands before and after B. Monitoring the condition of the cases affected
providing nursing care to the family members. by the communicable disease
COMMUNITY HEALTH NURSING

C. Participating in the investigation to determine done by comparing the present number of


the source of the epidemic cases with the usual number of cases of the
D. Teaching the community on preventive disease at the same time of the year, as well as
measures against the disease establishing the relatedness of the cases of the
disease.
Answer: (C) Participating in the investigation to
determine the source of the epidemic 50. The number of cases of Dengue fever
Epidemiology is the study of patterns of usually increases towards the end of the rainy
occurrence and distribution of disease in the season. This pattern of occurrence of Dengue
community, as well as the factors that affect fever is best described as
disease patterns. The purpose of an A. Epidemic occurrence
epidemiologic investigation is to identify the B. Cyclical variation
source of an epidemic, i.e., what brought about C. Sporadic occurrence
the epidemic. D. Secular variation

47. The primary purpose of conducting an Answer: (B) Cyclical variation


epidemiologic investigation is to A cyclical variation is a periodic fluctuation in the
A. Delineate the etiology of the epidemic number of cases of a disease in the community.
B. Encourage cooperation and support of the
community 51. In the year 1980, the World Health
C. Identify groups who are at risk of contracting Organization declared the Philippines, together
the disease with some other countries in the Western Pacific
D. Identify geographical location of cases of the Region, free of which disease?
disease in the community A. Pneumonic plague
B. Poliomyelitis
Answer: (A) Delineate the etiology of the C. Small pox
epidemic D. Anthrax
Delineating the etiology of an epidemic is
identifying its source. Answer: (C) Small pox
The last documented case of Small pox was in
48. Which is a characteristic of person-to- 1977 at Somalia.
person propagated epidemics?
A. There are more cases of the disease than 52. In the census of the Philippines in 1995,
expected. there were about 35,299,000 males and about
B. The disease must necessarily be transmitted 34,968,000 females. What is the sex ratio?
through a vector. A. 99.06:100
C. The spread of the disease can be attributed B. 100.94:100
to a common vehicle. C. 50.23%
D. There is a gradual build up of cases before D. 49.76%
the epidemic becomes easily noticeable.
Answer: (B) 100.94:100
Answer: (D) There is a gradual build up of cases Sex ratio is the number of males for every 100
before the epidemic becomes easily noticeable. females in the population.
A gradual or insidious onset of the epidemic is
usually observable in person-to-person 53. Primary health care is a total approach to
propagated epidemics. community development. Which of the following
is an indicator of success in the use of the
49. In the investigation of an epidemic, you primary health care approach?
compare the present frequency of the disease A. Health services are provided free of charge
with the usual frequency at this time of the year to individuals and families.
in this community. This is done during which B. Local officials are empowered as the major
stage of the investigation? decision makers in matters of health.
A. Establishing the epidemic C. Health workers are able to provide care
B. Testing the hypothesis based on identified health needs of the people.
C. Formulation of the hypothesis D. Health programs are sustained according to
D. Appraisal of facts the level of development of the community.

Answer: (A) Establishing the epidemic Answer: (D) Health programs are sustained
Establishing the epidemic is determining according to the level of development of the
whether there is an epidemic or not. This is community.
COMMUNITY HEALTH NURSING

Primary health care is essential health care that B. Letter of Instruction No. 949
can be sustained in all stages of development of C. Presidential Decree No. 147
the community. D. Presidential Decree 996

54. Sputum examination is the major screening Answer: (B) Letter of Instruction No. 949
tool for pulmonary tuberculosis. Clients would Letter of Instruction 949 was issued by then
sometimes get false negative results in this President Ferdinand Marcos, directing the
exam. This means that the test is not perfect in formerly called Ministry of Health, now the
terms of which characteristic of a diagnostic Department of Health, to utilize Primary Health
examination? Care approach in planning and implementing
A. Effectiveness health programs.
B. Efficacy
C. Specificity 59. Which of the following demonstrates
D. Sensitivity intersectoral linkages?
A. Two-way referral system
Answer: (D) Sensitivity B. Team approach
Sensitivity is the capacity of a diagnostic C. Endorsement done by a midwife to another
examination to detect cases of the disease. If a midwife
test is 100% sensitive, all the cases tested will D. Cooperation between the PHN and public
have a positive result, i.e., there will be no false school teacher
negative results.
Answer: (D) Cooperation between the PHN and
55. Use of appropriate technology requires public school teacher
knowledge of indigenous technology. Which Intersectoral linkages refer to working
medicinal herb is given for fever, headache and relationships between the health sector and
cough? other sectors involved in community
A. Sambong development.
B. Tsaang gubat
C. Akapulko 60. The municipality assigned to you has a
D. Lagundi population of about 20,000. Estimate the
number of 1-4 year old children who will be
Answer: (D) Lagundi given Retinol capsule 200,000 I.U. every 6
Sambong is used as a diuretic. Tsaang gubat is months.
used to relieve diarrhea. Akapulko is used for its A. 1,500
antifungal property. B. 1,800
C. 2,000
56. What law created the Philippine Institute of D. 2,300
Traditional and Alternative Health Care?
A. R.A. 8423 Answer: (D) 2,300
B. R.A. 4823 Based on the Philippine population composition,
C. R.A. 2483 to estimate the number of 1-4 year old children,
D. R.A. 3482 multiply total population by 11.5%.

