NLE JULY 2011

NURSING PRACTICE II

COMMUNITY HEALTH NURSING AND CARE OF THE MOTHER AND CHILD

GENERAL INSTRUCTIONS:

1. This test booklet contains 100 test questions.
2. Read INSTRUCTIONS TO EXAMINEES printed on your answer sheets.
3. Shade only (1) box for each question on your answer sheets. Two or more boxes shaded will invalidate your answer.
4. AVOID ERASURES
5. This is MERGE property only


INSTRUCTIONS:

1. Detach one (1) answer sheet from the bottom of your Examinee ID/Answer Sheet Set.
2. Each test set will be provided with an answer sheet. Write the subject title NURSING PRACTICE II on the box provided.
3. Shade Set Box A on your answer sheet if your test booklet is Set A; Shade Set Box B if your test booklet is Set B.

SITUATIONAL
Situation 1 You are caring for children and adolescents common health problems.

1. Which of the following actions initiated by the parents of an 8-month-old indicates they need further teaching about preventing childhood accidents?

A. Locking all cabinets
B. Placing circular pieces of hotdogs in the childs plate
C. Inspecting toys for loose parts.
D. Placing toxic substances out of reach or in its original containers.

2. Parents of a 15-year-old state that he is moody and rude. Nurse Roxhanne should advise his parents to:

A. restrict his activities C. Obtain family counseling.
B. Discuss their feelings with their child D. Talk to other parents of adolescents

3. A mother asks Nurse Roxhanne, How did my children get pinworms? She explains that pinworms are most commonly spread by which of the following
when contaminated?

A. Food C. Animals
B. Toilet seats D. Hands
4. Nurse Roxhanne discusses the eating habits of school-age children with their parents, explaining that these habits are most influenced by which of the
following?

A. Food preferences of their peers
B. Smell and appearance of food offered
C. Examples provided by parents at mealtimes
D. Parental encouragement to eat nutritious foods

5. A father asks Nurse Roxhanne how he would know if his child had developed mononucleosis. She explains that in addition to fatigue, which of the
following would be most common?

A. Enlarged lymph glands C. Persistent nonproductive cough
B. Enlarged liver and fever D. A blush-like generalized skin rash

Situation 2 Legal and Ethical Issues in Nursing.

6. On admission to same-day surgery, Nurse Joaquin reviews the chart to verify the clients identification documentation. Which of the following is most
important?

A. Admitting record C. Identification bracelet
B. Subpoena duces tecum D. Location of family

7. A 15-year-old client needs life-saving emergency surgery, but his relatives live an hour away from the hospital and cannot sign the consent form. What is
Nurse Joaquins best response?

A. Do not send the client for surgery.
B. Call the family for a consent over the telephone and have another nurse listen as a witness.


C. Have the family sign the consent form as soon as they arrive.
D. Let the nurse sign the consent in behalf of the patient

8. Nurse Joaquin should ask all clients age 65 or older who are having surgery which question?

A. Do you have PAG-IBIG membership card?
B. Do you have and advance directive such as health care proxy or living will?
C. Do you have TIN number to help pay for medications?
D. Are you are member of multi-level networking company?

9. The clients identification armband was removed to start an IV line as part of the preoperative preparation. The transport team has arrived to transport
the client to the OR. Nurse Joaquin notices that the clients identification band is not on his wrist. What is his best response?

A. Send the removed armband with the chart and the client to the operating room
B. Place a new identification armband on the clients wrist before transport.
C. Tape the cut armband back onto the clients wrist
D. Send the client without an armband because she can verbally identify herself

10. When a client cannot read or write and NOT of sound mind, Nurse Joaquin should read the consent to the client in the presence of two witnesses and:

A. Have the clients next-of-kin sign the consent
B. Have the nurse sign the consent
C. Have a court appoint a guardian for the client
D. Have a hospital quality management coordinator sign for the client


Situation 3 Nurses should be knowledgeable how to keep children healthy and should utilize critical thinking in assessing symptom and application of treatment to
certain diseases.

11. When assessing a 4-month-old infant diagnosed with possible intussusception, Nurse Trissh should expect the mother to relate which of the following
about the infants crying and episodes of pain?

