SAS 1

Check for Understanding

1. Filipino nurses are very religious people, there is a deep faith in God that is reflected
in the expression of “bahala na” (it is up to God or leave it to God”.) Which cultural
attitude still exist at present the” bahala” system.
A. Incorrectly equated with an expression of fatalism and a passive acceptance of or
resignation to fate.
B. May also apply to acceptance of illness or malady.
C. Operates psychologically to elevate one’s courage and conviction to persist in the
face of adversity and improve
D. All of the above
ANSWER: D.
RATIONALE: This tends to be incorrectly equated with an expression of fatalism
and a passive acceptance of or resignation to fate. Bahala na may also apply to
acceptance of illness or malady. Although it is an indication of acceptance of the
nature of things including one’s own inherent limitations, bahala na operates
psychologically to elevate one’s courage and conviction to persist in the face of
adversity and improve one’s situation (Okamura & Agbayani, 1991).

2. An American nurse tries to speak with a Korean client who cannot understand the
English language. To effectively communicate to a client with a different language,
which of the following should the nurse implement?
A. Have an interpreter to translate.
B. Speak slowly.
C. Speak loudly and closely to the client.
D. Speak to the client and family together.
ANSWER: A.
RATIONALE: It is better to ask for help from a person who can understand both
languages well so that there will be no miscommunication.

3. A nurse is caring for a Chinese client who is hospitalized due to pneumonia. Based
on their culture, which of the following is believed to be the cause of the illness?
A. An illness is cast by an enemy.
B. An illness is a result of punishment for sins.
C. An illness may be attributed to overexertion.
D. An illness may be given by someone who did not want it.
ANSWER: C.
RATIONALE: Illness for Chinese people may be attributed to prolonged sitting or
lying or to overexertion.

4. Which of the following food items would be appropriate for a Seventh Day Adventist
to be followed?
A. Shrimp and mussels.
B. Beef and pork.
C. Tuna and salmon.
D. Cheese and milk
ANSWER: C.
RATIONALE: SDAs are prohibited from the consumption of pork, shellfish,
alcohol, coffee and tea. The longest-lived Adventists are pesco-vegetarians. They
eat plant-based food and up to one serving of fish per day, most often salmon,
well known for its heart-healthy properties.

5. When assessing a patient from a different culture, what is the most important area to
consider?
A. Religious beliefs
B. Language spoken
C. Health Practices
D. Social Organizations
ANSWER: B.
RATIONALE: Language is important to determine whether the nurse and patient
can understand what the other is saying. It may be possible to find an interpreter
in the event of a language barrier. Religious beliefs, health practices, and social
organizations are an important area of cultural assessment, but not the most
important.

6. Identification of health risk in the community is a step-in formulating community health

diagnosis. Which of the following methods should be done by the public nurse to best
facilitate the identification of health risk threatening this community?
A. Review vital statistics available
B. Study health center records and reports
C. Assess community health resources and industries available
D. Familiarize with prevalent lifestyle of the people within the community
ANSWER: D.
RATIONALE: A Community Health Nurse monitors health by monitoring and
detecting the presence of health concerns in the community through contacts or
home visits, and recording and reporting health status and presence of health
problems in the community to figure out the risk threatening the community.

7. You are the new public health nurse. To obtain 100% population count of the
community, you should need to do a:
A. One to one interview
B. Survey
C. Sampling of the population
D. Census
ANSWER: B.
RATIONALE: As the new public nurse, I should follow a systematic process of
monitoring the health status of the community through the conduct of surveys
and home visits. Census surveys, in which you give your survey questionnaire to
every member of the population you want to learn about.

8. In order to raise people’s awareness on cancer prevention, the following danger signs
of cancer need to be disseminated.
A. Unexplained anemia and weight loss
B. All these groups
C. Indigestion and nagging cough
D. Change in normal bowel habits and unusual bleeding or discharge
ANSWER: B.
RATIONALE: In the present study, knowledge of nine possible warning signs of
cancer that were reported either in the European Code Against Cancer or by the
major cancer organizations was assessed. These warning signs include: (a)
changes in bowel or bladder habits; (b) a sore that does not heal; (c) unusual
bleeding or discharge; (d) thickening or lump in the breast or elsewhere; (e)
obvious change in a wart or mole; (f) nagging cough or hoarseness; (g)
unexplained loss of weight; (h) difficulty in swallowing, and (i) indigestion.

9. In the year 1995, 27% of all children under 5 were underweight and about 50% of
deaths among children under 5 are associated with:
A. Malnutrition
B. Diarrhea
C. Denque
D. Malaria
ANSWERS: A.
RATIONALE: In 1995, 27% (168 million) of all children under 5 were underweight.
Mortality rates are 5 times higher among severely underweight children than
those of normal weight. About 50% of deaths among children under 5 are
associated with malnutrition.

10. What government agency is responsible to undertake initiatives in health care

services through innovative approaches?
A. Department of Science and Technology
B. Department of Local Government
C. Department of Health
D. Department of Education
ANSWER: C.
RATIONALE: Department of Health or DOH is the principal health agency in the
Philippines. It is responsible for ensuring access to basic public health services
to all Filipinos through the provision of quality health care and regulation of
providers of health goods and services.
SAS 2
Check for Understanding
1. Which among the following is true to Public Health Nursing? (Select all that apply)
A. Both are special field of nursing
B. Both are combination of nursing and social skills
C. PHN and CHN can be used interchangeably
D. It is public service oriented
ANSWER: A., B., C., D.
RATIONALE: Community health nursing or public health nursing is a term used
by those nurses working towards providing health awareness, treatments,
promoting ways of healthy living, and serving the public health sector with their
nursing skills, etc.

2. The PHNs’ responsible of care is the:

A. Client
B. Family
C. Community
D. All of these
ANSWER: D.
RATIONALE: Nursing services wither singly or collaboratively to individuals,
families and communities in any health care setting.