Answer: (A) R.A. 8423 61. Estimate the number of pregnant women
(none) who will be given tetanus toxoid during an
immunization outreach activity in a barangay
57. In traditional Chinese medicine, the yielding, with a population of about 1,500.
negative and feminine force is termed A. 265
A. Yin B. 300
B. Yang C. 375
C. Qi D. 400
D. Chai
Answer: (A) 265
Answer: (A) Yin To estimate the number of pregnant women,
Yang is the male dominating, positive and multiply the total population by 3.5%.
masculine force.
62. To describe the sex composition of the
58. What is the legal basis for Primary Health population, which demographic tool may be
Care approach in the Philippines? used?
A. Alma Ata Declaration on PHC A. Sex ratio
COMMUNITY HEALTH NURSING

B. Sex proportion
C. Population pyramid Answer: (C) Swaroops index
D. Any of these may be used. Swaroops index is the proportion of deaths
aged 50 years and above. The higher the
Answer: (D) Any of these may be used. Swaroops index of a population, the greater the
Sex ratio and sex proportion are used to proportion of the deaths who were able to reach
determine the sex composition of a population. the age of at least 50 years, i.e., more people
A population pyramid is used to present the grew old before they died.
composition of a population by age and sex.
67. In the past year, Barangay A had an average
63. Which of the following is a natality rate? population of 1655. 46 babies were born in that
A. Crude birth rate year, 2 of whom died less than 4 weeks after
B. Neonatal mortality rate they were born. There were 4 recorded
C. Infant mortality rate stillbirths. What is the neonatal mortality rate?
D. General fertility rate A. 27.8/1,000
B. 43.5/1,000
Answer: (A) Crude birth rate C. 86.9/1,000
Natality means birth. A natality rate is a birth D. 130.4/1,000
rate.
Answer: (B) 43.5/1,000
64. You are computing the crude death rate of To compute for neonatal mortality rate, divide
your municipality, with a total population of the number of babies who died before reaching
about 18,000, for last year. There were 94 the age of 28 days by the total number of live
deaths. Among those who died, 20 died births, then multiply by 1,000.
because of diseases of the heart and 32 were
aged 50 years or older. What is the crude death 68. Which statistic best reflects the nutritional
rate? status of a population?
A. 4.2/1,000 A. 1-4 year old age-specific mortality rate
B. 5.2/1,000 B. Proportionate mortality rate
C. 6.3/1,000 C. Infant mortality rate
D. 7.3/1,000 D. Swaroops index

Answer: (B) 5.2/1,000 Answer: (A) 1-4 year old age-specific mortality
To compute crude death rate divide total rate
number of deaths (94) by total population Since preschoolers are the most susceptible to
(18,000) and multiply by 1,000. the effects of malnutrition, a population with
poor nutritional status will most likely have a
65. Knowing that malnutrition is a frequent high 1-4 year old age-specific mortality rate,
community health problem, you decided to also known as child mortality rate.
conduct nutritional assessment. What
population is particularly susceptible to protein 69. What numerator is used in computing
energy malnutrition (PEM)? general fertility rate?
A. Pregnant women and the elderly A. Estimated midyear population
B. Under-5 year old children B. Number of registered live births
C. 1-4 year old children C. Number of pregnancies in the year
D. School age children D. Number of females of reproductive age

Answer: (C) 1-4 year old children Answer: (B) Number of registered live births
Preschoolers are the most susceptible to PEM To compute for general or total fertility rate,
because they have generally been weaned. divide the number of registered live births by the
Also, this is the population who, unable to feed number of females of reproductive age (15-45
themselves, are often the victims of poor years), then multiply by 1,000.
intrafamilial food distribution.
70. You will gather data for nutritional
66. Which statistic can give the most accurate assessment of a purok. You will gather
reflection of the health status of a community? information only from families with members
A. 1-4 year old age-specific mortality rate who belong to the target population for PEM.
B. Infant mortality rate What method of data gathering is best for this
C. Swaroops index purpose?
D. Crude death rate A. Census
COMMUNITY HEALTH NURSING

B. Survey P.D. 651 amended R.A. 3753, requiring the


C. Record review registry of births within 30 days from their
D. Review of civil registry occurrence.

Answer: (B) Survey 75. Which of the following professionals can


A survey, also called sample survey, is data sign the birth certificate?
gathering about a sample of the population. A. Public health nurse
B. Rural health midwife
71. In the conduct of a census, the method of C. Municipal health officer
population assignment based on the actual D. Any of these health professionals
physical location of the people is termed
A. De jure Answer: (D) Any of these health professionals
B. De locus D. R.A. 3753 states that any birth attendant may
C. De facto sign the certificate of live birth.
D. De novo
76. Which criterion in priority setting of health
Answer: (C) De facto problems is used only in community health
The other method of population assignment, de care?
jure, is based on the usual place of residence of A. Modifiability of the problem
the people. B. Nature of the problem presented
C. Magnitude of the health problem
72. The Field Health Services and Information D. Preventive potential of the health problem
System (FHSIS) is the recording and reporting
system in public health care in the Philippines. Answer: (C) Magnitude of the health problem
The Monthly Field Health Service Activity Report Magnitude of the problem refers to the
is a form used in which of the components of percentage of the population affected by a
the FHSIS? health problem. The other choices are criteria
A. Tally report considered in both family and community health
B. Output report care.
C. Target/client list
D. Individual health record 77. The Sentrong Sigla Movement has been
launched to improve health service delivery.
Answer: (A) Tally report Which of the following is/are true of this
A tally report is prepared monthly or quarterly by movement?
the RHU personnel and transmitted to the A. This is a project spearheaded by local
Provincial Health Office. government units.
B. It is a basis for increasing funding from local
73. To monitor clients registered in long-term government units.
regimens, such as the Multi-Drug Therapy, C. It encourages health centers to focus on
which component will be most useful? disease prevention and control.
A. Tally report D. Its main strategy is certification of health
B. Output report centers able to comply with standards.
C. Target/client list
D. Individual health record Answer: (D) Its main strategy is certification of
health centers able to comply with standards.
Answer: (C) Target/client list Sentrong Sigla Movement is a joint project of
The MDT Client List is a record of clients the DOH and local government units. Its main
enrolled in MDT and other relevant data, such strategy is certification of health centers that are
as dates when clients collected their monthly able to comply with standards set by the DOH.
supply of drugs.
78. Which of the following women should be
74. Civil registries are important sources of considered as special targets for family
data. Which law requires registration of births planning?
within 30 days from the occurrence of the birth? A. Those who have two children or more
A. P.D. 651 B. Those with medical conditions such as
B. Act 3573 anemia
C. R.A. 3753 C. Those younger than 20 years and older than
D. R.A. 3375 35 years
D. Those who just had a delivery within the past
Answer: (A) P.D. 651 15 months
COMMUNITY HEALTH NURSING