A. Constant accompanied by leg extension
B. Intermittent with knees drawn to the chest
C. Shrill during ingestion of solids
D. Intermittent while being held in the mothers arms

12. While assessing a preschooler brought by her parents to the emergency department after ingestion of kerosene, Nurse Trissh should be alert for which of
the following?

A. Uremia C. Carditis
B. Hepatitis D. Pneumonitis

13. Nurse Trissh is inserting a nasogastric tube in a child admitted with head trauma. She should explain to the parents that the NG tube will be used for what
purpose?

A. Administer medications C. Obtain gas specimens for analysis
B. Decompress the stomach D. Provide adequate nutrition

14. When assessing a child diagnosed with diarrhea due to salmonella, for which of the possible sources should Nurse Trissh be alert during history taking?

A. Nonrefrigerated custard C. Undercooked eggs
B. bird droppings D. Cat litter box

15. The mother asks Nurse Trissh why peanuts are one of the worst thing a child can aspirate. Which of the following should she include in the explanation as
the main reason for the problem associated with aspirating peanuts?

A. They swell when wet C. They decompose when wet
B. They contain a fixed oil D. They contain sodium

SITUATION 4: You are conducting a mothers class at the Barangay Health Station and the participants are in varying periods of pregnancy. After the class session,
the mothers started asking more information from you.

16. Rhoda asks why she could not feel fetal movements all the time. Your most appropriate response is that fetal movements:

A. Decrease as the mothers activity decreases.
B. Decrease as the mother nears her term.
C. Increase if mother drinks alcohol.
D. Are usually not present during the fetal sleep cycle.



17. At 36 weeks gestation, Nina tells the nurse that she has been experiencing shortness of breath. Which of the following suggestions would be most helpful?

A. Warm shower before sleeping C. Sleep with extra pillows
B. Empty bladder regularly D. Avoid gas producing food

18. Cynthia, 24 weeks pregnant tells the nurse that she is bothered by pruritus. Which of the following would you suggest?

A. Drink six glasses of water a day C. Apply anti-pruritus ointment
B. Regular tepid bath then apply lotion D. Do deep breathing exercises
19. Myra states that she is uncomfortable with her experience of flatulence, bloating and belching now that she is 28
TH
weeks of gestation. What would be
your most appropriate suggestion?

A. Decrease intake of fluids C. Maintain regular bowel habits
B. Eat small and frequent meals D. Chew food slowly

20. Norie complains of leg cramps especially after reclining. She is now on her 36
th
weeks of gestation. Which of the following instruction will help client when
she has leg cramps?

A. Stand and flex the affected leg.
B. Have another person anteflex the foot of the affected leg and extend knee.
C. Sit and hyperextend the affected leg.
D. Stand and lean forward dorsiflexing foot of affected leg.

SITUATION 5: While working in the community, nurses observe various situations that require attention.

21. Nurse Nikki was doing case finding in a barangay in the rural communities of Lagonoy, Camarines Sur. Her target is to identify undocumented Hansens
Disease cases. Seeing her in uniform a woman remarks: Youre not a nursing student are you? I have many chores to do today, Please! and ignores the
nurse. Nikkis IMMEDIATE course would be to:

A. Visit the next house so as not to waste the days activity and return to re-visit this home after a day or two.
B. Process the feelings and behavior manifested by the woman and get to the root causes of such behavior.
C. Ignore the womans behavior, turn around and simply leave her alone.
D. Communicate the incident to the Barangay Captain and get him/her to join her in her next visit.

22. A student nurse visits Aling Mercy who immediately stated that she has too much work to do and she has been visited and interviewed by student nurses
almost daily After explaining the purpose of her visit, the students APPROPRIATE action would be to.

A. Tell her Clinical instructor about the problem.
B. Select another family as a client.
C. Set an appointment at Aling Mercys convenient time.
D. Ask the barangay chairman for assistance.

23. Nurse Rina intends to get maximum participation from the community members to get an accurate assessment of their health needs. To do this, nurse
Rina collaborates with the community to do a situational analysis. This process entails the following EXCEPT:

A. Asking people why they think the health problems exist.
B. Allowing people to freely express what they consider their health problems.
C. Providing immediate solution to identified health problem.
D. Assisting the community to identify health situations that need change.


