Page MEDICAL COLLEGES OF NORTHERN PHILIPPINES Alimannao Hills, Peablanca Cagayan COLLEGE OF NURSING

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GENERAL INSTRUCTIONS: 1. This test questionnaire contains 100 questions. 2. This exam is for 90 minutes only. You must pass your answer sheet when the time allotted has elapsed. Answer sheets that will be passed after the allotted time will NOT BE ACCEPTED. 3. Read the questions carefully and choose the BEST response. Write the letter of your choice before each number. Use only CAPITAL LETTERS. 4. Do not put any unnecessary markings on the answer sheet. Doing so will invalidate your answers. 5. Keep the answer sheets neat and clean. DO NOT MUTILATE.

START HERE! SITUATION: Public health nursing and community health nursing are two different fields of nursing concerned on applying the nursing process on the community level.
1. Concepts on public health and community health are sometimes used interchangeably. Which among the following is the utilization of the nursing process in the different levels of clientele? a. Public health c. Community health b. Public health nursing d. Community health nursing 2. It is considered to be the basic unit of a community a. Individuals c. Family b. Youth d. People 3. All but one is a basic principle in community health nursing a. The goal of CHN is achieved through multi-sectoral efforts b. CHN is a part of health care system and the larger human services system c. Based on the needs of the client d. CHN must be available solely to the poor e. All of the above 4. All but one is an objective of CHN I. To provide quality nursing service II. To coordinate nursing services with various members of the health team III. To participate in researches IV. To provide continuing education and own professional growth only a. I and II c. II and III b. II and IV d. I and II 5. All but one is the core of a public health nurse a. Disease control b. Injury prevention

c. Health protection d. None of the above

SITUATION: Occupational health nurses work in a variety of settings mainly industry, health services, commerce, and education. They can be employed as independent practitioners or as part of a larger occupational health service team, often attached to a personnel department.
6. As simply defined, occupational health nursing is: a. The utilization of the nursing process in the different levels of the clientele b. Part of the paramedical and medical intervention concerned on the whole population c. Nursing practice in the public sector d. Nursing the health of people in workplace

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7. All but one is a function of an occupational health nurse. a. Attends to complaints of all establishments related to hygiene b. Recommend to local health authority the issuance of license/permits c. Provide continuing education on own self d. Prepares and submits yearly reports 8. Which of the following is the primary focus of occupational health nursing? a. To assure so far as possible every working man and woman in the country is safe and in healthful working conditions b. Ensure strict compliance on the regular use and proper maintenance of PPE c. Provide employees/workers an occupational health services and facilities d. Participates to provide, install and maintain in good condition all control facilities and protective barriers for potential and actual hazards 9. In occupational health nursing, you work with other professionals. Which of the following study occupational diseases and injuries? a. Ergonomist c. Industrial engineer b. Epidemiologist d. Toxicologist

SITUATION: Is a complex set of organizations interacting to provide an array of health services

10. Which of the following is one of the Department of Healths plan as indicated in the national health plan? a. Providing quality health care to improve the quality of life for all Filipinos especially the poor b. :Health for all Filipinos by the year 2020 c. Health in the hands of the people by the year 2020 d. Improve the general health status of the people 11. All but one are factors contributing to limited health care in the Philippines a. Poor health care financing b. Inadequate enforcement of regulatory mechanism c. Appropriate health service delivery system d. Excessively high price of medicine 12. Which of the following statements defines what health system is? a. An organize plan of health services b. A set of interrelated and independent parts that form a complex whole, and of these parts can be viewed as a subsystem with its own set of interrelated and independent parts c. The network of health facilities and personnel which carries out the task of rendering health care to the people d. The interrelated ways in which a country organizes available resources for the maintenance and improvement of the health of the citizens and communities. 13. All but one is a characteristic of a health care delivery system a. At intermediate levels, simpler problems should be dealt with more skilled/specialized logistic support b. The essential elements of PHC should be delivered as the first point of contact between the individuals and the health system c. The system should encompass the entire population on the basis of equality and responsibility d. None of the above 14. This health facility focuses on preventive and promotive care a. First level facility c. Second level facility b. Second level facility d. Fourth level facility 15. All but one is an example of secondary level facility a. Emergency hospitals c. Provincial hospitals b. Private clinics d. District hospitals 16. All but one composes our government health sector