B. Riboflavin
Answer: (D) Those who just had a delivery C. Folic acid
within the past 15 months D. Thiamine
The ideal birth spacing is at least two years. 15
months plus 9 months of pregnancy = 2 years. Answer: (C) Folic acid
It is estimated that the incidence of neural tube
79. Freedom of choice is one of the policies of defects can be reduced drastically if pregnant
the Family Planning Program of the Philippines. women have an adequate intake of folic acid.
Which of the following illustrates this principle?
A. Information dissemination about the need for 83. You are in a clients home to attend to a
family planning delivery. Which of the following will you do first?
B. Support of research and development in A. Set up the sterile area.
family planning methods B. Put on a clean gown or apron.
C. Adequate information for couples regarding C. Cleanse the clients vulva with soap and
the different methods water.
D. Encouragement of couples to take family D. Note the interval, duration and intensity of
planning as a joint responsibility labor contractions.

Answer: (C) Adequate information for couples Answer: (D) Note the interval, duration and
regarding the different methods intensity of labor contractions.
To enable the couple to choose freely among Assessment of the woman should be done first
different methods of family planning, they must to determine whether she is having true labor
be given full information regarding the different and, if so, what stage of labor she is in.
methods that are available to them, considering
the availability of quality services that can 84. In preparing a primigravida for
support their choice. breastfeeding, which of the following will you
do?
80. A woman, 6 months pregnant, came to the A. Tell her that lactation begins within a day
center for consultation. Which of the following after delivery.
substances is contraindicated? B. Teach her nipple stretching exercises if her
A. Tetanus toxoid nipples are everted.
B. Retinol 200,000 IU C. Instruct her to wash her nipples before and
C. Ferrous sulfate 200 mg after each breastfeeding.
D. Potassium iodate 200 mg. capsule D. Explain to her that putting the baby to breast
will lessen blood loss after delivery.
Answer: (B) Retinol 200,000 IU
Retinol 200,000 IU is a form of megadose Answer: (D) Explain to her that putting the baby
Vitamin A. This may have a teratogenic effect. to breast will lessen blood loss after delivery.
Suckling of the nipple stimulates the release of
81. During prenatal consultation, a client asked oxytocin by the posterior pituitary gland, which
you if she can have her delivery at home. After causes uterine contraction. Lactation begins 1
history taking and physical examination, you to 3 days after delivery. Nipple stretching
advised her against a home delivery. Which of exercises are done when the nipples are flat or
the following findings disqualifies her for a home inverted. Frequent washing dries up the nipples,
delivery? making them prone to the formation of fissures.
A. Her OB score is G5P3.
B. She has some palmar pallor. 85. A primigravida is instructed to offer her
C. Her blood pressure is 130/80. breast to the baby for the first time within 30
D. Her baby is in cephalic presentation. minutes after delivery. What is the purpose of
offering the breast this early?
Answer: (A) Her OB score is G5P3. A. To initiate the occurrence of milk letdown
Only women with less than 5 pregnancies are B. To stimulate milk production by the mammary
qualified for a home delivery. It is also advisable acini
for a primigravida to have delivery at a childbirth C. To make sure that the baby is able to get the
facility. colostrum
D. To allow the woman to practice breastfeeding
82. Inadequate intake by the pregnant woman in the presence of the health worker
of which vitamin may cause neural tube
defects? Answer: (B) To stimulate milk production by the
A. Niacin mammary acini
COMMUNITY HEALTH NURSING