24. The community health nurse noticed that there are many out of school teenagers in the neighborhood who use drugs, smoke and drink alcohol. Their
parents are working overseas and these teenagers live with their aging grandparents who have difficulty controlling them. Before arriving at a SOCIAL
DIAGNOSIS, the nurse should:

1. Determine if this situation results in breakdown of families.
2. Explore to what extent the situation affects life in the neighborhood.
3. Determine what policies should be enacted to promote lifestyle changes.
4. Assess how the educational level of the community affects its ability to cope with the problem.

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

25. Inspired by the singing jail inmates, the nurse suggests to the barangay chairman that the out of school teenagers may be encouraged to stay out of
trouble by organizing activities that will occupy their time, use up their energy and unify them. To realize such goal/objectives, the nurses and
communitys actions should proceed in which order?

1. Identify what manpower and money resources are needed to implement the program.
2. Design the program that will meet goal/objectives.
3. Identify support activities that will sustain the programs.


4. Determine the programs impact on the target group.

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

SITUATION 6: Health Education among pregnant women is important. The following questions apply.

26. An understanding of physiologic adaptations to pregnancy is important. The following changes in pregnancy are important to keep in mind in order to
address clients needs EXCEPT:

A. Cardiac output increases by 25% to 50 % during pregnancy
B. The posterior pituitary gland secretes oxytocin late in pregnancy
C. The temperature decrease slightly early in pregnancy
D. The circulating fibrinogen level decreases as much as 50% during pregnancy

27. Which statement by a client indicates that further teaching about nausea and vomiting of pregnancy needs to be done by the nurse?

A. I need to drink an extra glass of water with every meal.
B. I hope that taking a nap when I get home from work makes me feel better.
C. I will ask my husband not to wear aftershave because it upsets my stomach.
D. I will try to eat at five of six smaller meals during the day.

28. Amanda is now 16 weeks pregnant. If the pregnancy is progressing as expected, where would the practitioner find the uterine fundus?

A. Halfway between the pubic bone and the umbilicus.
B. Just above the pubic bone
C. The uterine fundus would not be palpable at 16 weeks
D. At the umbilicus

29. You are teaching Amanda about proper diet during pregnancy. If Amanda understands your instructions, how will she reply when you ask her
approximately how many more calories per day she needs now that she is pregnant?

A. I should not increase my calories while Im pregnant.
B. About 300
C. I need to double my calories because Im eating for two.
D. Approximately 500

30. A 17 year old primigravida client at approximately 15 weeks gestation is to undergo alpha fetoprotein (AFP) screening. When developing the teaching plan
for this client, the nurse should include which of the following pieces of information?

A. A clean-catch midstream urine specimen is needed
B. Ultrasonography usually accompanies AFP testing
C. Increased levels of AFP are associated with neural tube defects
D. Results are usually very accurate until 20 weeks gestation.


SITUATION 7: In the growth and development of any child, you are fully aware that your responsibility for caring encompasses physical and psychological/emotional
dimensions of caring. The following apply;

31. Mother Elena is worried about her preschool-age child and says to the nurse, My 4-year-old frequently touches her genital. Which of the following
statements would be appropriate for the nurse to make?

A. Masturbation is normal and healthy, so you may help them channel it into more constructive outlets.
B. Masturbation is a form of sex play; this act must be openly exhibited in public so as to gain more acceptances.
C. When children are anxious and bored, they often masturbate.
D. When this child masturbates, they may be overwhelmed by their sexual feelings.

32. Illness and hospitalization are the first crises children must face most especially during the early years. Erwin is a 4-year old hospitalized child, who is
unable to cope with the separation; as a result, he may manifest many of the stage behaviors of separation anxiety. Which of the following behaviors
might indicate that Erwin is in the denial stage of separation? He:

A. Searches for parents with eyes, clings to them and screams
B. Uninterested in the environment and inactive
C. Kicks, bites, hits, pinches strangers
D. Appears happy, but Ignores caregivers when they visit

33. After Erwins discharge from the hospital, which of the following behaviors might indicate that he is afraid of another separation? He:

A. Carries a favorite blanket around the house
B. Plays with siblings for long periods of time


C. Wakes up very early in the morning
D. Request to go visit the nurses at the hospital

34. When caring for Catherine, a 3 year-old child, who is receiving oxygen in an oxygen tent, which of the following toys or activities would be BEST to offer?

