Gauge your knowledge about Community Health Nursing (CHN) in this 145­item

examination. Almost all common board exam questions about CHN and Public Health
Nursing (PHN) are covered in the exam.

Topics
 Community Health Nursing (CHN) in the Philippines
 Philippine Health Laws
 Medicinal herbs
 Integrated Management of Childhood Illnesses (IMCI)
 Community Diagnosis

Guidelines
 Read each question and choices carefully, choose the best answer!
 You are given 1 minute and 20 second per question.
 Take a deep breath.

Questions
1. Which is the primary goal of community health nursing?

A. To support and supplement the efforts of the medical profession in the promotion of
health and prevention of
B. To enhance the capacity of individuals, families and communities to cope with their
health needs
C. To increase the productivity of the people by providing them with services that will
increase their level of health
D. To contribute to national development through promotion of family welfare, focusing
particularly on mothers and children

2. CHN is a community­based practice. Which best explains this statement?

A. The service is provided in the natural environment of people

B. The nurse has to conduct community diagnosis to determine nursing needs and
problems
C. The service are based on the available resources within the community
D. Priority setting is based on the magnitude of the health problems identified

3. Population­ focused nursing practice requires which of the following processes?

A. Community organizing .
B. Nursing, process
C. Community diagnosis
D. Epidemiologic process

4. RA 1054 is also known as the Occupational Health Act. Aside from the number of
employees, what other factor must be considered in determining the occupational
health privileges to which the workers will be entitled?

A. Type of occupation,: agriculture, commercial, industrial

B. Location of the workplace in relation to health facilities
C. Classification of the business enterprise based on net profit
D. Sex and age composition of employees

5. A business firm must employ an occupational health nurse when it has at least
how many employees.

A. 21
B. 101
C. 201
D. 301

6. When the occupational health nurse employs ergonomic principles, she is

performing which of her roles?

A. Health care provider

B. Health educator
C. Health care coordinator
D. Environment manager
7. A garment factory does not have an occupational nurse. Who shall provide the
occupational health needs of the factory workers?

A. Occupational health nurse at the Provincial Health Office

B. Physician employed by the factory
C. Public Health nurse of the RHU of their municipality
D. Rural Sanitary inspector of the RHU in their municipality

8. “Public health services are given free of charge”. Is this statement true or false?

A. The statement is true; it is the responsibility of government to provide haste services

B. The statement is false; people pay indirectly for public health services
C. The statement may be true or false; depending on the Specific service required
D. The statement may be true or false; depending on policies of the government concerned.

9. According to C.E. Winslow, which of the following is the goal of Public Health?

A. For people to attain their birthrights and longevity

B. For promotion of health and prevention and diseases
C. For people to have access to basic health services
D. For people to be organized in their health efforts

10. We say that a Filipino has attained longevity when he is able to reach the average
life span of Filipinos. What other statistic may be used to determine attainment of
longevity?

A. Age­specific mortality rate

B. Proportionate mortality rate
C. Swaroop’s index
D. Case fatality rate

11. Which of the following is the most prominent feature of public health nursing?

A. It involves providing home care to sick people who are not confined in the hospital
B. Services are provided free of charge to people within the catchment area
C. The public health nurse functions as part of a team providing a public health nursing
service
D. Public health nursing focuses on preventive, not curative services

12. According to Margaret Shetland, the philosophy of public health nursing is based
on which of the following?

A. Health and longevity as birthrights

B. The mandate of the state to protect the birthrights of its citizens
C. Public health nursing as a specialized field of nursing
D. The worth and dignity of man

13. Which of the following is the mission of the Department of Health?

A. Health for all Filipinos

B. Ensure the accessibility and quality of health
C. Improve the general health status of the population
D. Health in the hands of the Filipino people by the year 2020

14. Region IV Hospital is classified as what level of facility?

A. Primary
B. Secondary
C. Intermediate
D. Tertiary

15. What is true of primary facilities?

A. They are usually government­run

B. Their services are provided on an out­patient basis
C. They are training facilities for health professionals
D. A community hospital is an example of this level of health facilities

16. Which is an example of the school nurse’s health care provider function?

A. Requesting for BCG from the RHU for school entrance immunization
B. Conducting random classroom inspection during measles epidemic
C. Taking remedial action on an accident hazard in the school playground
D. Observing places in the school where pupils spend their free times

17. When the nurse determines whether resources were maximized in implementing
Ligtas Tigdas, she is evaluating:

A. Effectiveness
B. Efficiency
C. Adequacy
D. Appropriateness

18. You are a new B.S.N. graduate. You want to become a Public Health Nurse. Where
will you apply?

A. Department of Health
B. Provincial Health Office
C. Regional Health Office
D. Rural Health Unit

19. RA 7160 mandates devolution of basic services from the national government to
local government units. Which of the following is the major goal of devolution?

A. To strengthen local government units

B. To allow greater autonomy to local government units.
C. To empower the people and promote their self­reliance
D. To make basic services more accessible to the people

20. Who is the Chairman of the Municipal Health Board?

A. Mayor
B. Municipal Health Officer
C. Public Health Nurse
D. Any qualified physician

21. Which level of health facility is the usual point of entry of a client into the health
caredelivery system?
A. Primary
B. Secondary
C. Intermediate
D. Tertiary

22. The public health nurse is the supervisor of rural health midwives. Which of the
following is a supervisory function of the pubic health nurse?

A. Referring cases or patients to the midwife

B. Providing technical guidance to the midwife
C. Proving nursing care to cases referred by the midwife
D. Formulating and implementing training programs for midwives

23. One of the participants in a hilot training class asked you to whom she should
refer a patient in labor who develops a complication. You will answer, to the;

A. Public health nurse

B. Rural health midwife
C. Municipal health officer
D. Any of these health professionals

24. You are the public health nurse in a municipality with a total population of about
20,000. There are3 health midwives among the RHU personnel. How many more
midwife items will the RHU need?

A. 1
B. 2
C. 3
D. 4

25. If the RHU needs additional midwife items, you will submit the request for
additional midwife items for approval to the:

A. Rural Health Unit

B. District Health Office
C. Provincial Health Office
D. Municipal Health Board

26. As an epidemiologist, the nurse is responsible for reporting cases or notifiable

diseases. What law mandates reporting cases of notifiable diseases?

A. Act 3573
B. RA.3753
C. RA 1054
D. RA 1082

27. According to Freeman and Heinrich, community health nursing is a

developmental service. Which of the following best illustrates this statement?

A. The community health nurse continuously develops himself personally and professionally
B. Health education and community organizing are necessary in providing community
health services
C. Community health nursing in intended primarily for health promotion and prevention and
treatment of disease.
D. The goal of community health nursing is to provide nursing services to people in their
own place of .residence

28. Which disease was declared through Presidential Proclamation No. 4 as a target
for, eradication in the Philippines?

A. Pioliomyelitis
B. Measles
C. Rabies
D. Neonatal Tetanus

29. The public health nurse is responsible for presenting the municipal health
statistics using graphs and tables. To compare the frequency of the leading causes
of mortality in the municipality, which graph will you prepare?

A. Line
B. Bar
C. Pie
D. Scatter diagram

30. Which step in community organizing involves training of potential leaders in the
community?

A. Integration
B. Community organization
C. Community study
D. Core group formation

31. In which step are plans formulated for solving community problems?

A. Mobilization
B. Community organization
C. Follow­up/extension
D. Core group formation

32. The public health nurse takes an active role in community participation. What is
the primary goal of community organizing?

A. To educate the people regarding community health problems

B. To mobilize the people to resolve community health problems
C. To maximize the community’s resources in dealing with health problems

33. An indicator of success in community organizing is when people are able to:

A. Participate in community activities for the solution of a community problem

B. Implement activities for the solution of the community problem
C. Plan activities for the solution of the community problem
D. Identify the health problem as a common concern

34. Tertiary prevention is needed in which stage of the natural history of disease?

A. Pre­pathogenesis
B. Pathogenesis
C. Predromal
D. Terminal

35. Isolation of a child with measles belongs to what level of prevention?

A. Primary
B. Secondary
C. Intermediate
D. Tertiary

36. On the other hand, Operation Timbang is_____ prevention?

A. Primary
B. Secondary
C. Intermediate
D. Tertiary

37. Which type of family­nurse contact will provide you with the best opportunity to
observe family dynamics?

A. Clinic consultation
B. Group conferences
C. Home visit
D. Written communication

38. The typology of family nursing problems is used in the statement of nursing
diagnosis in the care of families. The youngest child of the delos Reyes family has
been diagnosed as mentally retarded. This is classified as:

A. Health threat
B. Health deficit
C. Foreseeable crisis
D. Stress point

39. The delos Reyes couple have 6­year old child entering school for the first time.
The delos Reyes family has a:
A. Health threat
B. Health deficit
C. Foreseeable crisis
D. Stress point

40. Which of the following is an advantage of a home visit?

A. It allows the nurse to provide nursing care to a greater number of people

B. It provides an opportunity to do first hand appraisal of the home situation
C. It allows sharing of experience among people with similar health problems
D. It develops the family’s initiative in providing for health needs of its members

41. Which is CONTRARY to the principles in planning a home visit?

A. A home visit should have a purpose of objective

B. The plan should revolve around the family health .needs
C. A home visit should be conducted in the manner prescribed by RHU
D. Planning of continuing care should involve a responsible­family member

42. The PHN bag is an important tool in providing nursing care during a home visit.
The most important principle in bag technique states that it;

A. Should save time and effort

B. Should minimize if not totally prevent the spread of infection
C. Should not overshadow concern for the patient and his family
D. May be done in variety of ways depending on the home situation, etc.

43. To maintain the cleanliness of the bag and its contents, which of the following
must the nurse do?

A. Wash his/her hands before and after providing nursing care to the family members
B. In the care of family member’s, as much as possible, use only articles taken from the bag
C. Put on an apron to protect her uniform and fold it with the right side out before putting it
back into the bag.
D. At the end of the visit, fold the lining on which the bag was placed, ensuring that the
contaminated side is on the outside.
44. The public health conducts a study on the factors contributing to the high
morality rate due to heart diseases in the municipality where she works. Which
branch of epidemiology does the nurse practice in this situation?

A. Descriptive
B. Analytical
C. Therapeutic
D. Evaluation

45. Which of the following is a function of epidemiology?

A. Identifying the disease condition based on manifestations presented by a client

B. Determining factors that contributed to the occurrence of pneumonia in a 3 year old
C. Determining the efficacy of the antibiotic used in the treatment of the 3 year old client
withpneumonia
D. Evaluating the effectiveness of the implementation of the Integrated Management of
Childhood Illness

46. Which of the following is an epidemiologic function of the nurse during an

epidemic?

