Community Health Nursing Practice Questions with Rationales 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 illness 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 . To contribute to national development through promotion of family welfare, focusing particularly on mothers and children. Answer: (B) To enhance the capacity of in i!i uals" families an communities to cope with their health nee s To contribute to national development through promotion of family welfare, focusing particularly on mothers and children. !. C"# is a community$based practice. Which best e%plains this statement? A. The service is provided in the natural environment of people. B. The nurse has to conduct community diagnosis to determine nursing needs and problems. C. The services are based on the available resources within the community. . &riority setting is based on the magnitude of the health problems identified. Answer: A# The ser!ice is pro!i e in the natural en!ironment of people# Community$based practice means providing care to people in their own natural environments' the home, school and wor(place, for e%ample. ). &opulation$focused nursing practice re*uires which of the following processes? A. Community organi+ing B. #ursing process C. Community diagnosis . ,pidemiologic process Answer: (C) Community iagnosis &opulation$focused nursing care means providing care based on the greater need of the ma-ority of the population. The greater need is identified through community diagnosis. .. /.A. 101. is also (nown as the 2ccupational "ealth Act. Aside from number of employees, what other factor must be considered in determining the occupational health privileges to which the wor(ers will be entitled? A. Type of occupation' agricultural, commercial, industrial B. 3ocation of the wor(place in relation to health facilities C. Classification of the business enterprise based on net profit . 4e% and age composition of employees Answer: (B) $ocation of the wor%place in relation to health facilities Based on /.A. 101., an occupational nurse must be employed when there are )0 to 100 employees and the wor(place is more than 1 (m. away from the nearest health center.

C. !01 . )01 Answer: (B) &'& Again, this is based on /.A. 101.. 5. When the occupational health nurse employs ergonomic principles, she is performing which of her roles? A. "ealth care provider B. "ealth educator C. "ealth care coordinator . ,nvironmental manager Answer: (() )n!ironmental manager ,rgonomics is improving efficiency of wor(ers by improving the wor(er6s environment through appropriately designed furniture, for e%ample. 7. A garment factory does not have an occupational nurse. Who shall provide the occupational health needs of the factory wor(ers? A. 2ccupational health nurse at the &rovincial "ealth 2ffice B. &hysician employed by the factory C. &ublic health nurse of the /"8 of their municipality . /ural sanitary inspector of the /"8 of their municipality Answer: (C) Pu*lic health nurse of the RH+ of their municipality 9ou6re right: This *uestion is based on /.A.101.. ;. <&ublic health services are given free of charge.= >s this statement true or false? A. The statement is true? it is the responsibility of government to provide basic 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 re*uired. . The statement may be true or false, depending on policies of the government concerned. Answer: (B) The statement is false, people pay in irectly for pu*lic health ser!ices# Community health services, including public health services, are pre$paid services, though ta%ation, for e%ample. @. According to C.,.Winslow, which of the following is the goal of &ublic "ealth? A. Aor people to attain their birthrights of health and longevity B. Aor promotion of health and prevention of disease C. Aor people to have access to basic health services . Aor people to be organi+ed in their health efforts Answer: (A) -or people to attain their *irthrights of health an longe!ity According to Winslow, all public health efforts are for people to reali+e their birthrights of health and longevity.

10. We say that a Ailipino has attained longevity when he is able to reach the average lifespan of Ailipinos. What other statistic may be used to determine attainment of longevity? 1. A business firm must employ an occupational health nurse when it has A. Age$specific mortality rate at least how many employees? B. &roportionate mortality rate A. !1 C. 4waroop6s inde% B. 101 . Case fatality rate

Answer: (C) .waroop/s in e0 4waroop6s inde% is the percentage of the deaths aged 10 years or older. >ts inverse represents the percentage of untimely deaths Bthose who died younger than 10 yearsC. 11. Which of the following is the most prominent feature of public health nursing? A. >t involves providing home care to sic( people who are not confined in the hospital. B. 4ervices 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 services. . &ublic health nursing focuses on preventive, not curative, services. Answer: (() Pu*lic health nursing focuses on pre!enti!e" not curati!e" ser!ices# The catchment area in &"# consists of a residential community, many of whom are well individuals who have greater need for preventive rather than curative services. 1!. According to Dargaret 4hetland, the philosophy of public health nursing is based on which of the following? A. "ealth and longevity as birthrights B. The mandate of the state to protect the birthrights of its citi+ens C. &ublic health nursing as a speciali+ed field of nursing . The worth and dignity of man Answer: (() The worth an ignity of man This is a direct *uote from r. Dargaret 4hetland6s statements on &ublic "ealth #ursing. 1). Which of the following is the mission of the epartment of "ealth? A. "ealth for all Ailipinos B. ,nsure the accessibility and *uality of health care C. >mprove the general health status of the population . "ealth in the hands of the Ailipino people by the year !0!0 Answer: (B) )nsure the accessi*ility an 1uality of health care BnoneC 1.. /egion >E "ospital is classified as what level of facility? A. &rimary B. 4econdary C. >ntermediate . Tertiary Answer: (() Tertiary /egional hospitals are tertiary facilities because they serve as training hospitals for the region. 11. Which is true of primary facilities? A. They are usually government$run. B. Their services are provided on an out$patient basis. C. They are training facilities for health professionals. . A community hospital is an e%ample of this level of health facilities. Answer: (B) Their ser!ices are pro!i e on an out2patient *asis# &rimary facilities government and non$government facilities that provide basic out$patient services.

15. Which is an e%ample of the school nurse6s health care provider functions? A. /e*uesting for BCF from the /"8 for school entrant immuni+ation B. Conducting random classroom inspection during a measles epidemic C. Ta(ing remedial action on an accident ha+ard in the school playground . 2bserving places in the school where pupils spend their free time Answer: (B) Con ucting ran om classroom inspection uring a measles epi emic /andom classroom inspection is assessment of pupilsGstudents and teachers for signs of a health problem prevalent in the community. 17. When the nurse determines whether resources were ma%imi+ed in implementing 3igtas Tigdas, she is evaluating A. ,ffectiveness B. ,fficiency C. Ade*uacy . Appropriateness Answer: (B) )fficiency ,fficiency is determining whether the goals were attained at the least possible cost. 1;. 9ou are a new B.4.#. graduate. 9ou want to become a &ublic "ealth #urse. Where will you apply? A. epartment of "ealth B. &rovincial "ealth 2ffice C. /egional "ealth 2ffice . /ural "ealth 8nit Answer: (() Rural Health +nit /.A. 7150 devolved basic health services to local government units B3F86s C. The public health nurse is an employee of the 3F8. 1@. /.A. 7150 mandates devolution of basic services from the national government to local government units. Which of the following is the ma-or 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 self$reliance . To ma(e basic services more accessible to the people Answer: (C) To empower the people an promote their self2reliance &eople empowerment is the basic motivation behind devolution of basic services to 3F86s. !0. Who is the Chairman of the Dunicipal "ealth Board? A. Dayor B. Dunicipal "ealth 2fficer C. &ublic "ealth #urse . Any *ualified physician Answer: (A) 3ayor The local e%ecutive serves as the chairman of the Dunicipal "ealth Board. !1. Which level of health facility is the usual point of entry of a client into the health care delivery system? A. &rimary B. 4econdary C. >ntermediate

