NURSING112 COMMUNITY PRACTICE EXAM QUESTIONS WITH CORECTLY VERIFIED ANSWERS 2023/2024, Exams of Nursing

Download NURSING112 COMMUNITY PRACTICE EXAM QUESTIONS WITH CORECTLY VERIFIED ANSWERS 2023/2024 and more Exams Nursing in PDF only on Docsity! NURSING112 COMMUNITY PRACTICE EXAM QUESTIONS WITH CORECTLY VERIFIED ANSWERS 2023/2024 1. He defined public health as the science and art of preventing disease, prolonging life, promoting health and efficiency through organized community effort.  a. Winslow  b. Nightingale  c. Rosenstock  d. Maslow According to C. E Winslow, the goal of Public Health is for the people to attain their bright rights of health and longevity. Nightingale developed the environmental theory. Maslow developed the hierarchy of basic human needs. Rosenstock developed the health belief model. 2. The different clients of the community health nurse include the following: 1. Individual 2. Family 3. Population group 4. Community  a. 1 and 2 only  b. 1, 3, 4 only  c. 1, 2, 4 only  d. 1, 2, 3, 4 There are different levels of clientele in community health nursing – the individual, family, population group and community. 3. According to Maslow’s hierarchy of needs, developing one’s potential is included in which of the following:  a. Physiologic  b. Safety and Security  c. Love and Belonging  d. Self-actualization Other needs included in self-actualization are as follows: the need to learn a, create, understand, and comprehend the need for harmonious relationships, the need for beauty, the need for spiritual fulfillment. 4. Pandemic occurrence of a disease means:  a. The intermittent occurrence of a few isolated and unrelated cases in a given locality.  b. The simultaneous occurrence of epidemic of the same disease in several countries.  c. The unusually large number of cases in a relatively short period of time.  d. The continuous occurrence throughout a period of time of the usual number of cases in a given locality. Option B pertains to pandemic occurrence of a disease. Option A refers to the sporadic occurrence. Option C pertains to the epidemic occurrence. Option D is the endemic occurrence of a disease. 5. Mrs. Panganiban’s 6 year old son is entering school for the first time. Mrs. Panganiban has a:  a. Stress point  b. Foreseeable crisis  c. Health deficit  d. Health threat The entry of a 6 year old boy into school is an anticipated period of unusual demand on Mrs. Panganiban. 6. Operation Timbang is in which level of prevention of health problem?  a. Primary  b. Secondary  c. Tertiary  d. Intermediate Primary prevention is directed to the healthy population, focusing on prevention of emergence of risk factors and removal of the risk factors or reduction of their levels. Operation Timbang is done to identify members of the susceptible population who are malnourished. 7. A 3 year old boy was classified to have severe pneumonia or very severe disease. The following symptoms are present, except:  a. Convulsions  b. Chest indrawing  c. Stridor  d. Fast breathing In IMCI, options A, B and C are all under the pink category. Option D is under the yellow category. 8. Severe dehydration is classified when TWO of the following signs are present, except:  a. Drinks eagerly, thirsty  b. Sunken eyes  c. Skin pinch goes back very slowly  d. Abnormally sleepy or difficult to awaken Drinks eagerly, thirsty are signs that are classified under some dehydration. Options B, C and D are signs under severe dehydration. 9. Which of the following is an advantage of a home visit?  a. It allows the nurse to provide nursing care to a greater number of people.  b. It allows sharing of experiences among people with similar health problems. Evaluation structures and qualifications of health care team is part of the community health nursing planning process. Option B is in included in the assessment process while option C and D are both part of the implementation process. 19. Mrs. Larazabal brought her 2 month old baby to the health center for immunization. On assessment, the infant’s temperature registered 38 degrees C. Which is the best action that you will take?  a. Give paracetamol and wait for his fever to subside.  b. Refer the infant to the physician for further evaluation.  c. Proceed with the infant’s immunization.  d. Tell the mother to bring her baby back at the health center when her baby is feeling well. IN the EPI, fever up to 38.5 degrees C is not a contraindication to immunization. Mild acute respiratory tract infection, simple diarrhea and malnutrition are not contraindication either. 20. Which herbal plant is given for fever, headache and cough?  a. Sambong  b. Tsaang gubat  c. Akapulko  d. Lagundi Lagundi is given for fever, headache and cough. Sambong is used as a diuretic. Tsaang gubat is used to relieve diarrhea. Akapulko is used for its antifungal property. 21. Dependency ratio is best described as:  a. Compares the number of economically dependent with the economically productive group in population.  b. Graphical representation of the age-sex composition of the population.  c. Compares the number of males to the number of females in the population.  d. Illustrates the proportion of the people living in urban compared to the rural areas. Dependency ratio compares the number of economically dependent with the economically productive group in population. Option B refers to population pyramid. Option C refers to sex ratio. Option D is under population distribution and it refers to the urban-rural distribution. 22. Type of water supply facility composed of a system with a piped distribution network and household taps.  a. Level I  b. Level II  c. Level III  d. Level IV Level III type of water supply facility has a source, a reservoir, a piped distribution network and household taps. 23. Which of the following is not a principle of community organizing?  