A Conducting assessment of suspected cases to detect the communicable diseases

B. Monitoring the condition of the cases affected by the communicable disease
C. Participating in the investigation to determine the source of epidemic
D. Teaching the community on preventive measures against the disease

47. The primary purpose of conducting an epidemiologic investigation is to;

A. Delineate the etiology of the epidemic

B. Encourage cooperation and support of the community
C. Identify groups who are at risk of contracting the disease
D. Identify geographical location of cases of the disease in the community

48. Which is a characteristic of person­to­person propagated epidemic?

A. There are more cases of the disease than expected
B. The disease must necessarily be transmitted through a vector
C. The spread of the disease can be attributed to a common vehicle
D. There is gradual build up of cases before we epidemic becomes easily noticeable

49. In the investigation of an epidemic, you compare the present frequency of the
disease with the usual frequency at this time of the year in this community. This is
done during which stage of the investigation?

A. Establishing the epidemic

B. Testing the hypothesis
C. Formulation of the hypothesis
D. Appraisal of facts

50. The number of cases of Dengue fever usually increases towards the end of the
rainy season. This pattern of occurrence of Dengue fever is best described as;

A. Epidemic occurrence
B. Cyclical variation
C. Sporadic occurrence
D. Secular occurrence

51. In the year 1980, the World Health Organization declared the Philippines, together
with some other countries in the Western Pacific Region, “free” of which disease?

A. Pneumonic plaque
B. Poliomyelitis
C. Small pox
D. Anthrax

52. In the census of the Philippines in 1995, there were about 35,299,000 males and
about 34,968,000 females. What is the sex ratio?

A. 99.06:100
B. 100.94:100
C. 50.23%
D. 49.76%

53. Primary health care is a total approach to community development. Which of the
following is an indicator of success in the use of the primary health care approach?

A. Health services are provided free of charge to individuals and families

B. Local officials are empowered as the major decision makers in matters of health
C. Health workers are able too provide care based on identified health needs of the people
D. Health programs are sustained according to the level of development of the community

54. Sputum examination is the major screening tool for pulmonary tuberculosis.
Clients would sometimes get false negative results in this exam. This means that the
test is not perfect in terms of which characteristic of a diagnostic examination?

A. Effectiveness
B. Efficacy
C. Specificity
D. Sensitivity

55. Use of appropriate technology requires knowledge of indigenous technology.

Which medical herb is given for fever, headache and cough?

A. Sambong
B. Tsaang gubat
C. Akapulko
D. Lagundi

56. What law created the Philippine institute of Traditional and Alternative Health
Care?

A. RA 8483
B. RA4823
C. RA 2483
D. RA 3482
57. In traditional Chinese medicine, the yielding, negative and feminine force is
termed:

A. Yin
B. Yang
C. Qi
D. Chai

58. What is the legal basis of Primary Health Care approach in the Philippines?

A. Alma Ata Declaration of PHC

B. Letter of Instruction No 949
C. Presidential Decree No. 147
D. Presidential Decree 996

59. Which of the following demonstrates inter­sectoral linkages?

A. Two­way referral system

B. Team approach
C. Endorsement done by a midwife to another midwife
D. Cooperation between PHN and public school teacher

60. The municipality assigned to you has a population of about 20/000. Estimate the
number of 1­4 year old children who be given Retinol capsule 200.000 every 6
months.

A. 1,500
B. 1,800
C. 2,000
D. 2,300

61. Estimate the number of pregnant women who will be given tetanus toxoid during
an immunization outreach activity in a barangay with a population of about 1,500.

A. 265
B. 300
C. 375
D. 400

62. To describe the sex composition of the population, which demographic tool may
be used?

A. Sex ratio
B. Sex proportion
C. Population pyramid
D. Any of these maybe used

63. Which of the following is a natality rate?

A. Crude birth rate

B. Neonatal mortality rate
C. Infant mortality rate
D. General fertility rate

64. You are computing the crude rate of your municipality, with a total population o
about 18,000 for last year. There were 94 deaths. Among those who died, 20 died
because of diseases of the heart and 32 were aged 50 years or older. What is the
crude death rate?

A. 4.1/1000
B. 5.2/1000
C. 6.3/1000
D. 7.3/1000

65. Knowing that malnutrition is a frequent community health problem, you decided
to conduct nutritional assessment. What population is particularly susceptible to
protein energy malnutrition (PEM)?

A. Pregnant women and the elderly

B. Under 5 year old children
C. 1­4 year old children
D. School age children
66. Which statistic can give the most accurate reflection of the health status of a
community?

A. 1­4 year old age­specific mortality rate

B. Infant mortality rate
C. Swaroop’s index
D. Crude death rate

67. In the past year, Barangay A had an average population of 1655. 46 babies were
born in that year, 2 of whom died less than 4 weeks after they were born. They were 4
recorded stillbirths. What is the neonatal mortality rate?

A. 27.8/1000
B. 43.5/1000
C. 86.9/1000
D. 130.4/1000

68. Which statistic best reflects the nutritional status of a population?

A. 1­4 year old age­specific mortality rate

B. Proportionate mortality rate
C. Infant mortality rate
D. Swaroop’s index

69. What numerator is used in computing general fertility rate?

A. Estimated midyear population

B. Number of registered live births
C. Number of pregnancies in the year
D. Number of females of reproductive age

70. You will gather data for nutritional assessment of a purok. You will gather
information only from families with members who belong to the target population for
PEM. What method of delta gathering is best for this purpose?
A. Census
B. Survey
C. Record Review
D. Review of civil registry

71. In the conduct of a census, the method of population assignment based on the
actual physical location of the people is termed;

A. De jure
B. De locus
C. De facto
D. De novo

72. The Field Health Services and information System (FHSIS) is the recording and
reporting system in public health) care in the Philippines. The monthly field health
service activity report is a form used in which of the components of the FHSIS?

A. Tally report
B. Output report
C. Target/client list
D. Individual health record

73. To monitor clients registered in long­term regimens, such as the Multi­Drug

Therapy, which component will be most useful?

A. Tally report
B. Output report
C. Target/client list
D. Individual health record

74. Civil registries are important sources of data. Which law requires registration of
births within 30 days from the occurrence of the birth?

A. PD 651
B. Act 3573
C. RA 3753
D. RA 3375

75. Which of the following professionals can sign the birth certificate?

A. Public health nurse

B. Rural health midwife
C. Municipal health officer
D. Any of these health professionals

76. Which criterion in priority setting of health problems is used only in community
health care?

A. Modifiability of the problem

B. Nature of the problem presented
C. Magnitude of the health problem
D. Preventive potential of the health problem

77. The Sentrong Sigla Movement has been launched to improve health
service delivery. Which of the following is/are true of this movement?

A. This is a project spearheaded by local government units

B. It is a basis for increasing funding from local government units
C. It encourages health centers to focus on disease prevention and control
D. Its main strategy is certification of health centers able to comply with standards

78. Which of the following women should be considered as special targets for family
planning?
A. Those who have two children or more
B. Those with medical conditions such as anemia
C. Those younger than 20 years and older than 35 years
D. Those who just had a delivery within the past 15 months

79. Freedom of choice in one of the policies of the Family Planning Program of the
Philippines. Which of the following illustrates this principle?
A. Information dissemination about the need for family planning
B. Support of research and development in family planning methods
C. Adequate information for couples regarding the different methods
D. Encouragement of couples to take family planning as a joint responsibility

80. A woman, 6 months pregnant, came to the center for consultation. Which of the
following substances is contraindicated?

A. Tetanus toxoid
B. Retinol 200,000 IU
C. Ferrous sulfate 200mg
D. Potassium iodate 200 mg, capsule

81. During prenatal consultation, a client asked you if she can have her delivery at
home. After history taking and physical examination, you advised her against a
home delivery. Which of the following findings disqualifies her for a home delivery?

A. Her OB score is G5P3

B. She has some palmar pallor
C. Her blood pressure is 130/80
D. Her baby is in cephalic presentation

82. Inadequate intake by the pregnant woman of which vitamin may cause neural
tube defects?

A. Niacin
B. Riboflavin
C. Folic Acid
D. Thiamine

83. You are in a client’s home to attend to a delivery. Which of the following will you
do first?

A. Set up a sterile area

B. Put on a clean gown and apron
C. Cleanse the client’s vulva with soap and water
D. Note the interval, duration and intensity of labor and contractions

84. In preparing a primigravida for breastfeeding, which of the following will you do?

A. Tell her that lactation begins within a day after delivery

B. Teach her nipple stretching exercises if her nipples are everted
C. Instruct her to wash her nipples before and after each breastfeeding
D. Explain to her that putting the baby to breast will lessen blood loss after delivery

85. A primigravida is instructed to offer her breast to the baby for the first time within
30 minutes after delivery. What is the purpose of offering the breast this early?

A. To initiate the occurrence of milk letdown

B. To stimulate milk production by the mammary acini
C. To make sure that the baby is able to get the colustrum
D. To allow the woman to practice breastfeeding in the presence of the health worker

86. In a mother’s class, you discuss proper breastfeeding technique. Which of these
is a sign that the baby has “lactated on” the breast property?

A. The baby takes shallow, rapid sucks

B. The mother does not feel nipple pain
C. The baby’s mouth is only partly open
D. Only the mother’s nipple is inside the baby’s mouth

87. You explain to a breastfeeding mother that breastmilk is sufficient for all of the
baby’s nutrient needs only up to:

A. 3 months
B. 6 months
C. 1 year
D. 2 years

88. What is given to a woman within a month after the delivery of a baby?
A. Malunggay capsule
B. Ferrous sutfate l00mg O.D.
C. Retinol 200.000 IU 1 capsule
D. Potassium Iodate 200 mg, 1 capsule

89. Which biological used in EPI is stored in the freezer?

A. DPT
B. Tetanus toxoid
C. Measles vaccine
D. Hepatitis B vaccine

90. Unused BCG should be discarded how many hours after reconstitution?

A. 2
B. 4
C. 6
D. At the end of the day

91. In immunity school entrants with BCG, you not obliged to secure parental
consent. This is because of which legal document?

A. PD 996
B. RA 7864
C. Presidential Proclamation No. 6
D. Presidential Proclamation No. 46

92. Which immunization produces a permanent scar?

A. DPT
B. BCG
C. Measles vaccination
D. Hepatitis B vaccination

93. A 4 week old baby was brought to the health center for his first immunization.
Which can be given to him?
A. DPT1
B. OPV1
C. Infant BCG
D. Hepatitis B Vaccin

94. You will not give DPT 2 if the mother says that the infant had?

A. Seizures a day after DPT1

B. Fever for 3 days after DPT1
C. Abscess formation after DPT1
D. Local tenderness for 3 days after DPT1

95. A 2­month old infant was brought to the health center for immunization. During
assessment, the infant’s temperature registered at 38.1 C. Which is the best course
of action that you will take?

A. Go on with the infants immunization

B. Give paracetamol and wait for his fever to subside
C. Refer the infant to the physician for further assessment
D. Advise the infant’s mother to bring him back for immunization when he is well

96. A pregnant woman had just received her 4th dose of tetanus toxoid.
Subsequently, her baby will have protection against tetanus for how long?