. Tertiary Answer: (A) Primary The entry of a person into the health care delivery system is usually through a consultation in out$patient services. !!. The public health nurse is the supervisor of rural health midwives. Which of the following is a supervisory function of the public health nurse? A. /eferring cases or patients to the midwife B. &roviding technical guidance to the midwife C. &roviding nursing care to cases referred by the midwife . Aormulating and implementing training programs for midwives Answer: (B) Pro!i ing technical gui ance to the mi wife The nurse provides technical guidance to the midwife in the care of clients, particularly in the implementation of management guidelines, as in >ntegrated Danagement of Childhood >llness. !). 2ne of the participants in a hilot training class as(ed you to whom she should refer a patient in labor who develops a complication. 9ou will answer, to the A. &ublic "ealth #urse B. /ural "ealth Didwife C. Dunicipal "ealth 2fficer . Any of these health professionals Answer: (C) 3unicipal Health 4fficer 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. !.. 9ou are the public health nurse in a municipality with a total population of about !0,000. There are ) rural health midwives among the /"8 personnel. "ow many more midwife items will the /"8 need? A. 1 B. ! C. ) . The /"8 does not need any more midwife item. Answer: (A) & ,ach rural health midwife is given a population assignment of about 1,000. !1. >f the /"8 needs additional midwife items, you will submit the re*uest for additional midwife items for approval to the A. /ural "ealth 8nit B. istrict "ealth 2ffice C. &rovincial "ealth 2ffice . Dunicipal "ealth Board Answer: (() 3unicipal Health Boar As mandated by /.A. 7150, basic health services have been devolved from the national government to local government units. !5. As an epidemiologist, the nurse is responsible for reporting cases of notifiable diseases. What law mandates reporting of cases of notifiable diseases? A. Act )17) B. /.A. )71) C. /.A. 101. . /.A. 10;! Answer: (A) Act 5675 Act )17), the 3aw on /eporting of Communicable iseases, enacted in 1@!@, mandated the reporting of diseases listed in the law to the nearest health station. !7. According to Areeman and "einrich, 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. "ealth education and community organi+ing are necessary in providing community health services. C. Community health nursing is intended primarily for health promotion and prevention and treatment of disease. . The goal of community health nursing is to provide nursing services to people in their own places of residence. Answer: (B) Health e ucation an community organi8ing are necessary in pro!i ing community health ser!ices# The community health nurse develops the health capability of people through health education and community organi+ing activities. !;. Which disease was declared through &residential &roclamation #o. . as a target for eradication in the &hilippines? A. &oliomyelitis B. Deasles C. /abies . #eonatal tetanus Answer: (B) 3easles &residential &roclamation #o. . is on the 3igtas Tigdas &rogram. !@. The public health nurse is responsible for presenting the municipal health statistics using graphs and tables. To compare the fre*uency of the leading causes of mortality in the municipality, which graph will you prepare? A. 3ine B. Bar C. &ie . 4catter diagram 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. )0. Which step in community organi+ing involves training of potential leaders in the community? A. >ntegration B. Community organi+ation C. Community study . Core group formation Answer: (() Core group formation >n core group formation, the nurse is able to transfer the technology of community organi+ing to the potential or informal community leaders through a training program. )1. >n which step are plans formulated for solving community problems? A. Dobili+ation B. Community organi+ation

C. Aollow$upGe%tension . Core group formation Answer: (B) Community organi8ation Community organi+ation is the step when community assemblies ta(e place. uring the community assembly, the people may opt to formali+e the community organi+ation and ma(e plans for community action to resolve a community health problem. )!. The public health nurse ta(es an active role in community participation. What is the primary goal of community organi+ing? A. To educate the people regarding community health problems B. To mobili+e the people to resolve community health problems C. To ma%imi+e the community6s resources in dealing with health problems . To ma%imi+e the community6s resources in dealing with health problems Answer: (() To ma0imi8e the community/s resources in ealing with health pro*lems Community organi+ing is a developmental service, with the goal of developing the people6s self$reliance in dealing with community health problems. A, B and C are ob-ectives of contributory ob-ectives to this goal. )). An indicator of success in community organi+ing is when people are able to A. &articipate in community activities for the solution of a community problem B. >mplement activities for the solution of the community problem C. &lan activities for the solution of the community problem . >dentify the health problem as a common concern Answer: (A) Participate in community acti!ities for the solution of a community pro*lem &articipation in community activities in resolving a community problem may be in any of the processes mentioned in the other choices. ).. Tertiary prevention is needed in which stage of the natural history of disease? A. &re$pathogenesis B. &athogenesis C. &rodromal . Terminal Answer: (() Terminal Tertiary prevention involves rehabilitation, prevention of permanent disability and disability limitation appropriate for convalescents, the disabled, complicated cases and the terminally ill Bthose in the terminal stage of a diseaseC )1. >solation of a child with measles belongs to what level of prevention? A. &rimary B. 4econdary C. >ntermediate . Tertiary Answer: (A) Primary The purpose of isolating a client with a communicable disease is to protect those who are not sic( Bspecific disease preventionC.

)5. 2n the other hand, 2peration Timbang is HHHHH prevention. A. &rimary B. 4econdary C. >ntermediate . Tertiary Answer: (B) .econ ary 2peration Timbang is done to identify members of the susceptible population who are malnourished. >ts purpose is early diagnosis and, subse*uently, prompt treatment. )7. Which type of family$nurse contact will provide you with the best opportunity to observe family dynamics? A. Clinic consultation B. Froup conference C. "ome visit . Written communication Answer: (C) Home !isit ynamics of family relationships can best be observed in the family6s natural environment, which is the home. );. The typology of family nursing problems is used in the statement of nursing diagnosis in the care of families. The youngest child of the de los /eyes family has been diagnosed as mentally retarded. This is classified as a A. "ealth threat B. "ealth deficit C. Aoreseeable crisis . 4tress point Answer: (B) Health eficit Aailure of a family member to develop according to what is e%pected, as in mental retardation, is a health deficit. )@. The de los /eyes couple have a 5$year old child entering school for the first time. The de los /eyes family has a A. "ealth threat B. "ealth deficit C. Aoreseeable crisis . 4tress point Answer: (C) -oreseea*le crisis ,ntry of the 5$year old into school is an anticipated period of unusual demand on the family. .0. Which of the following is an advantage of a home visit? A. >t allows the nurse to provide nursing care to a greater number of people. B. >t provides an opportunity to do first hand appraisal of the home situation. C. >t allows sharing of e%periences among people with similar health problems. . >t develops the family6s initiative in providing for health needs of its members. Answer: (B) 9t pro!i es an opportunity to o first han appraisal of the home situation# Choice A is not correct since a home visit re*uires that the nurse spend so much time with the family. Choice C is an advantage of a group conference, while choice is true of a clinic consultation.