a. Principle of Leadership  b. Principle of Evaluation  c. Principle of Structure  d. Principle of Attainment There are 6 principles of community organizing such as principle of leadership, principle of evaluation, principle of structure, principle of needs, principle of participation and principle of communication. 24. Which method of family panning cannot be immediately used by a breastfeeding mother?  a. LAM  b. BTL  c. Combined OCP  d. Condom Combined OCP decreased the production of milk. Therefore, it cannot be immediately used by a breastfeeding mother. 25. If there were 250 deaths and 36,114 live births registered in Region III, with a total population of 200,000, the fetal death rate would be?  a. 6.9 per 1000 live births  b. 7.8 per 1000 live births  c. 0.16 per 1000 live births  d. 0.0014 per 1000 live births When getting the infant mortality rate, we use this formula, deaths under 1 year of age ÷ number of live births x 1000. 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 D. To contribute to national development through promotion of family welfare, focusing particularly on mothers and children. Answer: (B) To enhance the capacity of individuals, families and communities to cope with their health needs To contribute to national development through promotion of family welfare, focusing particularly on mothers and children. 2. CHN is a community-based practice. Which best explains this statement? A. The service is provided in the natural environment of people. B. The nurse has to conduct community diagnosis to determine nursing needs and problems. C. The services are based on the available resources within the community. D. Priority setting is based on the magnitude of the health problems identified. Answer: (B) The nurse has to conduct community diagnosis to determine nursing needs and problems. Community-based practice means providing care to people in their own natural environments: the home, school and workplace, for example. 3. Population-focused nursing practice requires which of the following processes? A. Community organizing B. Nursing process C. Community diagnosis D. Epidemiologic process Answer: (C) Community diagnosis Population-focused nursing care means providing care based on the greater need of the majority of the population. The greater need is identified through community diagnosis. 4. R.A. 1054 is also known as the Occupational Health Act. Aside from number of employees, what other factor must be considered in determining the occupational health privileges to which the workers will be entitled? A. Type of occupation: agricultural, commercial, industrial B. Location of the workplace in relation to health facilities C. Classification of the business enterprise based on net profit D. Sex and age composition of employees Answer: (B) Location of the workplace in relation to health facilities Based on R.A. 1054, an occupational nurse must be employed when there are 30 to 100 employees and the workplace is more than 1 km. away from the nearest health center. 5. A business firm must employ an occupational health nurse when it has at least how many employees? A. 21 B. 101 This is a direct quote from Dr. Margaret Shetland’s statements on Public Health Nursing. 13. Which of the following is the mission of the Department of Health? A. Health for all Filipinos B. Ensure the accessibility and quality of health care C. Improve the general health status of the population D. Health in the hands of the Filipino people by the year 2020 Answer: (B) Ensure the accessibility and quality of health care (none) 14. Region IV Hospital is classified as what level of facility? A. Primary B. Secondary C. Intermediate D. Tertiary Answer: (D) Tertiary Regional hospitals are tertiary facilities because they serve as training hospitals for the region. 15. 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. D. A community hospital is an example of this level of health facilities. Answer: (B) Their services are provided on an out-patient basis. Primary facilities government and non-government facilities that provide basic out-patient services. 16. Which is an example of the school nurse’s health care provider functions? A. Requesting for BCG from the RHU for school entrant immunization B. Conducting random classroom inspection during a measles epidemic C. Taking remedial action on an accident hazard in the school playground D. Observing places in the school where pupils spend their free time Answer: (B) Conducting random classroom inspection during a measles epidemic Random classroom inspection is assessment of pupils/students and teachers for signs of a health problem prevalent in the community. 17. When the nurse determines whether resources were maximized in implementing Ligtas Tigdas, she is evaluating A. Effectiveness B. Efficiency C. Adequacy D. Appropriateness Answer: (B) Efficiency Efficiency is determining whether the goals were attained at the least possible cost. 18. You are a new B.S.N. graduate. You want to become a Public Health Nurse. Where will you apply? A. Department of Health B. Provincial Health Office C. Regional Health Office D. Rural Health Unit Answer: (D) Rural Health Unit R.A. 7160 devolved basic health services to local government units (LGU’s ). The public health nurse is an employee of the LGU. 19. R.A. 7160 mandates devolution of basic services from the national government to local government units. Which of the following is the major goal of devolution? A. To strengthen local government units B. To allow greater autonomy to local government units C. To empower the people and promote their self-reliance D. To make basic services more accessible to the people Answer: (C) To empower the people and promote their self-reliance People empowerment is the basic motivation behind devolution of basic services to LGU’s. 20. Who is the Chairman of the Municipal Health Board? A. Mayor B. Municipal Health Officer C. Public Health Nurse D. Any qualified physician Answer: (A) Mayor The local executive serves as the chairman of the Municipal Health Board. 