Philippine NLE Board Exam: Community Health Nursing Question &

Answer w/ rationale

COMMUNITY HEALTH NURSING1. 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
illnessB. To enhance the capacity of individuals, families and
communities to cope with theirhealth needsC. To increase the
productivity of the people by providing them with services that
willincrease their level of healthD. To contribute to national
development through promotion of family welfare, focusingparticularly
on mothers and children.Answer: (B) To enhance the capacity of
individuals, families and communities to cope withtheir health needsTo
contribute to national development through promotion of family
welfare, focusingparticularly 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
andproblems.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
andproblems.Community-based practice means providing care to
people in their own naturalenvironments: the home, school and
workplace, for example.3. Population-focused nursing practice requires
which of the following processes?A. Community organizingB. Nursing
processC. Community diagnosisD. Epidemiologic processAnswer: (C)
Community diagnosisPopulation-focused nursing care means providing
care based on the greater need of themajority 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 healthprivileges to which the workers will be entitled?A.
Type of occupation: agricultural, commercial, industrialB. Location of
the workplace in relation to health facilitiesC. Classification of the
business enterprise based on net profitD. Sex and age composition of
employeesAnswer: (B) Location of the workplace in relation to health
facilitiesBased on R.A. 1054, an occupational nurse must be employed
when there are 30 to 100employees 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
manyemployees?A. 21B. 101C. 201D. 301

Answer: (B) 101Again, this is based on R.A. 1054.6. When the

occupational health nurse employs ergonomic principles, she is
performingwhich of her roles?A. Health care providerB. Health
educatorC. Health care coordinatorD. Environmental managerAnswer:
(D) Environmental managerErgonomics is improving efficiency of
workers by improving the worker’s environmentthrough appropriately
designed furniture, for example.7. A garment factory does not have an
occupational nurse. Who shall provide theoccupational health needs of
the factory workers?A. Occupational health nurse at the Provincial
Health OfficeB. Physician employed by the factoryC. Public health nurse
of the RHU of their municipalityD. Rural sanitary inspector of the RHU
of their municipalityAnswer: (C) Public health nurse of the RHU of their
municipalityYou’re right! This question is based on R.A.1054.8. “Public
health services are given free of charge.” Is this statement true or false?
A. The statement is true; it is the responsibility of government to
provide basic services.B. The statement is false; people pay indirectly
for public health services.C. The statement may be true or false,
depending on the specific service required.D. The statement may be
true or false, depending on policies of the
governmentconcerned.Answer: (B) The statement is false; people pay
indirectly for public health services.Community health services,
including public health services, are pre-paid services, thoughtaxation,
for example.9. According to C.E.Winslow, which of the following is the
goal of Public Health?A. For people to attain their birthrights of health
and longevityB. For promotion of health and prevention of diseaseC.
For people to have access to basic health servicesD. For people to be
organized in their health effortsAnswer: (A) For people to attain their
birthrights of health and longevityAccording to Winslow, all public
health efforts are for people to realize their birthrights of health and
longevity.10. We say that a Filipino has attained longevity when he is
able to reach the averagelifespan of Filipinos. What other statistic may
be used to determine attainment of longevity?A. Age-specific mortality
rateB. Proportionate mortality rateC. Swaroop’s indexD. Case fatality
rateAnswer: (C) Swaroop’s indexSwaroop’s index is the percentage of
the deaths aged 50 years or older. Its inverserepresents the percentage
of untimely deaths (those who died younger than 50 years).11. Which
of the following is the most prominent feature of public health nursing?
A. It involves providing home care to sick people who are not confined
in the hospital.

B. Services are provided free of charge to people within the catchment

area.C. The public health nurse functions as part of a team providing a
public health nursingservices.D. Public health nursing focuses on
preventive, not curative, services.Answer: (D) Public health nursing
focuses on preventive, not curative, services.The catchment area in
PHN consists of a residential community, many of whom are
wellindividuals who have greater need for preventive rather than
curative services.12. According to Margaret Shetland, the philosophy of
public health nursing is based onwhich of the following?A. Health and
longevity as birthrightsB. The mandate of the state to protect the
birthrights of its citizensC. Public health nursing as a specialized field of
nursingD. The worth and dignity of manAnswer: (D) The worth and
dignity of manThis 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 FilipinosB. Ensure
the accessibility and quality of health careC. Improve the general health
status of the populationD. Health in the hands of the Filipino people by
the year 2020Answer: (B) Ensure the accessibility and quality of health
care(none)14. Region IV Hospital is classified as what level of facility?A.
PrimaryB. SecondaryC. IntermediateD. TertiaryAnswer: (D)
TertiaryRegional hospitals are tertiary facilities because they serve as
training hospitals for theregion.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-patientservices.16. Which is an example
of the school nurse’s health care provider functions?A. Requesting for
BCG from the RHU for school entrant immunizationB. Conducting
random classroom inspection during a measles epidemicC. Taking
remedial action on an accident hazard in the school playgroundD.
Observing places in the school where pupils spend their free
timeAnswer: (B) Conducting random classroom inspection during a
measles epidemicRandom classroom inspection is assessment of
pupils/students and teachers for signs of ahealth problem prevalent in
the community.17. When the nurse determines whether resources
were maximized in implementing Ligtas

Tigdas, she is evaluatingA. EffectivenessB. EfficiencyC. AdequacyD.

AppropriatenessAnswer: (B) EfficiencyEfficiency 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
willyou apply?A. Department of HealthB. Provincial Health OfficeC.
Regional Health OfficeD. Rural Health UnitAnswer: (D) Rural Health
UnitR.A. 7160 devolved basic health services to local government units
(LGU’s ). The publichealth nurse is an employee of the LGU.19. R.A.
7160 mandates devolution of basic services from the national
government to localgovernment units. Which of the following is the
major goal of devolution?A. To strengthen local government unitsB. To
allow greater autonomy to local government unitsC. To empower the
people and promote their self-relianceD. To make basic services more
accessible to the peopleAnswer: (C) To empower the people and
promote their self-reliancePeople empowerment is the basic
motivation behind devolution of basic services to LGU’s.20. Who is the
Chairman of the Municipal Health Board?A. MayorB. Municipal Health
OfficerC. Public Health NurseD. Any qualified physicianAnswer: (A)
MayorThe 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 caredelivery system?A. PrimaryB.
SecondaryC. IntermediateD. TertiaryAnswer: (A) PrimaryThe entry of a
person into the health care delivery system is usually through a
consultationin out-patient services.22. The public health nurse is the
supervisor of rural health midwives. Which of thefollowing is a
supervisory function of the public health nurse?A. Referring cases or
patients to the midwifeB. Providing technical guidance to the midwifeC.
Providing nursing care to cases referred by the midwifeD. Formulating
and implementing training programs for midwivesAnswer: (B) Providing
technical guidance to the midwife