.1. Which is C2#T/A/9 to the principles in planning a home visit? A. A home visit should have a purpose or ob-ective. B. The plan should revolve around family health needs. C. A home visit should be conducted in the manner prescribed by the /"8. . &lanning of continuing care should involve a responsible family member. Answer: (C) A home !isit shoul *e con ucte in the manner prescri*e *y the RH+# The home visit plan should be fle%ible and practical, depending on factors, such as the family6s needs and the resources available to the nurse and the family. .!. The &"# bag is an important tool in providing nursing care during a home visit. The most important principle of bag techni*ue states that it A. 4hould save time and effort. B. 4hould minimi+e if not totally prevent the spread of infection. C. 4hould not overshadow concern for the patient and his family. . Day be done in a variety of ways depending on the home situation, etc. Answer: (B) .houl minimi8e if not totally pre!ent the sprea of infection# Bag techni*ue is performed before and after handling a client in the home to prevent transmission of infection to and from the client. .). To maintain the cleanliness of the bag and its contents, which of the following must the nurse do? A. Wash hisGher hands before and after providing nursing care to the family members. B. >n the care of family members, as much as possible, use only articles ta(en from the bag. C. &ut on an apron to protect her uniform and fold it with the right side out before putting it bac( into the bag. . At the end of the visit, fold the lining on which the bag was placed, ensuring that the contaminated side is on the outside. Answer: (A) :ash his;her han s *efore an after pro!i ing nursing care to the family mem*ers# Choice B goes against the idea of utili+ing the family6s resources, which is encouraged in C"#. Choices C and goes against the principle of asepsis of confining the contaminated surface of ob-ects. ... The public health nurse conducts a study on the factors contributing to the high mortality rate due to heart disease in the municipality where she wor(s. Which branch of epidemiology does the nurse practice in this situation? A. escriptive B. Analytical C. Therapeutic . ,valuation Answer: (B) Analytical Analytical epidemiology is the study of factors or determinants affecting the patterns of occurrence and distribution of disease in a community. .1. Which of the following is a function of epidemiology? A. >dentifying the disease condition based on manifestations presented by a client B. etermining factors that contributed to the occurrence of pneumonia in a ) year old

C. etermining the efficacy of the antibiotic used in the treatment of the ) year old client with pneumonia . ,valuating the effectiveness of the implementation of the >ntegrated Danagement of Childhood >llness Answer: (() )!aluating the effecti!eness of the implementation of the 9ntegrate 3anagement of Chil hoo 9llness ,pidemiology is used in the assessment of a community or evaluation of interventions in community health practice. .5. Which of the following is an epidemiologic function of the nurse during an epidemic? A. Conducting assessment of suspected cases to detect the communicable disease B. Donitoring the condition of the cases affected by the communicable disease C. &articipating in the investigation to determine the source of the epidemic . Teaching the community on preventive measures against the disease Answer: (C) Participating in the in!estigation to etermine the source of the epi emic ,pidemiology 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. .7. The primary purpose of conducting an epidemiologic investigation is to A. elineate the etiology of the epidemic B. ,ncourage cooperation and support of the community C. >dentify groups who are at ris( of contracting the disease . >dentify geographical location of cases of the disease in the community Answer: (A) (elineate the etiology of the epi emic elineating the etiology of an epidemic is identifying its source. .;. Which is a characteristic of person$to$person propagated epidemics? A. There are more cases of the disease than e%pected. B. The disease must necessarily be transmitted through a vector. C. The spread of the disease can be attributed to a common vehicle. . There is a gradual build up of cases before the epidemic becomes easily noticeable. Answer: (() There is a gra ual *uil up of cases *efore the epi emic *ecomes easily noticea*le# A gradual or insidious onset of the epidemic is usually observable in person$to$person propagated epidemics. .@. >n the investigation of an epidemic, you compare the present fre*uency of the disease with the usual fre*uency at this time of the year in this community. This is done during which stage of the investigation? A. ,stablishing the epidemic B. Testing the hypothesis C. Aormulation of the hypothesis . Appraisal of facts Answer: (A) )sta*lishing the epi emic ,stablishing 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. 10. The number of cases of engue fever usually increases towards the end of the rainy season. This pattern of occurrence of engue fever is best described as A. ,pidemic occurrence B. Cyclical variation C. 4poradic occurrence . 4ecular variation Answer: (B) Cyclical !ariation A cyclical variation is a periodic fluctuation in the number of cases of a disease in the community. 11. >n the year 1@;0, the World "ealth 2rgani+ation declared the &hilippines, together with some other countries in the Western &acific /egion, <free= of which disease? A. &neumonic plague B. &oliomyelitis C. 4mall po% . Anthra% Answer: (C) .mall po0 The last documented case of 4mall po% was in 1@77 at 4omalia. 1!. >n the census of the &hilippines in 1@@1, there were about )1,!@@,000 males and about ).,@5;,000 females. What is the se% ratio? A. @@.05'100 B. 100.@.'100 C. 10.!)I . .@.75I Answer: (B) &''#<=:&'' 4e% ratio is the number of males for every 100 females in the population. 1). &rimary 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. "ealth services are provided free of charge to individuals and families. B. 3ocal officials are empowered as the ma-or decision ma(ers in matters of health. C. "ealth wor(ers are able to provide care based on identified health needs of the people. . "ealth programs are sustained according to the level of development of the community.

Answer: (() .ensiti!ity 4ensitivity is the capacity of a diagnostic e%amination to detect cases of the disease. >f a test is 100I sensitive, all the cases tested will have a positive result, i.e., there will be no false negative results. 11. 8se of appropriate technology re*uires (nowledge of indigenous technology. Which medicinal herb is given for fever, headache and cough? A. 4ambong B. Tsaang gubat C. A(apul(o . 3agundi Answer: (() $agun i 4ambong is used as a diuretic. Tsaang gubat is used to relieve diarrhea. A(apul(o is used for its antifungal property. 15. What law created the &hilippine >nstitute of Traditional and Alternative "ealth Care? A. /.A. ;.!) B. /.A. .;!) C. /.A. !.;) . /.A. ).;! Answer: (A) R#A# >=?5 BnoneC 17. >n traditional Chinese medicine, the yielding, negative and feminine force is termed A. 9in B. 9ang C. Ji . Chai Answer: (A) @in 9ang is the male dominating, positive and masculine force. 1;. What is the legal basis for &rimary "ealth Care approach in the &hilippines? A. Alma Ata eclaration on &"C B. 3etter of >nstruction #o. @.@ C. &residential ecree #o. 1.7 . &residential ecree @@5

Answer: (B) $etter of 9nstruction No# <=< 3etter of >nstruction @.@ was issued by then &resident Aerdinand Darcos, directing the formerly called Dinistry of "ealth, now the epartment of "ealth, to utili+e &rimary "ealth Care approach in Answer: (() Health programs are sustaine accor ing to the le!el of planning and implementing health programs. e!elopment of the community# &rimary health care is essential health care that can be sustained in all 1@. Which of the following demonstrates intersectoral lin(ages? stages of development of the community. A. Two$way referral system B. Team approach 1.. 4putum e%amination is the ma-or screening tool for pulmonary C. ,ndorsement done by a midwife to another midwife tuberculosis. Clients would sometimes get false negative results in this . Cooperation between the &"# and public school teacher e%am. This means that the test is not perfect in terms of which characteristic of a diagnostic e%amination? Answer: (() Cooperation *etween the PHN an pu*lic school A. ,ffectiveness teacher B. ,fficacy >ntersectoral lin(ages refer to wor(ing relationships between the health C. 4pecificity sector and other sectors involved in community development. . 4ensitivity