21. Which level of health facility is the usual point of entry of a client into the health care delivery system? A. Primary B. Secondary C. Intermediate D. Tertiary Answer: (A) Primary The entry of a person into the health care delivery system is usually through a consultation in out-patient services. 22. 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. Referring cases or patients to the midwife B. Providing technical guidance to the midwife C. Providing nursing care to cases referred by the midwife D. Formulating and implementing training programs for midwives Answer: (B) Providing technical guidance to the midwife The nurse provides technical guidance to the midwife in the care of clients, particularly in the implementation of management guidelines, as in Integrated Management of Childhood Illness. 23. One of the participants in a hilot training class asked you to whom she should refer a patient in labor who develops a complication. You will answer, to the A. Public Health Nurse B. Rural Health Midwife C. Municipal Health Officer D. Any of these health professionals Answer: (C) Municipal Health Officer A public health nurse and rural health midwife can provide care during normal childbirth. A physician should attend to a woman with a complication during labor. B. Community organization C. Community study D. Core group formation Answer: (D) Core group formation In core group formation, the nurse is able to transfer the technology of community organizing to the potential or informal community leaders through a training program. 31. In which step are plans formulated for solving community problems? A. Mobilization B. Community organization C. Follow-up/extension D. Core group formation Answer: (B) Community organization Community organization is the step when community assemblies take place. During the community assembly, the people may opt to formalize the community organization and make plans for community action to resolve a community health problem. 32. The public health nurse takes an active role in community participation. What is the primary goal of community organizing? A. To educate the people regarding community health problems B. To mobilize the people to resolve community health problems C. To maximize the community’s resources in dealing with health problems D. To maximize the community’s resources in dealing with health problems Answer: (D) To maximize the community’s resources in dealing with health problems Community organizing is a developmental service, with the goal of developing the people’s self- reliance in dealing with community health problems. A, B and C are objectives of contributory objectives to this goal. 33. An indicator of success in community organizing is when people are able to A. Participate in community activities for the solution of a community problem B. Implement activities for the solution of the community problem C. Plan activities for the solution of the community problem D. Identify the health problem as a common concern Answer: (A) Participate in community activities for the solution of a community problem Participation in community activities in resolving a community problem may be in any of the processes mentioned in the other choices. 34. Tertiary prevention is needed in which stage of the natural history of disease? A. Pre-pathogenesis B. Pathogenesis C. Prodromal D. Terminal Answer: (D) Terminal Tertiary prevention involves rehabilitation, prevention of permanent disability and disability limitation appropriate for convalescents, the disabled, complicated cases and the terminally ill (those in the terminal stage of a disease) 35. Isolation of a child with measles belongs to what level of prevention? A. Primary B. Secondary C. Intermediate D. Tertiary Answer: (A) Primary The purpose of isolating a client with a communicable disease is to protect those who are not sick (specific disease prevention). 36. On the other hand, Operation Timbang is prevention. A. Primary B. Secondary C. Intermediate D. Tertiary Answer: (B) Secondary Operation Timbang is done to identify members of the susceptible population who are malnourished. Its purpose is early diagnosis and, subsequently, prompt treatment. 37. Which type of family-nurse contact will provide you with the best opportunity to observe family dynamics? A. Clinic consultation B. Group conference C. Home visit D. Written communication Answer: (C) Home visit Dynamics of family relationships can best be observed in the family’s natural environment, which is the home. 38. The typology of family nursing problems is used in the statement of nursing diagnosis in the care of families. The youngest child of the de los Reyes family has been diagnosed as mentally retarded. This is classified as a A. Health threat B. Health deficit C. Foreseeable crisis D. Stress point Answer: (B) Health deficit Failure of a family member to develop according to what is expected, as in mental retardation, is a health deficit. 39. The de los Reyes couple have a 6-year old child entering school for the first time. The de los Reyes family has a A. Health threat B. Health deficit C. Foreseeable crisis D. Stress point Answer: (C) Foreseeable crisis Entry of the 6-year old into school is an anticipated period of unusual demand on the family. 