3. The focus of the PHNs’ activities is:

A. Primary prevention
B. Curative
C. Rehabilitative
D. All of these
ANSWER: D.
RATIONALE: “The utilization of the nursing process in the different levels of
clientele-individuals, families, population groups and communities, concerned
with the promotion of health, prevention of disease and disability and
rehabilitation”, (Maglaya, et al).

4. Which of the following does not describe an urban community?

A. Highly dense in population
B. People are well-knit and having high degree of group feeling
C. Complex international relationship
D. Non-agricultural occupation
ANSWER: B.
RATIONALE: A rural community describes people by simple folk characterized by
primary group relations well-knit and having high degree of group feeling.
5. What health sector aims to achieve the health system goals of better health
outcomes in the Philippines?
A. Philippine Health Insurance
B. Universal Health Care
C. Home health Care
D. Department of Labor and Employment
ANSWER: B.
RATIONALE: In July 2011, the DOH issued another policy on local health
development through Administrative Order N0. 2011–0008, outlining the
framework for an intersectoral approach to support the development of urban
health systems in highly urbanized and rapidly urbanizing cities (Department of
Health, 2011). To improve health system outcomes in support of UHC goals is the
policy goal, taking into consideration the social determinants of health in urban
settings and focusing on the reduction of health disparities among the urban
poor population.

6. In this year, the Fajardo Act (Act No. 2156) created Sanitary Divisions.
A.1910
B.1911
C.1912
D. 1921
ANSWER: C.
RATIONALE: It was on 1012 that the President of the Sanitary Division took
charge of two or three municipalities. Where there were no physicians available,
male nurses were assigned to perform the duties of the President, Sanitary
Division.

7. These schools were primarily intended to train on-Christian women and prepare them
to render service among their people.
A. Philippine General Hospital and Chong Hua Hospital
B. Cardinal Santos Medical Center and the Medical City
C. University of Santo Tomas and Manila Doctor’s Hospital
D. Zamboanga General Hospital School of Nursing and Baguio General Hospital
ANSWER: D.
RATIONALE: Two government schools of nursing were established: Zamboanga
General Hospital School of Nursing in Mindanao and Baguio General Hospital in
Northern Luzon. These schools were primarily intended to train on-Christian
women and prepare them to render service among their people.

8. In what year did the Section of Public health Nursing was converted into Section of
Nursing due to pressing need for guidance not only in public nursing services but also in
hospital nursing and nursing education?
A. 1930
B. 1940
C. 1942
D. 1944
ANSWER: A.
RATIONALE: In 1930, the Section of Nursing was transferred from the Office of
General Services to the Division of Administration. This office covered the
supervision and guidance of nurses in the provincial hospital s and two
government schools of nursing.

9. In what year did the office of Health Education and Personnel Training were
established with Dr. Trinidad Gomez as Chief.
A. 1952
B. 1953
C. 1955
D. 1962
ANSWER: B.
RATIONALE: In 1953, the Office of Health Education and Personnel Training were
established with Dr. Trinidad Gomez as Chief.

10. In what year did the Philippine Health Services was abolished?
A.1967
B.1927
C.1972
D.1976
ANSWER: B.
RATIONALE: In 1927, the office of District Nursing under the Office of General
Inspection, Philippine Health Services was abolished and supplanted by the
section of Public Health Nursing. Ms. Genara de Guzman acted as consultant to
the Director of health on nursing matters.
SAS 3
Check for Understanding
1. In preparing to review different theories, nurse Bobby reviews basic information to
assist in understanding the material. Theories are defined as:
A. Statements that describe concepts or connect concepts
B. Mental formulations of objects or events
C. Aspects of reality than can be consciously sensed
D. Concepts or propositions that project a systematic view of phenomena
ANSWER: D.
RATIONALE: The nurses should use organizational resources in a focused
manner, so that they will solve the problem and can’t create new problems along
the way. The nursing profession has advanced and with it so has the need to
develop nursing theories that formalize the scientific base of community health
nursing. The richness of community health nursing comes from the challenge of
conceptualizing and implementing strategies that will enhance the health of the
people.

2. Kristy, a community health nurse is working with a variety of clients and decides to
use a Systems theory approach to assist them to meet their health care needs. In using
the Systems theory, nurse Kristy focuses on the:
A. Client’s interaction with the environment
B. Hierarchy of the client’s human needs
C. Client’s attitudes toward health behaviors
D. Response of the client to the process of growth and development
ANSWER: A.
RATIONALE: The family home and the community and its institution make up its
immediate environment and are therefore important aspects to be considered in
the assessment of the family health status. The nurse observes interpersonal
relationships among the members and appraises the physical environmental
conditions in the home.

3. When assessing the external variables that influence a client’s health beliefs and
practices, nurse Mindy must consider his:
A. Educational background
B. Religious practices
C. Income status
D. Reaction to the heart disease
ANSWER: C.
RATIONALE: External variables influencing a person’s health beliefs and
practices include family practices, cultural background, and socioeconomic
factors, such as income. Economic variables may affect a client’s level of health
by increasing the risk for disease and influencing how or at what point the client
enters the health care system. A person’s compliance with the treatment to
maintain or improve health also is affected by economic status.

4. In the Health Belief Model, nurse Chiara recognizes that the focus is placed on the:
A. Functioning of the individual in all dimensions
B. Relation of perceptions and compliance with therapy
C. Relation of perceptions and compliance with therapy
D. Multidimensional nature of clients and their interaction with the environment
ANSWER: C.
RATIONALE: In the Health Belief Model, the nurse focuses on the relation
between a person’s beliefs and health behaviors. By focusing on the client’s
perceptions of health, the nurse is better able to understand and predict how a
client will comply with health care therapies.