50. The municipality assigned to you has a population of about !0,000. ,stimate the number of 1$. year old children who will be given /etinol capsule !00,000 >.8. every 5 months. A. 1,100 B. 1,;00 C. !,000 . !,)00 Answer: (() ?"5'' Based on the &hilippine population composition, to estimate the number of 1$. year old children, multiply total population by 11.1I. 51. ,stimate the number of pregnant women who will be given tetanus to%oid during an immuni+ation outreach activity in a barangay with a population of about 1,100. A. !51 B. )00 C. )71 . .00 Answer: (A) ?A6 To estimate the number of pregnant women, multiply the total population by ).1I. 5!. To describe the se% composition of the population, which demographic tool may be used? A. 4e% ratio B. 4e% proportion C. &opulation pyramid . Any of these may be used. Answer: (() Any of these may *e use # 4e% ratio and se% proportion are used to determine the se% composition of a population. A population pyramid is used to present the composition of a population by age and se%. 5). Which of the following is a natality rate? A. Crude birth rate B. #eonatal mortality rate C. >nfant mortality rate . Feneral fertility rate Answer: (A) Cru e *irth rate #atality means birth. A natality rate is a birth rate. 5.. 9ou are computing the crude death rate of your municipality, with a total population of about 1;,000, for last year. There were @. deaths. Among those who died, !0 died because of diseases of the heart and )! were aged 10 years or older. What is the crude death rate? A. ..!G1,000 B. 1.!G1,000 C. 5.)G1,000 . 7.)G1,000 Answer: (B) 6#?;&"''' To compute crude death rate divide total number of deaths B@.C by total population B1;,000C and multiply by 1,000. 51. Knowing that malnutrition is a fre*uent community health problem, you decided to conduct nutritional assessment. What population is particularly susceptible to protein energy malnutrition B&,DC? A. &regnant women and the elderly

B. 8nder$1 year old children C. 1$. year old children . 4chool age children Answer: (C) &2= year ol chil ren &reschoolers are the most susceptible to &,D 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. 55. Which statistic can give the most accurate reflection of the health status of a community? A. 1$. year old age$specific mortality rate B. >nfant mortality rate C. 4waroop6s inde% . Crude death rate Answer: (C) .waroop/s in e0 4waroop6s inde% is the proportion of deaths aged 10 years and above. The higher the 4waroop6s inde% of a population, the greater the proportion of the deaths who were able to reach the age of at least 10 years, i.e., more people grew old before they died. 57. >n the past year, Barangay A had an average population of 1511. .5 babies were born in that year, ! of whom died less than . wee(s after they were born. There were . recorded stillbirths. What is the neonatal mortality rate? A. !7.;G1,000 B. .).1G1,000 C. ;5.@G1,000 . 1)0..G1,000 Answer: (B) =5#6;&"''' To compute for neonatal mortality rate, divide the number of babies who died before reaching the age of !; days by the total number of live births, then multiply by 1,000. 5;. Which statistic best reflects the nutritional status of a population? A. 1$. year old age$specific mortality rate B. &roportionate mortality rate C. >nfant mortality rate . 4waroop6s inde% Answer: (A) &2= year ol age2specific mortality rate 4ince preschoolers are the most susceptible to the effects of malnutrition, a population with poor nutritional status will most li(ely have a high 1$. year old age$specific mortality rate, also (nown as child mortality rate. 5@. What numerator is used in computing general fertility rate? A. ,stimated midyear population B. #umber of registered live births C. #umber of pregnancies in the year . #umber of females of reproductive age Answer: (B) Num*er of registere li!e *irths To compute for general or total fertility rate, divide the number of registered live births by the number of females of reproductive age B11$ .1 yearsC, then multiply by 1,000. 70. 9ou will gather data for nutritional assessment of a puro(. 9ou will gather information only from families with members who belong to the target population for &,D. What method of data gathering is best for this purpose?

A. Census B. 4urvey C. /ecord review . /eview of civil registry Answer: (B) .ur!ey A survey, also called sample survey, is data gathering about a sample of the population. 71. >n the conduct of a census, the method of population assignment based on the actual physical location of the people is termed A. e -ure B. e locus C. e facto . e novo Answer: (C) (e facto The other method of population assignment, de -ure, is based on the usual place of residence of the people. 7!. The Aield "ealth 4ervices and >nformation 4ystem BA"4>4C is the recording and reporting system in public health care in the &hilippines. The Donthly Aield "ealth 4ervice Activity /eport is a form used in which of the components of the A"4>4? A. Tally report B. 2utput report C. TargetGclient list . >ndividual health record Answer: (A) Tally report A tally report is prepared monthly or *uarterly by the /"8 personnel and transmitted to the &rovincial "ealth 2ffice. 7). To monitor clients registered in long$term regimens, such as the Dulti$ rug Therapy, which component will be most useful? A. Tally report B. 2utput report C. TargetGclient list . >ndividual health record Answer: (C) Target;client list The D T Client 3ist is a record of clients enrolled in D T and other relevant data, such as dates when clients collected their monthly supply of drugs. 7.. Civil registries are important sources of data. Which law re*uires registration of births within )0 days from the occurrence of the birth? A. &. . 511 B. Act )17) C. /.A. )71) . /.A. ))71 Answer: (A) P#(# A6& &. . 511 amended /.A. )71), re*uiring the registry of births within )0 days from their occurrence. 71. Which of the following professionals can sign the birth certificate? A. &ublic health nurse B. /ural health midwife C. Dunicipal health officer . Any of these health professionals

Answer: (() Any of these health professionals . /.A. )71) states that any birth attendant may sign the certificate of live birth. 75. Which criterion in priority setting of health problems is used only in community health care? A. Dodifiability of the problem B. #ature of the problem presented C. Dagnitude of the health problem . &reventive potential of the health problem Answer: (C) 3agnitu e of the health pro*lem Dagnitude 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. The 4entrong 4igla Dovement has been launched to improve health service delivery. Which of the following isGare true of this movement? A. This is a pro-ect spearheaded by local government units. B. >t is a basis for increasing funding from local government units. C. >t encourages health centers to focus on disease prevention and control. . >ts main strategy is certification of health centers able to comply with standards. Answer: (() 9ts main strategy is certification of health centers a*le to comply with stan ar s# 4entrong 4igla Dovement is a -oint pro-ect of the 2" and local government units. >ts main strategy is certification of health centers that are able to comply with standards set by the 2". 7;. 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 !0 years and older than )1 years . Those who -ust had a delivery within the past 11 months Answer: (() Those who Bust ha a eli!ery within the past &6 months The ideal birth spacing is at least two years. 11 months plus @ months of pregnancy L ! years. 7@. Areedom of choice is one of the policies of the Aamily &lanning &rogram of the &hilippines. Which of the following illustrates this principle? A. >nformation dissemination about the need for family planning B. 4upport of research and development in family planning methods C. Ade*uate information for couples regarding the different methods . ,ncouragement of couples to ta(e family planning as a -oint responsibility Answer: (C) A e1uate information for couples regar ing the ifferent metho s 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 *uality services that can support their choice. ;0. A woman, 5 months pregnant, came to the center for consultation. Which of the following substances is contraindicated? A. Tetanus to%oid

B. /etinol !00,000 >8 C. Aerrous sulfate !00 mg . &otassium iodate !00 mg. capsule Answer: (B) Retinol ?''"''' 9+ /etinol !00,000 >8 is a form of megadose Eitamin A. This may have a teratogenic effect. ;1. uring prenatal consultation, a client as(ed you if she can have her delivery at home. After history ta(ing and physical e%amination, you advised her against a home delivery. Which of the following findings dis*ualifies her for a home delivery? A. "er 2B score is F1&). B. 4he has some palmar pallor. C. "er blood pressure is 1)0G;0. . "er baby is in cephalic presentation. Answer: (A) Her 4B score is C6P5# 2nly women with less than 1 pregnancies are *ualified for a home delivery. >t is also advisable for a primigravida to have delivery at a childbirth facility. ;!. >nade*uate inta(e by the pregnant woman of which vitamin may cause neural tube defects? A. #iacin B. /iboflavin C. Aolic acid . Thiamine Answer: (C) -olic aci >t is estimated that the incidence of neural tube defects can be reduced drastically if pregnant women have an ade*uate inta(e of folic acid. ;). 9ou are in a client6s home to attend to a delivery. Which of the following will you do first? A. 4et up the sterile area. B. &ut on a clean gown or apron. C. Cleanse the client6s vulva with soap and water. . #ote the interval, duration and intensity of labor contractions. Answer: (() Note the inter!al" uration an intensity of la*or 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. ;.. >n 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 e%ercises if her nipples are everted. C. >nstruct her to wash her nipples before and after each breastfeeding. . ,%plain to her that putting the baby to breast will lessen blood loss after delivery. Answer: (() )0plain to her that putting the *a*y to *reast will lessen *loo loss after eli!ery# 4uc(ling of the nipple stimulates the release of o%ytocin by the posterior pituitary gland, which causes uterine contraction. 3actation begins 1 to ) days after delivery. #ipple stretching e%ercises are done when the nipples are flat or inverted. Are*uent washing dries up the nipples, ma(ing them prone to the formation of fissures.