A. Push and pull toys
B. A toy car that runs by rotating the wheels backward and at the same time emits different lights
C. A playstation
D. A favorite plastic toy belonging to the child

35. Tonton, a 9 year old, 4
th
grader bed wets. The mother asks your advice how this can be corrected. Your MOST appropriate response is:

1. It is normal for his age. Dont scold him.
2. Limit his fluids before sleeping.
3. Wake him up 2-3 hours from the time he sleeps.
4. He might have problems at home and school.

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

SITUATION 8: The nurse is taking care of clients who are in their 2
nd
and 3
rd
trimester of pregnancy.

36. Amor, 35 years old and 36 weeks pregnant, G1P0, goes to the hospital reporting a feeling of wanting to push, lower back pains, abdominal cramps and
passage of mucous with some blood. With the presenting symptoms of the client, Nurse Elsa suspects that the client suspects that the client is having:

A. Spontaneous abortion C. Abruptio placenta
B. Preterm labor D. Threatened abortion

37. Amors bag of waters ruptures spontaneously and she delivers the baby within the hour after the premature rupture of the membranes (PROM). The nurse
should watch out for the MOST immediate danger to the fetus.

1. Infection during the intra and postpartum periods
2. Infant respiratory distress syndrome
3. Umbilical cord compression
4. Fetal abnormality

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

38. Management of clients who had premature rupture of membranes (PROM) during the early stages of pregnancy without labor/delivery includes the use of
maternal antibiotics. After the premature rupture of the membranes, the nurse should closely observe the client. The IMMEDIATE nursing action would be
to:

A. Report foul or strong odor with yellowish color of vaginal drainage
B. Teach the client breast stimulation
C. Report presence of uterine contractions
D. Take clients vital signs and fetal heart rate every four hours and report significant changes.

39. Lower back pain in pregnant women is caused by the bodys attempt to balance as the uterus enlarges. To help reduce the lower back pain of Nancy who
is in her 6
th
month of pregnancy, the nurse advices her to:

A. Elevate her feet C. Do pelvic rocking
B. Do Kegels exercise D. Walk long distance until she feels out of breath

40. Allison is 7 months pregnant, G2P1, 42 years old and is expecting twin girls. She has shown symptoms of mild pregnancy induced hypertension (PIH) with a
blood pressure of 140/90 and protein in her urine tests. An appropriate nursing action would be to give Allison important health information while she is
managed at home. The nurse tells Allison to:

A. Regularly monitor her pulse rate
B. Perform mild 30 minute exercise daily
C. Eliminate sodium from her diet
D. Have frequent bed rest on left side lying position to facilitate placental and renal blood flow.

SITUATION 9: Promotion of Safe Motherhood in varied clinical settings is consistent with safety and quality concerns of every nurse in the care of women during
normal pregnancy. The following questions apply.

41. Nurse Jojie is taking care of pregnant client whose last day of menstrual period was June 22, 2010. Using the Nageles Rule the estimated date of birth
would be:

A. March 29, 2011 C. March 15, 2011


B. April 29, 2011 D. April 14, 2011

42. Nurse Jojie attends to another pregnant client who has two children. Her history reveals that her first pregnancy ended in a stillbirth at 32 weeks of
gestation, her second pregnancy with the birth of her daughter at 35 weeks, and her third pregnancy with the birth of her son at 41 weeks. Using the GP
TPALM format, Nurse Jojie would record the womans current obstetrical history as:

A. G3P3 (T1 P1 A1 L3 M0) C. G4P3 (T1 P2 L2 M0)
B. G4P4 (T2 P1 A0 L1 M0) D. G3P3 (T1 P2 A0 L1 M0)

43. A twenty-year-old client visits Nurse Jojie at her Nursing Prenatal Clinic because she suspects that she is pregnant. She tells Nurse Jojie that she missed one
menstrual period and that she experienced nausea and vomiting, urinary frequency, and fatigue. Based on her assessment, Nurse Jojie suspects that her
client has signs of pregnancy categorized as which of the following?