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a. LGU b. DOH

c. Private business organization d. Medical-dental services of DepEd

17. It is the subsector in the Philippines that has a clear profit orientation and include manufacturing companies and private institutions a. DOH c. Commercial organizations b. Non-commercial d. Non-government organizations 18. The following are roles of the private sector, except: a. Ensuring equal aspects to basic health services b. Ensuring a minimum level of implementation of nationwide services regarded as public health goods c. Inputs provision which covers supplies and equipment d. Important role in local and national development with emphasis on policy and program reforms and people empowerment 19. All but one is a characteristic of quality hospital a. Has an effective organization and producers system b. Low quality managerial resource c. Equipped with functioning physical activities and equipments d. None of the above

SITUATION: With the devolution, the responsibility for health promotion and protection has become shared one between the LGUs and DOH.
20. Republic Act 7160 is entitled as: a. Philippine Nursing Act of 2001 b. Sanitation Code

c. Youth Welfare Code d. Local Government Code

21. Prior to RA 7160, it has a direct authority on health promotion and protection of a municipality a. DOH c. Governors office b. Mayors office d. Public health nurse 22. On the other hand, prior to RA 7160, it has a direct authority on health promotion and protection of a province a. DOH c. Governors office b. Mayors office d. Public health nurse 23. After the implementation of RA 7160, it has a direct authority on health promotion and protection of a municipality a. DOH c. Governors office b. Mayors office d. Public health nurse 24. The first point of contact between the majority of the poor people and the health system a. Health center/BHS c. Private clinics/laboratories b. Hospital d. All of the above 25. Under the devolved set-up, the technical supervisor of Rural Health Midwife is the: a. Municipal Mayor c. Public Health Nurse b. Rural Health Physician d. barangay Captain

Situation: Immunization is one of the basic health services available in the community. 26. The original objective of the Expanded Program on Immunization (EPI) is a. to reduce morbidity and mortality among infants b. to control six immunizable diseases in children c. to eradicate epidemiological situations in the country d. reduce mortality and morbidity among pregnant women

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27. The target of EPI is a. the entire community b. attendees

c. individuals

d. mothers

28. It is the process by which vaccines are introduced into the body before infection sets in a. Prophylaxis b. Immunization c. Multi-drug therapy d. Chemotherapy 29. It is the type of immunization in which the host produces antibodies in response to natural antigens a. Active b. Cell-mediated c. Passive d. Phagocytic 30. If your patient was bitten by a dog yesterday, what type of immunity do you think should he receive? a. Natural active b. Artificial active c. Natural passive d. Artificial passive 31. Your exposure or experience/s to such diseases such as mumps, chicken pox gives you what type of immunity? a. Natural active b. Artificial active c. Natural passive d. Artificial passive 32. This is an example of artificial passive immunity a. Antitoxins b. Vaccines c. Mumps exposure

d. Immunoglobulins

SITUATION: Nurse should keep in mind the different laws to be guided of the standards of their practice. 33. Known as the Sanitation Code of the Philippines a. PD 856 b. PD 865 c. PD 825 34. Known as the Proper Garbage Disposal of the Philippines a. PD 856 b. PD 865 c. PD 825 35. What is the legal mandate covering EPI? a. PD 949 b. PD 825 36. Republic Act 9275 is titled as: a. Clean Water Act b. Ecological Solid Waste Management Act d. PD 852