;1. A primigravida is instructed to offer her breast to the baby for the first time within )0 minutes after delivery. What is the purpose of offering the breast this early? A. To initiate the occurrence of mil( letdown B. To stimulate mil( production by the mammary acini C. To ma(e sure that the baby is able to get the colostrum . To allow the woman to practice breastfeeding in the presence of the health wor(er Answer: (B) To stimulate mil% pro uction *y the mammary acini 4uc(ling of the nipple stimulates prolactin refle% Bthe release of prolactin by the anterior pituitary glandC, which initiates lactation. ;5. >n a mothers6 class, you discuss proper breastfeeding techni*ue. Which is of these is a sign that the baby has <latched on= to the breast properly? A. The baby ta(es shallow, rapid suc(s. B. The mother does not feel nipple pain. C. The baby6s mouth is only partly open. . 2nly the mother6s nipple is inside the baby6s mouth. Answer: (B) The mother oes not feel nipple pain# When the baby has properly latched on to the breast, he ta(es deep, slow suc(s? his mouth is wide open? and much of the areola is inside his mouth. And, you6re right: The mother does not feel nipple pain. ;7. 9ou e%plain to a breastfeeding mother that breast mil( is sufficient for all of the baby6s nutrient needs only up to HHHH. A. ) months B. 5 months C. 1 year . ! years Answer: (B) A months After 5 months, the baby6s nutrient needs, especially the baby6s iron re*uirement, can no longer be provided by mother6s mil( alone. ;;. What is given to a woman within a month after the delivery of a baby? A. Dalunggay capsule B. Aerrous sulfate 100 mg. 2 C. /etinol !00,000 >.8., 1 capsule . &otassium iodate !00 mg, 1 capsule Answer: (C) Retinol ?''"''' 9#+#" & capsule A capsule of /etinol !00,000 >8 is given within 1 month after delivery. &otassium iodate is given during pregnancy? malunggay capsule is not routinely administered after delivery? and ferrous sulfate is ta(en for two months after delivery. ;@. Which biological used in ,%panded &rogram on >mmuni+ation B,&>C is stored in the free+er? A. &T B. Tetanus to%oid C. Deasles vaccine . "epatitis B vaccine Answer: (C) 3easles !accine Among the biologicals used in the ,%panded &rogram on >mmuni+ation, measles vaccine and 2&E are highly sensitive to heat, re*uiring storage in the free+er.

@0. 8nused BCF should be discarded how many hours after reconstitution? A. ! B. . C. 5 . At the end of the day Answer: (B) = While the unused portion of other biologicals in ,&> may be given until the end of the day, only BCF is discarded . hours after reconstitution. This is why BCF immuni+ation is scheduled only in the morning. @1. >n immuni+ing school entrants with BCF, you are not obliged to secure parental consent. This is because of which legal document? A. &. . @@5 B. /.A. 7;.5 C. &residential &roclamation #o. 5 . &residential &roclamation #o. .5 Answer: (A) P#(# <<A &residential ecree @@5, enacted in 1@75, made immuni+ation in the ,&> compulsory for children under ; years of age. "epatitis B vaccination was made compulsory for the same age group by /.A. 7;.5. @!. Which immuni+ation produces a permanent scar? A. &T B. BCF C. Deasles vaccination . "epatitis B vaccination Answer: (B) BCC BCF causes the formation of a superficial abscess, which begins ! wee(s after immuni+ation. The abscess heals without treatment, with the formation of a permanent scar. @). A .$wee( old baby was brought to the health center for his first immuni+ation. Which can be given to him? A. &T1 B. 2&E1 C. >nfant BCF . "epatitis B vaccine 1 Answer: (C) 9nfant BCC >nfant BCF may be given at birth. All the other immuni+ations mentioned can be given at 5 wee(s of age. @.. 9ou will not give &T ! if the mother says that the infant had A. 4ei+ures a day after &T 1. B. Aever for ) days after &T 1. C. Abscess formation after &T 1. . 3ocal tenderness for ) days after &T 1. Answer: (A) .ei8ures a ay after (PT &# 4ei+ures within ) days after administration of &T is an indication of hypersensitivity to pertussis vaccine, a component of &T. This is considered a specific contraindication to subse*uent doses of &T. @1. A !$month old infant was brought to the health center for immuni+ation. uring assessment, the infant6s temperature registered at );.1MC. Which is the best course of action that you will ta(e? A. Fo on with the infant6s immuni+ations. B. Five &aracetamol and wait for his fever to subside.

C. /efer the infant to the physician for further assessment. . Advise the infant6s mother to bring him bac( for immuni+ation when he is well. Answer: (A) Co on with the infant/s immuni8ations# >n the ,&>, fever up to );.1MC is not a contraindication to immuni+ation. Dild acute respiratory tract infection, simple diarrhea and malnutrition are not contraindications either. @5. A pregnant woman had -ust received her .th dose of tetanus to%oid. 4ubse*uently, her baby will have protection against tetanus for how long? A. 1 year B. ) years C. 10 years . 3ifetime Answer: (A) & 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. 1 doses will give the mother lifetime protection. @7. A .$month old infant was brought to the health center because of cough. "er respiratory rate is .!Gminute. 8sing the >ntegrated Danagement of Child >llness B>DC>C guidelines of assessment, her breathing is considered A. Aast B. 4low C. #ormal . >nsignificant Answer: (C) Normal >n >DC>, a respiratory rate of 10Gminute or more is fast breathing for an infant aged ! to 1! months. @;. Which of the following signs will indicate that a young child is suffering from severe pneumonia? A. yspnea B. Whee+ing C. Aast breathing . Chest indrawing Answer: (() Chest in rawing >n >DC>, chest indrawing is used as the positive sign of dyspnea, indicating severe pneumonia. @@. 8sing >DC> guidelines, you classify a child as having severe pneumonia. What is the best management for the child? A. &rescribe an antibiotic. B. /efer him urgently to the hospital. C. >nstruct the mother to increase fluid inta(e. . >nstruct the mother to continue breastfeeding. Answer: (B) Refer him urgently to the hospital# 4evere pneumonia re*uires urgent referral to a hospital. Answers A, C and are done for a client classified as having pneumonia. 100. A 1$month old infant was brought by his mother to the health center because of diarrhea occurring . to 1 times a day. "is s(in goes bac( slowly after a s(in pinch and his eyes are sun(en. 8sing the >DC> guidelines, you will classify this infant in which category? A. #o signs of dehydration