A. Positive C. Probable
B. Predictive D. Presumptive
44. While doing Leopolds Maneuver on a client, nurse Jojie notes the presence of a firm round prominence over the pubic symphsis, a smooth convex
structure down her right side, and irregular lump down her left side, and soft roundness in the fundus. Nurse Jojie here should conclude that the fetal
position is:

A. LOP (left occiput anterior) C. RSA (right shoulder anterior)
B. ROA (right occiput anterior) D. LOA (left occiput anterior)

45. When performing Leopolds Maneuver to a primigravida client, Nurse Jojie is aware that to make her client more comfortable during the procedure, she
should prepare the client by asking her to:

A. Avoid eating immediately before the examination.
B. Hyperventilate for a short time before beginning the procedure.
C. Empty her bladder prior to the procedure.
D. Lie on her left side during the procedure.

SITUATION 10: Karina, 5 months old, weighs 5.2 kgs, temperature 38C., is brought to the center. Her mother says she is not eating well, feels hot to touch, able to
drink, no vomiting, no convulsions, not lethargic and no cough. They live in a malaria risk area. Her fever started 2 days ago. She has no signs of measles, no stiff
neck or runny nose.

46. How will you classify Karinas illness?

A. Severe febrile disease C. Fever: no malaria
B. Malaria D. Plain fever

47. The following treatments are appropriate for Karina EXCEPT:

A. Advise when to return immediately.
B. Give 1 dose of paracetamol for temp. 37.5C.
C. Follow-up in 2 days.
D. Give oral anti malaria drugs.

48. A child should be checked for capillary refill if:

A. There is fever for more than 7 days C. If the extremities feel cold
B. If the child has petechiae D. The childs extremities feel warm

49. If the capillary refill takes more than 3 seconds it may mean that the child is in:

A. Shock C. Circulatory failure
B. Alright D. Dehydrated state

50. A child living in a non-malaria risk area who has stiff neck may be classified as having:

A. Severe febrile disease C. R/O Malaria
B. Fever: no malaria D. Malaria

SITUATION 11: Management of resources and environment includes every potential and existing resources which the nurse can utilize to promote and maintain
health, prevent illness and assist in the task of cure and rehabilitation. The IMI Chart prescribed by the World Health Organization is one such resource. The
following questions apply.

51. The Integrated management of childhood illness (IMCI) chart provides the necessary procedure when identifying the appropriate interventions to be done.
However, the community health nurse should be aware that the following factor should be considered in utilizing the case management chart.

A. Ninong of the child C. Problem of the child
B. Chief complaint D. Danger signs





52. In the IMCI classification tables, color yellow indicate that a:

A. A child does not need specific medical treatment.
B. A chief complaint that needs an urgent attention.
C. A child needs an appropriate antibiotic or other treatment.
D. A referral or admission is needed.

53. Upon assessment, Nurse Sisa, notes that the child has fever. In the presence of mosquito bites she would suspect the following illnesses EXCEPT:

A. Malaria C. Measles
B. DHF D. Hemorrhagic fever

54. All of the following illnesses are caused by virus, EXCEPT:

A. Measles C. Parotitis
B. H-fever D. Malaria

55. Which of the following laboratory tests would classify the presence of fever as positive for malaria?

A. Occult blood C. Blood smear
B. Tourniquet D. CBC

SITUATION 12: Among the normal nurses responsibility after delivery is the provision of safe, physical, emotional, and psychological support for the mothers well-
being. The following questions apply.

56. What nursing intervention would be MOST helpful in providing emotional support to Lydia and her family after a cesarean delivery?

A. Providing opportunities to discuss reaction to the birth experience.
B. Recommending frequent rest periods for the new mother
C. Encouraging the father to observe the infants first bath
D. Positioning the infant with pillows during feeding

57. The nurse assesses Lydia after delivery. What data would suggest that Lydia is at increased risk for hemorrhage?

A. Infant birth weight of 7 lbs 11 oz (3487 g)
B. Gravid 7 Para 5
C. 8 hours length of labor
D. History of gestational diabetes

58. Another postpartum woman had post-partum bleeding. Which areas would the nurse need to assess before the woman ambulates?