d. PD 852

c. PD 996

d. PD 969

c. Clean Air Act d. None of the Above

SITUATION: Herbal medicine -- also called botanical medicine or phytomedicine -- refers to using a plant's seeds, berries, roots, leaves, bark, or flowers for medicinal purposes. Herbalism has a long tradition of use outside of conventional medicine. 37. The scientific name of lagundi: a. Vitex Negundo b. Blumea balsamifera 38. All but one is the use of lagundi: a. Asthma b. Rheumatis 39. The common name of Quisqualis indica a. Niyug-Niyogan b. Ampalaya c Mentha Cordifelia d. Carmona Retusa

c. Colds

d. Anti-helmintic

c. Sambong

d. Bayabas

40. All but one is a reminder on the use of herbal plants a. Use clay pot and and remove cover while cooking b. Use only the part that is being advocated c. Continue giving the herbal medication in case any untoward reaction occurs d. Consult doctor if signs and symptoms are not relived 41. All but one is considered to be a DOH advocated herbal plant a. Sambong b. Mamordica Charantia c. Pancit-pancitan

d. Oryza sativa

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SITUATION: Environmental health is the branch of public health that is concerned with all aspects of the natural and built environment that may affect human health. 42. All but one is factors that affect environmental health a. Agent b. Host 43. Which of the following requires disinfection a. Newly constructed water supply b. Water supply facility negative with bacteria c. Environment d. None of the above e. All of the above

c. Water supply facility with potable water d. All of the following

44. A treatment facility used in hospital waste management program a. Compost pit b. Autoclave c. Incinerator

d. All of the above

45. Which of the following is considered to be level II toilet facility? a. Non-water carriage c. Septic tank with treatment plan b. Water-seal d. Aqua privies 48. Which of the following is considered to be level III water supply facility? a. Point source b. Stand posts c. Communal faucet d. Individual house 50. How far should be a point source from the farthest house? a. 250m b. 200m c. 300m d. 150m

SITUATION: Human immunodeficiency virus (HIV) is a lentivirus (a member of the retrovirus family) that causes acquired immunodeficiency syndrome (AIDS),[1][2] a condition in humans in which progressive failure of the immune system allows life-threatening opportunistic infections and cancers to thrive. 51. A home care nurse begins caring for a 25 year old female client who has just been diagnosed with HIV infection. The client asks the nurse, How could this have happened? The nurse responds to the question based on the most frequent mode of HIV transmission, which is a. hugging HIV positive sexual partner without using barrier precautions. b. Inhaling cocaine c. Sharing food utensils with an HIV positive person without proper cleaning of the utensils d. Having sexual intercourse with an HIV positive person without using a condom 52. A client with HIV is taking zidovudine (AZT). AZT is a drug that acts to: a. destroy the virus c. slow replication of the virus b. enhance the bodys antibody production d. neutralize the toxins produced by the virus 53. A nurse is caring for a client with AIDS. Which finding noted in the client indicates the presence of an opportunistic respiratory infection? a. white plaques located on the oral mucosa c. loss of sight b. fever, exertional dypnea, and nonproductive cough d. ulcerated perirectal lesions 54. A male client with HIV infection becomes depressed and tells the nurse, I have nothing worth living for now. Which of the following statements would be the best response by the nurse? a. You are yopung person and have a great deal to live for. b. You should not be too depressed; we are close to finding cure for AIDS c. You are right; it is very depressing to have HIV d. Tell me more about how you are feeling about being HIV positive. Situation: Mariel Balio, a 12-year-old girl was told by her mother to clean their backyard & burn the leaves of the jackfruit tree. After 5 days, Mariel experienced fever, body malaise & occasional petechial hemorrhages. She was brought to the Rural health unit.