B. 4ome dehydration C. 4evere dehydration . The data is insufficient. Answer: (B) .ome ehy ration 8sing the assessment guidelines of >DC>, a child B! months to 1 years oldC with diarrhea is classified as having 42D, ,"9 /AT>2# if he shows ! or more of the following signs' restless or irritable, sun(en eyes, the s(in goes bac( slow after a s(in pinch. 101. Based on assessment, you classified a )$month old infant with the chief complaint of diarrhea in the category of 42D, ,"9 /AT>2#. Based on >DC> management guidelines, which of the following will you do? A. Bring the infant to the nearest facility where >E fluids can be given. B. 4upervise the mother in giving !00 to .00 ml. of 2resol in . hours. C. Five the infant6s mother instructions on home management. . Keep the infant in your health center for close observation. Answer: (B) .uper!ise the mother in gi!ing ?'' to ='' ml# of 4resol in = hours# >n the >DC> management guidelines, 42D, ,"9 /AT>2# is treated with the administration of 2resol within a period of . hours. The amount of 2resol is best computed on the basis of the child6s weight B71 mlG(g body weightC. >f the weight is un(nown, the amount of 2resol is based on the child6s age. 10!. A mother is using 2resol in the management of diarrhea of her )$ year old child. 4he as(ed you what to do if her child vomits. 9ou will tell her to A. Bring the child to the nearest hospital for further assessment. B. Bring the child to the health center for intravenous fluid therapy. C. Bring the child to the health center for assessment by the physician. . 3et the child rest for 10 minutes then continue giving 2resol more slowly. Answer: (() $et the chil rest for &' minutes then continue gi!ing 4resol more slowly# >f the child vomits persistently, that is, he vomits everything that he ta(es in, he has to be referred urgently to a hospital. 2therwise, vomiting is managed by letting the child rest for 10 minutes and then continuing with 2resol administration. Teach the mother to give 2resol more slowly. 10). A 1 N year old child was classified as having )rd degree protein energy malnutrition, (washior(or. Which of the following signs will be most apparent in this child? A. Eoracious appetite B. Wasting C. Apathy . ,dema Answer: (() ) ema ,dema, a ma-or sign of (washior(or, is caused by decreased colloidal osmotic pressure of the blood brought about by hypoalbuminemia. ecreased blood albumin level is due a protein$deficient diet. 10.. Assessment of a !$year old child revealed <baggy pants=. 8sing the >DC> guidelines, how will you manage this child? A. /efer the child urgently to a hospital for confinement. B. Coordinate with the social wor(er to enroll the child in a feeding program. C. Da(e a teaching plan for the mother, focusing on menu planning for her child.

. Assess and treat the child for health problems li(e infections and intestinal parasitism. Answer: (A) Refer the chil urgently to a hospital for confinement# <Baggy pants= is a sign of severe marasmus. The best management is urgent referral to a hospital. 101. uring the physical e%amination of a young child, what is the earliest sign of %erophthalmia that you may observe? A. Keratomalacia B. Corneal opacity C. #ight blindness . Con-unctival %erosis Answer: (() ConBuncti!al 0erosis The earliest sign of Eitamin A deficiency B%erophthalmiaC is night blindness. "owever, this is a functional change, which is not observable during physical e%amination.The earliest visible lesion is con-unctival %erosis or dullness of the con-unctiva due to inade*uate tear production. 105. To prevent %erophthalmia, young children are given /etinol capsule every 5 months. What is the dose given to preschoolers? A. 10,000 >8 B. !0,000 >8 C. 100,000 >8 . !00,000 >8 Answer: (() ?''"''' 9+ &reschoolers are given /etinol !00,000 >8 every 5 months. 100,000 >8 is given once to infants aged 5 to 1! months. The dose for pregnant women is 10,000 >8. 107. The ma-or sign of iron deficiency anemia is pallor. What part is best e%amined for pallor? A. &alms B. #ailbeds C. Around the lips . 3ower con-unctival sac Answer: (A) Palms The anatomic characteristics of the palms allow a reliable and convenient basis for e%amination for pallor. 10;. Aood fortification is one of the strategies to prevent micronutrient deficiency conditions. /.A. ;@75 mandates fortification of certain food items. Which of the following is among these food items? A. 4ugar B. Bread C. Dargarine . Ailled mil( Answer: (A) .ugar /.A. ;@75 mandates fortification of rice, wheat flour, sugar and coo(ing oil with Eitamin A, iron andGor iodine. 10@. What is the best course of action when there is a measles epidemic in a nearby municipality? A. Five measles vaccine to babies aged 5 to ; months. B. Five babies aged 5 to 11 months one dose of 100,000 >.8. of /etinol C. >nstruct mothers to (eep their babies at home to prevent disease transmission. . >nstruct mothers to feed their babies ade*uately to enhance their babies6 resistance.

Answer: (A) Ci!e measles !accine to *a*ies age A to > months# 2rdinarily, measles vaccine is given at @ months of age. uring an impending epidemic, however, one dose may be given to babies aged 5 to ; months. The mother is instructed that the baby needs another dose when the baby is @ months old. 110. A mother brought her daughter, . years old, to the /"8 because of cough and colds. Aollowing the >DC> assessment guide, which of the following is a danger sign that indicates the need for urgent referral to a hospital? A. >nability to drin( B. "igh grade fever C. 4igns of severe dehydration . Cough for more than )0 days Answer: (A) 9na*ility to rin% A sic( child aged ! months to 1 years must be referred urgently to a hospital if heGshe has one or more of the following signs' not able to feed or drin(, vomits everything, convulsions, abnormally sleepy or difficult to awa(en. 111. Danagement of a child with measles includes the administration of which of the following? A. Fentian violet on mouth lesions B. Antibiotics to prevent pneumonia C. Tetracycline eye ointment for corneal opacity . /etinol capsule regardless of when the last dose was given Answer: (() Retinol capsule regar less of when the last ose was gi!en An infant 5 to 1! months classified as a case of measles is given /etinol 100,000 >8? a child is given !00,000 >8 regardless of when the last dose was given. 11!. A mother brought her 10 month old infant for consultation because of fever, which started . days prior to consultation. To determine malaria ris(, what will you do? A. o a tourni*uet test. B. As( where the family resides. C. Fet a specimen for blood smear. . As( if the fever is present everyday. Answer: (B) As% where the family resi es# Because malaria is endemic, the first *uestion to determine malaria ris( is where the client6s family resides. >f the area of residence is not a (nown endemic area, as( if the child had traveled within the past 5 months, where heGshe was brought and whether heGshe stayed overnight in that area. 11). The following are strategies implemented by the epartment of "ealth to prevent mos*uito$borne diseases. Which of these is most effective in the control of engue fever? A. 4tream seeding with larva$eating fish B. estroying breeding places of mos*uitoes C. Chemoprophyla%is of non$immune persons going to endemic areas . Teaching people in endemic areas to use chemically treated mos*uito nets Answer: (B) (estroying *ree ing places of mos1uitoes Aedes aegypti, the vector of engue fever, breeds in stagnant, clear water. >ts feeding time is usually during the daytime. >t has a cyclical