A. Height, level of orientation, support system
B. Degree of responsiveness, respiratory rate, fundus location
C. Blood pressure, pulse, complaints of dizziness
D. Attachment, lochia color, complete blood cell count

59. When assessing client Myrna who gave birth 4 hours earlier, the nurse finds the uterus to be firm, 2 fingerbreadths above the umbilicus, and displaced to
the right. Lochia rubra is moderate. What would be the FIRST nursing action?

A. Record these as normal findings C. Gently massage the fundus
B. Encourage the woman to urinate D. Insert a foley catheter




60. When assessing Myrna 14 hours postpartum, the following data are collected: temperature 38.1C (100.6F), pulse 104, respiration 19, blood pressure
118/72. What would be the BEST nursing action?

A. Encourage the client to increase her fluid intake
B. Report these findings to the health care provider
C. Assess for uterine tenderness and odor to lochia
D. Massage the uterus and express clots

SITUATION 13: Community health nurses take care of clients with varying health concerns and establishing groups in the community.

61. A home health nurse is made aware that a client and family are about to lose their home due to foreclose. The nurse contacts the social service
department of the home health care agency for assistance in finding housing for the family. The actions taken by the?



A. Consultant C. Researcher
B. Clinician D. Advocate

62. Maria Corazon brought her child to the clinic for palmar pallor suggestive of anemia. The doctor prescribed iron medication and it was only the 3
rd
day of
taking such medication. Your next action would be to:

A. Instruct the mother to continue giving iron for 14 days
B. Give iron and return tomorrow
C. Refer the child immediately
D. Give iron medications 3x a day

63. With the community health activities started and in the entry phase, which of the activities should not be included?

A. Conduct of deepening social investigation C. Project management
B. Information campaign on health programs D. Core group formation

64. Identification of potential leaders is crucial during the entry phase. Which of the characteristics may not be necessary to an efficient and effective
community leader?

A. Responsive and willing to work for change
B. A college graduate with management skills
C. Must have relatively good communication skills
D. A respected member of the community

65. The core group is a composed of individuals in the community who possess leaders potential organized into a cohesive working unit. The core group works
with the team in:

A. Setting-up community organization that will serve the interest of a sector in the community
B. Selecting community activities according to their preferences
C. Monitoring the performance of the baranggay officials
D. Mobilizing the community to act on their most immediate felt needs and participate in delivery of essential health services.

SITUATION 14: Community empowerment is an important aspect in the work of a community health nurse. The following questions apply.

66. To empower the community members, the community health nurse performs which activity?

A. Step back at the beginning and giving little output
B. Do all the activities for community members
C. Define the community needs for the members
D. Give ownership and leadership to the community

67. When a community health nurse works as a client advocate, the nurse:

A. Uses a passive approach in solving identified problem
B. Is aggressive in pursuing the achievement
C. Is assertive is speaking and acting on behalf of the client
D. Attempts to smooth problems over to keep the community calm

68. The community health nurse leads a class on breastfeeding with group of prenatal parents. The nurse allows the participants to ask questions, make
comments, and reason out loud as feedback is given. Which of the following teaching techniques is the nurse using?

A. Discussion C. Demonstration
B. Lecture D. Role playing

69. When beginning a relationship with a family on home visit, the Community Health Nurse:

A. Allows the discussion to be open and non-directional
B. Encourages others to speak for the main client to get an unbiased view
C. Focuses on the problem of one of the family member
D. Is accepting and listens carefully to problem of all family members

70. The community health nurse as a manager, leader and supervisor best performs all these roles, except:

A. Performs surgical and dental procedures during medical missions
B. Plans, enhances and evaluates health skills of midwives and auxiliary health workers in their performance of their jobs.
C. Organizes and mobilizes the community in a campaign to prevent and control endemic diseases
D. Assumes the Municipal Health Officers role in his/her absence.



SITUATION 15: Carol is 15 months old, weighs 8.5 kgs., is not eating well and is unable to breast feed. She is not vomiting, has no convulsions and not abnormally
sleepy or difficult to awaken. Her temperature is 38.5C. Use the Integrated Management of Childhood Illness or IMCI strategy.