The nurse provides technical guidance to the midwife in the care of

clients, particularly inthe implementation of management guidelines, as
in Integrated Management of ChildhoodIllness.23. One of the
participants in a hilot training class asked you to whom she should refer
apatient in labor who develops a complication. You will answer, to
theA. Public Health NurseB. Rural Health MidwifeC. Municipal Health
OfficerD. Any of these health professionalsAnswer: (C) Municipal Health
OfficerA public health nurse and rural health midwife can provide care
during normal childbirth. Aphysician should attend to a woman with a
complication during labor.24. You are the public health nurse in a
municipality with a total population of about20,000. There are 3 rural
health midwives among the RHU personnel. How many moremidwife
items will the RHU need?A. 1B. 2C. 3D. The RHU does not need any
more midwife item.Answer: (A) 1Each rural health midwife is given a
population assignment of about 5,000.25. If the RHU needs additional
midwife items, you will submit the request for additionalmidwife items
for approval to theA. Rural Health UnitB. District Health OfficeC.
Provincial Health OfficeD. Municipal Health BoardAnswer: (D) Municipal
Health BoardAs mandated by R.A. 7160, basic health services have
been devolved from the nationalgovernment to local government
units.26. As an epidemiologist, the nurse is responsible for reporting
cases of notifiable diseases.What law mandates reporting of cases of
notifiable diseases?A. Act 3573B. R.A. 3753C. R.A. 1054D. R.A.
1082Answer: (A) Act 3573Act 3573, the Law on Reporting of
Communicable Diseases, enacted in 1929, mandated thereporting of
diseases listed in the law to the nearest health station.27. According to
Freeman and Heinrich, community health nursing is a
developmentalservice. Which of the following best illustrates this
statement?A. The community health nurse continuously develops
himself personally andprofessionally.B. Health education and
community organizing are necessary in providing community
healthservices.C. Community health nursing is intended primarily for
health promotion and prevention andtreatment of disease.D. The goal
of community health nursing is to provide nursing services to people in
theirown places of residence.

Answer: (B) Health education and community organizing are necessary

in providingcommunity health services.The community health nurse
develops the health capability of people through healtheducation and
community organizing activities.28. Which disease was declared
through Presidential Proclamation No. 4 as a target foreradication in
the Philippines?A. PoliomyelitisB. MeaslesC. RabiesD. Neonatal
tetanusAnswer: (B) MeaslesPresidential Proclamation No. 4 is on the
Ligtas Tigdas Program.29. The public health nurse is responsible for
presenting the municipal health statistics usinggraphs and tables. To
compare the frequency of the leading causes of mortality in
themunicipality, which graph will you prepare?A. LineB. BarC. PieD.
Scatter diagramAnswer: (B) BarA bar graph is used to present
comparison of values, a line graph for trends over time orage, a pie
graph for population composition or distribution, and a scatter diagram
forcorrelation of two variables.30. Which step in community organizing
involves training of potential leaders in thecommunity?A. IntegrationB.
Community organizationC. Community studyD. Core group
formationAnswer: (D) Core group formationIn core group formation,
the nurse is able to transfer the technology of communityorganizing to
the potential or informal community leaders through a training
program.31. In which step are plans formulated for solving community
problems?A. MobilizationB. Community organizationC. Follow-
up/extensionD. Core group formationAnswer: (B) Community
organizationCommunity organization is the step when community
assemblies take place. During thecommunity assembly, the people may
opt to formalize the community organization andmake plans for
community action to resolve a community health problem.32. The
public health nurse takes an active role in community participation.
What is theprimary goal of community organizing?A. To educate the
people regarding community health problemsB. To mobilize the people
to resolve community health problemsC. To maximize the community’s
resources in dealing with health problemsD. To maximize the
community’s resources in dealing with health problems

Answer: (D) To maximize the community’s resources in dealing with

health problemsCommunity organizing is a developmental service, with
the goal of developing the people’sself-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 toA. Participate in community
activities for the solution of a community problemB. Implement
activities for the solution of the community problemC. Plan activities for
the solution of the community problemD. Identify the health problem
as a common concernAnswer: (A) Participate in community activities
for the solution of a community problemParticipation in community
activities in resolving a community problem may be in any of
theprocesses mentioned in the other choices.34. Tertiary prevention is
needed in which stage of the natural history of disease?A. Pre-
pathogenesisB. PathogenesisC. ProdromalD. TerminalAnswer: (D)
TerminalTertiary prevention involves rehabilitation, prevention of
permanent disability and disabilitylimitation appropriate for
convalescents, the disabled, complicated cases and the terminallyill
(those in the terminal stage of a disease)35. Isolation of a child with
measles belongs to what level of prevention?A. PrimaryB. SecondaryC.
IntermediateD. TertiaryAnswer: (A) PrimaryThe purpose of isolating a
client with a communicable disease is to protect those who arenot sick
(specific disease prevention).36. On the other hand, Operation Timbang
is _____ prevention.A. PrimaryB. SecondaryC. IntermediateD.
TertiaryAnswer: (B) SecondaryOperation Timbang is done to identify
members of the susceptible population who aremalnourished. Its
purpose is early diagnosis and, subsequently, prompt treatment.37.
Which type of family-nurse contact will provide you with the best
opportunity to observefamily dynamics?A. Clinic consultationB. Group
conferenceC. Home visitD. Written communicationAnswer: (C) Home
visitDynamics 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
inthe care of families. The youngest child of the de los Reyes family has
been diagnosed as