5. Which of the following is the most basic type of health promotion activity? (Select all
that apply).
A. A billboard promoting abstinence to prevent sexually transmitted diseases and
unplanned pregnancies
B. A wellness assessment program
C. An environment control program about pesticide uses
D. A nurse who models healthy lifestyle behaviors
E. A school of nursing that holds a blood pressure fair
ANSWER: A., E.
RATIONALE: Examples are billboards, posters, brochures, newspapers, books,
and health fairs. It raises the level of awareness and knowledge of individuals and
groups about healthy behaviors.

6. Nurse Marco is providing health education about injury and poisoning prevention to a
group of young mothers at a health fair. What type of prevention is the nurse
conducting?
A. Primary prevention
B. Secondary prevention
C. Tertiary prevention
D. Limited prevention
ANSWER: A.
RATIONALE: Generalized health promotion and specific protection against
diseases or specific accidents are targeted to a specific group. This intervention
precedes disease or dysfunction and is applied to generally health group.

7. Pender’s health promotion model would benefit which of the following clients? (Select
all that apply)
A. An active 23-year-old who does not smoke or drink alcohol
B. A 49-year-old client who exercises four times a week
C. A 35-year-old who has yearly breast exams and other routine health screenings
D. An overweight 27-year-old who engages in risky behaviors
ANSWER: B., C.
RATIONALE: Pender’s Health Promotion Model explores many biopsychosocial
factors that influence individuals to pursue health promotion activities. The HPM
depicts the complex multidimensional factors which people interact as they work
to achieve optimum health. This model contains seven variables related to health
behaviors as well as individual characteristics that may influence them and these
two are examples.

8. Client Clint reports that he believes he will "never lick the habit" of smoking because
he has tried before and failed. Using the Transtheoretical model (TTM), what stage of
health behavior is the client functioning in?
A. Preparation stage
B. Contemplation stage
C. Termination stage
D. Action stage
ANSWER: Precontemplation Stage
RATIONALE: The transtheoretical model which act as central guideline to positive
health-behavior changes, indicated that individuals who were attempting to
change their health behavior might experience a series of stages of readiness for
change, namely: precontemplation (not intending to make changes or denying
the need for change), contemplation (seriously considering making changes),
preparation (making small changes), action (actively engaging in exercise for less
than 6 months), and maintenance (exercising regularly for at least 6 months) (Lee
et al., 2006).

9. Honey, a public health nurse compares the rate of teenage pregnancy in various
areas of the city. Which of the core functions of public health is being implemented?
A. Assurance
B. Assessment
C. Prevention
D. Policy development
ANSWER: B.
RATIONALE: Assessment refers to systematic data collection, which this nurse is
doing for teenage pregnancy. Prevention is not a core function, assurance is
making sure essential services are available, and policy development is needed
to provide leadership in developing policies.

10. Nurse Glynnis performs activities to meet the primary goals of public health. Which
of the following is nurse Glynnis most likely to complete?
A. Ensuring that a newly diagnosed 40-year-old hypertensive man takes his medication
B. Finding home care for a 70-year-old client recuperating from a hip replacement
C. Conducting an infant car seat safety check
D. Contacting a local hospice to admit a terminally ill 60-year-old woman
ANSWER: C.
RATIONALE: The correct answer is concerned with the health of many people,
while the other answers address individual interventions. According to the Core
Functions Project, all levels of health care, including population-based public
health care, must be funded or the goal of health of populations may never be
reached.
SAS 4
Check for Understanding
1. Which interventions are most commonly used by public health nurses caring for
families? Select all that apply:
A. Administer screening tools to all members
B. Apply the nursing process to the care of individuals
C. Collaborate and coordinate with referral as needed
D. Provide health teaching, including anticipatory guidance
E. Participate in collecting data on clients for clinical research
ANSWER: B., C., D.,
RATIONALE: The predominant intervention strategies used with families are
primary care, health teaching (including anticipatory guidance), referral, and
collaborating and coordinating care. Screening can be performed by various
nurses, as can care of individuals. Nurses probably cannot resolve conflict,
although they may help family members cope with conflict. Collecting data for
research can be done only with a client's permission.

2. The public health nurse must participate in the essential services of public health.
These include:
a. Monitoring health status by completing a community assessment
b. Diagnosing and investigating health problems in the world
c. Informing, educating, and empowering people about health issues
d. Working in law enforcement to regulate health and ensure safety
ANSWER: C.
RATIONALE: As independent practitioners, nurses are primarily responsible for
the promotion of health and prevention of illness. As members of the health team,
nurses shall collaborate with other health care providers for the curative,
preventive, and rehabilitative aspects of care, restoration of health, alleviation of
suffering, and when recovery is not possible, towards a peaceful death.

3. The term community-based nursing care is applied when implementing which nursing
intervention?
a. Assessing the health needs of a defined community
b. Providing care to families in a community
c. Promoting the health of an entire community
d. Investigating environmental health problems in a community
ANSWER: C.
RATIONALE: Nursing care includes, but not limited to, traditional and innovative
approaches, therapeutic use of self, executing health care techniques and
procedures, essential primary health care, comfort measures, health teachings,
and administration of
written prescription for treatment, therapies, oral, topical and parenteral
medications, internal examination during labor in the absence of antenatal
bleeding and delivery.

4. Which of the following demonstrates intersectoral linkages?

a. Two-way referral system
b. Team approach
c. Endorsement done by a midwife to another midwife
d. Cooperation between the Public Health Nurse and public-school teacher
ANSWER: D.
RATIONALE: Intersectoral linkages refer to working relationships between the
health sector and other sectors involved in community development.

5. Which of the following actions would most likely be performed by a public health
nurse?
a. Asking community leaders what interventions should be chosen
b. Assessing the community and deciding on appropriate interventions
c. Using data from the main health care institutions in the community to determine
needed health services
d. Working with community groups to create policies to improve the environment
ANSWER: D.
RATIONALE: A public health nurse must establish linkages with community
resources and coordination with the health team.

