COMMUNICABLE DISEASE NURSING

1. Nurse Aida is obtaining a specimen for sputum culture and sensitivity from a client with a
suspected pneumonia. Which of the following instruction is best for the client?
A. Do purse-lip breathing and cough into a container.
B. Upon awakening, cough deeply and expectorate into a container.
C. Save all sputum for three days in a sealed container.
D. After treatment has been initiated, expectorate into a container.
Rationale: Sputum specimen should be obtained early in the morning because of the secretions that
have accumulated during the night. Option C is done for pulmonary tuberculosis which is an acid fast
bacilli. Option D is not desirable because after treatment, culture and sensitivity test will show no
growth.
2. A 23 year old male student from the university belt area was admitted in Sampaloc Hospital
with hepatitis A. Nurse Aida is aware that the clients overall care during hospitalization
should include which of the following?
A. Protective isolation C. Standard precautions
B. Airborne protection D. Droplet precautions
Rationale: Standard precautions should be used for all types of patients. For hepatitis A, sources of the
virus include saliva, feces, and sometimes blood. The mode of transmission is enteric.
3. The National Tuberculosis Program of the Philippine has the following set of strategies except
one:
A. Ensure public and private healthcare providers adherence of national standard of TB
care
B. Ensure TB patients treatment compliance
C. Improve access to services through innovative service delivery
D. Decrease morbidity and mortality
Rationale: The strategies focus on the improvement of access and quality of services provided to TB
patients.
4. A child in the community has pediculosis capitis and is treated with 1% gamma benzene
hexachloride (Kwell shampoo).Nurse Beth should explain to the parents that:
A. Treatment is continued every other day for 1 week.
B. Clothing and personal belongings require normal washing with soap and water.
C. Application of the shampoo is done after 7 to 10 days.
D. Single treatment with Kwell kills nits and lice.
Rationale: Kwell is an organic solvent which is toxic so that frequent washing is not advised. It may be
repeated 7 days after first application. Very hot and a special detergent are used for washing clothes
and personal belongings.
5. The community health nurse is giving instructions to an elderly male client recently diagnosed
with pulmonary TB. Which of the following is an important part of the teaching plan?
A. During the first two weeks of treatment, client should cover his mouth when he
coughs.
B. It is necessary for the client to wear mask at all times to prevent transmission.
C. Family support is needed to reduce feelings of low self-esteem and isolation.
D. Client should be required to take medications for 6 to 9 months.
Rationale: Medication should be taken continuously for 6-9 months as prescribed. Patient is placed on
respiratory precaution for 2-4 weeks after initiation of treatment but there is already exposure of the
members of the family.
6. A charge notes that one of the staff nurse on duty caring for clients developed discharge from
her right eye with redness and pain. Which is the best action by the charge nurse?
A. Send the staff nurse home
B. Assess the staff nurses compliance with standard precaution
C. Assign the staff nurse to clients with chronic diseases
D. Reassign the staff nurse to documentation only
Rationale: Tearing, redness and eye pain are symptoms of viral conjunctivitis which is highly
contagious. Infected personnel cannot work until resolution of symptoms within 5-7 days. Infected
personnel should be restricted from patient contact.
7. A young child is placed on droplet precautions. Which of the following clients is given droplet
precautions?
A. Child with cystic fibrosis C. Child with bronchitis
B. Child with tonsillitis D. Child with pertussis
Rationale: Option A, B and C given standard precautions. Pertussis requires droplet precautions. Ptient
are given a private room. Visitors should stay at a distance of atleast 3 feet from the patient.
8. Miss Agassis was diagnosed with human papilloma virus (HPV).Which of the following
statements if made to the nurse indicates understanding of the possible sequelae of the
illness?
A. I will need to take antibiotics for one week.
B. I will use only prescribes douche to avoid recurrence.
C. I will return for a Pap smear in six months.
D. I will avoid using tampons for eight weeks.
Rationale: HPV is associated with occurrence of cervical cancer and early detection can be done by
annual pap smear. Viral infections are not treated with antibiotics.