40. Which of the following is an advantage of a home visit? A. It allows the nurse to provide nursing care to a greater number of people. B. It provides an opportunity to do first hand appraisal of the home situation. C. It allows sharing of experiences among people with similar health problems. D. It develops the family’s initiative in providing for health needs of its members. Answer: (B) It provides an opportunity to do first hand appraisal of the home situation. Choice A is not correct since a home visit requires that the nurse spend so much time with the A. Delineate the etiology of the epidemic B. Encourage cooperation and support of the community C. Identify groups who are at risk of contracting the disease D. Identify geographical location of cases of the disease in the community Answer: (A) Delineate the etiology of the epidemic Delineating the etiology of an epidemic is identifying its source. 48. Which is a characteristic of person-to-person propagated epidemics? A. There are more cases of the disease than expected. B. The disease must necessarily be transmitted through a vector. C. The spread of the disease can be attributed to a common vehicle. D. There is a gradual build up of cases before the epidemic becomes easily noticeable. Answer: (D) There is a gradual build up of cases before the epidemic becomes easily noticeable. A gradual or insidious onset of the epidemic is usually observable in person-to-person propagated epidemics. 49. In the investigation of an epidemic, you compare the present frequency of the disease with the usual frequency at this time of the year in this community. This is done during which stage of the investigation? A. Establishing the epidemic B. Testing the hypothesis C. Formulation of the hypothesis D. Appraisal of facts Answer: (A) Establishing the epidemic Establishing the epidemic is determining whether there is an epidemic or not. This is done by comparing the present number of cases with the usual number of cases of the disease at the same time of the year, as well as establishing the relatedness of the cases of the disease. 50. The number of cases of Dengue fever usually increases towards the end of the rainy season. This pattern of occurrence of Dengue fever is best described as A. Epidemic occurrence B. Cyclical variation C. Sporadic occurrence D. Secular variation Answer: (B) Cyclical variation A cyclical variation is a periodic fluctuation in the number of cases of a disease in the community. 51. In the year 1980, the World Health Organization declared the Philippines, together with some other countries in the Western Pacific Region, “free” of which disease? A. Pneumonic plague B. Poliomyelitis C. Small pox D. Anthrax Answer: (C) Small pox The last documented case of Small pox was in 1977 at Somalia. 52. In the census of the Philippines in 1995, there were about 35,299,000 males and about 34,968,000 females. What is the sex ratio? A. 99.06:100 B. 100.94:100 C. 50.23% D. 49.76% Answer: (B) 100.94:100 Sex ratio is the number of males for every 100 females in the population. 53. Primary health care is a total approach to community development. Which of the following is an indicator of success in the use of the primary health care approach? A. Health services are provided free of charge to individuals and families. B. Local officials are empowered as the major decision makers in matters of health. C. Health workers are able to provide care based on identified health needs of the people. D. Health programs are sustained according to the level of development of the community. Answer: (D) Health programs are sustained according to the level of development of the community. Primary health care is essential health care that can be sustained in all stages of development of the community. 54. Sputum examination is the major screening tool for pulmonary tuberculosis. Clients would sometimes get false negative results in this exam. This means that the test is not perfect in terms of which characteristic of a diagnostic examination? A. Effectiveness B. Efficacy C. Specificity D. Sensitivity Answer: (D) Sensitivity Sensitivity is the capacity of a diagnostic examination to detect cases of the disease. If a test is 100% sensitive, all the cases tested will have a positive result, i.e., there will be no false negative results. 55. Use of appropriate technology requires knowledge of indigenous technology. Which medicinal herb is given for fever, headache and cough? A. Sambong B. Tsaang gubat C. Akapulko D. Lagundi Answer: (D) Lagundi Sambong is used as a diuretic. Tsaang gubat is used to relieve diarrhea. Akapulko is used for its antifungal property. 56. What law created the Philippine Institute of Traditional and Alternative Health Care? A. R.A. 8423 B. R.A. 4823 C. R.A. 2483 D. R.A. 3482 Answer: (A) R.A. 8423 (none) 57. In traditional Chinese medicine, the yielding, negative and feminine force is termed A. Yin B. Yang C. Qi D. Chai 65. Knowing that malnutrition is a frequent community health problem, you decided to conduct nutritional assessment. What population is particularly susceptible to protein energy malnutrition (PEM)? A. Pregnant women and the elderly B. Under-5 year old children C. 1-4 year old children D. School age children Answer: (C) 1-4 year old children Preschoolers are the most susceptible to PEM because they have generally been weaned. Also, this is the population who, unable to feed themselves, are often the victims of poor intrafamilial food distribution. 66. Which statistic can give the most accurate reflection of the health status of a community? A. 1-4 year old age-specific mortality rate B. Infant mortality rate C. Swaroop’s index D. Crude death rate Answer: (C) Swaroop’s index Swaroop’s index is the proportion of deaths aged 50 years and above. The higher the Swaroop’s index of a population, the greater the proportion of the deaths who were able to reach the age of at least 50 years, i.e., more people grew old before they died. 67. In the past year, Barangay A had an average population of 1655. 