6. The community health nurse asks a client, "Have you ever been exposed to any
radiation or chemical liquids, dust, mists, or fumes?" The nurse is conducting an:
a. Environmental advocacy activity
b. Environmental compliance activity
c. Environmental health assessment
d. Environmental risk communication
ANSWER: C.
RATIONALE: An environmental risk assessment (ERA) is a process for evaluating
how likely it is that the environment may be impacted as a result of exposure to
one or more environmental stressors, such as chemicals, disease, invasive
species, and climate change.

7. Which public health nursing actions may be most helpful to the community's long-
term health?
a. Careful assessment, diagnosis, planning, and giving care to individual patients and
their families
b. Dialogue with community members concerning what health issues are of importance
in that community
c. Focusing on family health through school-based neighborhood clinics
d. Helping the community create political change through organization, use of media,
legislative lobbying, and mass demonstrations
ANSWER: D.
RATIONALE: The ultimate goal is liberating people from health-damaging
environmental conditions by using collective actions. Mechanisms have included
strategic organization, litigation, public hearing testimony, letter-writing
campaigns, legislative lobbying, and mass demonstrations.
8. Which is an example of the public-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.
RATIONALE: Random classroom inspection is assessment of pupils/students
and teachers for signs of a health problem prevalent in the community.

9. Heidi, a 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
ANSWERS: B.
RATIONALE: 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.

10. 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.
RATIONALE: 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.
SAS 5
Check for Understanding
1. Ethical principles for professional nursing practice in a clinical setting are guided by
the principles of conduct that are written as the:
A. Philippine Regulation Commission
B. Philippine Nursing Act of 2002
C. Standards of care from experts in the practice field
D. Good Samaritan laws for civil guidelines
ANSWER: A.
RATIONALE: This set of ethical principles provides the professional guidelines
established by the ANA to maintain the highest standards for ideal conduct in
practice. As a profession, the ANA wanted to establish rules and then incorporate
guidelines for accountability and responsibility of each nurse within the practice
setting.

2. The distribution of nurses to areas of “most need” in the time of a nursing shortage is
an example of:
A. Utilitarianism theory
B. Deontological theory
C. Justice
D. Beneficence
ANSWER: C.
RATIONALE: Justice is defined as the fairness of distribution of resources.
However, guidelines for a hierarchy of needs have been established, such as with
organ transplantation. Nurses are moved to areas of greatest need when
shortages occur on the floors. No floor is left without staff, and another floor that
had five staff will give up two to go help the floor that had no staff.

3. When signing a form as a witness, nurse signature shows that the client:
A. Is fully informed and is aware of all consequences.
B. Was awake and fully alert and not medicated with narcotics.
C. Was free to sign without pressure
D. Has signed that form and the witness saw it being done
ANSWER: D.
RATIONALE: Your signature as a witness only states that the person signing the
form was the person who was listed in the procedure.

4. Which criterion is needed for someone to give consent to a procedure?

A. An appointed guardianship
B. Unemancipated minor
C. Minimum of 21 years or older
D. An advocate for a child
ANSWER: A.
RATIONALE: A guardian has been appointed by a court and has full legal rights
to choose management of care.

5. Successful ethical discussion depends on people who have a clear sense of personal
values. When many people share the same values, it may be possible to identify a
philosophy of utilitarianism, with proposes that:
A. The value of people is determined solely by leaders in the Unitarian church.
B. The decision to perform a liver transplant depends on a measure of the moral life that
the client has led so far
C. The best way to determine the solution to an ethical dilemma is to refer the case to
the attending
physician.
D. The value of something is determined by its usefulness to society.
ANSWER: D.
RATIONALE: A utilitarian system of ethics proposes that the value of something
is determined by its usefulness.

6. The client’s right to refuse treatment is an example of:

A. Statutory law
B. Common law
C. Civil laws
D. Nurse practice acts
ANSWER: C.
RATIONALE: The client has the right to be informed about his/her condition and
treatment or any health intervention that need to be done. He/ She are entitled to
accurate and adequate information so that he/she could make an informed. The
nurse, therefore should respect the client’s decision and his/her refusal should
not affect the latter’s access to other health services.

7. Even though the nurse may obtain the client’s signature on a form, obtaining
informed consent is the responsibility of the:
A. Client
B. Physician
C. Student nurse
D. Supervising nurse
ANSWER: B.
RATIONALE: The physician, or another licensed independent practitioner such as
a nurse practitioner or a physician's assistant, provides the client with complete
information about the treatment or procedure, the potential risks including pain
and complications, the benefits of the treatment or procedure, who will perform
the planned treatment or procedure, and any possible alternatives to the
treatment or procedure including their benefits and risks.
8. To respect a client’s personal space and territoriality, the nurse:
A. Avoids the use of touch
B. Explains nursing care and procedures
C. Keeps the curtains pulled around the client’s bed
D. Stands 8 feet away from the bed, if possible.
ANSWER: B.
RATIONALE: Client has the right to safe and quality care: therefore, the nurse
has responsibility to update himself/ herself on the latest developments in health
care and in the nursing profession.

9. The philosophy sometimes called the code of ethics of care suggests that ethical
dilemmas can best be solved by attention to:
A. Relationships
B. Ethical principles
C. Clients
D. Code of ethics for nurses
ANSWER: A.
RATIONALE: The ethic of care explores the notion of care as a central activity of
human behavior. Those who write about the ethics of care advocate a more
female biased theory that is based on understanding relationships, especially
personal narratives.