mentally retarded. This is classified as aA. Health threatB. Health

deficitC. Foreseeable crisisD. Stress pointAnswer: (B) Health
deficitFailure of a family member to develop according to what is
expected, as in mentalretardation, is a health deficit.39. The de los
Reyes couple have a 6-year old child entering school for the first time.
Thede los Reyes family has aA. Health threatB. Health deficitC.
Foreseeable crisisD. Stress pointAnswer: (C) Foreseeable crisisEntry 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 withthe
family. Choice C is an advantage of a group conference, while choice D
is true of a clinicconsultation.41. Which is CONTRARY to the principles
in planning a home visit?A. A home visit should have a purpose or
objective.B. The plan should revolve around family health needs.C. A
home visit should be conducted in the manner prescribed by the
RHU.D. Planning of continuing care should involve a responsible family
member.Answer: (C) A home visit should be conducted in the manner
prescribed by the RHU.The home visit plan should be flexible and
practical, depending on factors, such as thefamily’s needs and the
resources available to the nurse and the family.42. The PHN bag is an
important tool in providing nursing care during a home visit. Themost
important principle of bag technique states that itA. Should save time
and effort.B. Should minimize if not totally prevent the spread of
infection.C. Should not overshadow concern for the patient and his
family.D. May be done in a variety of ways depending on the home
situation, etc.Answer: (B) Should minimize if not totally prevent the
spread of infection.Bag technique is performed before and after
handling a client in the home to preventtransmission of infection to and
from the client.43. To maintain the cleanliness of the bag and its
contents, which of the following must thenurse do?A. Wash his/her
hands before and after providing nursing care to the family members.B.
In the care of family members, as much as possible, use only articles
taken from thebag.C. Put on an apron to protect her uniform and fold it
with the right side out before putting it

back into the bag.D. At the end of the visit, fold the lining on which the
bag was placed, ensuring that thecontaminated side is on the
outside.Answer: (A) Wash his/her hands before and after providing
nursing care to the familymembers.Choice B goes against the idea of
utilizing the family’s resources, which is encouraged inCHN. Choices C
and D goes against the principle of asepsis of confining the
contaminatedsurface of objects.44. The public health nurse conducts a
study on the factors contributing to the highmortality rate due to heart
disease in the municipality where she works. Which branch of
epidemiology does the nurse practice in this situation?A. DescriptiveB.
AnalyticalC. TherapeuticD. EvaluationAnswer: (B) AnalyticalAnalytical
epidemiology is the study of factors or determinants affecting the
patterns of occurrence and distribution of disease in a community.45.
Which of the following is a function of epidemiology?A. Identifying the
disease condition based on manifestations presented by a clientB.
Determining factors that contributed to the occurrence of pneumonia
in a 3 year oldC. Determining the efficacy of the antibiotic used in the
treatment of the 3 year old clientwith pneumoniaD. Evaluating the
effectiveness of the implementation of the Integrated Management of
Childhood IllnessAnswer: (D) Evaluating the effectiveness of the
implementation of the IntegratedManagement of Childhood
IllnessEpidemiology is used in the assessment of a community or
evaluation of interventions incommunity health practice.46. Which of
the following is an epidemiologic function of the nurse during an
epidemic?A. Conducting assessment of suspected cases to detect the
communicable diseaseB. Monitoring the condition of the cases affected
by the communicable diseaseC. Participating in the investigation to
determine the source of the epidemicD. Teaching the community on
preventive measures against the diseaseAnswer: (C) Participating in the
investigation to determine the source of the epidemicEpidemiology is
the study of patterns of occurrence and distribution of disease in
thecommunity, as well as the factors that affect disease patterns. The
purpose of anepidemiologic investigation is to identify the source of an
epidemic, i.e., what brought aboutthe epidemic.47. The primary
purpose of conducting an epidemiologic investigation is toA. Delineate
the etiology of the epidemicB. Encourage cooperation and support of
the communityC. Identify groups who are at risk of contracting the
diseaseD. Identify geographical location of cases of the disease in the
communityAnswer: (A) Delineate the etiology of the
epidemicDelineating 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 easilynoticeable.A gradual or insidious onset of the
epidemic is usually observable in person-to-personpropagated
epidemics.49. In the investigation of an epidemic, you compare the
present frequency of the diseasewith the usual frequency at this time
of the year in this community. This is done duringwhich stage of the
investigation?A. Establishing the epidemicB. Testing the hypothesisC.
Formulation of the hypothesisD. Appraisal of factsAnswer: (A)
Establishing the epidemicEstablishing the epidemic is determining
whether there is an epidemic or not. This is doneby comparing the
present number of cases with the usual number of cases of the disease
atthe same time of the year, as well as establishing the relatedness of
the cases of thedisease.50. The number of cases of Dengue fever
usually increases towards the end of the rainyseason. This pattern of
occurrence of Dengue fever is best described asA. Epidemic
occurrenceB. Cyclical variationC. Sporadic occurrenceD. Secular
variationAnswer: (B) Cyclical variationA cyclical variation is a periodic
fluctuation in the number of cases of a disease in thecommunity.51. In
the year 1980, the World Health Organization declared the Philippines,
together withsome other countries in the Western Pacific Region,
“free” of which disease?A. Pneumonic plagueB. PoliomyelitisC. Small
poxD. AnthraxAnswer: (C) Small poxThe 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 about34,968,000 females.
What is the sex ratio?A. 99.06:100B. 100.94:100C. 50.23%D.
49.76%Answer: (B) 100.94:100Sex 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 thefollowing 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
thecommunity.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.
Clientswould sometimes get false negative results in this exam. This
means that the test is notperfect in terms of which characteristic of a
diagnostic examination?A. EffectivenessB. EfficacyC. SpecificityD.
SensitivityAnswer: (D) SensitivitySensitivity is the capacity of a
diagnostic examination to detect cases of the disease. If atest is 100%
sensitive, all the cases tested will have a positive result, i.e., there will
be nofalse negative results.55. Use of appropriate technology requires
knowledge of indigenous technology. Whichmedicinal herb is given for
fever, headache and cough?A. SambongB. Tsaang gubatC. AkapulkoD.
LagundiAnswer: (D) LagundiSambong is used as a diuretic. Tsaang gubat
is used to relieve diarrhea. Akapulko is usedfor its antifungal
property.56. What law created the Philippine Institute of Traditional
and Alternative Health Care?A. R.A. 8423B. R.A. 4823C. R.A. 2483D. R.A.
3482Answer: (A) R.A. 8423(none)57. In traditional Chinese medicine,
the yielding, negative and feminine force is termedA. YinB. YangC. QiD.
ChaiAnswer: (A) YinYang is the male dominating, positive and masculine
force.58. What is the legal basis for Primary Health Care approach in
the Philippines?A. Alma Ata Declaration on PHCB. Letter of Instruction
No. 949C. Presidential Decree No. 147D. Presidential Decree
996Answer: (B) Letter of Instruction No. 949Letter of Instruction 949
was issued by then President Ferdinand Marcos, directing the