9. A physician orders Metronidazole (Flagyl 250 mg) for Miss Francesca,a 26 year old female
because of amoebiasis. Nurse Gemma gives her teachings about the drug. Teaching has been
effective when Miss Francesca says:
A. I should take this medication between meals to increase absorption.
B. I should not drink alcohol while taking the medications.
C. If I experience a metallic taste in my mouth,I should notify the physician.
D. I should avoid strong sunlight while on the medication.
Rationale: Metronidazole causes a disufiram-like reaction which includes nausea, vomiting, headache,
cramps and flushing if taken with alcohol. The medication is given with meals to decrease gastric
irritation and sensitivity to the sunlight is not seen with this medication.
10. In giving teachings to Mario who is being treated for syphilis, it is most important for Nurse
Carlo, a community health nurse, to include which of the following information?
A. Practice restraint of sexual activity
B. Practice safe sex
C. Information on family planning
D. Signs of secondary infection
Rationale: Practice of safe sex like use of condoms is the primary prevention of sexually transmitted
disease. Option A, C and D is inappropriate teachings.
11. Nurse Carlo is giving teachings about leprosy, a communicable disease that affects the skin,
peripheral nerves, eyes and mucosa of the upper respiratory tract. Late signs and symptoms
includes the following except:
A. Madarosis C. Lagophthalmos
B. Ulcers that do not heal D. Contractures
Rationale: Madarosis, lagophthalmos and contarctures are all late signs. Ulcers that do not heal is an
early sign.
12. Lorenzo is diagnosed with paralytic shellfish poisoning. Nurse Carlo knows that one of the
following is not true about it?
A. Poison victims who survive the first twelve hours after ingestion of the toxic shellfish
have a greater chance of survival.
B. Shellfish affected by red tide must be cooked with vinegar as the toxin of pyromidium
decreases when mixed with acid.
C. Toxin of red tide is not totally destroyed by cooking so consumers must be educated
to avoid bivalve mollusks.
D. Drinking pure coconut milk weakens the toxic effect of red tide if combined with
sodium bicarbonate in the early stage of poisoning.
Rationale: Shellfish affected by red tide must not be cooked with vinegar as the toxin of pyromidium
increases for up to 15 times greater when mixed with acid.
13. DOTS is the internationally recommended TB control strategy. All of the following are
elements of DOTS except:
A. Sustained political commitment
B. Standardized short course chemotherapy for all TB cases under proper case
management conditions
C. Increase and sustain support and financing for TB control and accreditation
D. Recording and reporting system enabling outcome assessment of overall program
performance
Rationale: There are 5 elements for DOTS, which includes Options A, B and D. Option C is an objective
of the National Tuberculosis Control Program (NTP).
14. Nurse Carlo is aware the portal of entry of schistosomiasis is/are the:
A. Gastrointestinal tract C. Respiratory tract
B. Skin D. Blood vessels
Rationale: From the intermediate host, a snail called oncomelania quadrasi, emerges in two months
called cercaria (infectve stage) into the water and enter the skin of man and other warm-blooded
anomals. From the skin, it enters the systemic circulation and into the intrahepatic portal circulation.
15. Which of the following is the most common virus that causes diarrhea in children?
A. Giardia lamblia C. Borrelia burgdorferi
B. Respiratory syncitial virus D. Rotavirus
Rationale: Most infections that occur in children are caused by viruses and diarrhea is not an
exception. The most common causative agent of diarrhea in children is the rotavirus. The highest
incidences of illness occur among infants and young children and are characterize by vomiting and
watery diarrhea for 3 to 8 days. About 40% of these infections will require hospitalization for IV fluids
administration.
16. Which of the following is considered a prophylaxis for leprosy?
A. Multidrug therapy C. Specific drug therapy
B. BCG vaccination D. Good personal hygiene
Rationale: Specific prophylaxis is the administration of BCG vaccination. Option A and C are
therapeutic treatment while option D is a preventive measure.
17. Nurse Minda is teaching a group of women about the prevention and control for scabies. All
the following are part of the prevention and control except:
A. Improving the sanitation of the surroundings
B. Regular change of clean clothing, beddings and towels
C. Good personal hygiene
D. Use of benzyl benzoate emulsion
Rationale: Use of benzyl benzoate emulsion is cleaner to be use but this is already part of the
therapeutic management, not prevention and control.