71. If you were the nurse in charge of Carol, how will you classify her illness?

A. Severe malnutrition C. A child with a general danger sign
B. Severe pneumonia D. Very severe febrile disease

72. Which of the following signs is considered to be a general danger sign in Carols case?

A. Temperature of 38.5C C. Has no convulsions
B. Unable to breastfeed D. No vomiting

73. Which of the following signs is NOT included in the general danger sign?

A. Has had convulsion C. Unable to drink or breast feed
B. Vomits everything D. Fast breathing

74. Which of the following steps is NOT included in the IMCI strategy?

A. Identify treatment C. Assess and Classify
B. Counsel and follow-up D. Referral

75. Which of the following sign should be included in deciding that the child vomits everything?

A. Maybe too weak to drink and eat at all.
B. When offered fluids, may not be able to drink.
C. Child experience occasional vomiting.
D. Child is not able to keep anything down at all (what goes down comes back).
SITUATION 16: Total quality Management (TQM) and Continuous Quality Improvement(CQI) are considered sound tools in the management of organizations,
groups, agencies in various care setting where professional nurse are involved.

76. A nurse manager understands that the development of TQM and CQI are meant to:

A. Serve as a system of improving products and services needed to provide quality care to patient.
B. Results in extensive statistical databases
C. Assure society that cost containment would not compromise safety
D. Protect patients and families during health care crisis

77. Which of the following does NOT belong as a general principle of total quality management?

A. Improving the quality of service is a continuous process
B. Quality is achieved by the participation of everyone
C. Focus on improving process develops opportunities
D. Promote on individual accomplishments rather than teamwork

78. Which of the following are examples of STRUCTURE standards that are critical to the success of different public health programs?

1. Cold chain in Expanded Program on Immunization
2. Essential Drugs in Maternal Care Health
3. Acute Respiratory Infection Program Management
4. TB Control Program Management

A. 1, 2 C. All except 3
B. 3 and 4 D. All of the above

79. To ensure the provision of safe and quality nursing care, clinical practice guidelines have been developed. Which of the following is NOT example of
Clinical Practice Guidelines?

A. Algorithms C. Protocol
B. Clinical Pathways D. Research Expectations


80. One of the major challenges in nursing management is the provision of an environment that is conducive to legal and ethical practice. Which of the
following is NOT considered part of ethical nursing practice?

A. Providing care to clients regardless of social class and political beliefs
B. Working in accordance with the Nursing law and other laws affecting nursing practice
C. Behaving in a manner that is consistent with values, professional code of ethics and norms of the community
D. Maintaining confidentiality of information



SITUATION 17: Family/ Home Nursing has currently become a significant area in nursing. Community health nurse Bianca is a taking care of different clients.

81. Bianca has been caring for a child in the home. She has tracheostomy tube and is oxygen dependent. Bianca prefers to do care early in the morning due to
heavy caseload. The family request that care be done when the child is awake by 10am. The best response by Bianca would be:

A. If I give care at 10am, other children needing my care may not be attended to.
B. Lets look at what time is in the childs best interest and then we can work out a better schedule
C. I will see if I can find another nurse who can meet your preferred work schedule.
D. Im sorry, I wish I could, but I cannot do so, due to heavy workload.

82. Bianca BEST exemplifies primary prevention by which of the following activities?

A. Tracheostomy care C. Infant photototherapy
B. Oxygen humudification D. Teaching new mothers infant care

83. Which of Biancas activities would be considered PRIMARY prevention when caring for clients in her caseload?

A. Teaching parents first aid for insect bites
B. Educating parents on the importance of routine immunization
C. Providing families with her telephone number for any home emergencies
D. Educating parents on the signs of lead poisoning

84. The principal government agency mandated by the constitution for health and protection of our people is the:

A. Department of Transportation C. Department of Health
B. Department of Justice D. Department of Education

85. Which best describes community health nursing practice?

A. Prioritizes health-promotive and disease preventive strategies
B. It is population-focused
C. Setting of practice is situated in the natural environment of the people
D. A synthesis of nursing practice and public health practice

SITUATION 18: Public health programs are sets of interventions put together to for the policies to be operational and standards directed towards the prevention of
certain public health problems.

86. Inform, teach and counsel the woman on the importance of maternal and child health, Newborn Screening for babies delivered in RHU or at home.