Suckling of the nipple stimulates prolactin reflex OPV are highly sensitive to heat, requiring
(the release of prolactin by the anterior pituitary storage in the freezer.
gland), which initiates lactation.
90. Unused BCG should be discarded how
86. In a mothers class, you discuss proper many hours after reconstitution?
breastfeeding technique. Which is of these is a A. 2
sign that the baby has latched on to the breast B. 4
properly? C. 6
A. The baby takes shallow, rapid sucks. D. At the end of the day
B. The mother does not feel nipple pain.
C. The babys mouth is only partly open. Answer: (B) 4
D. Only the mothers nipple is inside the babys While the unused portion of other biologicals in
mouth. EPI may be given until the end of the day, only
BCG is discarded 4 hours after reconstitution.
Answer: (B) The mother does not feel nipple This is why BCG immunization is scheduled
pain. only in the morning.
When the baby has properly latched on to the
breast, he takes deep, slow sucks; his mouth is 91. In immunizing school entrants with BCG,
wide open; and much of the areola is inside his you are not obliged to secure parental consent.
mouth. And, youre right! The mother does not This is because of which legal document?
feel nipple pain. A. P.D. 996
B. R.A. 7846
87. You explain to a breastfeeding mother that C. Presidential Proclamation No. 6
breast milk is sufficient for all of the babys D. Presidential Proclamation No. 46
nutrient needs only up to ____.
A. 3 months Answer: (A) P.D. 996
B. 6 months Presidential Decree 996, enacted in 1976, made
C. 1 year immunization in the EPI compulsory for children
D. 2 years under 8 years of age. Hepatitis B vaccination
was made compulsory for the same age group
Answer: (B) 6 months by R.A. 7846.
After 6 months, the babys nutrient needs,
especially the babys iron requirement, can no 92. Which immunization produces a permanent
longer be provided by mothers milk alone. scar?
A. DPT
88. What is given to a woman within a month B. BCG
after the delivery of a baby? C. Measles vaccination
A. Malunggay capsule D. Hepatitis B vaccination
B. Ferrous sulfate 100 mg. OD
C. Retinol 200,000 I.U., 1 capsule Answer: (B) BCG
D. Potassium iodate 200 mg, 1 capsule BCG causes the formation of a superficial
abscess, which begins 2 weeks after
Answer: (C) Retinol 200,000 I.U., 1 capsule immunization. The abscess heals without
A capsule of Retinol 200,000 IU is given within 1 treatment, with the formation of a permanent
month after delivery. Potassium iodate is given scar.
during pregnancy; malunggay capsule is not
routinely administered after delivery; and ferrous 93. A 4-week old baby was brought to the health
sulfate is taken for two months after delivery. center for his first immunization. Which can be
given to him?
89. Which biological used in Expanded Program A. DPT1
on Immunization (EPI) is stored in the freezer? B. OPV1
A. DPT C. Infant BCG
B. Tetanus toxoid D. Hepatitis B vaccine 1
C. Measles vaccine
D. Hepatitis B vaccine Answer: (C) Infant BCG
Infant BCG may be given at birth. All the other
Answer: (C) Measles vaccine immunizations mentioned can be given at 6
Among the biologicals used in the Expanded weeks of age.
Program on Immunization, measles vaccine and
COMMUNITY HEALTH NURSING

94. You will not give DPT 2 if the mother says Answer: (C) Normal
that the infant had In IMCI, a respiratory rate of 50/minute or more
A. Seizures a day after DPT 1. is fast breathing for an infant aged 2 to 12
B. Fever for 3 days after DPT 1. months.
C. Abscess formation after DPT 1.
D. Local tenderness for 3 days after DPT 1. 98. Which of the following signs will indicate that
a young child is suffering from severe
Answer: (A) Seizures a day after DPT 1. pneumonia?
Seizures within 3 days after administration of A. Dyspnea
DPT is an indication of hypersensitivity to B. Wheezing
pertussis vaccine, a component of DPT. This is C. Fast breathing
considered a specific contraindication to D. Chest indrawing
subsequent doses of DPT.
Answer: (D) Chest indrawing
95. A 2-month old infant was brought to the In IMCI, chest indrawing is used as the positive
health center for immunization. During sign of dyspnea, indicating severe pneumonia.
assessment, the infants temperature registered
at 38.1C. Which is the best course of action 99. Using IMCI guidelines, you classify a child
that you will take? as having severe pneumonia. What is the best
A. Go on with the infants immunizations. management for the child?
B. Give Paracetamol and wait for his fever to A. Prescribe an antibiotic.
subside. B. Refer him urgently to the hospital.
C. Refer the infant to the physician for further C. Instruct the mother to increase fluid intake.
assessment. D. Instruct the mother to continue breastfeeding.
D. Advise the infants mother to bring him back
for immunization when he is well. Answer: (B) Refer him urgently to the hospital.
Severe pneumonia requires urgent referral to a
Answer: (A) Go on with the infants hospital. Answers A, C and D are done for a
immunizations. client classified as having pneumonia.
In the EPI, fever up to 38.5C is not a
contraindication to immunization. Mild acute 100. A 5-month old infant was brought by his
respiratory tract infection, simple diarrhea and mother to the health center because of diarrhea
malnutrition are not contraindications either. occurring 4 to 5 times a day. His skin goes back
slowly after a skin pinch and his eyes are
96. A pregnant woman had just received her 4th sunken. Using the IMCI guidelines, you will
dose of tetanus toxoid. Subsequently, her baby classify this infant in which category?
will have protection against tetanus for how A. No signs of dehydration
long? B. Some dehydration
A. 1 year C. Severe dehydration
B. 3 years D. The data is insufficient.
C. 10 years
D. Lifetime Answer: (B) Some dehydration
Using the assessment guidelines of IMCI, a
Answer: (A) 1 year child (2 months to 5 years old) with diarrhea is
The baby will have passive natural immunity by classified as having SOME DEHYDRATION if
placental transfer of antibodies. The mother will he shows 2 or more of the following signs:
have active artificial immunity lasting for about restless or irritable, sunken eyes, the skin goes
10 years. 5 doses will give the mother lifetime back slow after a skin pinch.
protection.