formerly called Ministry of Health, now the Department of Health, to

utilize Primary HealthCare approach in planning and implementing
health programs.59. Which of the following demonstrates intersectoral
linkages?A. Two-way referral systemB. Team approachC. Endorsement
done by a midwife to another midwifeD. Cooperation between the PHN
and public school teacherAnswer: (D) Cooperation between the PHN
and public school teacherIntersectoral linkages refer to working
relationships between the health sector and othersectors involved in
community development.60. The municipality assigned to you has a
population of about 20,000. Estimate thenumber of 1-4 year old
children who will be given Retinol capsule 200,000 I.U. every
6months.A. 1,500B. 1,800C. 2,000D. 2,300Answer: (D) 2,300Based on
the Philippine population composition, to estimate the number of 1-4
year oldchildren, multiply total population by 11.5%.61. Estimate the
number of pregnant women who will be given tetanus toxoid during
animmunization outreach activity in a barangay with a population of
about 1,500.A. 265B. 300C. 375D. 400Answer: (A) 265To estimate the
number of pregnant women, multiply the total population by 3.5%.62.
To describe the sex composition of the population, which demographic
tool may beused?A. Sex ratioB. Sex proportionC. Population pyramidD.
Any of these may be used.Answer: (D) Any of these may be used.Sex
ratio and sex proportion are used to determine the sex composition of
a population. Apopulation pyramid is used to present the composition
of a population by age and sex.63. Which of the following is a natality
rate?A. Crude birth rateB. Neonatal mortality rateC. Infant mortality
rateD. General fertility rateAnswer: (A) Crude birth rateNatality means
birth. A natality rate is a birth rate.64. You are computing the crude
death rate of your municipality, with a total population of about
18,000, for last year. There were 94 deaths. Among those who died, 20
died becauseof diseases of the heart and 32 were aged 50 years or
older. What is the crude death rate?A. 4.2/1,000

B. 5.2/1,000C. 6.3/1,000D. 7.3/1,000Answer: (B) 5.2/1,000To compute

crude death rate divide total number of deaths (94) by total
population(18,000) and multiply by 1,000.65. Knowing that
malnutrition is a frequent community health problem, you decided
toconduct nutritional assessment. What population is particularly
susceptible to protein energymalnutrition (PEM)?A. Pregnant women
and the elderlyB. Under-5 year old childrenC. 1-4 year old childrenD.
School age childrenAnswer: (C) 1-4 year old childrenPreschoolers 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 poorintrafamilial food distribution.66. Which
statistic can give the most accurate reflection of the health status of
acommunity?A. 1-4 year old age-specific mortality rateB. Infant
mortality rateC. Swaroop’s indexD. Crude death rateAnswer: (C)
Swaroop’s indexSwaroop’s index is the proportion of deaths aged 50
years and above. The higher theSwaroop’s index of a population, the
greater the proportion of the deaths who were able toreach 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 bornin that year, 2 of whom died less than 4 weeks after they
were born. There were 4 recordedstillbirths. What is the neonatal
mortality rate?A. 27.8/1,000B. 43.5/1,000C. 86.9/1,000D.
130.4/1,000Answer: (B) 43.5/1,000To compute for neonatal mortality
rate, divide the number of babies who died beforereaching 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 rateB. Proportionate mortality rateC.
Infant mortality rateD. Swaroop’s indexAnswer: (A) 1-4 year old age-
specific mortality rateSince preschoolers are the most susceptible to
the effects of malnutrition, a population withpoor 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 populationB. Number of registered live birthsC.

Number of pregnancies in the yearD. Number of females of
reproductive ageAnswer: (B) Number of registered live birthsTo
compute for general or total fertility rate, divide the number of
registered live births bythe 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 informationonly from families
with members who belong to the target population for PEM. What
methodof data gathering is best for this purpose?A. CensusB. SurveyC.
Record reviewD. Review of civil registryAnswer: (B) SurveyA 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 actualphysical location of the people is
termedA. De jureB. De locusC. De factoD. De novoAnswer: (C) De
factoThe 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 andreporting system in
public health care in the Philippines. The Monthly Field Health
ServiceActivity Report is a form used in which of the components of the
FHSIS?A. Tally reportB. Output reportC. Target/client listD. Individual
health recordAnswer: (A) Tally reportA tally report is prepared monthly
or quarterly by the RHU personnel and transmitted to theProvincial
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 reportB. Output reportC. Target/client listD. Individual health
recordAnswer: (C) Target/client listThe MDT Client List is a record of
clients enrolled in MDT and other relevant data, such asdates when
clients collected their monthly supply of drugs.74. Civil registries are
important sources of data. Which law requires registration of
birthswithin 30 days from the occurrence of the birth?A. P.D. 651B. Act
3573

C. R.A. 3753D. R.A. 3375Answer: (A) P.D. 651P.D. 651 amended R.A.
3753, requiring the registry of births within 30 days from
theiroccurrence.75. Which of the following professionals can sign the
birth certificate?A. Public health nurseB. Rural health midwifeC.
Municipal health officerD. Any of these health professionalsAnswer: (D)
Any of these health professionalsD. R.A. 3753 states that any birth
attendant may sign the certificate of live birth.76. Which criterion in
priority setting of health problems is used only in community
healthcare?A. Modifiability of the problemB. Nature of the problem
presentedC. Magnitude of the health problemD. Preventive potential of
the health problemAnswer: (C) Magnitude of the health
problemMagnitude of the problem refers to the percentage of the
population affected by a healthproblem. The other choices are criteria
considered in both family and community healthcare.77. The Sentrong
Sigla Movement has been launched to improve health service
delivery.Which of the following is/are true of this movement?A. This is
a project spearheaded by local government units.B. It is a basis for
increasing funding from local government units.C. It encourages health
centers to focus on disease prevention and control.D. Its main strategy
is certification of health centers able to comply with standards.Answer:
(D) Its main strategy is certification of health centers able to comply
withstandards.Sentrong Sigla Movement is a joint project of the DOH
and local government units. Its mainstrategy is certification of health
centers that are able to comply with standards set by theDOH.78.
Which of the following women should be considered as special targets
for familyplanning?A. Those who have two children or moreB. Those
with medical conditions such as anemiaC. Those younger than 20 years
and older than 35 yearsD. Those who just had a delivery within the past
15 monthsAnswer: (D) Those who just had a delivery within the past 15
monthsThe ideal birth spacing is at least two years. 15 months plus 9
months of pregnancy = 2years.79. Freedom of choice is one of the
policies of the Family Planning Program of thePhilippines. Which of the
following illustrates this principle?A. Information dissemination about
the need for family planningB. Support of research and development in
family planning methodsC. Adequate information for couples regarding
the different methodsD. Encouragement of couples to take family
planning as a joint responsibility