46 babies were born in that year, 2 of whom died less than 4 weeks after they were born. There were 4 recorded stillbirths. What is the neonatal mortality rate? A. 27.8/1,000 B. 43.5/1,000 C. 86.9/1,000 D. 130.4/1,000 Answer: (B) 43.5/1,000 To compute for neonatal mortality rate, divide the number of babies who died before reaching the age of 28 days by the total number of live births, then multiply by 1,000. 68. Which statistic best reflects the nutritional status of a population? A. 1-4 year old age-specific mortality rate B. Proportionate mortality rate C. Infant mortality rate D. Swaroop’s index Answer: (A) 1-4 year old age-specific mortality rate Since preschoolers are the most susceptible to the effects of malnutrition, a population with poor nutritional status will most likely have a high 1-4 year old age-specific mortality rate, also known as child mortality rate. 69. What numerator is used in computing general fertility rate? A. Estimated midyear population B. Number of registered live births C. Number of pregnancies in the year D. Number of females of reproductive age Answer: (B) Number of registered live births To compute for general or total fertility rate, divide the number of registered live births by the number of females of reproductive age (15-45 years), then multiply by 1,000. 70. You will gather data for nutritional assessment of a purok. You will gather information only from families with members who belong to the target population for PEM. What method of data gathering is best for this purpose? A. Census B. Survey C. Record review D. Review of civil registry Answer: (B) Survey A survey, also called sample survey, is data gathering about a sample of the population. 71. In the conduct of a census, the method of population assignment based on the actual physical location of the people is termed A. De jure B. De locus C. De facto D. De novo Answer: (C) De facto The other method of population assignment, de jure, is based on the usual place of residence of the people. 72. The Field Health Services and Information System (FHSIS) is the recording and reporting system in public health care in the Philippines. The Monthly Field Health Service Activity Report is a form used in which of the components of the FHSIS? A. Tally report B. Output report C. Target/client list D. Individual health record Answer: (A) Tally report A tally report is prepared monthly or quarterly by the RHU personnel and transmitted to the Provincial Health Office. 73. To monitor clients registered in long-term regimens, such as the Multi-Drug Therapy, which component will be most useful? A. Tally report B. Output report C. Target/client list D. Individual health record Answer: (C) Target/client list The MDT Client List is a record of clients enrolled in MDT and other relevant data, such as dates when clients collected their monthly supply of drugs. 74. Civil registries are important sources of data. Which law requires registration of births within 30 days from the occurrence of the birth? A. P.D. 651 B. Act 3573 C. R.A. 3753 D. R.A. 3375 Answer: (A) P.D. 651 P.D. 651 amended R.A. 3753, requiring the registry of births within 30 days from their 82. Inadequate intake by the pregnant woman of which vitamin may cause neural tube defects? A. Niacin B. Riboflavin C. Folic acid D. Thiamine Answer: (C) Folic acid It is estimated that the incidence of neural tube defects can be reduced drastically if pregnant women have an adequate intake of folic acid. 83. You are in a client’s home to attend to a delivery. Which of the following will you do first? A. Set up the sterile area. B. Put on a clean gown or apron. C. Cleanse the client’s vulva with soap and water. D. Note the interval, duration and intensity of labor contractions. Answer: (D) Note the interval, duration and intensity of labor contractions. Assessment of the woman should be done first to determine whether she is having true labor and, if so, what stage of labor she is in. 84. In preparing a primigravida for breastfeeding, which of the following will you do? A. Tell her that lactation begins within a day after delivery. B. Teach her nipple stretching exercises if her nipples are everted. C. Instruct her to wash her nipples before and after each breastfeeding. D. Explain to her that putting the baby to breast will lessen blood loss after delivery. Answer: (D) Explain to her that putting the baby to breast will lessen blood loss after delivery. Suckling of the nipple stimulates the release of oxytocin by the posterior pituitary gland, which causes uterine contraction. Lactation begins 1 to 3 days after delivery. Nipple stretching exercises are done when the nipples are flat or inverted. Frequent washing dries up the nipples, making them prone to the formation of fissures. 85. A primigravida is instructed to offer her breast to the baby for the first time within 30 minutes after delivery. What is the purpose of offering the breast this early? A. To initiate the occurrence of milk letdown B. To stimulate milk production by the mammary acini C. To make sure that the baby is able to get the colostrum D. To allow the woman to practice breastfeeding in the presence of the health worker Answer: (B) To stimulate milk production by the mammary acini Suckling of the nipple stimulates prolactin reflex (the release of prolactin by the anterior pituitary gland), which initiates lactation. 