97. A 4-month old infant was brought to the 101. Based on assessment, you classified a 3-
health center because of cough. Her respiratory month old infant with the chief complaint of
rate is 42/minute. Using the Integrated diarrhea in the category of SOME
Management of Child Illness (IMCI) guidelines DEHYDRATION. Based on IMCI management
of assessment, her breathing is considered guidelines, which of the following will you do?
A. Fast A. Bring the infant to the nearest facility where
B. Slow IV fluids can be given.
C. Normal B. Supervise the mother in giving 200 to 400 ml.
D. Insignificant of Oresol in 4 hours.
COMMUNITY HEALTH NURSING

C. Give the infants mother instructions on home C. Make a teaching plan for the mother,
management. focusing on menu planning for her child.
D. Keep the infant in your health center for close D. Assess and treat the child for health
observation. problems like infections and intestinal
Answer: (B) Supervise the mother in giving 200 parasitism.
to 400 ml. of Oresol in 4 hours.
In the IMCI management guidelines, SOME Answer: (A) Refer the child urgently to a
DEHYDRATION is treated with the hospital for confinement.
administration of Oresol within a period of 4 Baggy pants is a sign of severe marasmus.
hours. The amount of Oresol is best computed The best management is urgent referral to a
on the basis of the childs weight (75 ml/kg body hospital.
weight). If the weight is unknown, the amount of
Oresol is based on the childs age. 105. During the physical examination of a young
child, what is the earliest sign of xerophthalmia
102. A mother is using Oresol in the that you may observe?
management of diarrhea of her 3-year old child. A. Keratomalacia
She asked you what to do if her child vomits. B. Corneal opacity
You will tell her to C. Night blindness
A. Bring the child to the nearest hospital for D. Conjunctival xerosis
further assessment.
B. Bring the child to the health center for Answer: (D) Conjunctival xerosis
intravenous fluid therapy. The earliest sign of Vitamin A deficiency
C. Bring the child to the health center for (xerophthalmia) is night blindness. However,
assessment by the physician. this is a functional change, which is not
D. Let the child rest for 10 minutes then observable during physical examination.The
continue giving Oresol more slowly. earliest visible lesion is conjunctival xerosis or
dullness of the conjunctiva due to inadequate
Answer: (D) Let the child rest for 10 minutes tear production.
then continue giving Oresol more slowly.
If the child vomits persistently, that is, he vomits 106. To prevent xerophthalmia, young children
everything that he takes in, he has to be are given Retinol capsule every 6 months. What
referred urgently to a hospital. Otherwise, is the dose given to preschoolers?
vomiting is managed by letting the child rest for A. 10,000 IU
10 minutes and then continuing with Oresol B. 20,000 IU
administration. Teach the mother to give Oresol C. 100,000 IU
more slowly. D. 200,000 IU

103. A 1 year old child was classified as Answer: (D) 200,000 IU


having 3rd degree protein energy malnutrition, Preschoolers are given Retinol 200,000 IU
kwashiorkor. Which of the following signs will be every 6 months. 100,000 IU is given once to
most apparent in this child? infants aged 6 to 12 months. The dose for
A. Voracious appetite pregnant women is 10,000 IU.
B. Wasting
C. Apathy 107. The major sign of iron deficiency anemia is
D. Edema pallor. What part is best examined for pallor?
A. Palms
Answer: (D) Edema B. Nailbeds
Edema, a major sign of kwashiorkor, is caused C. Around the lips
by decreased colloidal osmotic pressure of the D. Lower conjunctival sac
blood brought about by hypoalbuminemia.
Decreased blood albumin level is due a protein- Answer: (A) Palms
deficient diet. The anatomic characteristics of the palms allow
a reliable and convenient basis for examination
104. Assessment of a 2-year old child revealed for pallor.
baggy pants. Using the IMCI guidelines, how 108. Food fortification is one of the strategies to
will you manage this child? prevent micronutrient deficiency conditions. R.A.
A. Refer the child urgently to a hospital for 8976 mandates fortification of certain food
confinement. items. Which of the following is among these
B. Coordinate with the social worker to enroll food items?
the child in a feeding program. A. Sugar
COMMUNITY HEALTH NURSING

B. Bread given 200,000 IU regardless of when the last


C. Margarine dose was given.
D. Filled milk
112. A mother brought her 10 month old infant
Answer: (A) Sugar for consultation because of fever, which started
R.A. 8976 mandates fortification of rice, wheat 4 days prior to consultation. To determine
flour, sugar and cooking oil with Vitamin A, iron malaria risk, what will you do?
and/or iodine. A. Do a tourniquet test.
B. Ask where the family resides.
109. What is the best course of action when C. Get a specimen for blood smear.
there is a measles epidemic in a nearby D. Ask if the fever is present everyday.
municipality?
A. Give measles vaccine to babies aged 6 to 8 Answer: (B) Ask where the family resides.
months. Because malaria is endemic, the first question
B. Give babies aged 6 to 11 months one dose of to determine malaria risk is where the clients
100,000 I.U. of Retinol family resides. If the area of residence is not a
C. Instruct mothers to keep their babies at home known endemic area, ask if the child had
to prevent disease transmission. traveled within the past 6 months, where he/she
D. Instruct mothers to feed their babies was brought and whether he/she stayed
adequately to enhance their babies resistance. overnight in that area.

Answer: (A) Give measles vaccine to babies 113. The following are strategies implemented
aged 6 to 8 months. by the Department of Health to prevent
Ordinarily, measles vaccine is given at 9 months mosquito-borne diseases. Which of these is
of age. During an impending epidemic, however, most effective in the control of Dengue fever?
one dose may be given to babies aged 6 to 8 A. Stream seeding with larva-eating fish
months. The mother is instructed that the baby B. Destroying breeding places of mosquitoes
needs another dose when the baby is 9 months C. Chemoprophylaxis of non-immune persons
old. going to endemic areas
D. Teaching people in endemic areas to use
110. A mother brought her daughter, 4 years old, chemically treated mosquito nets
to the RHU because of cough and colds.
Following the IMCI assessment guide, which of Answer: (B) Destroying breeding places of
the following is a danger sign that indicates the mosquitoes
need for urgent referral to a hospital? Aedes aegypti, the vector of Dengue fever,
A. Inability to drink breeds in stagnant, clear water. Its feeding time
B. High grade fever is usually during the daytime. It has a cyclical
C. Signs of severe dehydration pattern of occurrence, unlike malaria which is
D. Cough for more than 30 days endemic in certain parts of the country.