A. 1 year
B. 3 years
C. 10 years
D. Lifetime

97. A 4­month old infant was brought to the health center of cough. Her respiratory
rate is 42/minute. Using the IMCI guidelines of assessment, her breathing is
considered;

A. Fast
B. Slow
C. Normal
D. Insignificant

98. Which of the following signs will indicate that a young child is suffering from
severepneumonia?

A. Dyspnea
B. Wheezing
C. Fast breathing
D. Chest indrawing

99. Using IMCI guidelines, you classify a child as having severe pneumonia. What is
the best management for the child?

A. Prescribe antibiotic
B. Refer him urgently to the hospital
C. Instruct the mother to increase fluid intake
D. Instruct the mother to continue breastfeeding

100. A 5­month old infant was brought by his mother to the health center because of
diarrhea occurring 4 to 5 times a day. His skin goes back slowly after a skin pinch
and his eyes are sunken. Using the IMCI guidelines, you will classify this infant in
which category?

A. No signs of dehydration
B. Some dehydration
C. Severe dehydration
D. The data is insufficient

101. Based on the assessment, you classified a 3­month old infant with the chief
complaint of diarrhea in the category of SOME DEHYDRATION. Based on the IMCI
management guidelines, which of the following will you do?

A. Bring the infant to the nearest facility where IV fluids can be given
B. Supervise the mother in giving 200 to 400 ml of Oresol in 4 hours
C. Give the infant’s mother instructions on home management
D. Keep the infant in your health center for close observation

102. A mother is using Oresol’ in the management of diarrhea of her 3­year old child.
She asked you what to do if her child vomits. You will tell her to:

A. Bring the child to the nearest hospital for further assessment

B. Bring the child to the health center for IV therapy
C. Bring the child to the health center for assessment by the physician
D. Let the child rest for 10 minutes then continue giving Oresol more slowly

103. A 1 1/2 year old child was classified as having 3rd degree of protein energy
malnutrition, kwashjorkor. Which of the following signs will be most apparent in this
child?

A. Voracious appetite
B. Wasting
C. Apathy
D. Edema

104. Assessment of a 2­year old child revealed “baggy pants”. Using the IMCI
guidelines, how will you manage this child?
A. Refer the child urgently to a hospital for confinement
B. Coordinate with the social worker to enroll the child in a feeding program
C. Make a teaching plan for the mother, focusing on the menu planning for her child
D. Assess and treat the child for health problems like infections and intestinal parasitism

105. During the physical examination of a young child, what is the earliest sign of
xerophthalmia that may observe?

A. Keratomalacia
B. Corneal opacity
C. Night blindness
D. Conjunctival xerosis
106. To prevent xerophthalmia, young children are given Retinol capsule every 6
months. What is the dose given to preschoolers?

A. 10, 000 IU
B. 20, 000 IU
C. 100, 000 IU
D. 200, 000 IU

107. The major sign of iron deficiency anemia is pallor. What part is best examined
for pallor?

A. Palms
B. Nailbeds
C. Around the lips
D. Lower conjunctival sac

108. Food fortification is one of the strategies to prevent micronutrient deficiency

conditions. RA 8976 mandates fortification of certain food items. Which of the
following is among these food items?

A. Sugar
B. Bread
C. Margarine
D. Filled milk

109. What is the best course of action when there is a measles epidemic in a nearby
municipality?

A. Give measles vaccine to babies aged 6 to 3 months

B. Give babies aged 6 to 11 months one dose of 100,000 IU of Retinol
C. Instruct mother to keep their babies at home to prevent disease transmission
D. Instruct mothers to feed their babies adequately to enhance their babies resistance

110. A mother brought her daughter, 4 years old, to the RHU because of cough and
colds. Following the IMCI assessment guide, which of the following is a danger sign
that indicates the need for urgent referral to a hospital?
A. Inability to drink
B. High grade fever
C. Signs of severe dehydration
D. Cough for more than 30 days

111. Management of a child with measles includes the administration of which of the
following?

A. Gentian violet on mouth lesions

B. Antibiotic to prevent pneumonia
C. Tetracycline eye ointment for corneal opacity
D. Retinol capsule regardless of when the last dose was given

112. A mother brought her 10 month old infant for consultation because of fever
which started 4 days prior to consultation. To determine malaria risk, what will you
do?

A. Do a tourniquet test
B. Ask where the family resides
C. Get a specimen for blood smear
D. Ask if the fever is present everyday

113. The following are strategies implemented by the DOH to prevent mosquito­borne
diseases. Which of these is most effective in the control of Dengue fever?

A. Stream seeding with larva­eating fish

B. Destroying breeding places of mosquitoes
C. Chemoprophylaxis of non­immune persons going to endemic areas
D. Teaching people in endemic areas to use chemically treated mosquito nets

114. Secondary prevention for malaria includes?

A. Planting of neem or eucalyptus trees

B. Residual spraying of insecticides at night
C. Determining whether a place is endemic or not
D. Growing larva­eating fish in mosquito breeding places
115. Scotch tape swab is done to check for which intestinal parasite?

A. Ascaris
B. Pinworm
C. Hookworm
D. Schistosoma

116. Which of the following signs indicates the need for sputum examination for
AFB?

A. Hematemesis
B. Fever for 1 week
C. Cough for 3 weeks
D. Chest pain for 1 week

117. Which clients are considered targets for DOTS category?

A. Sputum negative cavitary cases

B. Clients returning after default
C. Relapses and failures of previous PTB treatment regimens
D. Clients diagnosed for the first time through a positive sputum exam

118. To improve compliance to treatment, what innovation is being implemented in

DOTS?

A. Having the health worker follow up the client at home

B. Having the health worker or a responsible family member monitor drug intake
C. Having the patient come to the health center every month to get his medications
D. Having a target list to check on whether the patient has collected his monthly supply of
drugs

119. Diagnosis of leprosy is highly dependent on recognition of symptoms. Which of

the following is an early sign of leprosy?

A. Macular lesions
B. Inability to close eyelids
C. Thickened painful nerves
D. Sinking of the nose bridge

120. Which of the following clients should be classified as a case of mutibacillary

leprosy?

A. 3 skin lesions, negative slit skin smear

B. 3 skin lesions, positive slit skin smear
C. 5 skin lesions, negative slit skin smear
D. 5 skin lesions, positive slit skin smear

121. In the Philippines, which condition is the most frequent cause of death
associated by schistosomiasis?

A. Liver cancer
B. Liver cirrhosis
C. Bladder cancer
D. Intestinal perforation

122. What is the most effective way of controlling schistosomiasis in an endemic

area?

A. Use of molluscicides
B. Building of foot bridges
C. Proper use of sanitary toilets
D. Use of protective footwear, such as rubber boots

123. When residents obtain water from an artesian well in the neighborhood, the level
of this approved type of water facility is:

A. I
B. II
C. III
D. IV
124. For prevention of Hepatitis A, you decided to conduct health education
activities. Which of the following is Irrelevant?

A. Use of sterile syringes and needles

B. Safe food preparation and food handling by vendors
C. Proper disposal of human excreta and personal hygiene
D. Immediate reporting of water pipe leaks and illegal water connections

125. Which biological used in EPI should not be stored in the freezer?

A. DPT
B. OPV
C. Measles vaccine
D. MMR

126. You will conduct outreach immunization in a barangay with a population of

about 1500. Estimate the number of infants in the barangay.

A. 45
B. 50
C. 55
D. 60

127. In IMCI, severe conditions generally require urgent referral to a hospital. Which
of the following severe conditions Does not always require urgent referral to
hospital?

A. Mastoiditis
B. Severe dehydration
C. Severe pneumonia
D. Severe febrile disease.

128. A client was diagnosed as having Dengue Fever. You will say that there is slow
capillary refill when the color of the nailbed that you pressed does not return within
how many seconds?
A. 3
B. 5
C. 8
D. 10

129. A 3­year old child was brought by his mother to the health center because of
fever of 4­day duration. The child had a positive tourniquet test result. In the absence
of other signs, which of the most appropriate measure that the PHN may carry out to
prevent Dengue shock syndrome?

A. Insert an NGT and give fluids per NGT

B. Instruct the mother to give the child Oresol
C. Start the patient on IV Stat
D. Refer the client to the physician for appropriate management

130. The pathognomonic sign of measles is Koplik’s spot. You may see Koplik’s spot
by inspecting the:

A. Nasal Mucosa
B. Buccal mucosa
C. Skin on the abdomen
D. Skin on the antecubital surface

131. Among the following diseases, which is airborne?

A. Viral conjunctivitis
B. Acute poliomyelitis
C. Diphtheria
D. Measles

132. Among children aged 2 months to 3 years, the most prevalent form of meningitis
is caused by which microorganism?

A. Hemophilus Influenzae
B. Morbillivirus
C. Streptococcus Pneumoniae
D. Neisseria meningitides

133. Human beings are the major reservoir of malaria. Which of the following
strategies in malaria control is based on this fact?

A. Stream seeding
B. Stream clearing
C. Destruction of breeding places
D. Zooprophylaxis

134. The use of larvivorous fish in malaria control is the basis for which strategy of
malaria control?

A. Stream seeding
B. Stream clearing
C. Destruction of breeding places
D. Zooprophylaxis .

135. Mosquito­borne diseases are prevented mostly with the use of mosquito control
measures. Which of the following is NOT appropriate for malaria control?

A. Use of chemically treated mosquito nets

B. Seeding of breeding places with larva­eating fish
C. Destruction of breeding places of the mosquito vector
D. Use of mosquito­repelling soaps, such as those with basil or citronella

136. A 4­year old client was brought to the health center with chief complaint of
severe diarrhea and the passage of “rice water”. The client is most probably
suffering from which condition?

A. Giardiasis
B. Cholera
C. Amebiasis
D. Dysentery
137. In the Philippines, which specie of schistosoma is endemic in certain regions?

A. S. mansoni
B. S. japonicum
C. S. malayensis
D. S. haematobium

138. A 32 year old client came for consultation at the health center with the chief
complaint of fever for a week. Accompanying symptoms were muscle pains and body
malaise. A week after the start of fever, the client noted yellowish discoloration of his
sclera. History showed that he waded in flood waters about 2 weeks before the onset
of symptoms. Based on this history/ which disease condition will you suspect?

A. Hepatitis A
B. Hepatitis B
C. Tetanus
D. Leptospirosis

139. MWSS provides water to Manila and other cities in Metro Manila. This is an
example of which level of water facility?

A. I
B. II
C. III
D. IV

140. You are the PHN in the city health center. A client underwent screening for AIDS
using ELISA. His result was positive. What is the best course of action that you may
take?

A. Get a thorough history of the client, focusing on the practice of high risk behavior
B. Ask the client to be accompanied by a significant person before revealing the result.
C. Refer the client to the physician since he is the best person to reveal the result to the
client
D. Refer the client for a supplementary test, such as Western blot, since the ELISA result
maybe false
141. Which is the BEST control measure for AIDS?

A. Being faithful to a single sexual partner

B. Using a condom during each sexual contact
C. Avoiding sexual contact with commercial sex workers
D. Making sure that one’s sexual partner does not have signs of AIDS

142. The most frequent causes of death among clients with AIDS are opportunistic
diseases. Which of the following opportunistic infections is characterized by
tonsilllopharyngitis?