10. In most ethical dilemmas, the solution to the dilemma requires negotiation among
members of the health care team.
The nurse’s point of view is valuable because:
A. Nurses have a legal license that encourages their presence during ethical
discussions.
B. The principle of autonomy guides all participants to respect their own self-worth.
C. Nurses develop a relationship to the client that is unique among all professional
health care providers.
D. The nurse’s code of ethics recommends that a nurse be present at any ethical
discussion about client care.
ANSWER: C.
RATIONALE: When ethical dilemmas arise, the nurse’s point of view are unique
and critical. The nurse usually interacts with clients over longer time intervals
than do other disciples.
SAS 6
Check for Understanding
1. An infant who had been in foster care since birth requires a blood transfusion. Who is
authorized to give written informed consent for the procedure?
a. Nurse manager
b. Social worker who placed the infant in foster home
c. Registered nurse caring for the infant
d. The foster mother
ANSWER: D.
RATIONALE: The foster parents are the primary caregivers. When children are
minors and aren't emancipated, their parents or designated legal guardians are
responsible for providing consent for medical procedures. Therefore, the foster
mother is authorized to give consent for the blood transfusion because she has
been appointed the legal guardian of the child. The social worker, the nurse, and
the nurse-manager have no legal rights to give consent in this case.

2. The foster parents of a child age 6, who will begin school in the facility, ask the nurse
for anticipatory guidance. The nurse should explain that a child of this age:
a. Rebel against scheduled activities
b. Still depends on the parent
c. Loves to tattle
d. Is highly sensitive to criticism
ANSWER: D.
RATIONALE: In a 6-year-old child, a precarious sense of self causes overreaction
to criticism and a sense of inferiority. By age 6, most children no longer depend
on the parents for daily tasks and love the routine of a schedule. Tattling is more
common at age 4 to 5, by age 6, the child wants to make friends and be a friend.

3. The nurse is discussing negativism with the parents of a 30-month-old child when
administering immunization. How should the nurse tell the parents to best respond to
this behavior?
a. Reprimand the child and give a 15-minute “time out”
b. Maintain a permissive attitude for this behavior
c. Use patience and a sense of humor to deal with this behavior
d. Assert authority over the child through limit setting
ANSWER: C.
RATIONALE: The nurse should help the parents see that negativity is a normal
part of growth of autonomy in the toddler. They can best handle the negative
toddler by using patience and humor.

4. A victim of domestic violence states, “If I were better, I would not have been beaten.”
Which feeling best describes what the victim may be experiencing?
a. Fear
b. Helplessness
c. Self-blame
d. Rejection
ANSWER: C.
RATIONALE: The victim is obviously thinking that it was her fault which is
common to victims of domestic violence. Blaming themselves may also help
them feel safer in some ways.

5. The nurse is at the community center speaking with retired people. To which
comment by one of the retirees during a discussion about the benefits for senior citizen
would the nurse give a supportive comment to reinforce correct information?
a. I usually bring my senior citizen ID wherever I will go
b. No need to ask doctors’ prescription if I will buy my medicines.
c. I was given discount for doctors’ professional fee
d. I registered my name as a member of senior citizen.
ANSWER: A.
RATIONALE: An elderly should get a senior citizen identification card and present
it whenever needed to avail of the benefits and discounts.

6. The community health nurse is assigned to care for administering vaccination. Which
of the following should the nurse give the priority in giving vaccination?
a. The client who came first.
b. The adult client together with mother
c. The client with age of 60 years old
d. The mother who brought her lactating child with her
ANSWER: C.
RATIONALE: Another privilege of senior citizens is the provision of express lanes
for them in all commercial and government establishments. A good example
would be the Covax, the senior citizens belong in the A2, which is after the
frontliners.

7. Nurse Meredith is observing 8-year-old Anna during a community visit. Which of the
following findings would lead the nurse to suspect that Anna is a victim of sexual
abuse?
a. The child is fearful of the caregiver and other adults.
b. The child has a lack of peer relationships.
c. The child has self-injurious behavior.
d. The child has an interest in things of a sexual nature.
ANSWER: D.
RATIONALE: An 8-year-old child is in the latency phase of development; in this
stage, the child's interest in peers, activities, and school is priority. Interest in sex
and things of a sexual nature would occur appropriately during the age of
puberty, not at this time. A child who is the victim of sexual abuse, however, may
show unusual interest in sex. The assessments in the other answer choices may
indicate abuse, but not necessarily sexual abuse.
8. Sheila tells the community nurse that her boyfriend has been abusive and she is
afraid of him. but she doesn't want to leave. The client asks the nurse for assistance.
Which nursing interventions are appropriate in this situation? Select all that apply.
a. Help Sheila to develop a plan to ensure safety including phone numbers for
emergency help.
b. Help Sheila to get her boyfriend into an appropriate treatment program.
c. Communicate acceptance. avoiding any implication that Sheila is at fault for not
leaving.
d. Help Sheila to explore available options. including shelters and legal protection.
ANSWER: A., D.
RATIONALE: The client is not responsible for seeking help for the abuser, and
encouraging her to do so may reinforce the client's feeling responsible for the
abuse. Advising the client must decide for herself whether to leave, and the nurse
must respect any decision the client makes. Making the decision for the client will
erode her self-esteem and reinforce her sense of powerlessness.

9. What is R.A. 9994?

a. Anti-Terror Law
b. Expanded Senior Citizen Act of 2010
c. Magna Carta for Health Care Workers
d. Providing Mandatory Basic Immunization
ANSWER: B.
RATIONALE: Expanded Senior Citizens Act of 2010, defines senior citizen or
elderly as any resident citizen of the Philippines at least 60 years old.

10. As the government cares for the health of Senior Citizens, what are the entitlement
of benefits given to them?
a. Purchase of medicines
b. 20% discount
c. Diagnostic and laboratory fees in private hospitals
d. All of the above
ANSWER: D.
RATIONALE: Senior citizens are entitled to 20% discount and exemption from the
value-added tax (VAT) on certain goods and services for their exclusive use.
SAS 7
Check for Understanding
1. What is the function of FDA Generic Drug Program?
A. To revise health care delivery system
B. To conduct review to make a certain that the medicine met the standard for safety
use.
C. To organize community forum
D. To formulate health care law
ANSWER: B.
RATIONALE: The FDA Generic Drugs Program conducts a rigorous review to
make certain generic medicines meet these standards, in addition to conducting
3,500 inspections of manufacturing plants a year and monitoring drug safety after
the generic medicine has been approved and brought to market.