18. Maricel, a young adolescent, tells the clinic nurse that she had sexual contact with her
boyfriend 3 days ago. Her boyfriend admitted having been diagnosed with gonorrhea. Maricel
wants to know when she can expect symptoms to appear/The nurse inform her that onset of
symptoms are expected within:
A. Two to five days C. Five to seven days
B. One to two weeks D. Two to three weeks
Rationale: The incubation period of Neisseria gonorrhea infections is usually 2-10 days after which the
initial symptoms are expected to appear.
19. Nurse Maria has been assigned at the rural health unit in Palawan where malaria continues to
be a health problem. She is aware of the following signs and symptoms of malaria. Which of
the following is NOT INCLUDED?
A. Recurrent chills C. Anemia
B. Profuse sweating D. Vomiting
Rationale: Vomiting is not part of the symptomatology. Signs and symptom include recurrent chills,
fever, profuse sweating, anemia, malaise, hepatomegaly and splenomegaly.
20. A mother consults at the health center for vaccination of her child. The nurse teaches her
about the recommended age for giving hepatitis B vaccine which is:
A. One month and a half C. Four months
B. Six months D. One year
Rationale: The minimum age of first dose of Hepatitis B vsccine(HBV) is 6 weeksIt is started at an early
age to reduce the chance of being infected and becoming a carrier.
21. James a 9 year old child is brought to the health center for consult because of popular pruritic
rah with some vesicles on his trunk and back. He has fever and body malaise. Based on the
assessment of Nurse Maria, which illness does Jaime have?
A. Measles C. Rubeola
B. Roseola D. Varicella
Rationale: The assessment findings are consistent with the signs and symptoms of chickenpox or
varicella.
22. A nurse in the health center attends to a child who is brought by the mother because of a
possible pertussis. Which of the following characteristics is commonly seen in a child with
pertussis?
A. Barking cough C. Whooping cough
B. Sudden high grade fever D. Inspiratory stridor
Rationale: In the paroxysmal stage of pertussis, the cough ranges from mild to paroxysmal type which
involves 5 to 10 short rapid coughs followed by rapid inspiration that cause the whoop or high
pitched crowing sound.
23. Mrs. Delos Santos brought her 2 year old child to the pediatric unit of the District Hospital
with a diagnosis of bacterial meningitis. Which should be the initial intervention of Nurse
Anabel for the child?
A. Obtain a urine specimen
B. Place the toddler in respiratory isolation
C. Draw the ordered laboratory tests
D. Explain the treatment plan to the parents
Rationale: Children diagnosed with bacterial meningitis are placed on respiratory isolation for 24
hours after initiation of medication to prevent transmission of the infection.
24. The community health nurse has the following functions in communicable disease control:
1. Assist the family in recognizing and solving health problems
2. Guides the family in recognizing need for medical supervision and care
3. Instructs on isolation and quarantine procedures
4. Confidentiality in care for cases of sexually transmitted disease

A. 1 only C. 1,2 and 3
B. 1 and 2 D. 1,2,3 and 4
Rationale: All the mentioned functions are part of the responsibility of the community health nurse in
communicable disease control.
25. Nurse Jaime is giving health teachings on the preventive measures against hepatitis B
infections. Which of the following is not a part of the teachings?
A. Immunization with hepatitis vaccine
B. Avoid injury with sharp objects like needles, scalpels, blades
C. Avoid eating foods prepared by an infected food handler
D. Proper screening of blood and blood products for transfusion
Rationale: Prevention measures for hepatitis B include option A, B and D.Option C is a measure
against hepatitis A or E.
26. Nurse Jaime continues his health teachings on sexually transmitted diseases. He emphasizes
practice of safe sex which includes all of the following except one:
A. Have adequate sleep, rest and exercise
B. Use condom properly
C. Avoid sexual practices which may break like skin like anal intercourse
D. Have sex with only one faithful partner
Rationale: Option A is part of the prevention and control measures for hepatitis B. Safe sexual
practices are specific for option B, C and D.
27. Of the three clinical forms of anthrax, the most common and is contracted by contact with
infected animals is the:
A. Cutaneous form C. Gastrointestinal form
B. Pulmonary form D. Renal form
Rationale: This is the most common form and is contracted by contact with infected animals, usually
carcasses or contaminated wool and fur. The exposed part of the skin begins to itch and a papule
appears.