Answer: (A) Inability to drink 114. Secondary prevention for malaria includes
A sick child aged 2 months to 5 years must be A. Planting of neem or eucalyptus trees
referred urgently to a hospital if he/she has one B. Residual spraying of insecticides at night
or more of the following signs: not able to feed C. Determining whether a place is endemic or
or drink, vomits everything, convulsions, not
abnormally sleepy or difficult to awaken. D. Growing larva-eating fish in mosquito
breeding places
111. Management of a child with measles
includes the administration of which of the Answer: (C) Determining whether a place is
following? endemic or not
A. Gentian violet on mouth lesions This is diagnostic and therefore secondary level
B. Antibiotics to prevent pneumonia prevention. The other choices are for primary
C. Tetracycline eye ointment for corneal opacity prevention.
D. Retinol capsule regardless of when the last
dose was given 115. Scotch tape swab is done to check for
which intestinal parasite?
Answer: (D) Retinol capsule regardless of when A. Ascaris
the last dose was given B. Pinworm
An infant 6 to 12 months classified as a case of C. Hookworm
measles is given Retinol 100,000 IU; a child is D. Schistosoma
COMMUNITY HEALTH NURSING

A. Macular lesions
Answer: (B) Pinworm B. Inability to close eyelids
Pinworm ova are deposited around the anal C. Thickened painful nerves
orifice. D. Sinking of the nosebridge

116. Which of the following signs indicates the Answer: (C) Thickened painful nerves
need for sputum examination for AFB? The lesion of leprosy is not macular. It is
A. Hematemesis characterized by a change in skin color (either
B. Fever for 1 week reddish or whitish) and loss of sensation,
C. Cough for 3 weeks sweating and hair growth over the lesion.
D. Chest pain for 1 week Inability to close the eyelids (lagophthalmos)
and sinking of the nosebridge are late
Answer: (C) Cough for 3 weeks symptoms.
A client is considered a PTB suspect when he
has cough for 2 weeks or more, plus one or 120. Which of the following clients should be
more of the following signs: fever for 1 month or classified as a case of multibacillary leprosy?
more; chest pain lasting for 2 weeks or more not A. 3 skin lesions, negative slit skin smear
attributed to other conditions; progressive, B. 3 skin lesions, positive slit skin smear
unexplained weight loss; night sweats; and C. 5 skin lesions, negative slit skin smear
hemoptysis. D. 5 skin lesions, positive slit skin smear

117. Which clients are considered targets for Answer: (D) 5 skin lesions, positive slit skin
DOTS Category I? smear
A. Sputum negative cavitary cases A multibacillary leprosy case is one who has a
B. Clients returning after a default positive slit skin smear and at least 5 skin
C. Relapses and failures of previous PTB lesions.
treatment regimens
D. Clients diagnosed for the first time through a 121. In the Philippines, which condition is the
positive sputum exam most frequent cause of death associated with
schistosomiasis?
Answer: (D) Clients diagnosed for the first time A. Liver cancer
through a positive sputum exam B. Liver cirrhosis
Category I is for new clients diagnosed by C. Bladder cancer
sputum examination and clients diagnosed to D. Intestinal perforation
have a serious form of extrapulmonary
tuberculosis, such as TB osteomyelitis. Answer: (B) Liver cirrhosis
The etiologic agent of schistosomiasis in the
118. To improve compliance to treatment, what Philippines is Schistosoma japonicum, which
innovation is being implemented in DOTS? affects the small intestine and the liver. Liver
A. Having the health worker follow up the client damage is a consequence of fibrotic reactions
at home to schistosoma eggs in the liver.
B. Having the health worker or a responsible
family member monitor drug intake 122. What is the most effective way of
C. Having the patient come to the health center controlling schistosomiasis in an endemic area?
every month to get his medications A. Use of molluscicides
D. Having a target list to check on whether the B. Building of foot bridges
patient has collected his monthly supply of C. Proper use of sanitary toilets
drugs D. Use of protective footwear, such as rubber
boots
Answer: (B) Having the health worker or a
responsible family member monitor drug intake Answer: (C) Proper use of sanitary toilets
Directly Observed Treatment Short Course is The ova of the parasite get out of the human
so-called because a treatment partner, body together with feces. Cutting the cycle at
preferably a health worker accessible to the this stage is the most effective way of
client, monitors the clients compliance to the preventing the spread of the disease to
treatment. susceptible hosts.

119. Diagnosis of leprosy is highly dependent 123. When residents obtain water from an
on recognition of symptoms. Which of the artesian well in the neighborhood, the level of
following is an early sign of leprosy? this approved type of water facility is
COMMUNITY HEALTH NURSING