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56. Upon seeing Mariel, which of the following questions would the nurse ask to obtain history of the illness? a. Why didnt you show to your mother the skin lesions right away? b. Dont you have a maid to clean your backyard? c. Do you have a communicable disease? d. Were you bitten by mosquitoes when cleaning your backyard? 57. What is the vector of the patients illness? a. Female anopheles mosquito b. Housefly c. Cockroaches d. Aedes aegypti

58. Which of the following is immediately performed to Mariel which serves as the screening test for dengue hemorrhagic fever? a. ELISA b. Rumpel-leeds test c. Complete blood count d. Sedimentation rate 59. The community physician ordered CBC to Mariel. As the nurse taking care of the patient, your expected CBC finding in patients with dengue hemorrhagic fever is a. Increased WBC & decreased RBC c. Decreased platelet & increased hematocrit b. Decreased hematocrit & increased platelet d. Increased hematocrit & decreased hemoglobin 60. The best measure to control spread of Mariels illness is to a. avoid hanging clothes in the backyard c. spay insecticides once a month b. keep water container open d. eliminate breeding places of vector Situation: A 10-year-old boy arrives with his mother at the emergency department after being bitten by a stray dog. There is a bleeding soft tissue injury on the inner aspect of the left forearm 61. The first nursing action would be a. Notify the barangay tanod to capture the dog b. Ask the mother if her son is allergic to horse serum c. Assess the injury, vital signs, and past health history d. inoculate with human rabies immune globulin

62. Sight & sound of water as well as drip of the faucet disturb a patient with rabies. Which of the following should the nurse do first in taking care of a patient with rabies? a. Place patient near the window c. Give tepid sponge bath b. Cover IV bottle with brown paper bag d. Place the patient near a utility room 63. If a dog bites a person, it should be a. Leashed immediately & observed for 10 days b. Killed immediately c. Brought to a veterinarian for examination to determine the presence of rabies in the blood d. Punished by not giving food & water 64. Emilie Lopamia, a 35-year-old female was bitten by a stray dog on the left hand. She sought an advice of the nurse in the health center. The best response of the nurse is a. You should observe the dog for changes in behavior so you will know if the dog is possibly rabid or not. b. You should receive immunization for rabies immediately. c. You dont have to worry because its just a minor wound. d. You should receive immunization for rabies & tetanus as soon as possible. 65. Emilie asked the nurse regarding the incubation period of rabies. Which of the following statements made by the nurse is appropriate? a. The incubation period is about 2 weeks. b. The incubation period varies depending on the site of the bite. c. The incubation period is about 1 month. d. The incubation period is about 1 year. Situation: Varicella is a common childhood sontagious disease. It provides a life-long immunity to the host. 66. A community health nurse teaches a mother comfort measures for her six-year-old child who has varicellazoster virus. Which of the following actions, if taken by the mother, requires further intervention? a. Applying cortisone-based cream to the childs lesion c. Bathing the child with tepid sponge bath

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b. Patting the childs lesions with calamine lotion

d. Trimming the childs fingernails very short

67. When teaching a mother about communicable diseases, the nurse informs her that chickenpox is a. Communicable until all the vesicles have dried b. No longer communicable after a high fever has subsided c. Not communicable as long as the vesicles are intact and surrounded by a red areola d. Not communicable at all 68. The nurse manager is planning the clinical assignments for the day. The nurse manager avoids assigning which of the following staff members to the client with herpes zoster? a. The nurse who never had mumps c. The nurse who never had roseola b. An experienced nurse who never had chickenpox d. The nurse who never had german measles 69. A nurse is performing an assessment on a 3 year old child with chicken pox. The childd mother tells the nurse that the child keeps scratching at night, and the nurse teaches the mother about measures that will prevent an alteration in skin integrity. Which statement by the mother indicates that teaching was effective? a. I will apply generous amounts of a cortisone cream to prevent itching. b. I need to place white gloves on my childs hands at night. c. I need to keep my child ia a warm room at night so that covers will not cause my child to scratch. d. I will give my child a glass of warm milk at bedtime to help my child sleep. 70. Nursing care of patients with measles is avoidance of complications. Which of the following interventions is done when the child is sensitive to light? a. Advise to wear dark glasses b. Cover eyes with a piece of cloth c. Place patient in a dim, quiet room d. Shut down windows & door Situation: A nurse is assessing a 12-month-old infant who recently had fever, runny nose, cough, and white spots in the mouth for 3 days. A rash developed that started on the face and spread to the whole body. 71. Basing from the above situation, he nurse should suspect that the child has: a. Rubella b. Rubeola c. Varicella d. Scarlet fever 72. Which of the following should you do first? a. Perform nursing procedures b. Plan for your care regimen c. Assess the patient d. Identify nursing diagnosis