A. Within 24 to 48 hours after birth
B. Within 24 hours up to two weeks after birth
C. Within 48 hours up to two weeks after birth
D. Within 48 hours up to one week after birth
E. Within 24 hours up to one week after birth

87. Guideline no.2 in the Nutritional Guidelines for Filipinos is intended to promote exclusive breastfeeding:

A. From birth to 4 6 months C. From birth up to one year only
B. From birth to 2 years or longer D. From birth to 5 years

88. In the community, whether it is in the urban or rural, children usually move their bowels elsewhere despite that there is a toilet in their own areas. An
example of approved excreta disposal:

1. Reed odorless earth closet
2. Pit latrineS
3. Pour flush toilet
4. Aqua Privies

A. 1 only C. 4 only
B. 3 only D. All of these

89. In Baranggay Paraiso, you have 7 children suffering from parasitism of worms and there is no available antihelminthic in your health center, what would be
your alternative medication for these children?

A. Bawang C. Lagundi
B. Ampalaya D. Niyog Niyogan


90. During your home visit, you observe that some of the family members are experiencing toothache. You tell them that they can use:



1. Bawang 4. Sambong
2. Tsaang gubat 5. Bayabas
3. Yerba Buena

A. 1 and 3 C. 2 and 5
B. 1 and 4 D. All of the above

SITUATION 19- There are other public health programs that the public health nurse must be aware as they are important support in the achievement of quality health
services in the community.

91. The Aquino Health Agenda : Achieving Universal Health Care for all Filipinos is also known as:

A. FOURmula One (F1) for health in 2005
B. Millennium Development Goals
C. Quality Assurance through Sentrong Sigla Certification
D. Universal Health Agenda 2010

92. The department of health is one of the agencies comprising the NDRRMC (former NDCC) which is the lead agency in coordinating, integrating, supervising
and implementing disaster related functions.

A disaster brought about by the force of nature is:

A. Human generated C. Technological
B. Manmade D. Natural

93. General Principles of Disaster Management is:

A. It is the responsibility of the President
B. Emergency preparedness is not connected to other LGU agencies
C. The first priority is the protection of people who are at risk
D. Capabilities must be developed after the impact of a hazard

94. By nature of the Republic Act 7719 otherwise known as the National Blood Services Act of 1994, DOH in cooperation with the Philippine National Red
Cross is mandated to plan and implement a National Voluntary Blood Services Program. Conditions preventing one from donating blood:

1. AIDS and STDS
2. Sever Psychiatric Disorder
3. DM and Cancer
4. Epilepsy and Convulsions
5. Hyperthyroidism and Cardiovascular Disorders

A. All of these C. 3 and 4 only
B. 1 and 2 only D. All except 5

95. Botika ng Baranggay refers to a drug outlet managed by a legitimate community organization, NGO & LGU
Antihelminthics include

A. Paracetamol 500mg tablet
B. Alumnum hydrochloride 320mg/5mL suspension
C. Mebendazole 500 mg tablet
D. Loperamide 2mg capsule


Situation 20 - COPAR is an important tool for community development and people empowerment as this helps the community workers to generate community
participation in development activites. COPAR prepares people to eventually take over the management of a development program in the future.

96. COPAR stands for:

A. Community Organization Participatory Action Research
B. Community Organization Participatory Activity Research
C. Community Organization Program Action Research
D. Community Organizing Participatory Action Research

97. When members of the community identify needs, work on its solutions with confidence in the spirit of cooperation. The process is:


Community Health Nursing
A. Community Health Nursing process
B. Community Health
C. Community organizing

98. Organizing the community is the responsibility of:

A. health center staff
B. barangay leaders
C. barangay health workers
D. NGOs
E. A, B, C, D

99. With the community health activities started and in the ENTRY PHASE, which of these activities should NOT be included?

A. Conduct deepening social investigation. D. Core group formation.
B. Information campaign on health programs. E. None of the above
C. Project management.

100. Which of the following activities are expected to be done by an effectively organized community?
1. Conduct community assemblies to make plans
2. Identify community health problems
3. Determine effectiveness of community health action
4. Implement plans to resolve community health problems

A. 1, 2 and 3 C. 2, 3 and 4
B. 1, 3 and 4 D. All of these


The first and most important step toward success is the feeling that we can succeed.
Written in 2010 by Nelson Boswell