2. What type of medicine created to work the same as an existing approved brand-
name drugs.
A. Intravenous fluids
B. Acupuncture
C. Generic
ANSWER: C.
RATIONALE: A generic medicine is the same as a brand-name medicine in
dosage, safety, effectiveness, strength, stability, and quality, as well as in the way
it is taken and the way it should be used.

3. What health Republic Act in the government that provide insurance coverage for all
citizens of the Philippines to ensure affordable, acceptable, available and accessible
health care services?
A. Philippine Medical Act
B. Philippine Technological Transfer Act
C. Dangerous drug Act
D. National Health Insurance Act
ANSWER: D.
RATIONALE: National Health Insurance Act is the compulsory health insurance
program of the government as established in this Act, which shall provide
universal health insurance coverage and ensure affordable, acceptable, available
and accessible health care services for all citizens of the Philippines.

4. What are the three components of access to health care as implemented in the
insurance act? (Select all that apply)
A. Coverage
B. Services
C. Timeless
D. Prevention
ANSWER: A., B., C.
RATIONALE: Access to health care consists of four components (Healthy People
2020): a. Coverage: facilitates entry into the health care system where uninsured
people are less likely to receive medical care and more likely to have poor health
status, b. Services: having a usual source of care is associated with adults
receiving recommended screening and prevention services, c. Timeliness: ability
to provide health care when the need is recognized, and d. Workforce: capable,
qualified, culturally competent providers.

5. Which of the following that can avail the Philippine health government insurance
coverage except
A. Sponsored members
B. Foreigner
C. Life time members
D. Indigent members
ANSWER: B.
RATIONALE: The National Insurance Health Act covers the members in the formal
economy, sponsored members, members in the informal economy, lifetime
members, indigent members, and senior citizens.

6. A volunteer individual approached the nurse that he wants to donate blood and asked
what age group can donate blood? The nurse reply which of the following:
A. Between 7–12-year-old
B. Between 17-65 years old
C. All of the above
D None of the above
ANSWER: B.
RATIONALE: Most people can give blood if they are in good health. One of the
basic requirements one needs to fulfill in order to become a blood donor. Age:
You are aged between 18 and 65. In some countries national legislation permits
16–17-year-olds to donate provided that they fulfil the physical and hematological
criteria required and that appropriate consent is obtained. In some countries,
regular donors over the age of 65 may be accepted at the discretion of the
responsible physician. The upper age limit in some countries is 60 (WHO).

7. One of the donors asked, when I donate blood am I at risk of acquiring blood-borne
diseases such as HIV, Hepatitis B and C? What is the nurse best answer?
A. True
B. False
C. Maybe
D. None of the above
ANSWER: B.
RATIONALE: No. HIV is transmitted in blood, semen, vaginal fluids, and breast
milk, so some people are concerned about the risk of HIV when giving blood.
Prior to donating blood to assist in determining if they are in good health and free
of any diseases that could be transmitted by blood transfusion, blood donors are
asked a set of standard questions. If the donor’s answers indicate they are not
well or are at risk for having a disease transmissible by blood transfusion, they
are not allowed to donate blood.

8. The amount of blood collected at one time is:

A. 250 ml.
B. 450 ml.
C. 1liter
D. 6 liters
ANSWER: B.
RATIONALE: For a whole blood donation, approximately one pint (which weighs
about one pound) is collected. This is also equivalent to about 450 to 500
milliliters (DOH PH).

9. After the bloodletting, the client asked the laboratory staff how often regularly can he
donate blood? The staff response:
A. Once a year
B. Every 2 years
C. Every 4 months
ANSWER: C.
RATIONALE: Across the world, the minimum interval between whole blood
donations varies between 56 days (8 weeks) and 16 weeks and different donation
intervals are usually followed for male and female donors; in practice, some
female donors are unable to give blood more than once or twice per year due to
iron deficient states (Blood Donor Selection).

10. The nurse instruct the client before giving blood patient should:
A. Eat her/his normal meal or snack
B. Drinks lots of fluids
C. Not drink, not eat
D. Consider A and B
ANSWER: D.
RATIONALE: Most BTS guidelines recommend that donors should maintain their
usual food and fluid intake before donation but should avoid heavy or fatty meals
which may result in a lipaemic donation that may need to be discarded (Blood
Donor Selection).
SAS 8
Check for Understanding
1. In order to solicit cooperation /assistance of the community in the environmental
sanitation program, which of the following needs to be done first?
a. Create public awareness on the environmental sanitation problems
b. Form working groups or committees
c. Solicit the help of the municipal and barangay officials
d. Involve community members in the sanitation program
ANSWER: A.
RATIONALE: It is important to spread awareness to the community first so that
they will be updated and know what is happening.

2. The RHU team consist of the following except:

a. Community health workers
b. Public health nurse
c. Health axillary volunteer
d. Respiratory therapist
ANSWER: D.
RATIONALE: A respiratory therapist (RT) is a certified medical professional who
specializes in providing healthcare for your lungs. They have advanced
knowledge of high-tech equipment, such as mechanical ventilators. RTs work
alongside doctors and nurses.

3. Tertiary Care by the home health nurse is directed towards children with:
a. Problem in mobility
b. Minor problems
c. Short-term needs
d. Clinically apparent disease
ANSWER: A.
RATIONALE: Disability prevention and rehabilitation is the level of prevention in
tertiary care.