73. The nurse is aware that rubeola often causes children to have a. A maculopapular rash b. A paroxysmal cough c. An enlarges parotid gland d. A generalized vesicular lesion 74. A child with rubeola (measles) is being admitted to the hospital. In preparing for the admission of the child, a nurse plans to place the child on which precautions? a. contact c. respiratory b. enteric d. protective 75. A nurse is caring for a child diagnosed with rubeola. The nurse notes that the physician has documented the presence of Koplik spots. Based on this documentation, which of the following would the nurse expect to note on assessment of the child. a. petechiae spots that are reddish and pinpoint on the soft palate. b. Whitish vesicles located across the chest c. Small, blue-white spots with a red base found on the buccal mucosa d. Pinpoint petechiae noted on both legs

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Situation: Mang Romy is malnourished living in a squatters area. He came in the health center due to loss of weight easy, fatigability, chronic cough and low grade fever. 76. The main source of infection pulmonary tuberculosis is: a. Crowded living quarters c. Direct contact with infected person b. Unavailability of potable drinking water d. Unsanitary surroundings 77. A physician orders an X-ray examination for patient. What is the purpose for this? a. To check if patient have relatives with TB b. To see the evidence of having the disease c. Determine severity of the lesions in the lungs d. To aid in doctors prescriptions. 78. The nurse notes 12 mm of induration at the site of a Mantoux test when a client returns to the health office to have it read. The nurse should explain to the client that this is a. Test result is negative, & no follow-up is needed. b. Test was used for screening and a TINE test will now be given. c. Skin test is inconclusive and will have to be repeated in six weeks. d. The result is positive and a need for further tests, including chest x-ray is indicated 79. Staff nurses learn that a patient they have been caring for during the last few weeks has just been diagnosed with tuberculosis. When the nurses express concern about contracting tuberculosis themselves, the charge nurses response should be based on which of the following statements? a. Tuberculosis is easily treated with short course of antibiotics b. The Mantoux test is used to confirm diagnosis of tuberculosis c. Tuberculosis is not highly infectious when standard precautions are followed d. Vaccination with BCG will be used to immunize the nurses against infection 80. Which of the following instructions should a nurse give to a patient who has tuberculosis and is receiving rifampicin? a. Stay out of the sun while you are taking the medication. b. Expect your urine to turn reddish-orange. c. Take your medication on an empty stomach. d. Take your medication until your skin test is negative. Situation: Tetanus is an infectious disease which is caused by Clostridium tetani. An anaerobic bacteria. 81. The organism which causes tetanus is a gam positive anaerobic microorganism. This organism is said to release toxins. Which of the following toxin is responsible for muscle spasm? a. Exotoxin c. Tetanolysin b. Neurotoxin d.Tetanospasmin 82. It is considered as the pathognomonic sign of tetanus: a. Risus sardonicus c. Trismus b. Laryngospasm d. Opisthotonus 83. You explained to the mother that the following id characteristic of tetanus: a. It is communicable under natural conditions b. It is caused by non-spore forming organism c. It is directly transmitted from person to person d. It is usually introduced into the skin during an injury 84. Immunizing a pregnant a mother with tetanus: a. Produces tetanus antibodies for transmission to the fetus for protection b. Has no medical value c. Prepares mother antibodies against tetanus foe subsequent pregnancies d. Prevents mother from developing tetanus during delivery