86. In a mothers’ class, you discuss proper breastfeeding technique. Which is of these is a sign that the baby has “latched on” to the breast properly? A. The baby takes shallow, rapid sucks. B. The mother does not feel nipple pain. C. The baby’s mouth is only partly open. D. Only the mother’s nipple is inside the baby’s mouth. Answer: (B) The mother does not feel nipple pain. When the baby has properly latched on to the breast, he takes deep, slow sucks; his mouth is wide open; and much of the areola is inside his mouth. And, you’re right! The mother does not feel nipple pain. 87. You explain to a breastfeeding mother that breast milk is sufficient for all of the baby’s nutrient needs only up to . A. 3 months B. 6 months C. 1 year D. 2 years Answer: (B) 6 months After 6 months, the baby’s nutrient needs, especially the baby’s iron requirement, can no longer be provided by mother’s milk alone. 88. What is given to a woman within a month after the delivery of a baby? A. Malunggay capsule B. Ferrous sulfate 100 mg. OD C. Retinol 200,000 I.U., 1 capsule D. Potassium iodate 200 mg, 1 capsule Answer: (C) Retinol 200,000 I.U., 1 capsule A capsule of Retinol 200,000 IU is given within 1 month after delivery. Potassium iodate is given during pregnancy; malunggay capsule is not routinely administered after delivery; and ferrous sulfate is taken for two months after delivery. 89. Which biological used in Expanded Program on Immunization (EPI) is stored in the freezer? A. DPT B. Tetanus toxoid C. Measles vaccine D. Hepatitis B vaccine Answer: (C) Measles vaccine Among the biologicals used in the Expanded Program on Immunization, measles vaccine and OPV are highly sensitive to heat, requiring storage in the freezer. 90. Unused BCG should be discarded how many hours after reconstitution? A. 2 B. 4 C. 6 D. At the end of the day Answer: (B) 4 While the unused portion of other biologicals in EPI may be given until the end of the day, only BCG is discarded 4 hours after reconstitution. This is why BCG immunization is scheduled only in the morning. 91. In immunizing school entrants with BCG, you are not obliged to secure parental consent. This is because of which legal document? A. P.D. 996 B. R.A. 7846 C. Presidential Proclamation No. 6 D. Presidential Proclamation No. 46 Answer: (A) P.D. 996 Presidential Decree 996, enacted in 1976, made immunization in the EPI compulsory for children under 8 years of age. Hepatitis B vaccination was made compulsory for the same age group by R.A. 7846. 92. Which immunization produces a permanent scar? A. DPT B. BCG 99. Using IMCI guidelines, you classify a child as having severe pneumonia. What is the best management for the child? A. Prescribe an antibiotic. B. Refer him urgently to the hospital. C. Instruct the mother to increase fluid intake. D. Instruct the mother to continue breastfeeding. Answer: (B) Refer him urgently to the hospital. Severe pneumonia requires urgent referral to a hospital. Answers A, C and D are done for a client classified as having pneumonia. 100. A 5-month old infant was brought by his mother to the health center because of diarrhea occurring 4 to 5 times a day. His skin goes back slowly after a skin pinch and his eyes are sunken. Using the IMCI guidelines, you will classify this infant in which category? A. No signs of dehydration B. Some dehydration C. Severe dehydration D. The data is insufficient. Answer: (B) Some dehydration Using the assessment guidelines of IMCI, a child (2 months to 5 years old) with diarrhea is classified as having SOME DEHYDRATION if he shows 2 or more of the following signs: restless or irritable, sunken eyes, the skin goes back slow after a skin pinch. 101. Based on assessment, you classified a 3-month old infant with the chief complaint of diarrhea in the category of SOME DEHYDRATION. Based on IMCI management guidelines, which of the following will you do? A. Bring the infant to the nearest facility where IV fluids can be given. B. Supervise the mother in giving 200 to 400 ml. of Oresol in 4 hours. C. Give the infant’s mother instructions on home management. D. Keep the infant in your health center for close observation. Answer: (B) Supervise the mother in giving 200 to 400 ml. of Oresol in 4 hours. In the IMCI management guidelines, SOME DEHYDRATION is treated with the administration of Oresol within a period of 4 hours. The amount of Oresol is best computed on the basis of the child’s weight (75 ml/kg body weight). If the weight is unknown, the amount of Oresol is based on the child’s age. 102. A mother is using Oresol in the management of diarrhea of her 3-year old child. She asked you what to do if her child vomits. You will tell her to A. Bring the child to the nearest hospital for further assessment. B. Bring the child to the health center for intravenous fluid therapy. C. Bring the child to the health center for assessment by the physician. D. Let the child rest for 10 minutes then continue giving Oresol more slowly. Answer: (D) Let the child rest for 10 minutes then continue giving Oresol more slowly. If the child vomits persistently, that is, he vomits everything that he takes in, he has to be referred urgently to a hospital. Otherwise, vomiting is managed by letting the child rest for 10 minutes and then continuing with Oresol administration. Teach the mother to give Oresol more slowly. 