A. Respiratory candidiasis
B. Infectious mononucleosis
C. Cytomegalovirus disease
D. Pneumocystis carinii pneumonia

143. To determine the possible sources of sexually transmitted infections, which is

the BEST method that may be undertaken by the public health nurse?

A. Contact tracing
B. Community survey
C. Mass screening tests
D. Interview suspects

144. Antiretroviral agents, such as AZT are used in the management of AIDS. Which
of the following is not an action expected of these drugs?

A. They prolong the life of the client with AIDS

B. They reduce the risk of opportunistic infections
C. They shorten the period of communicability of the disease
D. They are able to bring about a cure of the disease condition

145. A barangay had an outbreak of German measles. To prevent congenital rubella,

what is the BEST advice that you can give to women in the first trimester of
pregnancy in the barangay?
a. Advice them on the sign of German Measles
b. Avoid crowded places, such as markets and moviehouses
c. Consult at the health center where rubella vaccine may be given
d. Consult a physician who may give them rubella immunoglobulin

Answers and Rationale

Gauge your performance by counter­checking your answers to those below. If you have
disputes or further questions, please direct them to the comments section.

1. Answer: (B) To enhance the capacity of individuals, families and communities to cope
with their health needs.
To contribute to national development through promotion of family welfare, focusing
particularly on mothers and children.

2. Answer: (B) The nurse has to conduct community diagnosis to determine nursing needs
and problems.
Community­based practice means providing care to people in their own natural
environments: the home, school and workplace, for example.

3. Answer: (C) Community diagnosis

Population­focused nursing care means providing care based on the greater need of the
majority of the population. The greater need is identified through community diagnosis.

4. Answer: (B) Location of the workplace in relation to health facilities

Based on R.A. 1054, an occupational nurse must be employed when there are 30 to 100
employees and the workplace is more than 1 km. away from the nearest health center.
5. Answer: (B) 101

6. Answer: (D) Environmental manager

Ergonomics is improving efficiency of workers by improving the worker’s environment
through appropriately designed furniture, for example.

7. Answer: (C) Public health nurse of the RHU of their municipality

8. Answer: (B) The statement is false; people pay indirectly for public health services.
Community health services, including public health services, are prepaid paid services,
through taxation, for example.

9. Answer: (A) For people to attain their birthrights of health and longevity
According to Winslow, all public health efforts are for people to realize their birthrights of
health and longevity.

10. Answer: (C) Swaroop’s index

Swaroop’s index is the percentage of the deaths aged 50 years or older. Its inverse
represents the percentage of untimely deaths (those who died younger than 50 years).

11. Answer: (D) Public health nursing focuses on preventive, not curative, services.
The catchment area in PHN consists of a residential community, many of whom are well
individuals who have greater need for preventive rather than curative services.

12. Answer: (D) The worth and dignity of man

This is a direct quote from Dr. Margaret Shetland’s statements on Public Health Nursing.

13. Answer: (B) Ensure the accessibility and quality of health care

14. Answer: (D) Tertiary

Regional hospitals are tertiary facilities because they serve as training hospitals for the
region.

15. Answer: (B) Their services are provided on an out­patient basis.

Primary facilities government and non­government facilities that provide basic out­patient
services.

16. Answer: (B) Conducting random classroom inspection during a measles epidemic
Random classroom inspection is assessment of pupils/students and teachers for signs of a
health problem prevalent in the community.

17. Answer: (B) Efficiency

Efficiency is determining whether the goals were attained at the least possible cost.
18. Answer: (D) Rural Health Unit
R.A. 7160 devolved basic health services to local government units (LGU’s). The public
health nurse is an employee of the LGU.

19. Answer: (C) To empower the people and promote their self­reliance
People empowerment is the basic motivation behind devolution of basic services to LGU’s.

20. Answer: (A) Mayor

The local executive serves as the chairman of the Municipal Health Board.

21. Answer: (A) Primary

The entry of a person into the health care delivery system is usually through a consultation
in out­patient services.

22. Answer: (B) Providing technical guidance to the midwife

The nurse provides technical guidance to the midwife in the care of clients, particularly in
the implementation of management guidelines, as in Integrated Management of Childhood
Illness.

23. Answer: (C) Municipal Health Officer

A public health nurse and rural health midwife can provide care during normal childbirth. A
physician should attend to a woman with a complication during labor.

24. Answer: (A) 1

Each rural health midwife is given a population assignment of about 5,000.

25. Answer: (D) Municipal Health Board

As mandated by R.A. 7160, basic health services have been devolved from the national
government to local government units.

26. Answer: (A) Act 3573

Act 3573, the Law on Reporting of Communicable Diseases, enacted in 1929, mandated
the reporting of diseases listed in the law to the nearest health station.

27. Answer: (B) Health education and community organizing are necessary in providing
community health services.
The community health nurse develops the health capability of people through health
education and community organizing activities.

28. Answer: (B) Measles

Presidential Proclamation No. 4 is on the Ligtas Tigdas Program.

29. Answer: (B) Bar

A bar graph is used to present comparison of values, a line graph for trends over time or
age, a pie graph for population composition or distribution, and a scatter diagram for
correlation of two variables.

30. Answer: (D) Core group formation

In core group formation, the nurse is able to transfer the technology of community
organizing to the potential or informal community leaders through a training program.

31. Answer: (B) Community organization

Community organization is the step when community assemblies take place. During the
community assembly, the people may opt to formalize the community organization and
make plans for community action to resolve a community health problem.

32. Answer: (D) To maximize the community’s resources in dealing with health problems
Community organizing is a developmental service, with the goal of developing the people’s
self­reliance in dealing with community health problems. A, B and C are objectives of
contributory objectives to this goal.

33. Answer: (A) Participate in community activities for the solution of a community problem
Participation in community activities in resolving a community problem may be in any of the
processes mentioned in the other choices.

34. Answer: (D) Terminal

Tertiary prevention involves rehabilitation, prevention of permanent disability and disability
limitation appropriate for convalescents, the disabled, complicated cases and the terminally
ill (those in the terminal stage of a disease)
35. Answer: (A) Primary
The purpose of isolating a client with a communicable disease is to protect those who are
not sick (specific disease prevention).

36. Answer: (B) Secondary

Operation Timbang is done to identify members of the susceptible population who are
malnourished. Its purpose is early diagnosis and, subsequently, prompt treatment.

37. Answer: (C) Home visit

Dynamics of family relationships can best be observed in the family’s natural environment,
which is the home.

38. Answer: (B) Health deficit

Failure of a family member to develop according to what is expected, as in mental
retardation, is a health deficit.

39. Answer: (C) Foreseeable crisis

Entry of the 6­year old into school is an anticipated period of unusual demand on the family.

40. Answer: (B) It provides an opportunity to do first hand appraisal of the home situation.
Choice A is not correct since a home visit requires that the nurse spend so much time with
the family. Choice C is an advantage of a group conference, while choice D is true of a
clinic consultation.

41. Answer: (C) A home visit should be conducted in the manner prescribed by the RHU.
The home visit plan should be flexible and practical, depending on factors, such as the
family’s needs and the resources available to the nurse and the family.

42. Answer: (B) Should minimize if not totally prevent the spread of infection.
Bag technique is performed before and after handling a client in the home to prevent
transmission of infection to and from the client.

43. Answer: (A) Wash his/her hands before and after providing nursing care to the family
members.
Choice B goes against the idea of utilizing the family’s resources, which is encouraged in
CHN. Choices C and D goes against the principle of asepsis of confining the contaminated
surface of objects.

44. Answer: (B) Analytical

Analytical epidemiology is the study of factors or determinants affecting the patterns of
occurrence and distribution of disease in a community.

45. Answer: (D) Evaluating the effectiveness of the implementation of the Integrated
Management of Childhood Illness
Epidemiology is used in the assessment of a community or evaluation of interventions in
community health practice.

46. Answer: (C) Participating in the investigation to determine the source of the epidemic
Epidemiology is the study of patterns of occurrence and distribution of disease in the
community, as well as the factors that affect disease patterns. The purpose of an
epidemiologic investigation is to identify the source of an epidemic, i.e., what brought about
the epidemic.

47. Answer: (A) Delineate the etiology of the epidemic

Delineating the etiology of an epidemic is identifying its source.

48. Answer: (D) There is a gradual build up of cases before the epidemic becomes easily
noticeable.
A gradual or insidious onset of the epidemic is usually observable in person­to­person
propagated epidemics.

49. Answer: (A) Establishing the epidemic

Establishing the epidemic is determining whether there is an epidemic or not. This is done
by comparing the present number of cases with the usual number of cases of the disease at
the same time of the year, as well as establishing the relatedness of the cases of the
disease.

50. Answer: (B) Cyclical variation

A cyclical variation is a periodic fluctuation in the number of cases of a disease in the
community.
51. Answer: (C) Smallpox
The last documented case of Smallpox was in 1977 at Somalia.

52. Answer: (B) 100.94:100

Sex ratio is the number of males for every 100 females in the population.

53. Answer: (D) Health programs are sustained according to the level of development of the
community.
Primary health care is essential health care that can be sustained in all stages of
development of the community.

54. Answer: (D) Sensitivity

Sensitivity is the capacity of a diagnostic examination to detect cases of the disease. If a
test is 100% sensitive, all the cases tested will have a positive result, i.e., there will be no
false negative results.

55. Answer: (D) Lagundi

Sambong is used as a diuretic. Tsaang gubat is used to relieve diarrhea. Akapulko is used
for its antifungal property.

56. Answer: (A) R.A. 8423 or “AN ACT CREATING THE PHILIPPINE INSTITUTE OF
TRADITIONAL AND ALTERNATIVE HEALTH CARE (PITAHC) TO ACCELERATE THE
DEVELOPMENT OF TRADITIONAL AND ALTERNATIVE HEALTH CARE IN THE
PHILIPPINES, PROVIDING FOR A TRADITIONAL AND ALTERNATIVE HEALTH CARE
DEVELOPMENT FUND AND FOR OTHER PURPOSES” signed to a law on December 9,
1997.

57. Answer: (A) Yin

Yang is the male dominating, positive and masculine force.

58. Answer: (B) Letter of Instruction No. 949

Letter of Instruction 949 was issued by then President Ferdinand Marcos, directing the
formerly called Ministry of Health, now the Department of Health, to utilize Primary Health
Care approach in planning and implementing health programs.
59. Answer: (D) Cooperation between the PHN and public school teacher
Intersectoral linkages refer to working relationships between the health sector and other
sectors involved in community development.

60. Answer: (D) 2,300

Based on the Philippine population composition, to estimate the number of 1­4 year old
children, multiply total population by 11.5%.

61. Answer: (A) 265

To estimate the number of pregnant women, multiply the total population by 3.5%.

62. Answer: (D) Any of these may be used.

Sex ratio and sex proportion are used to determine the sex composition of a population. A
population pyramid is used to present the composition of a population by age and sex.

63. Answer: (A) Crude birth rate

Natality means birth. A natality rate is a birth rate.