28. The 4 Cs in the case management of sexually transmitted diseases are the following:
A. Compliance, case finding, counseling, condoms
B. Compliance, counseling, contact tracing, condoms
C. Case finding, complete treatment, consultation, contact treatment
D. Consultation, counseling, compliance, case finding
Rationale: There are the 4 Cs in the syndromic case management of sexually transmitted diseases.
29. The responsibility and function of the community health nurse are focused mainly on all of the
following except one:
A. Case finding C. Prevention
B. Supportive care during management D. Therapeutic management
Rationale: Therapeutic management is usually ordered by the physician-in-charge.
30. Mang Rodel diagnosed with pulmonary Tb has been taking medications for the treatment of
TB. How so after initiation of treatment will he be non infectious?
A. Within 48 hours after initiation of treatment
B. Results differ with each patient, so it is difficult to say
C. Two to three weeks after initiation of treatment
D. After completion of 6 months of chemotherapy
Rationale: People are considered no infectious after 2 to 3 weeks of continuous medication therapy.
31. Nurse Rayna was assigned to Mrs.Ferrer who is in the icteric stage of Hepatitis A. Which action
by Nurse Rayna would be inappropriate?
A. Force fluids( 2 to 3 L) C. Administer Vitamin K as ordered
B. Encourage ambulation to prevent pneumonia D. Provide mittens to the patient
Rationale: Viral hepatitis is a systemic viral infection producing necrosis and inflammation of liver cells
which produces symptoms like jaundice. Patients are advised to avoid substances like injectable
medications which may further affect liver function.
32. Nurse Rayna gives health teachings to a group of adolescents in a local high school. She is
correct when she says that one of the following clients is at greater risk for developing
acquired immune deficiency syndrome (AIDS)?
A. Clients who lived in a crowded housing with poor ventilation
B. A young sexually active client with multiple partners
C. Adolescents who are homeless who live in shelter
D. A young sexually active adult with one partner
Rationale: Having multiple sexual partners puts a client at risk for developing AIDS. Being in a
monogamous relationship is one way of preventing and controlling the disease.
33. Nurse Rayna is teaching about syphilis. Which statement should the nurse include in her
teaching?
A. Syphilis is rarely transmitted sexually.
B. There is no known cure for syphilis.
C. Viability outside the body is long.
D. Affected persons are most infectious in the first 6 months.
Rationale: Primary syphilis is the most infectious stage and it is when chancre or sore develop. The
appearance of chancre usually lasts between one week to 6 months after which the secondary stage
stares to appear.
34. Marian brought her toddler home because of exposure to varicella in the day care center.
Which statement is true about varicella?
A. Child is not contagious once crusting has developed.
B. Treatment of choice is aspirin.
C. Varicella has an incubation period of 13 to 17 days
D. Rash is nonvesicular.
Rationale: The incubation period of varicella is 2 to 3 weeks or 13 to 17 days and the period of
communicability is not more than one day before and more than 6 days after the appearance of the
first crop of vesicles.
35. Mrs.Dimayuga consults at the health center and reports that his 3 year old son is always
scratching his anus. Which of parasites would the nurse suspect?
A. Liver pluke C. Ascaris
B. Pinworm D. Scabies
Rationale: Pinworms are small, white, threadlike worms that migrate out of the GI tract and deposit
eggs in the anal area causing pruritus.
36. A 3 year old child is admitted because of diarrhea of 7 to 8 episodes a day which started 3
days prior to consult. Nurse Emilia assesses the child and notes severe dehydration. Which of
the following findings indicates severe dehydration?
A. Gray skin and decreased tears C. Mottled skin and skin tenting
B. Capillary refill less than 2 seconds D. Pale skin with dry mucous membranes
Rationale: In the presence of dehydration, the skin is primarily involved with regard to color,
temperature, moisture and turgor. Skin becomes mottled and there is delayed return of the skin when
pinched.
37. A child was brought to the rural health unit because of suspected pertussis. The community
health nurse is aware that she should obtain specimen for culture from the:
A. Blood C. Urine
B. Stool D. Nasopharyngeal secretions
Rationale: The source of infection comes from the discharges from laryngeal and bronchial mucous
membrane of infected persons and thus, specimen collection should come from these.