103. A 1 ½ year old child was classified as having 3rd degree protein energy malnutrition, kwashiorkor. Which of the following signs will be most apparent in this child? A. Voracious appetite B. Wasting C. Apathy D. Edema Answer: (D) Edema Edema, a major sign of kwashiorkor, is caused by decreased colloidal osmotic pressure of the blood brought about by hypoalbuminemia. Decreased blood albumin level is due a protein- deficient diet. 104. Assessment of a 2-year old child revealed “baggy pants”. Using the IMCI guidelines, how will you manage this child? A. Refer the child urgently to a hospital for confinement. B. Coordinate with the social worker to enroll the child in a feeding program. C. Make a teaching plan for the mother, focusing on menu planning for her child. D. Assess and treat the child for health problems like infections and intestinal parasitism. Answer: (A) Refer the child urgently to a hospital for confinement. “Baggy pants” is a sign of severe marasmus. The best management is urgent referral to a hospital. 105. During the physical examination of a young child, what is the earliest sign of xerophthalmia that you may observe? A. Keratomalacia B. Corneal opacity C. Night blindness D. Conjunctival xerosis Answer: (D) Conjunctival xerosis The earliest sign of Vitamin A deficiency (xerophthalmia) is night blindness. However, this is a functional change, which is not observable during physical examination.The earliest visible lesion is conjunctival xerosis or dullness of the conjunctiva due to inadequate tear production. 106. To prevent xerophthalmia, young children are given Retinol capsule every 6 months. What is the dose given to preschoolers? A. 10,000 IU B. 20,000 IU C. 100,000 IU D. 200,000 IU Answer: (D) 200,000 IU Preschoolers are given Retinol 200,000 IU every 6 months. 100,000 IU is given once to infants aged 6 to 12 months. The dose for pregnant women is 10,000 IU. 107. The major sign of iron deficiency anemia is pallor. What part is best examined for pallor? A. Palms B. Nailbeds C. Around the lips D. Lower conjunctival sac Answer: (A) Palms The anatomic characteristics of the palms allow a reliable and convenient basis for examination for pallor. 108. Food fortification is one of the strategies to prevent micronutrient deficiency conditions. R.A. 8976 mandates fortification of certain food items. Which of the following is among these food items? A. Sugar B. Bread C. Margarine D. Filled milk 115. Scotch tape swab is done to check for which intestinal parasite? A. Ascaris B. Pinworm C. Hookworm D. Schistosoma Answer: (B) Pinworm Pinworm ova are deposited around the anal orifice. 116. Which of the following signs indicates the need for sputum examination for AFB? A. Hematemesis B. Fever for 1 week C. Cough for 3 weeks D. Chest pain for 1 week Answer: (C) Cough for 3 weeks A client is considered a PTB suspect when he has cough for 2 weeks or more, plus one or more of the following signs: fever for 1 month or more; chest pain lasting for 2 weeks or more not attributed to other conditions; progressive, unexplained weight loss; night sweats; and hemoptysis. 117. Which clients are considered targets for DOTS Category I? A. Sputum negative cavitary cases B. Clients returning after a default C. Relapses and failures of previous PTB treatment regimens D. Clients diagnosed for the first time through a positive sputum exam Answer: (D) Clients diagnosed for the first time through a positive sputum exam Category I is for new clients diagnosed by sputum examination and clients diagnosed to have a serious form of extrapulmonary tuberculosis, such as TB osteomyelitis. 118. To improve compliance to treatment, what innovation is being implemented in DOTS? A. Having the health worker follow up the client at home B. Having the health worker or a responsible family member monitor drug intake C. Having the patient come to the health center every month to get his medications D. Having a target list to check on whether the patient has collected his monthly supply of drugs Answer: (B) Having the health worker or a responsible family member monitor drug intake Directly Observed Treatment Short Course is so-called because a treatment partner, preferably a health worker accessible to the client, monitors the client’s compliance to the treatment. 119. Diagnosis of leprosy is highly dependent on recognition of symptoms. Which of the following is an early sign of leprosy? A. Macular lesions B. Inability to close eyelids C. Thickened painful nerves D. Sinking of the nosebridge Answer: (C) Thickened painful nerves The lesion of leprosy is not macular. It is characterized by a change in skin color (either reddish or whitish) and loss of sensation, sweating and hair growth over the lesion. Inability to close the eyelids (lagophthalmos) and sinking of the nosebridge are late symptoms. 120. Which of the following clients should be classified as a case of multibacillary leprosy? A. 3 skin lesions, negative slit skin smear B. 3 skin lesions, positive slit skin smear C. 5 skin lesions, negative slit skin smear D. 5 skin lesions, positive slit skin smear Answer: (D) 5 skin lesions, positive slit skin smear A multibacillary leprosy case is one who has a positive slit skin smear and at least 5 skin lesions. 121. In the Philippines, which condition is the most frequent cause of death associated with schistosomiasis? A. Liver cancer B. Liver cirrhosis C. Bladder cancer D. Intestinal perforation Answer: (B) Liver cirrhosis The etiologic agent of schistosomiasis in the Philippines is Schistosoma japonicum, which affects the small intestine and the liver. Liver damage is a consequence of fibrotic reactions to schistosoma eggs in the liver. 122. What is the most effective way of controlling schistosomiasis in an endemic area? A. Use of molluscicides B. Building of foot bridges C. Proper use of sanitary toilets D. Use of protective footwear, such as rubber boots Answer: (C) Proper use of sanitary toilets The ova of the parasite get out of the human body together with feces. Cutting the cycle at this stage is the most effective way of preventing the spread of the disease to susceptible hosts. 