Answer: (C) Adequate information for couples regarding the different

methodsTo enable the couple to choose freely among different
methods of family planning, theymust be given full information
regarding the different methods that are available to them,considering
the availability of quality services that can support their choice.80. A
woman, 6 months pregnant, came to the center for consultation. Which
of thefollowing substances is contraindicated?A. Tetanus toxoidB.
Retinol 200,000 IUC. Ferrous sulfate 200 mgD. Potassium iodate 200
mg. capsuleAnswer: (B) Retinol 200,000 IURetinol 200,000 IU is a form
of megadose Vitamin A. This may have a teratogenic effect.81. During
prenatal consultation, a client asked you if she can have her delivery at
home.After history taking and physical examination, you advised her
against a home delivery.Which of the following findings disqualifies her
for a home delivery?A. Her OB score is G5P3.B. She has some palmar
pallor.C. Her blood pressure is 130/80.D. Her baby is in cephalic
presentation.Answer: (A) Her OB score is G5P3.Only women with less
than 5 pregnancies are qualified for a home delivery. It is alsoadvisable
for a primigravida to have delivery at a childbirth facility.82. Inadequate
intake by the pregnant woman of which vitamin may cause neural
tubedefects?A. NiacinB. RiboflavinC. Folic acidD. ThiamineAnswer: (C)
Folic acidIt 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 dofirst?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 truelabor 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 afterdelivery.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. Nipplestretching exercises are done when the nipples are flat
or inverted. Frequent washing driesup 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 30minutes after delivery.
What is the purpose of offering the breast this early?A. To initiate the
occurrence of milk letdownB. To stimulate milk production by the
mammary aciniC. To make sure that the baby is able to get the
colostrumD. To allow the woman to practice breastfeeding in the
presence of the health workerAnswer: (B) To stimulate milk production
by the mammary aciniSuckling of the nipple stimulates prolactin reflex
(the release of prolactin by the anteriorpituitary gland), which initiates
lactation.86. In a mothers’ class, you discuss proper breastfeeding
technique. Which is of these is asign 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 mouthis wide
open; and much of the areola is inside his mouth. And, you’re right! The
motherdoes not feel nipple pain.87. You explain to a breastfeeding
mother that breast milk is sufficient for all of the baby’snutrient needs
only up to ____.A. 3 monthsB. 6 monthsC. 1 yearD. 2 yearsAnswer: (B)
6 monthsAfter 6 months, the baby’s nutrient needs, especially the
baby’s iron requirement, can nolonger 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 capsuleB. Ferrous sulfate 100 mg. ODC. Retinol
200,000 I.U., 1 capsuleD. Potassium iodate 200 mg, 1 capsuleAnswer:
(C) Retinol 200,000 I.U., 1 capsuleA capsule of Retinol 200,000 IU is
given within 1 month after delivery. Potassium iodate isgiven 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 thefreezer?A. DPTB. Tetanus toxoidC. Measles vaccineD.
Hepatitis B vaccineAnswer: (C) Measles vaccineAmong 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. 2B. 4C. 6D. At the end of the dayAnswer: (B) 4While
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 isscheduled only in the morning.91. In
immunizing school entrants with BCG, you are not obliged to secure
parentalconsent. This is because of which legal document?A. P.D. 996B.
R.A. 7846C. Presidential Proclamation No. 6D. Presidential Proclamation
No. 46Answer: (A) P.D. 996Presidential Decree 996, enacted in 1976,
made immunization in the EPI compulsory forchildren under 8 years of
age. Hepatitis B vaccination was made compulsory for the sameage
group by R.A. 7846.92. Which immunization produces a permanent
scar?A. DPTB. BCGC. Measles vaccinationD. Hepatitis B
vaccinationAnswer: (B) BCGBCG causes the formation of a superficial
abscess, which begins 2 weeks afterimmunization. The abscess heals
without treatment, with the formation of a permanentscar.93. A 4-
week old baby was brought to the health center for his first
immunization. Whichcan be given to him?A. DPT1B. OPV1C. Infant
BCGD. Hepatitis B vaccine 1Answer: (C) Infant BCGInfant BCG may be
given at birth. All the other immunizations mentioned can be given at
6weeks of age.94. You will not give DPT 2 if the mother says that the
infant hadA. Seizures a day after DPT 1.B. Fever for 3 days after DPT 1.C.
Abscess formation after DPT 1.D. Local tenderness for 3 days after DPT
1.Answer: (A) Seizures a day after DPT 1.Seizures within 3 days after
administration of DPT is an indication of hypersensitivity topertussis
vaccine, a component of DPT. This is considered a specific
contraindication tosubsequent doses of DPT.95. A 2-month old infant
was brought to the health center for immunization. During