A. I C. Severe pneumonia
B. II D. Severe febrile disease
C. III
D. IV Answer: (B) Severe dehydration
The order of priority in the management of
Answer: (B) II severe dehydration is as follows: intravenous
A communal faucet or water standpost is fluid therapy, referral to a facility where IV fluids
classified as Level II. can be initiated within 30 minutes,
Oresol/nasogastric tube, Oresol/orem. When
124. For prevention of hepatitis A, you decided the foregoing measures are not possible or
to conduct health education activities. Which of effective, tehn urgent referral to the hospital is
the following is IRRELEVANT? done.
A. Use of sterile syringes and needles
B. Safe food preparation and food handling by 129. A client was diagnosed as having Dengue
vendors fever. You will say that there is slow capillary
C. Proper disposal of human excreta and refill when the color of the nailbed that you
personal hygiene pressed does not return within how many
D. Immediate reporting of water pipe leaks and seconds?
illegal water connections A. 3
B. 5
Answer: (A) Use of sterile syringes and needles C. 8
Hepatitis A is transmitted through the fecal oral D. 10
route. Hepatitis B is transmitted through infected
body secretions like blood and semen. Answer: (A) 3
Adequate blood supply to the area allows the
126. Which biological used in Expanded return of the color of the nailbed within 3
Program on Immunization (EPI) should NOT be seconds.
stored in the freezer?
A. DPT 130. A 3-year old child was brought by his
B. Oral polio vaccine mother to the health center because of fever of
C. Measles vaccine 4-day duration. The child had a positive
D. MMR tourniquet test result. In the absence of other
signs, which is the most appropriate measure
Answer: (A) DPT that the PHN may carry out to prevent Dengue
DPT is sensitive to freezing. The appropriate shock syndrome?
storage temperature of DPT is 2 to 8 C only. A. Insert an NGT and give fluids per NGT.
OPV and measles vaccine are highly sensitive B. Instruct the mother to give the child Oresol.
to heat and require freezing. MMR is not an C. Start the patient on intravenous fluids STAT.
immunization in the Expanded Program on D. Refer the client to the physician for
Immunization. appropriate management.

127. You will conduct outreach immunization in Answer: (B) Instruct the mother to give the child
a barangay with a population of about 1500. Oresol.
Estimate the number of infants in the barangay. Since the child does not manifest any other
A. 45 danger sign, maintenance of fluid balance and
B. 50 replacement of fluid loss may be done by giving
C. 55 the client Oresol.
D. 60
131. The pathognomonic sign of measles is
Answer: (A) 45 Kopliks spot. You may see Kopliks spot by
To estimate the number of infants, multiply total inspecting the _____.
population by 3%. A. Nasal mucosa
B. Buccal mucosa
128. In Integrated Management of Childhood C. Skin on the abdomen
Illness, severe conditions generally require D. Skin on the antecubital surface
urgent referral to a hospital. Which of the
following severe conditions DOES NOT always Answer: (B) Buccal mucosa
require urgent referral to a hospital? Kopliks spot may be seen on the mucosa of the
A. Mastoiditis mouth or the throat.
B. Severe dehydration
COMMUNITY HEALTH NURSING

132. Among the following diseases, which is


airborne? 136. Mosquito-borne diseases are prevented
A. Viral conjunctivitis mostly with the use of mosquito control
B. Acute poliomyelitis measures. Which of the following is NOT
C. Diphtheria appropriate for malaria control?
D. Measles A. Use of chemically treated mosquito nets
B. Seeding of breeding places with larva-eating
Answer: (D) Measles fish
Viral conjunctivitis is transmitted by direct or C. Destruction of breeding places of the
indirect contact with discharges from infected mosquito vector
eyes. Acute poliomyelitis is spread through the D. Use of mosquito-repelling soaps, such as
fecal-oral route and contact with throat those with basil or citronella
secretions, whereas diphtheria is through direct
and indirect contact with respiratory secretions. Answer: (C) Destruction of breeding places of
the mosquito vector
133. Among children aged 2 months to 3 years, Anopheles mosquitoes breed in slow-moving,
the most prevalent form of meningitis is caused clear water, such as mountain streams.
by which microorganism?
A. Hemophilus influenzae 137. A 4-year old client was brought to the
B. Morbillivirus health center with the chief complaint of severe
C. Steptococcus pneumoniae diarrhea and the passage of rice water stools.
D. Neisseria meningitidis The client is most probably suffering from which
condition?
Answer: (A) Hemophilus influenzae A. Giardiasis
Hemophilus meningitis is unusual over the age B. Cholera
of 5 years. In developing countries, the peak C. Amebiasis
incidence is in children less than 6 months of D. Dysentery
age. Morbillivirus is the etiology of measles.
Streptococcus pneumoniae and Neisseria Answer: (B) Cholera
meningitidis may cause meningitis, but age Passage of profuse watery stools is the major
distribution is not specific in young children. symptom of cholera. Both amebic and bacillary
dysentery are characterized by the presence of
134. Human beings are the major reservoir of blood and/or mucus in the stools. Giardiasis is
malaria. Which of the following strategies in characterized by fat malabsorption and,
malaria control is based on this fact? therefore, steatorrhea.
A. Stream seeding
B. Stream clearing 138. In the Philippines, which specie of
C. Destruction of breeding places schistosoma is endemic in certain regions?
D. Zooprophylaxis A. S. mansoni
B. S. japonicum
Answer: (D) Zooprophylaxis C. S. malayensis
Zooprophylaxis is done by putting animals like D. S. haematobium
cattle or dogs close to windows or doorways just
before nightfall. The Anopheles mosquito takes Answer: (B) S. japonicum
his blood meal from the animal and goes back S. mansoni is found mostly in Africa and South
to its breeding place, thereby preventing America; S. haematobium in Africa and the
infection of humans. Middle East; and S. malayensis only in
peninsular Malaysia.
135. The use of larvivorous fish in malaria
control is the basis for which strategy of malaria 139. A 32-year old client came for consultation
control? at the health center with the chief complaint of
A. Stream seeding fever for a week. Accompanying symptoms
B. Stream clearing were muscle pains and body malaise. A week
C. Destruction of breeding places after the start of fever, the client noted yellowish
D. Zooprophylaxis discoloration of his sclera. History showed that
he waded in flood waters about 2 weeks before
Answer: (A) Stream seeding the onset of symptoms. Based on his history,
Stream seeding is done by putting tilapia fry in which disease condition will you suspect?
streams or other bodies of water identified as A. Hepatitis A
breeding places of the Anopheles mosquito B. Hepatitis B
COMMUNITY HEALTH NURSING