pattern of occurrence, unli(e malaria which is endemic in certain parts of the country. 11.. 4econdary prevention for malaria includes A. &lanting of neem or eucalyptus trees B. /esidual spraying of insecticides at night C. etermining whether a place is endemic or not . Frowing larva$eating fish in mos*uito breeding places Answer: (C) (etermining whether a place is en emic or not This is diagnostic and therefore secondary level prevention. The other choices are for primary prevention. 111. 4cotch tape swab is done to chec( for which intestinal parasite? A. Ascaris B. &inworm C. "oo(worm . 4chistosoma Answer: (B) Pinworm &inworm ova are deposited around the anal orifice. 115. Which of the following signs indicates the need for sputum e%amination for AAB? A. "ematemesis B. Aever for 1 wee( C. Cough for ) wee(s . Chest pain for 1 wee( Answer: (C) Cough for 5 wee%s A client is considered a &TB suspect when he has cough for ! wee(s or more, plus one or more of the following signs' fever for 1 month or more? chest pain lasting for ! wee(s or more not attributed to other conditions? progressive, une%plained weight loss? night sweats? and hemoptysis. 117. Which clients are considered targets for 2T4 Category >? A. 4putum negative cavitary cases B. Clients returning after a default C. /elapses and failures of previous &TB treatment regimens . Clients diagnosed for the first time through a positive sputum e%am Answer: (() Clients iagnose for the first time through a positi!e sputum e0am Category > is for new clients diagnosed by sputum e%amination and clients diagnosed to have a serious form of e%trapulmonary tuberculosis, such as TB osteomyelitis. 11;. To improve compliance to treatment, what innovation is being implemented in 2T4? A. "aving the health wor(er follow up the client at home B. "aving the health wor(er or a responsible family member monitor drug inta(e C. "aving the patient come to the health center every month to get his medications . "aving a target list to chec( on whether the patient has collected his monthly supply of drugs Answer: (B) Ha!ing the health wor%er or a responsi*le family mem*er monitor rug inta%e irectly 2bserved Treatment 4hort Course is so$called because a treatment partner, preferably a health wor(er accessible to the client, monitors the client6s compliance to the treatment.

11@. iagnosis of leprosy is highly dependent on recognition of symptoms. Which of the following is an early sign of leprosy? A. Dacular lesions B. >nability to close eyelids C. Thic(ened painful nerves . 4in(ing of the nosebridge Answer: (C) Thic%ene painful ner!es The lesion of leprosy is not macular. >t is characteri+ed by a change in s(in color Beither reddish or whitishC and loss of sensation, sweating and hair growth over the lesion. >nability to close the eyelids BlagophthalmosC and sin(ing of the nosebridge are late symptoms. 1!0. Which of the following clients should be classified as a case of multibacillary leprosy? A. ) s(in lesions, negative slit s(in smear B. ) s(in lesions, positive slit s(in smear C. 1 s(in lesions, negative slit s(in smear . 1 s(in lesions, positive slit s(in smear Answer: (() 6 s%in lesions" positi!e slit s%in smear A multibacillary leprosy case is one who has a positive slit s(in smear and at least 1 s(in lesions. 1!1. >n the &hilippines, which condition is the most fre*uent cause of death associated with schistosomiasis? A. 3iver cancer B. 3iver cirrhosis C. Bladder cancer . >ntestinal perforation Answer: (B) $i!er cirrhosis The etiologic agent of schistosomiasis in the &hilippines is 4chistosoma -aponicum, which affects the small intestine and the liver. 3iver damage is a conse*uence of fibrotic reactions to schistosoma eggs in the liver. 1!!. What is the most effective way of controlling schistosomiasis in an endemic area? A. 8se of molluscicides B. Building of foot bridges C. &roper use of sanitary toilets . 8se of protective footwear, such as rubber boots 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. 1!). When residents obtain water from an artesian well in the neighborhood, the level of this approved type of water facility is A. > B. >> C. >>> . >E Answer: (B) 99 A communal faucet or water standpost is classified as 3evel >>. 1!.. Aor prevention of hepatitis A, you decided to conduct health education activities. Which of the following is >//,3,EA#T? A. 8se of sterile syringes and needles

B. 4afe food preparation and food handling by vendors C. &roper disposal of human e%creta and personal hygiene . >mmediate reporting of water pipe lea(s and illegal water connections Answer: (A) +se of sterile syringes an nee les "epatitis A is transmitted through the fecal oral route. "epatitis B is transmitted through infected body secretions li(e blood and semen. 1!5. Which biological used in ,%panded &rogram on >mmuni+ation B,&>C should #2T be stored in the free+er? A. &T B. 2ral polio vaccine C. Deasles vaccine . DD/ Answer: (A) (PT &T is sensitive to free+ing. The appropriate storage temperature of &T is ! to ;M C only. 2&E and measles vaccine are highly sensitive to heat and re*uire free+ing. DD/ is not an immuni+ation in the ,%panded &rogram on >mmuni+ation. 1!7. 9ou will conduct outreach immuni+ation in a barangay with a population of about 1100. ,stimate the number of infants in the barangay. A. .1 B. 10 C. 11 . 50 Answer: (A) =6 To estimate the number of infants, multiply total population by )I. 1!;. >n >ntegrated Danagement of Childhood >llness, severe conditions generally re*uire urgent referral to a hospital. Which of the following severe conditions 2,4 #2T always re*uire urgent referral to a hospital? A. Dastoiditis B. 4evere dehydration C. 4evere pneumonia . 4evere febrile disease Answer: (B) .e!ere ehy ration The order of priority in the management of severe dehydration is as follows' intravenous fluid therapy, referral to a facility where >E fluids can be initiated within )0 minutes, 2resolGnasogastric tube, 2resolGorem. When the foregoing measures are not possible or effective, tehn urgent referral to the hospital is done. 1!@. A client was diagnosed as having engue fever. 9ou 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. ) B. 1 C. ; . 10 Answer: (A) 5 Ade*uate blood supply to the area allows the return of the color of the nailbed within ) seconds. 1)0. A )$year old child was brought by his mother to the health center because of fever of .$day duration. The child had a positive tourni*uet

test result. >n the absence of other signs, which is the most appropriate measure that the &"# may carry out to prevent engue shoc( syndrome? A. >nsert an #FT and give fluids per #FT. B. >nstruct the mother to give the child 2resol. C. 4tart the patient on intravenous fluids 4TAT. . /efer the client to the physician for appropriate management. Answer: (B) 9nstruct the mother to gi!e the chil 4resol# 4ince 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 2resol. 1)1. The pathognomonic sign of measles is Kopli(6s spot. 9ou may see Kopli(6s spot by inspecting the HHHHH. A. #asal mucosa B. Buccal mucosa C. 4(in on the abdomen . 4(in on the antecubital surface Answer: (B) Buccal mucosa Kopli(6s spot may be seen on the mucosa of the mouth or the throat. 1)!. Among the following diseases, which is airborne? A. Eiral con-unctivitis B. Acute poliomyelitis C. iphtheria . Deasles Answer: (() 3easles Eiral con-unctivitis is transmitted by direct or indirect contact with discharges from infected eyes. Acute poliomyelitis is spread through the fecal$oral route and contact with throat secretions, whereas diphtheria is through direct and indirect contact with respiratory secretions. 1)). Among children aged ! months to ) years, the most prevalent form of meningitis is caused by which microorganism? A. "emophilus influen+ae B. Dorbillivirus C. 4teptococcus pneumoniae . #eisseria meningitidis Answer: (A) Hemophilus influen8ae "emophilus meningitis is unusual over the age of 1 years. >n developing countries, the pea( incidence is in children less than 5 months of age. Dorbillivirus is the etiology of measles. 4treptococcus pneumoniae and #eisseria meningitidis may cause meningitis, but age distribution is not specific in young children. 1).. "uman beings are the ma-or reservoir of malaria. Which of the following strategies in malaria control is based on this fact? A. 4tream seeding B. 4tream clearing C. estruction of breeding places . Oooprophyla%is Answer: (() Dooprophyla0is Oooprophyla%is is done by putting animals li(e cattle or dogs close to windows or doorways -ust before nightfall. The Anopheles mos*uito ta(es his blood meal from the animal and goes bac( to its breeding place, thereby preventing infection of humans.