assessment, the infant’s temperature registered at 38.1°C. Which is the

best course of action that you will take?A. Go on with the infant’s
immunizations.B. Give Paracetamol and wait for his fever to subside.C.
Refer the infant to the physician for further assessment.D. Advise the
infant’s mother to bring him back for immunization when he is
well.Answer: (A) Go on with the infant’s immunizations.In the EPI, fever
up to 38.5°C is not a contraindication to immunization. Mild
acuterespiratory tract infection, simple diarrhea and malnutrition are
not contraindications either.96. A pregnant woman had just received
her 4th dose of tetanus toxoid. Subsequently, herbaby will have
protection against tetanus for how long?A. 1 yearB. 3 yearsC. 10
yearsD. LifetimeAnswer: (A) 1 yearThe baby will have passive natural
immunity by placental transfer of antibodies. The motherwill have
active artificial immunity lasting for about 10 years. 5 doses will give the
motherlifetime protection.97. A 4-month old infant was brought to the
health center because of cough. Herrespiratory rate is 42/minute. Using
the Integrated Management of Child Illness (IMCI)guidelines of
assessment, her breathing is consideredA. FastB. SlowC. NormalD.
InsignificantAnswer: (C) NormalIn IMCI, a respiratory rate of 50/minute
or more is fast breathing for an infant aged 2 to 12months.98. Which of
the following signs will indicate that a young child is suffering from
severepneumonia?A. DyspneaB. WheezingC. Fast breathingD. Chest
indrawingAnswer: (D) Chest indrawingIn IMCI, chest indrawing is used
as the positive sign of dyspnea, indicating severepneumonia.99. Using
IMCI guidelines, you classify a child as having severe pneumonia. What
is thebest 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 aclient 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 hiseyes are sunken. Using the IMCI guidelines, you will
classify this infant in which category?A. No signs of dehydrationB. Some
dehydrationC. Severe dehydrationD. The data is insufficient.Answer: (B)
Some dehydrationUsing the assessment guidelines of IMCI, a child (2
months to 5 years old) with diarrhea isclassified 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 administrationof 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 Oresolis based
on the child’s age.102. A mother is using Oresol in the management of
diarrhea of her 3-year old child. Sheasked you what to do if her child
vomits. You will tell her toA. 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
bereferred urgently to a hospital. Otherwise, vomiting is managed by
letting the child rest for10 minutes and then continuing with Oresol
administration. Teach the mother to give Oresolmore 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 appetiteB. WastingC. ApathyD.
EdemaAnswer: (D) EdemaEdema, 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 aprotein-
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 ahospital.105. During the physical examination of a
young child, what is the earliest sign of xerophthalmia that you may
observe?A. KeratomalaciaB. Corneal opacityC. Night blindnessD.
Conjunctival xerosisAnswer: (D) Conjunctival xerosisThe earliest sign of
Vitamin A deficiency (xerophthalmia) is night blindness. However, this
isa functional change, which is not observable during physical
examination.The earliest visiblelesion is conjunctival xerosis or dullness
of the conjunctiva due to inadequate tearproduction.106. To prevent
xerophthalmia, young children are given Retinol capsule every 6
months.What is the dose given to preschoolers?A. 10,000 IUB. 20,000
IUC. 100,000 IUD. 200,000 IUAnswer: (D) 200,000 IUPreschoolers are
given Retinol 200,000 IU every 6 months. 100,000 IU is given once
toinfants 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 forpallor?A. PalmsB. NailbedsC. Around the lipsD. Lower
conjunctival sacAnswer: (A) PalmsThe anatomic characteristics of the
palms allow a reliable and convenient basis forexamination for
pallor.108. Food fortification is one of the strategies to prevent
micronutrient deficiencyconditions. R.A. 8976 mandates fortification of
certain food items. Which of the following isamong these food items?A.
SugarB. BreadC. MargarineD. Filled milkAnswer: (A) SugarR.A. 8976
mandates fortification of rice, wheat flour, sugar and cooking oil with
Vitamin A,iron and/or iodine.109. What is the best course of action
when there is a measles epidemic in a nearbymunicipality?A. Give
measles vaccine to babies aged 6 to 8 months.B. Give babies aged 6 to
11 months one dose of 100,000 I.U. of RetinolC. Instruct mothers to
keep their babies at home to prevent disease transmission.D. Instruct
mothers to feed their babies adequately to enhance their babies’
resistance.

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

months.Ordinarily, measles vaccine is given at 9 months of age. During
an impending epidemic,however, one dose may be given to babies
aged 6 to 8 months. The mother is instructedthat the baby needs
another dose when the baby is 9 months old.110. A mother brought
her daughter, 4 years old, to the RHU because of cough and
colds.Following the IMCI assessment guide, which of the following is a
danger sign that indicatesthe need for urgent referral to a hospital?A.
Inability to drinkB. High grade feverC. Signs of severe dehydrationD.
Cough for more than 30 daysAnswer: (A) Inability to drinkA sick child
aged 2 months to 5 years must be referred urgently to a hospital if
he/she hasone or more of the following signs: not able to feed or drink,
vomits everything,convulsions, abnormally sleepy or difficult to
awaken.111. Management of a child with measles includes the
administration of which of thefollowing?A. Gentian violet on mouth
lesionsB. Antibiotics to prevent pneumoniaC. Tetracycline eye ointment
for corneal opacityD. Retinol capsule regardless of when the last dose
was givenAnswer: (D) Retinol capsule regardless of when the last dose
was givenAn infant 6 to 12 months classified as a case of measles is
given Retinol 100,000 IU; a childis given 200,000 IU regardless of when
the last dose was given.112. A mother brought her 10 month old infant
for consultation because of fever, whichstarted 4 days prior to
consultation. To determine malaria risk, what will you do?A. Do a
tourniquet test.B. Ask where the family resides.C. Get a specimen for
blood smear.D. Ask if the fever is present everyday.Answer: (B) Ask
where the family resides.Because malaria is endemic, the first question
to determine malaria risk is where the client’sfamily resides. If the area
of residence is not a known endemic area, ask if the child hadtraveled
within the past 6 months, where he/she was brought and whether
he/she stayedovernight in that area.113. The following are strategies
implemented by the Department of Health to preventmosquito-borne
diseases. Which of these is most effective in the control of Dengue
fever?A. Stream seeding with larva-eating fishB. Destroying breeding
places of mosquitoesC. Chemoprophylaxis of non-immune persons
going to endemic areasD. Teaching people in endemic areas to use
chemically treated mosquito netsAnswer: (B) Destroying breeding
places of mosquitoesAedes aegypti, the vector of Dengue fever, breeds
in stagnant, clear water. Its feeding timeis usually during the daytime. It
has a cyclical pattern of occurrence, unlike malaria which isendemic in
certain parts of the country.114. Secondary prevention for malaria
includesA. Planting of neem or eucalyptus treesB. Residual spraying of
insecticides at night

C. Determining whether a place is endemic or notD. Growing larva-

eating fish in mosquito breeding placesAnswer: (C) Determining
whether a place is endemic or notThis is diagnostic and therefore
secondary level prevention. The other choices are forprimary
prevention.115. Scotch tape swab is done to check for which intestinal
parasite?A. AscarisB. PinwormC. HookwormD. SchistosomaAnswer: (B)
PinwormPinworm ova are deposited around the anal orifice.116. Which
of the following signs indicates the need for sputum examination for
AFB?A. HematemesisB. Fever for 1 weekC. Cough for 3 weeksD. Chest
pain for 1 weekAnswer: (C) Cough for 3 weeksA client is considered a
PTB suspect when he has cough for 2 weeks or more, plus one ormore
of the following signs: fever for 1 month or more; chest pain lasting for
2 weeks ormore 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 casesB. Clients returning after a defaultC. Relapses and failures
of previous PTB treatment regimensD. Clients diagnosed for the first
time through a positive sputum examAnswer: (D) Clients diagnosed for
the first time through a positive sputum examCategory I is for new
clients diagnosed by sputum examination and clients diagnosed tohave
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 homeB. Having the health worker or a
responsible family member monitor drug intakeC. Having the patient
come to the health center every month to get his medicationsD. Having
a target list to check on whether the patient has collected his monthly
supply of drugsAnswer: (B) Having the health worker or a responsible
family member monitor drug intakeDirectly 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
thetreatment.119. Diagnosis of leprosy is highly dependent on
recognition of symptoms. Which of thefollowing is an early sign of
leprosy?A. Macular lesionsB. Inability to close eyelidsC. Thickened
painful nervesD. Sinking of the nosebridgeAnswer: (C) Thickened
painful nerves