4. Nurse Nicolas is scheduled for Pap smear. She has a strong family history for
cervical cancer. This is an example of?
a. Secondary prevention
b. Primary prevention
c. Tertiary prevention
d. Health screening
ANSWER: A.
RATIONALE: Secondary prevention emphasizes early disease detection, and its
target is healthy-appearing individuals with subclinical forms of the disease. The
subclinical disease consists of pathologic changes, but no overt symptoms that
are diagnosable in a doctor's visit. Secondary prevention often occurs in the form
of screenings. For example, a Papanicolaou (Pap) smear is a form of secondary
prevention aimed to diagnose cervical cancer in its subclinical state before
progression.
5. Which of the following is the new Mission of the DOH?
a. Promote healthy lifestyle
b. Ensure accessibility and quality of health care
c. Equitable and people-centered health system
d. Improve general’s health status of the people
ANSWER: C.
RATIONALE: The new mission of the DOH is to lead the country in the
development of a productive, resilient, equitable and people-centered health
system.

6. The new vision of the DOH is:

a. Health for all Filipinos by 2012
b. Leader, staunch, advocate and model in promoting health for all in the Philippines
c. Guarantee equitable and quality health for all Filipinos
d. Healthiest people in Southeast Asia by 2022, and Asia by 2040
ANSWER: D.
RATIONALE: The new vision of the DOH is to include Filipinos among the
healthiest people in Southeast Asia by 2022, and Asia by 2040.

7. If the primary level of care is not capable of solving the problem, where would you
prefer for secondary level of care?
a. Rehabilitation center
b. Barangay captain house
c. Doctor’s clinic in the municipality
d. District hospital
ANSWER: D.
RATIONALE: The choices for location in secondary level of care are the district
hospital, municipal hospital, provincial hospital, and city hospital.

8. Health sectors reform has been formulated because of the following excepts:
a. Persistence of large variations in health status across population groups and
geographic areas
b. Arising burden from chronic and degenerative diseases
c. High burden from infectious disease
d. Burden from disease is heaviest among middle class families
ANSWER: D.
RATIONALE: The rationale of HSRA is slowing down in the reduction in the infant
mortality rate and maternal mortality health, persistence of large variation in
health status across population groups and geographical areas, high burden
from infectious diseases, rising burden from chronic and degenerative diseases,
unattended emerging health risk for environmental and work-related factors,
burden of diseases is heaviest on the poor.

9. The DOH adopted which of the following as the framework for the implementation of
the health sector reform?
a. FOURmula One for Health
b. National Health Insurance Program (NHIP)
c. High Five Formula
d. Healthcare system upgrading plan
ANSWERS: A.
RATIONALE: The framework for implementation of HSRA is the FOURmula ONE
for Health having its goals and elements of strategy.

10. Health care services were devolved to the Local Government Units (LGU) for the
following reasons except:
a. To transform LGU into self- reliant communities
b. To involve people in the development and progress of their communities
c. Empower local health officials
d. To provide people better access to decision making
ANSWER: D.
RATIONALE: The implementation of the Local Government Code of 1991 resulted
in the devolution of health services to local government units (LGUs) which
included among others the provision, management and maintenance of health
services at different levels of LGUs. What used to be a centralized national health
system became many independent local health systems. After more than
seventeen (17) years of devolution, improvements in health status of populations
show marked variations across LGUs. Variations in health status were associated
with variations in the performance of health care providers and health care
professionals in localities.
SAS 9
Check for Understanding
1. Which of the following agencies will be responsible for the protection and promotion
of the people’s health?
a. Local Government Unit
b. Department of Interior and Local Government
c. Department of health
d. Barangay and Municipal Councils
ANSWER: C.
RATIONALE: The Department of Health serves as the main governing body of
health services in the country.

2. A method wherein the superficial soft parts of the body are rubbed, stroked, kneaded,
or tapped for remedial, aesthetic, hygienic, or limited therapeutic purposes
a. Massage
b. Chiropractic
c. Acupuncture
d. Acupressure
ANSWER: A.
RATIONALE: Massage is a method wherein the superficial soft parts of the body
are rubbed, stroked, kneaded, or tapped for remedial, aesthetic, hygienic, or
limited therapeutic purposes.

3. The Department of Health adopts measures to augment basic services and facilities
assigned to LGU’s. which of the following are priority areas for the provision of
assistance by the DOH?
a. Areas where studies/researches on health are conducted
b. Selected areas in the city
c. Areas recommended by government /local officials
d. Less developed and deserving local government units
ANSWER: D.
RATIONALE: One of the basic principles is to achieve improvement in health is
the health and nutrition of vulnerable groups must be prioritized.

4. Which of the following assistance is/are far given by the DOH to the LGU?
a. Provide health information statistics and other necessary data
b. All of these forms of assistance
c. Ensure that public have access to higher and more advanced facilities
d. Monitor and evaluate local health projects, programs and services
ANSWER: B.
RATIONALE: All of these are given by the DOH to the LGU, they both work hand-
in-hand.
5. Primary health care as a strategy in the delivery of health care services is best
characterized by:
a. Essential health services accessible and acceptable to the community
b. Partnership between and among the health workers
c. Provision of health services at the district level
d. Top-down decision making
ANSWER: A.
RATIONALE: Essential health care made universally accessible to individuals and
families in the community by means acceptable to them, through their full
participation and at cost that the community can afford at every stage of
development.

6. The following are strategies of primary health care, EXCEPT:

a. Reorientation and reorganization of the health care systems with the establishment of
functional support mechanism in support of the mandate of devolution under the local
government code of 1991.
b. Effective preparation and enabling process for health action at all levels.
c. Mobilization of the people to know their communities and identifying their basic health
needs with the end in view of providing appropriate solutions leading to self-reliance and
self-determination.
d. None of the above
ANSWER: A.
RATIONALE: This is the legislated Republic Act No. 7160.