123. When residents obtain water from an artesian well in the neighborhood, the level of this approved type of water facility is A. I B. II C. III D. IV Answer: (B) II A communal faucet or water standpost is classified as Level II. 124. For prevention of hepatitis A, you decided to conduct health education activities. Which of the following is IRRELEVANT? A. Use of sterile syringes and needles B. Safe food preparation and food handling by vendors C. Proper disposal of human excreta and personal hygiene D. Immediate reporting of water pipe leaks and illegal water connections Answer: (A) Use of sterile syringes and needles Hepatitis A is transmitted through the fecal oral route. Hepatitis B is transmitted through infected body secretions like blood and semen. 126. Which biological used in Expanded Program on Immunization (EPI) should NOT be stored in the freezer? A. DPT B. Oral polio vaccine C. Measles vaccine D. MMR Answer: (A) DPT C. Steptococcus pneumoniae D. Neisseria meningitidis Answer: (A) Hemophilus influenzae Hemophilus meningitis is unusual over the age of 5 years. In developing countries, the peak incidence is in children less than 6 months of age. Morbillivirus is the etiology of measles. Streptococcus pneumoniae and Neisseria meningitidis may cause meningitis, but age distribution is not specific in young children. 134. Human beings are the major reservoir of malaria. Which of the following strategies in malaria control is based on this fact? A. Stream seeding B. Stream clearing C. Destruction of breeding places D. Zooprophylaxis Answer: (D) Zooprophylaxis Zooprophylaxis is done by putting animals like cattle or dogs close to windows or doorways just before nightfall. The Anopheles mosquito takes his blood meal from the animal and goes back to its breeding place, thereby preventing infection of humans. 135. The use of larvivorous fish in malaria control is the basis for which strategy of malaria control? A. Stream seeding B. Stream clearing C. Destruction of breeding places D. Zooprophylaxis Answer: (A) Stream seeding Stream seeding is done by putting tilapia fry in streams or other bodies of water identified as breeding places of the Anopheles mosquito 136. Mosquito-borne diseases are prevented mostly with the use of mosquito control measures. Which of the following is NOT appropriate for malaria control? A. Use of chemically treated mosquito nets B. Seeding of breeding places with larva-eating fish C. Destruction of breeding places of the mosquito vector D. Use of mosquito-repelling soaps, such as those with basil or citronella Answer: (C) Destruction of breeding places of the mosquito vector Anopheles mosquitoes breed in slow-moving, clear water, such as mountain streams. 137. A 4-year old client was brought to the health center with the chief complaint of severe diarrhea and the passage of “rice water” stools. The client is most probably suffering from which condition? A. Giardiasis B. Cholera C. Amebiasis D. Dysentery Answer: (B) Cholera Passage of profuse watery stools is the major symptom of cholera. Both amebic and bacillary dysentery are characterized by the presence of blood and/or mucus in the stools. Giardiasis is characterized by fat malabsorption and, therefore, steatorrhea. 138. In the Philippines, which specie of schistosoma is endemic in certain regions? A. S. mansoni B. S. japonicum C. S. malayensis D. S. haematobium Answer: (B) S. japonicum S. mansoni is found mostly in Africa and South America; S. haematobium in Africa and the Middle East; and S. malayensis only in peninsular Malaysia. 139. A 32-year old client came for consultation at the health center with the chief complaint of fever for a week. Accompanying symptoms were muscle pains and body malaise. A week after the start of fever, the client noted yellowish discoloration of his sclera. History showed that he waded in flood waters about 2 weeks before the onset of symptoms. Based on his history, which disease condition will you suspect? A. Hepatitis A B. Hepatitis B C. Tetanus D. Leptospirosis Answer: (D) Leptospirosis Leptospirosis is transmitted through contact with the skin or mucous membrane with water or moist soil contaminated with urine of infected animals, like rats. 140. MWSS provides water to Manila and other cities in Metro Manila. This is an example of which level of water facility? A. I B. II C. III D. IV Answer: (C) III Waterworks systems, such as MWSS, are classified as level III. 141. You are the PHN in the city health center. A client underwent screening for AIDS using ELISA. His result was positive. What is the best course of action that you may take? A. Get a thorough history of the client, focusing on the practice of high risk behaviors. B. Ask the client to be accompanied by a significant person before revealing the result. C. Refer the client to the physician since he is the best person to reveal the result to the client. D. Refer the client or a supplementary test, such as Western blot, since the ELISA result may be false. Answer: (D) Refer the client for a supplementary test, such as Western blot, since the ELISA result may be false. A client having a reactive ELISA result must undergo a more specific test, such as Western blot. A negative supplementary test result means that the ELISA result was false and that, most probably, the client is not infected. 142. Which is the BEST control measure for AIDS? A. Being faithful to a single sexual partner B. Using a condom during each sexual contact C. Avoiding sexual contact with commercial sex workers D. Making sure that one’s sexual partner does not have signs of AIDS Answer: (A) Being faithful to a single sexual partner Sexual fidelity rules out the possibility of getting the disease by sexual contact with another infected person. Transmission occurs mostly through sexual intercourse and exposure to blood or tissues.