64. Answer: (B) 5.2/1,000

To compute crude death rate divide total number of deaths (94) by total population (18,000)
and multiply by 1,000.

65. Answer: (C) 1­4 year old children

Preschoolers are the most susceptible to PEM because they have generally been weaned.
Also, this is the population who, unable to feed themselves, are often the victims of poor
intrafamilial food distribution.

66. Answer: (C) Swaroop’s index

Swaroop’s index is the proportion of deaths aged 50 years and above. The higher the
Swaroop’s index of a population, the greater the proportion of the deaths who were able to
reach the age of at least 50 years, i.e., more people grew old before they died.

67. Answer: (B) 43.5/1,000

To compute for neonatal mortality rate, divide the number of babies who died before
reaching the age of 28 days by the total number of live births, then multiply by 1,000.
68. Answer: (A) 1­4 year old age­specific mortality rate
Since preschoolers are the most susceptible to the effects of malnutrition, a population with
poor nutritional status will most likely have a high 1­4 year old age­specific mortality rate,
also known as child mortality rate.

69. Answer: (B) Number of registered live births

To compute for general or total fertility rate, divide the number of registered live births by the
number of females of reproductive age (15­45 years), then multiply by 1,000.

70. Answer: (B) Survey

A survey, also called sample survey, is data gathering about a sample of the population.

71. Answer: (C) De facto

The other method of population assignment, de jure, is based on the usual place of
residence of the people.

72. Answer: (A) Tally report

A tally report is prepared monthly or quarterly by the RHU personnel and transmitted to the
Provincial Health Office.

73. Answer: (C) Target/client list

The MDT Client List is a record of clients enrolled in MDT and other relevant data, such as
dates when clients collected their monthly supply of drugs.

74. Answer: (A) P.D. 651

P.D. 651 amended R.A. 3753, requiring the registry of births within 30 days from their
occurrence.

75. Answer: (D) Any of these health professionals

R.A. 3753 states that any birth attendant may sign the certificate of live birth.

76. Answer: (C) Magnitude of the health problem

Magnitude of the problem refers to the percentage of the population affected by a health
problem. The other choices are criteria considered in both family and community health
care.
77. Answer: (D) Its main strategy is certification of health centers able to comply with
standards.
Sentrong Sigla Movement is a joint project of the DOH and local government units. Its main
strategy is certification of health centers that are able to comply with standards set by the
DOH.

78. Answer: (D) Those who just had a delivery within the past 15 months
The ideal birth spacing is at least two years. 15 months plus 9 months of pregnancy = 2
years.

79. Answer: (C) Adequate information for couples regarding the different methods
To enable the couple to choose freely among different methods of family planning, they
must be given full information regarding the different methods that are available to them,
considering the availability of quality services that can support their choice.

80. Answer: (B) Retinol 200,000 IU

Retinol 200,000 IU is a form of megadose Vitamin A. This may have a teratogenic effect.

81. Answer: (A) Her OB score is G5P3.

Only women with less than 5 pregnancies are qualified for a home delivery. It is also
advisable for a primigravida to have delivery at a childbirth facility.

82. Answer: (C) Folic acid

It is estimated that the incidence of neural tube defects can be reduced drastically if
pregnant women have an adequate intake of folic acid.

83. Answer: (D) Note the interval, duration and intensity of labor contractions.
Assessment of the woman should be done first to determine whether she is having
true labor and, if so, what stage of labor she is in.

84. Answer: (D) Explain to her that putting the baby to breast will lessen blood loss
after delivery.
Suckling of the nipple stimulates the release of oxytocin by the posterior pituitary gland,
which causes uterine contraction. Lactation begins 1 to 3 days after delivery. Nipple
stretching exercises are done when the nipples are flat or inverted. Frequent washing dries
up the nipples, making them prone to the formation of fissures.
85. Answer: (B) To stimulate milk production by the mammary acini
Suckling of the nipple stimulates prolactin reflex (the release of prolactin by the anterior
pituitary gland), which initiates lactation.

86. Answer: (B) The mother does not feel nipple pain.
When the baby has properly latched on to the breast, he takes deep, slow sucks; his mouth
is wide open; and much of the areola is inside his mouth. And, you’re right! The mother
does not feel nipple pain.

87. Answer: (B) 6 months

After 6 months, the baby’s nutrient needs, especially the baby’s iron requirement, can no
longer be provided by mother’s milk alone.

88. Answer: (C) Retinol 200,000 I.U., 1 capsule

A capsule of Retinol 200,000 IU is given within 1 month after delivery. Potassium iodate is
given during pregnancy; malunggay capsule is not routinely administered after delivery; and
ferrous sulfate is taken for two months after delivery.

89. Answer: (C) Measles vaccine

Among the biologicals used in the Expanded Program on Immunization, measles vaccine
and OPV are highly sensitive to heat, requiring storage in the freezer.

90. Answer: (B) 4

While the unused portion of other biologicals in EPI may be given until the end of the day,
only BCG is discarded 4 hours after reconstitution. This is why BCG immunization is
scheduled only in the morning.

91. Answer: (A) P.D. 996

Presidential Decree 996, enacted in 1976, made immunization in the EPI compulsory for
children under 8 years of age. Hepatitis B vaccination was made compulsory for the same
age group by R.A. 7846.

92. Answer: (B) BCG

BCG causes the formation of a superficial abscess, which begins 2 weeks after
immunization. The abscess heals without treatment, with the formation of a permanent scar.
93. Answer: (C) Infant BCG
Infant BCG may be given at birth. All the other immunizations mentioned can be given at 6
weeks of age.

94. Answer: (A) Seizures a day after DPT 1.

Seizures within 3 days after administration of DPT is an indication of hypersensitivity to
pertussis vaccine, a component of DPT. This is considered a specific contraindication to
subsequent doses of DPT.

95. Answer: (A) Go on with the infant’s immunizations.

In the EPI, fever up to 38.5°C is not a contraindication to immunization. Mild acute
respiratory tract infection, simple diarrhea and malnutrition are not contraindications either.

96. Answer: (A) 1 year

The baby will have passive natural immunity by placental transfer of antibodies. The mother
will have active artificial immunity lasting for about 10 years. 5 doses will give the mother
lifetime protection.

97. Answer: (C) Normal

In IMCI, a respiratory rate of 50/minute or more is fast breathing for an infant aged 2 to 12
months.

98. Answer: (D) Chest indrawing

In IMCI, chest indrawing is used as the positive sign of dyspnea, indicating
severe pneumonia.

99. Answer: (B) Refer him urgently to the hospital.

Severe pneumonia requires urgent referral to a hospital. Answers A, C and D are done for a
client classified as having pneumonia.

100. Answer: (B) Some dehydration

Using the assessment guidelines of IMCI, a child (2 months to 5 years old) with diarrhea is
classified as having SOME DEHYDRATION if he shows 2 or more of the following signs:
restless or irritable, sunken eyes, the skin goes back slow after a skin pinch.
101. Answer: (B) Supervise the mother in giving 200 to 400 ml. of Oresol in 4 hours.
In the IMCI management guidelines, SOME DEHYDRATION is treated with the
administration of Oresol within a period of 4 hours. The amount of Oresol is best computed
on the basis of the child’s weight (75 ml/kg body weight). If the weight is unknown, the
amount of Oresol is based on the child’s age.

102. Answer: (D) Let the child rest for 10 minutes then continue giving Oresol more slowly.
If the child vomits persistently, that is, he vomits everything that he takes in, he has to be
referred urgently to a hospital. Otherwise, vomiting is managed by letting the child rest for
10 minutes and then continuing with Oresol administration. Teach the mother to give Oresol
more slowly.

103. Answer: (D) Edema

Edema, a major sign of kwashiorkor, is caused by decreased colloidal osmotic pressure of
the blood brought about by hypoalbuminemia. Decreased blood albumin level is due a
protein­deficient diet.

104. Answer: (A) Refer the child urgently to a hospital for confinement.
“Baggy pants” is a sign of severe marasmus. The best management is urgent referral to a
hospital.

105. Answer: (D) Conjunctival xerosis

The earliest sign of Vitamin A deficiency (xerophthalmia) is night blindness. However, this is
a functional change, which is not observable during physical examination.The earliest
visible lesion is conjunctival xerosis or dullness of the conjunctiva due to inadequate tear
production.

106. Answer: (D) 200,000 IU

Preschoolers are given Retinol 200,000 IU every 6 months. 100,000 IU is given once to
infants aged 6 to 12 months. The dose for pregnant women is 10,000 IU.

107. Answer: (A) Palms

The anatomic characteristics of the palms allow a reliable and convenient basis for
examination for pallor.
108. Answer: (A) Sugar
R.A. 8976 mandates fortification of rice, wheat flour, sugar and cooking oil with Vitamin A,
iron and/or iodine.

109. Answer: (A) Give measles vaccine to babies aged 6 to 8 months.

Ordinarily, measles vaccine is given at 9 months of age. During an impending epidemic,
however, one dose may be given to babies aged 6 to 8 months. The mother is instructed
that the baby needs another dose when the baby is 9 months old.

110. Answer: (A) Inability to drink

A sick child aged 2 months to 5 years must be referred urgently to a hospital if he/she has
one or more of the following signs: not able to feed or drink, vomits everything, convulsions,
abnormally sleepy or difficult to awaken.

111. Answer: (D) Retinol capsule regardless of when the last dose was given
An infant 6 to 12 months classified as a case of measles is given Retinol 100,000 IU; a child
is given 200,000 IU regardless of when the last dose was given.

112. Answer: (B) Ask where the family resides.

Because malaria is endemic, the first question to determine malaria risk is where the client’s
family resides. If the area of residence is not a known endemic area, ask if the child had
traveled within the past 6 months, where he/she was brought and whether he/she stayed
overnight in that area.

113. Answer: (B) Destroying breeding places of mosquitoes

Aedes aegypti, the vector of Dengue fever, breeds in stagnant, clear water. Its feeding time
is usually during the daytime. It has a cyclical pattern of occurrence, unlike malaria which is
endemic in certain parts of the country.

114. Answer: (C) Determining whether a place is endemic or not

This is diagnostic and therefore secondary level prevention. The other choices are for
primary prevention.

115. Answer: (B) Pinworm

Pinworm ova are deposited around the anal orifice.
116. Answer: (C) Cough for 3 weeks
A client is considered a PTB suspect when he has cough for 2 weeks or more, plus one or
more of the following signs: fever for 1 month or more; chest pain lasting for 2 weeks or
more not attributed to other conditions; progressive, unexplained weight loss; night sweats;
and hemoptysis.

117. Answer: (D) Clients diagnosed for the first time through a positive sputum exam
Category I is for new clients diagnosed by sputum examination and clients diagnosed to
have a serious form of extrapulmonary tuberculosis, such as TB osteomyelitis.

118. Answer: (B) Having the health worker or a responsible family member monitor drug
intake
Directly Observed Treatment Short Course is so­called because a treatment partner,
preferably a health worker accessible to the client, monitors the client’s compliance to the
treatment.