1)1. The use of larvivorous fish in malaria control is the basis for which strategy of malaria control? A. 4tream seeding B. 4tream clearing C. estruction of breeding places . Oooprophyla%is Answer: (A) .tream see ing 4tream seeding is done by putting tilapia fry in streams or other bodies of water identified as breeding places of the Anopheles mos*uito 1)5. Dos*uito$borne diseases are prevented mostly with the use of mos*uito control measures. Which of the following is #2T appropriate for malaria control? A. 8se of chemically treated mos*uito nets B. 4eeding of breeding places with larva$eating fish C. estruction of breeding places of the mos*uito vector . 8se of mos*uito$repelling soaps, such as those with basil or citronella Answer: (C) (estruction of *ree ing places of the mos1uito !ector Anopheles mos*uitoes breed in slow$moving, clear water, such as mountain streams. 1)7. A .$year old client was brought to the health center with the chief complaint of severe diarrhea and the passage of <rice water= stools. The client is most probably suffering from which condition? A. Fiardiasis B. Cholera C. Amebiasis . ysentery Answer: (B) Cholera &assage of profuse watery stools is the ma-or symptom of cholera. Both amebic and bacillary dysentery are characteri+ed by the presence of blood andGor mucus in the stools. Fiardiasis is characteri+ed by fat malabsorption and, therefore, steatorrhea. 1);. >n the &hilippines, which specie of schistosoma is endemic in certain regions? A. 4. mansoni B. 4. -aponicum C. 4. malayensis . 4. haematobium Answer: (B) .# Baponicum 4. mansoni is found mostly in Africa and 4outh America? 4. haematobium in Africa and the Diddle ,ast? and 4. malayensis only in peninsular Dalaysia. 1)@. A )!$year old client came for consultation at the health center with the chief complaint of fever for a wee(. Accompanying symptoms were muscle pains and body malaise. A wee( after the start of fever, the client noted yellowish discoloration of his sclera. "istory showed that he waded in flood waters about ! wee(s before the onset of symptoms. Based on his history, which disease condition will you suspect? A. "epatitis A B. "epatitis B C. Tetanus . 3eptospirosis Answer: (() $eptospirosis

3eptospirosis is transmitted through contact with the s(in or mucous membrane with water or moist soil contaminated with urine of infected animals, li(e rats. 1.0. DW44 provides water to Danila and other cities in Detro Danila. This is an e%ample of which level of water facility? A. > B. >> C. >>> . >E Answer: (C) 999 Waterwor(s systems, such as DW44, are classified as level >>>. 1.1. 9ou are the &"# in the city health center. A client underwent screening for A> 4 using ,3>4A. "is result was positive. What is the best course of action that you may ta(e? A. Fet a thorough history of the client, focusing on the practice of high ris( behaviors. B. As( the client to be accompanied by a significant person before revealing the result. C. /efer the client to the physician since he is the best person to reveal the result to the client. . /efer the client for a supplementary test, such as Western blot, since the ,3>4A result may be false. Answer: (() Refer the client for a supplementary test" such as :estern *lot" since the )$9.A result may *e false# A client having a reactive ,3>4A result must undergo a more specific test, such as Western blot. A negative supplementary test result means that the ,3>4A result was false and that, most probably, the client is not infected. 1.!. Which is the B,4T control measure for A> 4? A. Being faithful to a single se%ual partner B. 8sing a condom during each se%ual contact C. Avoiding se%ual contact with commercial se% wor(ers . Da(ing sure that one6s se%ual partner does not have signs of A> 4 Answer: (A) Being faithful to a single se0ual partner 4e%ual fidelity rules out the possibility of getting the disease by se%ual contact with another infected person. Transmission occurs mostly through se%ual intercourse and e%posure to blood or tissues. 1.). The most fre*uent causes of death among clients with A> 4 are opportunistic diseases. Which of the following opportunistic infections is characteri+ed by tonsillopharyngitis? A. /espiratory candidiasis B. >nfectious mononucleosis C. Cytomegalovirus disease . &neumocystis carinii pneumonia Answer: (B) 9nfectious mononucleosis Cytomegalovirus disease is an acute viral disease characteri+ed by fever, sore throat and lymphadenopathy. 1... To determine possible sources of se%ually transmitted infections, which is the B,4T method that may be underta(en by the public health nurse? A. Contact tracing B. Community survey C. Dass screening tests

. >nterview of suspects Answer: (A) Contact tracing Contact tracing is the most practical and reliable method of finding possible sources of person$to$person transmitted infections, such as se%ually transmitted diseases. 1.1. Antiretroviral agents, such as AOT, are used in the management of A> 4. Which of the following is #2T an action e%pected of these drugs. A. They prolong the life of the client with A> 4. B. They reduce the ris( of opportunistic infections C. They shorten the period of communicability of the disease. . They are able to bring about a cure of the disease condition. Answer: (() They are a*le to *ring a*out a cure of the isease con ition# There is no (nown treatment for A> 4. Antiretroviral agents reduce the ris( of opportunistic infections and prolong life, but does not cure the underlying immunodeficiency. 1.5. A barangay had an outbrea( of Ferman measles. To prevent congenital rubella, what is the B,4T advice that you can give to women in the first trimester of pregnancy in the barangay? A. Advice them on the signs of Ferman measles. B. Avoid crowded places, such as mar(ets and moviehouses. C. Consult at the health center where rubella vaccine may be given. . Consult a physician who may give them rubella immunoglobulin. Answer: (() Consult a physician who may gi!e them ru*ella immunoglo*ulin# /ubella vaccine is made up of attenuated Ferman measles viruses. This is contraindicated in pregnancy. >mmune globulin, a specific prophylactic against Ferman measles, may be given to pregnant women. 1.7. 9ou were invited to be the resource person in a training class for food handlers. Which of the following would you emphasi+e regarding prevention of staphylococcal food poisoning? A. All coo(ing and eating utensils must be thoroughly washed. B. Aood must be coo(ed properly to destroy staphylococcal microorganisms. C. Aood handlers and food servers must have a negative stool e%amination result. . &roper handwashing during food preparation is the best way of preventing the condition. Answer: (() Proper han washing uring foo preparation is the *est way of pre!enting the con ition# 4ymptoms of this food poisoning are due to staphylococcal enteroto%in, not the microorganisms themselves. Contamination is by food handling by persons with staphylococcal s(in or eye infections. 1.;. >n a mothers6 class, you discussed childhood diseases such as chic(en po%. Which of the following statements about chic(en po% is correct? A. The older one gets, the more susceptible he becomes to the complications of chic(en po%. B. A single attac( of chic(en po% will prevent future episodes, including conditions such as shingles. C. To prevent an outbrea( in the community, *uarantine may be imposed by health authorities. . Chic(en po% vaccine is best given when there is an impending outbrea( in the community.

Answer: (A) The ol er one gets" the more suscepti*le he *ecomes to the complications of chic%en po0# Chic(en po% is usually more severe in adults than in children. Complications, such as pneumonia, are higher in incidence in adults. 1.@. Complications to infectious parotitis BmumpsC may be serious in which type of clients? A. &regnant women B. ,lderly clients C. 9oung adult males . 9oung infants Answer: (C) @oung a ult males ,pididymitis and orchitis are possible complications of mumps. >n post$ adolescent males, bilateral inflammation of the testes and epididymis may cause sterility.