38. The following are measures to prevent and control the spread of malaria expect:
A. Treatment of mosquito nets C. On stream seeding
B. On steam clearing D. None of the above
Rationale: Options A, B and C are all measures to prevent and control malaria. In addition, neam trees
and spraying of anti mosquito insecticides could also help in vector control.
39. Nurse Chie is assigned to administer Mantoux testing to a group of factory workers. The
vaccine is administered in the:
A. Gluteal muscle C.Forearm
B. Lateral aspect of the thigh D. Biceps muscle
Rationale: Mantoux testing is administered by intradermal route in the volar aspect of the forearm.
Results are read 48 to 72 hours.
40. Nurse Maya teaches a womens class about prevention of leprosy. All are part of prevention
except one:
A. Ambulatory chemotherapy through use of multidrug therapy
B. Avoidance of prolonged skin to skin contact
C. Children should avoid close contact with active untreated leprosy case
D. Good personal hygiene
Rationale: Chemotherapy is part of the management and treatment of active cases.Options B, C and D
are preventive techniques.
41. Nurse Melanie is caring for a client diagnosed with schistosomiasis. The primary medication
she will administer is :
A. Doxycycline C. Metronidazole
B. Amoxicillin D. Praziquantel
Rationale: Praziquantel or Biltricide is the drug of choice for schistosomiasis. It is safe and effective
and is givne as a single dose or in divided doses.
42. Which of the following is given for treatment of syphilis?
A. Glucocorticods C. Salmeterol
B. Penicillin G D. Metronidazole
Rationale: The antibiotic of choice for syphilis is still a single injection of benzatine penicillin G IM 2.4M
units/week for 3 weeks. For allergies or resistant cases. Tetracycline or doxicycline may be used.
43. Which of the following diarrheal diseases may not be reported to the Health Officer?
A. Cholera C. Typhoid fever
B. Bacillary dysentery D. Acute gastroenteritis
Rationale: Cases of gastroenteritis may not be reported;all the other options need to be reported for
prevention and control.
44. At the health center,immunization schedules are promptly followed. Measles vaccine given
subcutaneously is administered at what age?
A. One and a half years C. Nine months
B. Six months D. Twelve months
Rationale: Measles vaccination is administered at 9 months of age and 80% of measles can be
prevented by immunizations at this age.
45. Oral polio vaccine is administered at what age?
A. One and a half years C. Six months
B. Six weeks D. Nine months
Rationale: Oral polio vaccine is administered at a minimum age of 6 weeks with an interval of 4 weeks
for 3 doses.
46. One of the following is not transmitted by a vector :
A. Ascariasis C. Schistosomiasis
B. Malaria D. Dengue fever
Rationale: Ascariasis is a parasitic infection that is transmitted by contact when the infected larva in
the soil penetrates the skin of barefooted individuals. They do not need any intermediate host.
47. Paralytic shellfish poisoning or red tide is caused by dinoflagellates that are found in all the
following except :
A. Samar C. Laguna Bay
B. Bataan D. Zambales
Rationale: The organism that causes red tide is present in the seas around Manila Bay, Bataan, Samar
and Zambales.
48. A nurse in Baguio is attending to a patient with suspected meningococcemia. She is aware
that this infection is not transmitted by :
A. Kissing C. Sneezing
B. Coughing D. Eating foods from outbreak areas
Rationale: The bacteria are present in the upper respiratory tract and localized in the nasopharynx.
Transmission takes place through inhalation of an infected droplet from carriers.
49. The family members of a client with meningococcemia are asking if they will develop the
infection. The nurse instructs them that in order to protect the exposed family members, they
must :
A. Take mega doses of vitamin C for 10 days
B. Take rifampicin as prophylaxis
C. Administer vaccine against meningitis
D. No precaution needed , it is non-infectious
Rationale: Chemoprophylaxis with rifampicin or minicycline is useful for close contacts of the patient.
Minocycline is known to eradicate infections in meningococcal carriers.
50. Nurse Tina is discussing AIDS with a group of student nurses. She asks the groups which one is
the best indicator for the diagnosis of HIV. Nurse Tina is correct when she said :
A. Western blot C. FTA-Abs
B. ELISA D. RPR test
Rationale: The confirmatory test for AIDS/HIV is the Western blot test.