119. Answer: (C) Thickened painful nerves

The lesion of leprosy is not macular. It is characterized by a change in skin color (either
reddish or whitish) and loss of sensation, sweating and hair growth over the lesion. Inability
to close the eyelids (lagophthalmos) and sinking of the nosebridge are late symptoms.

120. Answer: (D) 5 skin lesions, positive slit skin smear

A multibacillary leprosy case is one who has a positive slit skin smear and at least 5 skin
lesions.

121. Answer: (B) Liver cirrhosis

The etiologic agent of schistosomiasis in the Philippines is Schistosoma japonicum, which
affects the small intestine and the liver. Liver damage is a consequence of fibrotic reactions
to schistosoma eggs in the liver.

122. Answer: (C) Proper use of sanitary toilets

The ova of the parasite get out of the human body together with feces. Cutting the cycle at
this stage is the most effective way of preventing the spread of the disease to susceptible
hosts.
123. Answer: (B) II
A communal faucet or water standpost is classified as Level II.

124. Answer: (A) Use of sterile syringes and needles

Hepatitis A is transmitted through the fecal oral route. Hepatitis B is transmitted through
infected body secretions like blood and semen.

125. Answer: (A) DPT

DPT is sensitive to freezing. The appropriate storage temperature of DPT is 2 to 8° C only.
OPV and measles vaccine are highly sensitive to heat and require freezing. MMR is not an
immunization in the Expanded Program on Immunization.

126. Answer: (A) 45

To estimate the number of infants, multiply total population by 3%.

127. Answer: (B) Severe dehydration

The order of priority in the management of severe dehydration is as follows: intravenous
fluid therapy, referral to a facility where IV fluids can be initiated within 30 minutes,
Oresol/nasogastric tube, Oresol/orem. When the foregoing measures are not possible or
effective, tehn urgent referral to the hospital is done.

128. Answer: (A) 3

Adequate blood supply to the area allows the return of the color of the nailbed within 3
seconds.

129. Answer: (B) Instruct the mother to give the child Oresol.
Since the child does not manifest any other danger sign, maintenance of fluid balance and
replacement of fluid loss may be done by giving the client Oresol.

130. Answer: (B) Buccal mucosa

Koplik’s spot may be seen on the mucosa of the mouth or the throat.

131. Answer: (D) Measles

Viral conjunctivitis is transmitted by direct or indirect contact with discharges from infected
eyes. Acute poliomyelitis is spread through the fecal­oral route and contact with throat
secretions, whereas diphtheria is through direct and indirect contact with respiratory
secretions.

132. Answer: (A) Hemophilus influenzae

Hemophilus meningitis is unusual over the age of 5 years. In developing countries, the peak
incidence is in children less than 6 months of age. Morbillivirus is the etiology of measles.
Streptococcus pneumoniae and Neisseria meningitidis may cause meningitis, but age
distribution is not specific in young children.

133. Answer: (D) Zooprophylaxis

Zooprophylaxis is done by putting animals like cattle or dogs close to windows or doorways
just before nightfall. The Anopheles mosquito takes his blood meal from the animal and
goes back to its breeding place, thereby preventing infection of humans.

134. Answer: (A) Stream seeding

Stream seeding is done by putting tilapia fry in streams or other bodies of water identified as
breeding places of the Anopheles mosquito.

135. Answer: (C) Destruction of breeding places of the mosquito vector

Anopheles mosquitoes breed in slow­moving, clear water, such as mountain streams.

136. Answer: (B) Cholera

Passage of profuse watery stools is the major symptom of cholera. Both amebic and
bacillary dysentery are characterized by the presence of blood and/or mucus in the stools.
Giardiasis is characterized by fat malabsorption and, therefore, steatorrhea.

137. Answer: (B) S. japonicum

S. mansoni is found mostly in Africa and South America; S. haematobium in Africa and the
Middle East; and S. malayensis only in peninsular Malaysia.

138. Answer: (D) Leptospirosis

Leptospirosis is transmitted through contact with the skin or mucous membrane with water
or moist soil contaminated with urine of infected animals, like rats.

139. Answer: (C) III

Waterworks systems, such as MWSS, are classified as level III.
140. Answer: (D) Refer the client for a supplementary test, such as Western blot, since the
ELISA result may be false.
A client having a reactive ELISA result must undergo a more specific test, such as Western
blot. A negative supplementary test result means that the ELISA result was false and that,
most probably, the client is not infected.

141. Answer: (A) Being faithful to a single sexual partner

Sexual fidelity rules out the possibility of getting the disease by sexual contact with another
infected person. Transmission occurs mostly through sexual intercourse and exposure to
blood or tissues.

142. Answer: (B) Infectious mononucleosis

Cytomegalovirus disease is an acute viral disease characterized by fever, sore throat and
lymphadenopathy.

143. Answer: (A) Contact tracing

Contact tracing is the most practical and reliable method of finding possible sources of
person­to­person transmitted infections, such as sexually transmitted diseases.

144. Answer: (D) They are able to bring about a cure of the disease condition.
There is no known treatment for AIDS. Antiretroviral agents reduce the risk of opportunistic
infections and prolong life, but does not cure the underlying immunodeficiency.

145. Answer: (D) Consult a physician who may give them rubella immunoglobulin.
Rubella vaccine is made up of attenuated German measles viruses. This is contraindicated
in pregnancy. Immune globulin, a specific prophylactic against German measles, may be
given to pregnant women.
1. Period of maximum infectivity in mumps is during

A. incubation period

B. onset of swelling

C. after swelling appears

D. prodromal period

Answer Key

2. Shick test is done in:

A. meningitis

B. diphtheria

C. pertussis

D. polimyelitis

Answer Key

3. Recommended site of administration of DPT in infants is

A. gluteal

B. deltoid

C. lateral aspect of thigh

D. forearm

Answer Key

4. . Major epidemics of influenza A occur at intervals of:

A. 1 year
B. 2-3 years

C. 10-15 years

D. 20-25 years

Answer Key

5. The vaccine usually given to pilgrims to the Middle East is:

A. DPT

B. influenza

C. yellow fever

d. meningitis

Answer Key

6. Measles vaccine is given under the National Immunization

Programme:

A. 6 weeks

B. 6 months

C. 9 Months

D. 18 months

Answer Key

7. Modifiable risk factors in case of Hypertension include all,

EXCEPT:

A. Age
B. Obesity

C. Salt intake

D. Alcohol intake

Answer Key

8. Saturated fatty acids are all, EXCEPT:

A. Lauric

B. Palmitic

C. Stearic

D. Oleic

Answer Key

9. Infections primarily of animals that can be transmitted

through milk is all, EXCEPT:

A. Tuberculosis

B. Brucellosis

C. Q fever

D. Malaria

Answer Key

10. The diseases notifiable to the WHO under the International

Regulation Act are all except:

A. Cholera

B. Plague
C. Yellow Fever

D. Diphtheria

Answer Key

11. Quickening means:

A. Hearing of the fetal heart sound

B. Sudden cessation of Menstruation

C. The movement of the feuts in the uterus felt by the mother

D. Nausa and vomiting in the morning

Answer Key

12. Discolouration of teeth is caused by a kind of antibiotics

called:

A. Streptomycin

B. Neomycin

C. Tetracycline

D. Penicillin

Answer Key

ANSWER KEY

1. B 2. B 3. B 4. D 5. C
6. C 7.A 8. D 9. D 10. D
11. D 12. C
 Questions and Answers
 1.
Involvement is not only cleaning surroundings and toilet construction but also sharing responsibilities and
participation in one of the following:
o A.

Problem­solving seminars
o B.

Meetings with barangay officers

o C.

Social work about livelihood

o D.

Defining health needs( C)

 2.
To encourage community participation, which of the following should a nurse do?
o A.

Invite people from civic organizations

o B.

Refer to the doctor for prescriptions

o C.

Encourage sponsorship to programs

o D.

Listen when people relate their problems ( correct)

 3.
Which of the following is appropriate for common ailments such as cough and fever?
o A.

Ndigenous plants with proven benefits( Correct)

o B.

Medicine at Botika sa Baryo Project

o C.

Medicine from other drugstores

o D.
 Medicine in the doctor’s clinic

 4.
Which one of the following is NOT an essential element of Primary Health Care?
o A.

Multi Sectoral Approach

o B.

Community involvement
o C.

Appropriate technology
o D.

Qualification of health providers( Correct)

 5.
The mission of PHC must be embodied in the hearts of health care providers. Which mission strengthens health care
system?
o A.

Supporting conditions for healthy habits

o B.

Increasing opportunities to be healthy

o C.

Letting people manage their own health( Correct)

o D.

Financing health care programs

 6.
The key strategy to obtain the mission of PHC is:
o A.

Linkages with health organizations

o B.

Requesting donations from NGO’s

o C.

Partnership with people( correct)

o D.

Electing good people in government

 7.
 Aim of PHC is to evolved a total community health care system integrated in people’s way of life. What was done by
the government?
o A.

Mandate of devolution(correct)
o B.

Soliciting from NGO’s

o C.

International acceptance
o D.

Linkages with WHO

 8.
What factor contributes to the effectiveness of care to your clients as an Rural Unit nurse?
o A.

Interpersonal relationship with barangay officials

o B.

Expertise in health education

o C.

Knowledge of the objectives of health programs

o D.

Respect of customs beliefs and values of clients(correct)

 9.
As a nurse, your organize community groups to participate in your program?
o A.

Instruct them to agree with you

o B.

Assign roles
o C.

Let people decide for themselves(correct)

o D.

Conduct group work

 10.
Utilization of indigenous resources maximizes efforts of the community Health Nurse. Which one of the following
Department of Health programs could you apply this principle?
o A.
 Vegetable gardening
o B.

Training of Hilots(correct)
o C.

Herbal medicine
o D.

Nutrition of children

 11.
One important function and responsibility of the Regional Training Nurse is:
o A.

Designing training program for nurses and midwives

o B.

Assessing needs of nurses and midwives( correct)

o C.

Organizing field trips to tertiary hospital

o D.

Evaluating credentials of applicants

 12.
Perla is Elena’s co-worker as community Health Nurse. Which of the following is the general duty of Perla?
o A.

Provides nursing care to the community(correct)

o B.

Communicates to the health team

o C.

Coordinates with municipal Health Officer

o D.

Establishes rapport with clients

 13.
The Rural Health Midwife, Rosita, is under the Supervisor of the Public Health Nurse. In which of the following health
care aspects should Rosita be assigned?
o A.

Reporting of disease incidence

o B.
 Coordinating with clients
o C.

Basic maternal child care(correct)

o D.

Monitoring use of equipment

 14.
Which factor influence OLOF?
o A.

Eco­system(correct)
o B.

Environment
o C.

Health care delivery

o D.

Behavior

 15.
What is the focus of secondary health care?
o A.

Early malnutrition
o B.

Early signs and symptoms

o C.

Early diagnosis and treatment(correct)

o D.

Early detection

 16.
Each process has unique way on adaptation. Which aspect should man co-exist with?
o A.

Environment(correct)
o B.

Family
o C.