The lesion of leprosy is not macular. It is characterized by a change in

skin color (eitherreddish or whitish) and loss of sensation, sweating and
hair growth over the lesion. Inabilityto 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 smearB. 3 skin
lesions, positive slit skin smearC. 5 skin lesions, negative slit skin
smearD. 5 skin lesions, positive slit skin smearAnswer: (D) 5 skin lesions,
positive slit skin smearA multibacillary leprosy case is one who has a
positive slit skin smear and at least 5 skinlesions.121. In the Philippines,
which condition is the most frequent cause of death associated
withschistosomiasis?A. Liver cancerB. Liver cirrhosisC. Bladder cancerD.
Intestinal perforationAnswer: (B) Liver cirrhosisThe etiologic agent of
schistosomiasis in the Philippines is Schistosoma japonicum,
whichaffects the small intestine and the liver. Liver damage is a
consequence of fibrotic reactionsto schistosoma eggs in the liver.122.
What is the most effective way of controlling schistosomiasis in an
endemic area?A. Use of molluscicidesB. Building of foot bridgesC.
Proper use of sanitary toiletsD. Use of protective footwear, such as
rubber bootsAnswer: (C) Proper use of sanitary toiletsThe ova of the
parasite get out of the human body together with feces. Cutting the
cycle atthis stage is the most effective way of preventing the spread of
the disease to susceptiblehosts.123. When residents obtain water from
an artesian well in the neighborhood, the level of this approved type of
water facility isA. IB. IIC. IIID. IVAnswer: (B) IIA communal faucet or
water standpost is classified as Level II.124. For prevention of hepatitis
A, you decided to conduct health education activities. Whichof the
following is IRRELEVANT?A. Use of sterile syringes and needlesB. Safe
food preparation and food handling by vendorsC. Proper disposal of
human excreta and personal hygieneD. Immediate reporting of water
pipe leaks and illegal water connectionsAnswer: (A) Use of sterile
syringes and needlesHepatitis A is transmitted through the fecal oral
route. Hepatitis B is transmitted throughinfected body secretions like
blood and semen.126. Which biological used in Expanded Program on
Immunization (EPI) should NOT be

stored in the freezer?A. DPTB. Oral polio vaccineC. Measles vaccineD.

MMRAnswer: (A) DPTDPT is sensitive to freezing. The appropriate
storage temperature of DPT is 2 to 8° C only.OPV and measles vaccine
are highly sensitive to heat and require freezing. MMR is not
animmunization in the Expanded Program on Immunization.127. You
will conduct outreach immunization in a barangay with a population of
about 1500.Estimate the number of infants in the barangay.A. 45B. 50C.
55D. 60Answer: (A) 45To estimate the number of infants, multiply total
population by 3%.128. In Integrated Management of Childhood Illness,
severe conditions generally requireurgent referral to a hospital. Which
of the following severe conditions DOES NOT alwaysrequire urgent
referral to a hospital?A. MastoiditisB. Severe dehydrationC. Severe
pneumoniaD. Severe febrile diseaseAnswer: (B) Severe dehydrationThe
order of priority in the management of severe dehydration is as follows:
intravenousfluid therapy, referral to a facility where IV fluids can be
initiated within 30 minutes,Oresol/nasogastric tube, Oresol/orem.
When the foregoing measures are not possible oreffective, tehn urgent
referral to the hospital is done.129. A client was diagnosed as having
Dengue fever. You will say that there is slow capillaryrefill when the
color of the nailbed that you pressed does not return within how
manyseconds?A. 3B. 5C. 8D. 10Answer: (A) 3Adequate blood supply to
the area allows the return of the color of the nailbed within
3seconds.130. A 3-year old child was brought by his mother to the
health center because of fever of 4-day duration. The child had a
positive tourniquet test result. In the absence of othersigns, which is
the most appropriate measure that the PHN may carry out to
preventDengue shock syndrome?A. Insert an NGT and give fluids per
NGT.B. Instruct the mother to give the child Oresol.C. Start the patient
on intravenous fluids STAT.D. Refer the client to the physician for
appropriate management.Answer: (B) Instruct the mother to give the
child Oresol.

Since the child does not manifest any other danger sign, maintenance
of fluid balance andreplacement of fluid loss may be done by giving the
client Oresol.131. The pathognomonic sign of measles is Koplik’s spot.
You may see Koplik’s spot byinspecting the _____.A. Nasal mucosaB.
Buccal mucosaC. Skin on the abdomenD. Skin on the antecubital
surfaceAnswer: (B) Buccal mucosaKoplik’s spot may be seen on the
mucosa of the mouth or the throat.132. Among the following diseases,
which is airborne?A. Viral conjunctivitisB. Acute poliomyelitisC.
DiphtheriaD. MeaslesAnswer: (D) MeaslesViral conjunctivitis is
transmitted by direct or indirect contact with discharges from
infectedeyes. Acute poliomyelitis is spread through the fecal-oral route
and contact with throatsecretions, whereas diphtheria is through direct
and indirect contact with respiratorysecretions.133. Among children
aged 2 months to 3 years, the most prevalent form of meningitis
iscaused by which microorganism?A. Hemophilus influenzaeB.
MorbillivirusC. Steptococcus pneumoniaeD. Neisseria
meningitidisAnswer: (A) Hemophilus influenzaeHemophilus meningitis
is unusual over the age of 5 years. In developing countries, the
peakincidence is in children less than 6 months of age. Morbillivirus is
the etiology of measles.Streptococcus pneumoniae and Neisseria
meningitidis may cause meningitis, but agedistribution is not specific in
young children.134. Human beings are the major reservoir of malaria.
Which of the following strategies inmalaria control is based on this
fact?A. Stream seedingB. Stream clearingC. Destruction of breeding
placesD. ZooprophylaxisAnswer: (D) ZooprophylaxisZooprophylaxis 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 andgoes 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 malariacontrol?A.
Stream seedingB. Stream clearingC. Destruction of breeding placesD.
ZooprophylaxisAnswer: (A) Stream seeding