C. Tetanus
D. Leptospirosis 143. The most frequent causes of death among
clients with AIDS are opportunistic diseases.
Answer: (D) Leptospirosis Which of the following opportunistic infections is
Leptospirosis is transmitted through contact with characterized by tonsillopharyngitis?
the skin or mucous membrane with water or A. Respiratory candidiasis
moist soil contaminated with urine of infected B. Infectious mononucleosis
animals, like rats. C. Cytomegalovirus disease
D. Pneumocystis carinii pneumonia
140. MWSS provides water to Manila and other
cities in Metro Manila. This is an example of Answer: (B) Infectious mononucleosis
which level of water facility? Cytomegalovirus disease is an acute viral
A. I disease characterized by fever, sore throat and
B. II lymphadenopathy.
C. III
D. IV 144. To determine possible sources of sexually
transmitted infections, which is the BEST
Answer: (C) III method that may be undertaken by the public
Waterworks systems, such as MWSS, are health nurse?
classified as level III. A. Contact tracing
B. Community survey
141. You are the PHN in the city health center. A C. Mass screening tests
client underwent screening for AIDS using D. Interview of suspects
ELISA. His result was positive. What is the best
course of action that you may take? Answer: (A) Contact tracing
A. Get a thorough history of the client, focusing Contact tracing is the most practical and reliable
on the practice of high risk behaviors. method of finding possible sources of person-to-
B. Ask the client to be accompanied by a person transmitted infections, such as sexually
significant person before revealing the result. transmitted diseases.
C. Refer the client to the physician since he is
the best person to reveal the result to the client. 145. Antiretroviral agents, such as AZT, are
D. Refer the client for a supplementary test, used in the management of AIDS. Which of the
such as Western blot, since the ELISA result following is NOT an action expected of these
may be false. drugs.
A. They prolong the life of the client with AIDS.
Answer: (D) Refer the client for a supplementary B. They reduce the risk of opportunistic
test, such as Western blot, since the ELISA infections
result may be false. C. They shorten the period of communicability
A client having a reactive ELISA result must of the disease.
undergo a more specific test, such as Western D. They are able to bring about a cure of the
blot. A negative supplementary test result disease condition.
means that the ELISA result was false and that,
most probably, the client is not infected. Answer: (D) They are able to bring about a cure
of the disease condition.
142. Which is the BEST control measure for There is no known treatment for AIDS.
AIDS? Antiretroviral agents reduce the risk of
A. Being faithful to a single sexual partner opportunistic infections and prolong life, but
B. Using a condom during each sexual contact does not cure the underlying immunodeficiency.
C. Avoiding sexual contact with commercial sex
workers 146. A barangay had an outbreak of German
D. Making sure that ones sexual partner does measles. To prevent congenital rubella, what is
not have signs of AIDS the BEST advice that you can give to women in
the first trimester of pregnancy in the barangay?
Answer: (A) Being faithful to a single sexual A. Advice them on the signs of German
partner measles.
Sexual fidelity rules out the possibility of getting B. Avoid crowded places, such as markets and
the disease by sexual contact with another moviehouses.
infected person. Transmission occurs mostly C. Consult at the health center where rubella
through sexual intercourse and exposure to vaccine may be given.
blood or tissues.
COMMUNITY HEALTH NURSING

D. Consult a physician who may give them A. The older one gets, the more susceptible he
rubella immunoglobulin. becomes to the complications of chicken pox.
B. A single attack of chicken pox will prevent
Answer: (D) Consult a physician who may give future episodes, including conditions such as
them rubella immunoglobulin. shingles.
Rubella vaccine is made up of attenuated C. To prevent an outbreak in the community,
German measles viruses. This is quarantine may be imposed by health
contraindicated in pregnancy. Immune globulin, authorities.
a specific prophylactic against German D. Chicken pox vaccine is best given when
measles, may be given to pregnant women. there is an impending outbreak in the
community.
147. You were invited to be the resource person
in a training class for food handlers. Which of Answer: (A) The older one gets, the more
the following would you emphasize regarding susceptible he becomes to the complications of
prevention of staphylococcal food poisoning? chicken pox.
A. All cooking and eating utensils must be Chicken pox is usually more severe in adults
thoroughly washed. than in children. Complications, such as
B. Food must be cooked properly to destroy pneumonia, are higher in incidence in adults.
staphylococcal microorganisms.
C. Food handlers and food servers must have a
negative stool examination result.
D. Proper handwashing during food preparation
is the best way of preventing the condition. 149. Complications to infectious parotitis
(mumps) may be serious in which type of
Answer: (D) Proper handwashing during food clients?
preparation is the best way of preventing the A. Pregnant women
condition. B. Elderly clients
Symptoms of this food poisoning are due to C. Young adult males
staphylococcal enterotoxin, not the D. Young infants
microorganisms themselves. Contamination is
by food handling by persons with staphylococcal Answer: (C) Young adult males
skin or eye infections. Epididymitis and orchitis are possible
complications of mumps. In post-adolescent
148. In a mothers class, you discussed males, bilateral inflammation of the testes and
childhood diseases such as chicken pox. Which epididymis may cause sterility.
of the following statements about chicken pox is
correct?

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