Church
o D.

Organization

 17.
What would you tell a mother who refuses to immunize her baby?
o A.

“Immunization is okay for your baby.”

o B.

“Vaccines are expensive, you get it free.”

o C.

“It’s up to you if your baby gets sick

o D.

“Vaccines will prevent diseases.”(correct)

 18.
Pregnant woman seeks the help for a trained hilot. What are the reasons why they like hilot?
o A.

Cumadrona is busy(correct)
o B.

Hilot renders holistic touch

o C.

Babaylan is better than none

o D.

Faith healers are less expensive

 19.
If nurses are busy, hilots can really be of help. What cases should be assigned to hilots?
o A.

Would dressing
o B.

Respiratory infection
o C.

Normal deliveries( correct)

o D.

Immunization
 20.
Which one of the following Acts means that “Health Workers” are all persons engaged in health-related work
regardless of their employment status?
o A.

Magma Carta of Public Health workers(correct)

o B.

Security of tenure of regular employees

o C.

Discrimination Prohibition
o D.

Code of ethical standards of Public Officials and employees

 21.
The Philippine Nursing Act of 1991, in Section 27 Scope of Nursing, describes the person practicing Nursing when
the person uses which one of the following scientific knowledge?
o A.

Nursing process(correct)
o B.

Management skills
o C.

Studies of nursing manpower needs

o D.

Diagnostic procedures

 22.
The nurse assigned in the Rural Health Unit as a beginning nurse practitioner is described as one of the following:
o A.

Specialist
o B.

Mother­child nurse
o C.

Generalist(correct)
o D.

Home care nurse

 23.
In Rural Health Unit, which kinds of health services are available?
o A.

Safe motherhood
o B.

Post hospitalization
o C.

Home care
o D.

All types(correct)

 24.
Which of these scientific processes is used by the nurse where in biological and sociological sciences are utilized to
obtain community resources?
o A.

Nursing management
o B.

Nursing program
o C.

Nursing networking
o D.

Nursing process(correct)

 25.
What is the legal basis of the implementation of PHC in conjunction to the First International Conference on Primary
Health Care sponsored by the WHO?
o A.

Letter of Instruction 949(correct)

o B.

Presidential Decree 996

o C.

R.A 7305
o D.

R.A 7164

139
. In unit planning which of the following questions initiate the process?

a. How to schedule the activities?b. Who will do the planning?

c. What is to be accomplished?

d. Where to get unit supplies?140

. This is an example of data that should be analyzed when identifying missing needs.a. Number of
nursing staf

b. Medical diagnosis of patientc. Ward supplies and materialsd. Patient classification141

. To accomplish the nursing unit work, you should first get information about:a. Objectives of the unit

c. Nursing budgetb. Nursing service organizational chartd. Mission of the hospital142

This is an example of a patient care unit objective

a. To ensure adequate unit supplies/materialsb. To use the kardex system of chartingc. To determine the
number of nursing staff needed

d. To provide safe nursing

143

. Which of the following tools can be most helpful in the evaluation of staf performance?

a. Performance assessment

b. Performance standard

c. Performance auditd. Performance appraisalSituation 18. Rebecca, a 2 year old and her Mother are
consulting the community health nurse144

. The nurse observes Rebecca at play in the clinic. She realizes that at this age, Rebecca could
beexpected to exhibit which of the following?

a. Build houses with blocks

b. Is extremely possessive of toys

c. Attempts to stay within the hue when coloringd. Amuses herself with a picture book of 15 minutes145

. When observing Rebecca, the nurse would expect her to engage in which type of play?a. Parallel play

b. Solitary playc. Competitive playd. tumbling play146

. Rebecca's mother asks the nurse when it would be appropriate to take her to the dentist fordental
prophylaxis. What is the nurse most appropriate response?

a. Before starting school

b. Between 2 and 3 years of age

c. When Rebecca begins to lose deciduous teethd. The next time another family member goes to the
dental147

. Rebecca's mother say's that Rebecca consistently says "no” every time she is ofered
fluids.Considering Rebecca's development, how could the nurse assist the mother to increase
Rebecca'sfluid intake?

a. Distract her with some foodb. Be firm and hand her the glass

c. Ofer her a choice of two things to drink

d. Let Rebecca see that she is making her mother angry148

. Rebecca is well and is to be discharged- Her mother asks the nurse why Rebecca persists insaying
''no'' to everything. The nurse explains to Rebecca's mother that this negativism is helpingRebecca to
meet a 2 year old need for which of the following?

a. Trustb. Attentionc. Discipline

d. Independence

Situation 19. You are the nurse assigned in the nursery unit and your patients are of various ages.149

. Assessment an infant, the nurse knows that a pincer grasp nornally appears

a. At the same time as the palmar grasp

b. Between 9 & 12 month of age

c. Between 5 & 7 month of aged. Along with the ability to "rake" objects toward themselves150

. In a child development, the period of negativism begins when the child

a. Can manipulate his or her parentsb. Copies negative behavior of sibling.

c. Is struggling between dependence and independence

d. Is learning manual skills151

. The nurse is caring for a hospitalized toddler who was toilet trained home. He wets his pants.The best
response to this situation is to say?

a. "Its okay, try not to wet your pants next time”

b. "That's okay. Now lets get you cleaned up”

c. "I know you understand how to use the toilet; what happened?"

d. "Your mom told me you don't wet anymore; what's wrong?"152

. Which of the following behavior would a normal 18 moths old be likely to exhibit during the firstfew
hours of hospitalization?a. Crying loudly when parents leave
b. Readily accepting the nurse caring for himc. Showing considerable interest in new toyd. Sitting quietly
in the comer of the cab, showing little or no interest in his surrounding153

. Evaluating a 1 month old infant normal developmental skills, the Nurse should observe that
theinfanta. Actively follow movement of familiar persons with her eyes

b. Responds to "No-No"c. Turns her head to a familiar noised. Discriminates between family and
strangers

154.

The nurse knows which of the following indicates protein deficiency?a. Hypoalbuminemia and pot
belly

b. Koionychia (spoon-shaped nails)c. Beefy red tongued.d. Bleeding gums155.

Before administering a tube feeding the nurse knows to perform which of the followingassessments?
a. The GI tract including bowel sound, last BM and distention

b. The clients neurologic status, especially gag reflexc. The amount of air in the stomachd. The formula
used directly from the refrigerator156

. An adult is being taught about a healthy diet. The nurse can ofer:

a. Milkb. Jello

c. Freshly squeezed orange juice

d. Ice cream157

. An adult has received an injection of immunoglobulin. The nurse knows that the client willdevelop
which of the following types of immunity:

a. Active natural immunityb. Active artificial immunityc. Passive natural immunity

d. Passive artificial immunity

158

. Which of these groups should a nurse target when planning a community

education presentationabout testicular cancer?

a. Day care providersb. Senior citizensc. Middle - aged mend. High - school students159

. A woman reports all of the following data when giving his history to a nurse. Which one
wouldindicate a risk factor for developing cancer of cervix?

a. Diet high in fatb. Exposure to pesticidesc. "What does your family want you to do."

d. "I wouldn't have the surgery done without a second opinion."

160
. A nurse is planning a community education presentation about testicular cancer. The largegroups
should be men aged:a. 20 to 39 years

b. 40 to 49 yearsc. 50 to 64 yearsd. 65 years and older161

. A 10-year-old boy who is in the terminal stages of Duchenne muscular dystrophy is being caredfor at
home. When evaluating for major complications of this disease, a nurse would give priority
toassessing which of the following body systems?

a. Integumentaryb. Neurological

c. Respiratory

d. Gastrointestinal162

. The physician asks the nurse to describe the laparoscopy procedure for sterilization to Ms.Bruce.
Which of the following is part of a correct explanation of this procedure?a. Two small abdominal
incisions are made to introduce the instrument

b. Hospitalization for 4 to 5 days is normally requiredc. This procedure is performed vaginallyd. This
procedure requires the consent of the sexual partner163

. The nurse is asked to plan a health teaching program for women of child-bearing age withgenital
herpes. Which one of the following should the nurse include in a teaching session?

a. The physician will prescribe an antiviral drug as a pregnancy is confirmedb. Genital herpes in the
mother-has no effect on the infantc. Wait until the infection has been cured before becoming pregnant

d. If pregnant, in form the physician of a history of genital herpes

164

. Ms. Manning is scheduled for Papanicolaou test (Pap Smear) at the time of the next visit to
thephysician's office. Which one of the following instructions should the nurse give to Ms. Manning?a.
Do not douche for 2 to 3 days before this test

b. Do not drink coffee or alcoholic beverages for 2 days before this testc. It will be necessary to fast from
midnight the night before the test

d. Bring a sanitary napkin with you because bleeding usually occurs after this week165

. The nurse obtains a health history from Ms. Reeves who states that she usually has symptomswhen
she ovulates. If Ms. Reeves has a normal menstrual cycle, how many days after ovulationshould
menstruation begin?

a. 3 daysb. 7 days

c. 14 days

d. 21 days166
. The physician asks the nurse to discuss the use of an oral contraceptive with Ms. Sheppard. Thenurse
should instruct Ms. Sheppard that oral contraceptive:a. Are taken at the same time each day,
preferably in the evening

b. Must be taken on an empty stomachc. Are started on the first day of menstruationd. Are best taken in
the morning before breakfast167

. Ms. Dodd has been told by her physician that she has genital warts, which are caused by ahuman
.papilloma-virus-infection. She asks the nurse if there is any danger or problems associatedwith this
condition. The most correct response-is based on the fact that genital warts:

a. Can be treated with an antibiotic, such as penicillin or tetracyclineb. Appear to increase the risk of
cancer of the vulva, vagina, and cervixc. Can be prevented of the individual takes birth control pills

d. Are of no danger and need not be treated

168

. Which of the following are included in the instructions for a client having a pelvic examination?

a. Self-administer an enema or take a laxative for 2 nights prior to the examination

b. Void immediately before the examination

c. Douche the day before the examinationd. Do not eat or drink fluids after midnight169

. The nurse is assigned to teach young women attending a gynecology clinic. The physiciansuggests
that the nurse include explaining ways to prevent toxic shock syndrome. Which one of thefollowing
suggestions can be included in this teaching session?a. Avoid using super absorbed tampons

b. Take a diuretic at the onset of menstruationc. Avoid the use of large sanitary padsd. Use a tampon
on(y during the night

b. collecting and analyzing informationc. withholding results from the community until they can
be statisticallyconfirmed, to avoid alarming peopled. setting action priorities based on the needs of the
community andavailable resources4. a valid way to collect data for a community assessment is:a. using a
library database for literative reviewb. reading government documents to find out about previous
datac. using surveys or questionnaires to gather information from thecommunity membersd. all of the
above

CHN CLINIC VISIT:

PRE-CONSUATION VISIT

: clinical history taking, vital sings, physicalassessments, laboratory exams and documentation-

MEDICAL EXAMINATION
: ensure privacy, safety and comfort of thepatient throughout procedure-