Stream seeding is done by putting tilapia fry in streams or other bodies

of water identifiedas breeding places of the Anopheles mosquito136.
Mosquito-borne diseases are prevented mostly with the use of
mosquito controlmeasures. Which of the following is NOT appropriate
for malaria control?A. Use of chemically treated mosquito netsB.
Seeding of breeding places with larva-eating fishC. Destruction of
breeding places of the mosquito vectorD. Use of mosquito-repelling
soaps, such as those with basil or citronellaAnswer: (C) Destruction of
breeding places of the mosquito vectorAnopheles 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
severediarrhea and the passage of “rice water” stools. The client is
most probably suffering fromwhich condition?A. GiardiasisB. CholeraC.
AmebiasisD. DysenteryAnswer: (B) CholeraPassage of profuse watery
stools is the major symptom of cholera. Both amebic andbacillary
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. mansoniB. S.
japonicumC. S. malayensisD. S. haematobiumAnswer: (B) S.
japonicumS. mansoni is found mostly in Africa and South America; S.
haematobium in Africa and theMiddle East; and S. malayensis only in
peninsular Malaysia.139. A 32-year old client came for consultation at
the health center with the chief complaintof fever for a week.
Accompanying symptoms were muscle pains and body malaise. A
weekafter the start of fever, the client noted yellowish discoloration of
his sclera. History showedthat he waded in flood waters about 2 weeks
before the onset of symptoms. Based on hishistory, which disease
condition will you suspect?A. Hepatitis AB. Hepatitis BC. TetanusD.
LeptospirosisAnswer: (D) LeptospirosisLeptospirosis is transmitted
through contact with the skin or mucous membrane with wateror 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. IB. IIC. IIID. IV

Answer: (C) IIIWaterworks 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 usingELISA. 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 theclient.D. Refer the client for a supplementary
test, such as Western blot, since the ELISA resultmay be false.Answer:
(D) Refer the client for a supplementary test, such as Western blot,
since the ELISAresult may be false.A client having a reactive ELISA result
must undergo a more specific test, such as Westernblot. 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 partnerB.
Using a condom during each sexual contactC. Avoiding sexual contact
with commercial sex workersD. Making sure that one’s sexual partner
does not have signs of AIDSAnswer: (A) Being faithful to a single sexual
partnerSexual fidelity rules out the possibility of getting the disease by
sexual contact with anotherinfected person. Transmission occurs
mostly through sexual intercourse and exposure toblood or tissues.143.
The most frequent causes of death among clients with AIDS are
opportunistic diseases.Which of the following opportunistic infections
is characterized by tonsillopharyngitis?A. Respiratory candidiasisB.
Infectious mononucleosisC. Cytomegalovirus diseaseD. Pneumocystis
carinii pneumoniaAnswer: (B) Infectious
mononucleosisCytomegalovirus disease is an acute viral disease
characterized by fever, sore throat andlymphadenopathy.144. To
determine possible sources of sexually transmitted infections, which is
the BESTmethod that may be undertaken by the public health nurse?A.
Contact tracingB. Community surveyC. Mass screening testsD. Interview
of suspectsAnswer: (A) Contact tracingContact tracing is the most
practical and reliable method of finding possible sources of person-to-
person transmitted infections, such as sexually transmitted
diseases.145. Antiretroviral agents, such as AZT, are used in the
management of AIDS. Which of thefollowing is NOT an action expected
of these drugs.A. They prolong the life of the client with AIDS.B. They
reduce the risk of opportunistic infectionsC. They shorten the period of
communicability of the disease.D. They are able to bring about a cure of
the disease condition.

Answer: (D) They are able to bring about a cure of the disease
condition.There is no known treatment for AIDS. Antiretroviral agents
reduce the risk of opportunisticinfections and prolong life, but does not
cure the underlying immunodeficiency.146. A barangay had an
outbreak of German measles. To prevent congenital rubella, whatis the
BEST advice that you can give to women in the first trimester of
pregnancy in thebarangay?A. Advice them on the signs of German
measles.B. Avoid crowded places, such as markets and moviehouses.C.
Consult at the health center where rubella vaccine may be given.D.
Consult a physician who may give them rubella
immunoglobulin.Answer: (D) Consult a physician who may give them
rubella immunoglobulin.Rubella vaccine is made up of attenuated
German measles viruses. This is contraindicated inpregnancy. Immune
globulin, a specific prophylactic against German measles, may be
givento pregnant women.147. You were invited to be the resource
person in a training class for food handlers. Whichof the following
would you emphasize regarding prevention of staphylococcal
foodpoisoning?A. All cooking and eating utensils must be thoroughly
washed.B. Food must be cooked properly to destroy staphylococcal
microorganisms.C. Food handlers and food servers must have a
negative stool examination result.D. Proper handwashing during food
preparation is the best way of preventing the condition.Answer: (D)
Proper handwashing during food preparation is the best way of
preventing thecondition.Symptoms of this food poisoning are due to
staphylococcal enterotoxin, not themicroorganisms themselves.
Contamination is by food handling by persons withstaphylococcal skin
or eye infections.148. In a mothers’ class, you discussed childhood
diseases such as chicken pox. Which of the following statements about
chicken pox is correct?A. The older one gets, the more susceptible he
becomes to the complications of chickenpox.B. A single attack of
chicken pox will prevent future episodes, including conditions such
asshingles.C. To prevent an outbreak in the community, quarantine
may be imposed by healthauthorities.D. Chicken pox vaccine is best
given when there is an impending outbreak in thecommunity.Answer:
(A) The older one gets, the more susceptible he becomes to the
complications of chicken pox.Chicken pox is usually more severe in
adults than in children. Complications, such aspneumonia, are higher in
incidence in adults.149. Complications to infectious parotitis (mumps)
may be serious in which type of clients?A. Pregnant womenB. Elderly
clientsC. Young adult malesD. Young infantsAnswer: (C) Young adult
malesEpididymitis and orchitis are possible complications of mumps. In
post-adolescent males,bilateral inflammation of the testes and
epididymis may cause sterility.

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