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85. The following but one is a nursing intervention for patient with tetanus. a. Give (ATS) IM within 72 hours after a punctured wound b. Place the patient in a dark lit and quiet room c. Hold extremities if seizures occur prevent the patient from falling out of bed d. Have intubation set readily available at bedside Situation: Mandy started to complain severe headache and high grade fever for almost two weeks. She remembered eating sapin sapin in a nearby store. The initial impression of the admitting doctor was typhoid fever. 86. The organ of predilection of typhoid infection is: a. small intestine b. colon

c. gallbladder d. Spleen

87. Mandy reported presence of black or tarry stool a day prior to admission. Based on the natural history of disease, she is on what stage of the disease process? a. prodomal satge c. defervescence stage b. fastidial stage d. recovery stage 88. Nurse Arianne examined Mandy. She was trying to look for the an exanthema of typhoid fever which is a. maculopapular rashes on trunk c. bluish discoloration on arms b. petechial rashes on extremities d. migratory painless nodules 89. The confirmatory test for typhoid on the first week of illness is a. Widal test c. Typhidot b. Urine culture d. Blood culture 90. The stool culture of a child with profuse diarrhea reveals Salmonella bacilli. After teaching the mother about the course of Salmonella enteritis, which of the following statements by the mother indicates effective teaching? a.Some people become carriers and stay infectious for a long time b. After the acute stage passes the organism is usually not present in the stool. c. Although the organism may be alive indefinitely, in time it will be of no danger to anyone. d. If my child continues to have the organism in the stool, an antitoxin can help destroy the organism. SITUATION: Community Organizing Participatory Action Research (COPAR) - is a continuous and a sustained process of educating the people , working with people and mobilizing with people. 91. The organism responsible for causing syphilis is classified as a: a. Virus c. rickettsia b. Fungus d. spirochete 92. The typical chancre of syphilis appears as a. a grouping of small, tender pimples b. an elevated wart c. a painless, moist chancre d. an itching, crusted area.

93. When interviewing a client with newly diagnosed syphilis, The public health nurse should be aware that the spread of the disease ca be controlled by a. motivating the client to undergo treatment b. obtaining a list of the clients sexual contacts c. increasing the clients knowledge of the disease d. reassuring the client that records are confidential. 94. Benzathine penicillin G, 2.4 million units IM, is prescribed as treatment for an adult client with primary syphilis. The intramuscular injection is administered in a. the deltoid

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b. the upper outer quadrant of the buttock c. the quadriceps lateralis of the thigh d. the midlateral aspect of the thigh 95. A priority nursing diagnosis for a client with primary syphilis a. Deficient Knowledge relataed to lack of exposure to information about mode of transmission b. Pain related tocutaneous skin lesion on palms and soles c. Ineffective tissue perfusion related to bleeding chancre d. Disturbed body image related to alopecia 96. A model for establishing & implementing effective, sustainable & participatory PHC programs in DDU communities. a. COPAR b. HRDP c. CHO d. PAR 97. A social development approach that aims to transform the apathetic, individualistic, voiceless poor into dynamic, participatory & politically responsive community a. COPAR b. HRDP c. CHO d. PAR SITUATION: COPAR is an important tool for community development and people empowerment as this helps the community workers to generate community participation in development activites. COPAR prepares people to eventually take over the management of a development program in the future. 98. The main goal of COPAR in communities: a. People empowerment b. Self-reliant community c. Community development d. Mobilize resources e. All of the above 99. Which of the following characteristics is not used as a criterion in selecting a community? a. Health services are accessible or adequate to meet the needs of community residents b. Poor health status in general c. Not currently served by similar agencies d. No serious peace and order problem 100. All but one of the following is a criteria for choosing potential/community leader: A. Respected in the community C. Responsible, committed individualistic, willing to work B. Willing to learn D. With good communication skills

HAVE A FRUITFUL SEMESTRAL BREAK! GOD BLESS!

Prepared by:

Noted by:

Recommending approval:

AMIEL F. REYES, RN, MSN

Subject Head, CHN, Level 2 Team

MARCELYN L. ALMAZAN, RN, MAN

BSN Level 1 and 2 Coordinator

REYNALDO M. ADDUCUL, RN, RM, MSN

Dean, College of Nursing

Approved by:

CHERYLL JM M. GUMABAY, RN, RM, MSN

Vice- President for Academic Affairs

College of Nursing
LEVEL TWO (2) TEAM