POST-CONSULATION

: explain findings and needed care, refer asneeded, make appointment for nest clinic/ home visitSample
questions:1. during clinic visits, all of the following are done in the consultationconference, EXCEPT:a.
take clinical history after greeting and making client at easeb. refer client to other related staff or
agency if necessaryc. take temperature, BP, height and weightd. perform physical assessment and
selective laboratory examination

COMMUNITY ORGANIZING

:- a continuous of awareness building, organizing and mobilizing communitymembers towards

community development- phases of activities:

PRE-ENTRY

- preparation of the staff- site selection

ENTRY PHASE

– integration with the community- courtesy calls, information campaigns, identificationof potential
leaders

CORE-GROUP FORMATION AND MOBILIZING

- integration with the core group

ORGANIZATIO- BUILDING

- organizing barrio health committee, setting up the communityorganization

CONSOLIDATION AND EXPANSION PHASE

- networking and establishing linkages, implementation oflivelihood-projects and developing secondary

leaders

Sample questions

1. one of the primary tasks of the community health nurses during thepre-entry phase is the selection of
the barangay to become the initialsite for their organizing efforts. The following are the steps in
theselection of the project site by the team, EXCEPT:a. developing criteria for site selectionb. identifying
potential barangays and choosing the final project villagec. identification of potential leadersd.
identification of the host family2. it is during this period that one member of the team formed was
giventhe ole of a community organizer:a. organizing-building phaseb. core stoup formation phasec.
consolidation phased. expansion phase3. for potential leaders to perform their roles effectively, they
have topossess certain characteristics. Among these are the following, EXCEPT:a. they must belong to the
poor sectorb. they must be respected members of the communityc. preferably informal leadersd. formal
leaders with many community responsibilities4. this phase signals the start of community self-
management of anydevelopment program:a. consolidation and expansion phaseb. core group
formationc. entry phased. organization building phase5. under this phase of the education and training
process, the conduct oftraining, monitoring and documentation of training are included in:a.
implementation phaseb. planning phasec. evaluation phased. post-training phase

DENTAL HEALTH PROGRAM:-

vision

: a lifetime oral health and no tooth decay for the nestgenerations-

objective

: to prevent and control dental diseases and conditions- “Sang milyong Sepilyo”- project for social
mobilization of dental healthprogram

DEPARTMENT OF HEALTH:

Vision:

health for all filipinos-

mission:

enhance accessibility and quality of health care to improve thequality of life of all Filipinos, especially the
poor

- basic principles to achieve improvement of health

1. ensured universal access to basic health services2. health and nutrition of vulnerable groups must be
prioritized

3. epidemiological shift from infection to degenerative diseases mustbe managed4. performance of the
health sector must be enhanced-

primary strategies:

1. assurance of health care2. increased investment for primary health care3. development of national
standards and objectives for health4. support to local health system development and frontline
healthworkers

Sample questions:
Situation: the department of health formulated plan, programs andprojects with the vision, “health for
all Filpinos’1. which of the following is the mission of the department of health?a. promote healthy
lifestyleb. ensure accessibility and quality of health carec. reduce morbidity and mortalityd. improve
general health status of the people2. which of the following is not a basic principle in the achievement
ofimproved health?a. health and nutrition prioritiesb. universal access to health servicec. enhancement
of performance of health sectord. investment for primary health care3. which of the following is not a
primary strategies to achieve healthgoals?a. support of local health systemb. development of national
standards for healthc. assurance of health care for alld. funding from non-government organization

D.Neisseria meningitidis

Answer: (A) Hemophilus influenzae

Hemophilus meningitis is unusual over the age of 5 years. In developing countries, the peak incidence is
in childrenless than 6 months of age. Morbillivirus is the etiology of measles. Streptococcus pneumoniae
and Neisseriameningitidis may cause meningitis, but age distribution is not specific in
young children.134. Human beings are the major reservoir of malaria. Which of the following strategies
in malaria control is based onthis fact?A.Stream seedingB.Stream clearingC.Destruction of breeding
placesD.Zooprophylaxis

Answer: (D) Zooprophylaxis

Zooprophylaxis is done by putting animals like cattle or dogs close to windows or doorways just before
nightfall. TheAnopheles mosquito takes his blood meal from the animal and goes back to its breeding
place, thereby preventinginfection of humans.135. The use of larvivorous fish in malaria control is the
basis for which strategy of malaria control?A.Stream seedingB.Stream clearingC.Destruction of breeding
placesD.Zooprophylaxis

Answer: (A) Stream seeding

Stream seeding is done by putting tilapia fry in streams or other bodies of water identified as breeding
places of theAnopheles mosquito136. Mosquito-borne diseases are prevented mostly with the use of
mosquito control measures. Which of thefollowing is NOT appropriate for malaria control?A.Use of
chemically treated mosquito netsB.Seeding of breeding places with larva-eating fishC.Destruction of
breeding places of the mosquito vector D.Use of mosquito-repelling soaps, such as those with basil or
citronella

Answer: (C) Destruction of breeding places of the mosquito vector

Anopheles mosquitoes breed in slow-moving, clear water, such as mountain streams.137. A 4-year old
client was brought to the health center with the chief complaint of severe diarrhea and the passageof
“rice water” stools. The client is most probably suffering from which condition?
A.GiardiasisB.CholeraC.AmebiasisD.Dysentery

Answer: (B) Cholera

Passage of profuse watery stools is the major symptom of cholera. Both amebic and bacillary dysentery
arecharacterized by the presence of blood and/or mucus in the stools. Giardiasis is characterized by fat
malabsorptionand, therefore, steatorrhea.138. In the Philippines, which specie of schistosoma is
endemic in certain regions?A.S. mansoniB.S. japonicumC.S. malayensisD.S. haematobium

Answer: (B) S. japonicum

S. mansoni is found mostly in Africa and South America; S. haematobium in Africa and the Middle East;
and S.malayensis only in peninsular Malaysia.

139. A 32-year old client came for consultation at the health center with the chief complaint of fever for
a week.Accompanying symptoms were muscle pains and body malaise. A week after the start of fever,
the client notedyellowish discoloration of his sclera. History showed that he waded in flood waters about
2 weeks before the onset of symptoms. Based on his history, which disease condition will you suspect?
A.Hepatitis AB.Hepatitis BC.TetanusD.Leptospirosis

Answer: (D) Leptospirosis

Leptospirosis is transmitted through contact with the skin or mucous membrane with water or moist soil
contaminatedwith urine of infected animals, like rats.140. MWSS provides water to Manila and other
cities in Metro Manila. This is an example of which level of water facility?A.IB.IIC.IIID.IV

Answer: (C) III

Waterworks systems, such as MWSS, are classified as level III.141. You are the PHN in the city health
center. A client underwent screening for AIDS using ELISA. His result waspositive. What is the best course
of action that you may take?A.Get a thorough history of the client, focusing on the practice of high risk
behaviors.B.Ask the client to be accompanied by a significant person before revealing the result.C.Refer
the client to the physician since he is the best person to reveal the result to the client.D.Refer the client
for a supplementary test, such as Western blot, since the ELISA result may be false.

Answer: (D) Refer the client for a supplementary test, such as Western blot, since the ELISA result may
befalse.

A client having a reactive ELISA result must undergo a more specific test, such as Western blot. A
negativesupplementary test result means that the ELISA result was false and that, most probably, the
client is not infected.142. Which is the BEST control measure for AIDS?A.Being faithful to a single
sexual partner B.Using a condom during each sexual contactC.Avoiding sexual contact with commercial
sex workersD.Making sure that one’s sexual partner does not have signs of AIDS

Answer: (A) Being faithful to a single sexual partner

Sexual fidelity rules out the possibility of getting the disease by sexual contact with another infected
person.Transmission occurs mostly through sexual intercourse and exposure to blood or tissues.143. The
most frequent causes of death among clients with AIDS are opportunistic diseases. Which of the
followingopportunistic infections is characterized by tonsillopharyngitis?A.Respiratory
candidiasisB.Infectious mononucleosisC.Cytomegalovirus diseaseD.Pneumocystis carinii pneumonia
Answer: (B) Infectious mononucleosis

Cytomegalovirus disease is an acute viral disease characterized by fever, sore throat and
lymphadenopathy.144. To determine possible sources of sexually transmitted infections, which is the
BEST method that may beundertaken by the public health nurse?A.Contact tracingB.Community
surveyC.Mass screening testsD.Interview of suspects

Answer: (A) Contact tracing

Contact tracing is the most practical and reliable method of finding possible sources of person-to-person
transmittedinfections, such as sexually transmitted diseases.145. Antiretroviral agents, such as AZT, are
used in the management of AIDS. Which of the following is NOT anaction expected of these drugs.A.They
prolong the life of the client with AIDS.B.They reduce the risk of opportunistic infectionsC.They shorten
the period of communicability of the disease.D.They are able to bring about a cure of the disease
condition.

Answer: (D) They are able to bring about a cure of the disease condition.

There is no known treatment for AIDS. Antiretroviral agents reduce the risk of opportunistic
infections and prolong life,but does not cure the underlying immunodeficiency.146. A barangay had an
outbreak of German measles. To prevent congenital rubella, what is the BEST advice thatyou can give to
women in the first trimester of pregnancy in the barangay?A.Advice them on the signs of German
measles.B.Avoid crowded places, such as markets and moviehouses.C.Consult at the health center
where rubella vaccine may be given.D.Consult a physician who may give them rubella immunoglobulin.

Answer: (D) Consult a physician who may give them rubella immunoglobulin.

Rubella vaccine is made up of attenuated German measles viruses. This is contraindicated in pregnancy.
Immuneglobulin, a specific prophylactic against German measles, may be given to pregnant women.147.
You were invited to be the resource person in a training class for food handlers. Which of the following
wouldyou emphasize regarding prevention of staphylococcal food poisoning?A.All cooking and eating
utensils must be thoroughly washed.B.Food must be cooked properly to destroy 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.

Answer: (D) Proper handwashing during food preparation is the best way of preventing the condition.

Symptoms of this food poisoning are due to staphylococcal enterotoxin, not the microorganisms
themselves.Contamination is by food handling by persons with staphylococcal skin or eye infections.148.
In a mothers’ class, you discussed childhood diseases such as chicken pox. Which of the following
statementsabout chicken pox is correct?A.The older one gets, the more susceptible he becomes to the
complications of chicken pox.B.A single attack of chicken pox will prevent future episodes, including
conditions such as shingles.C.To prevent an outbreak in the community, quarantine may be imposed by
health authorities.D.Chicken pox vaccine is best given when there is an impending outbreak in the
community.

Answer: (A) The older one gets, the more susceptible he becomes to the complications of chicken pox.
Chicken pox is usually more severe in adults than in children. Complications, such as pneumonia, are
higher inincidence in adults.149. Complications to infectious parotitis (mumps) may be serious in
which type of clients?A.Pregnant womenB.Elderly clientsC.Young adult malesD.Young infants

Answer: (C) Young adult males

Epididymitis and orchitis are possible complications of mumps. In post-adolescent males, bilateral
inflammation of thetestes and epididymis may cause sterility