7. The devolution of health services to the local government unit was mandated by:
a. R.A 7160
b. Executive Order 51
c. R.A. 7305
d. R.A. 7164
ANSWER: A.
RATIONALE: The 1987 Philippine Constitution mandated the Congress to “enact
a local government code which shall provide for a more responsive and
accountable local government structure instituted through a system of
decentralization with effective mechanisms of recall, initiative and referendum,
allocate among the different local government units their powers, responsibilities,
and resources, and provide for the qualifications, election, appointment and
removal, term, salaries, powers and functions and duties of local officials, and all
other matters relating to the organization and operation of the local units (Section
3, Article X).” In response to this Constitutional directive, the Congress legislated
the Republic Act No. 7160, otherwise known as the Local Government Code of
1991 (hereafter Code), which was signed into law on October 10, 1991 and took
effect on January 1, 1992.
8. What care strategy has the Department of Health used for accessibility of health?
a. Deregulation of health services
b. Regionalization of health services
c. opening barangay wellness clinics
d. Primary Health Care
ANSWER: D.
RATIONALE: Primary health care is the essential health care made universally
accessible to individuals and families in the community by means acceptable to
them, through their full participation and at cost that the community can afford at
every stage of development..

9. Which of the following herbal can be recommended for scabies?

a. kakawati fresh leaves
b. kaymito leaves
c. kabuyao leaves
d. lagundi leaves
ANSWER: D.
RATIONALE: Lagundi leaves can be used for asthma, cough and colds, fever,
dysentery, pain, and skin diseases (scabies, ulcer, eczema), wounds.

10. Which of the following alternative care can be recommended for alleviating pain by
applying pressure on the body surfaces?
a. Acupuncture
b. Acupressure
c. Aromatherapy
d. Pranic Healing
ANSWER: B.
RATIONALE: Acupressure is a method of healing and health promotion that uses
the application of pressure on acupuncture points without puncturing the skin.

11. Should you teach a member of household on the use of niyog-niyugan, what
possible disease condition could be remedied?
a. parasitism
b. none of these
c. fever
d. Constipation
ANSWER: A.
RATIONALE: Anthelmintics are a type of medicine that kills helminths. Helminths
are worm-like parasites such as flukes, roundworms, and tapeworms. It is
important that anthelmintics are selectively toxic to the parasite and not the host.
SAS 10
Check for Understanding
1. A nurse demonstrated caring by helping the family members to: Select that all apply.
a. Become active participants in care
b. Remove themselves from personal care
c. Make health care decision for the patient
d. Have uninterrupted time for family and patient to be together
e. Have opportunities for the family to discuss their concerns
ANSWER: A., D., E.
RATIONALE: These are the characteristics of a family as a client.

2. Which of the followings most greatly affects a family’s access to adequate health
care, opportunity for education and sound nutrition?
a. Development
b. Family function
c. Family structure
d. Economic stability
ANSWER: D.
RATIONALE: Finance is one of the biggest factors and needs of a family.

3. Which of the following family assessment are most important for successful family
caregiving? Select that apply:
a. Educational level of family members
b. Cultural references
c. Collaboration between family members
d. Social support
e. Conflict resolution practices
ANSWER: C., D., E.
RATIONALE: These are just come of the behaviors indicating a well family.

4. Which of the following phases of parental process that changing identities and role of
both husband and wife are sources of anxieties concerns?
a. Establishment Phase
b. Expectant Phase
c. Parenteral Phase
d. None of the above
ANSWER: D.
RATIONALE: This is the authoritative stage on which they have to learn to accept
their authority and decide how much control they need to exercise on their child.

5. Particular societal trends may have an influence on the overall health of families and
create a challenge for health care providers, especially the nurses. Of the following
trends, which represents the greatest current health care challenge to nurses?
a. Single-parent families
b. “Sandwiched” or middle generation
c. Alternate relationship patterns
d. “Homelessness”
ANSWER: D.
RATIONALE: One of the family tasks is physical maintenance in which these
things should be provided - food, shelter, clothing, and health care to its
members being certain that a family has ample resources to provide.

6. When a nurse is working with families, the nurse may view the family as context or
client. Which of the following examples demonstrates the view of the family as context?
a. The client’s ability to understand and manage his or her own dietary needs
b. The family’s ability to support the client’s dietary and recreational needs
c. The adjustment of the client and family to changes in diet and exercise
d. The family’s demands on the client based on his or her role performance
ANSWER: A.
RATIONALE: When the nurse views the family as context, the primary focus is on
the health and development of an individual member existing within the client's
family. The client's ability to understand and manage his or her own dietary needs
demonstrates the view of the family as context. The family's ability to support the
client's dietary and recreational needs demonstrates the view of the family as
client. The family's demands on the client based on his or her role performance
demonstrates the view of the family as client. The adjustment of the client and
family to changes in diet and exercise demonstrates the view of the family as
client. Nursing practice that focuses on family as client is also known as family
systems nursing.

7. Nurse Jay is observing for the signs of a healthy family. In an assessment of a

healthy family, nurse Jay expects to find that:
a. Minimal influence is exerted on the environment.
b. The structure is flexible enough to adapt to crises
c. A passive response exists to stressors.
d. Change is viewed as detrimental to family processes
ANSWER: B.
RATIONALE: A healthy family has a flexible structure that allows adaptable
performance of tasks and acceptance of help from outside the family system. The
structure is flexible enough to allow adaptability but not so flexible that the family
lacks cohesiveness and a sense of stability. The healthy family is able to
integrate the need for stability with the need for growth and change. It does not
view change as detrimental to family processes. The healthy family demonstrates
control over the environment and does not passively respond to stressors. The
healthy family exerts influence on the immediate environment of home,
neighborhood, and school.

8. Nurse Luna is visiting Mrs. Panalo and her family in the community for the first time.
In completing Mrs. Panalo and her family’s assessment, the nurse should begin by:
a. Evaluating communication patterns
b. Testing the family’s ability to cope
c. Determining the family’s structure and attitudes
d. Gathering the health data from all the family members
ANSWER: D.
RATIONALE: The nurse begins the family assessment by determining issues that
are pertinent to the client's well-being. During the assessment the nurse, client,
and family collaboratively engage in conversation to systematically collect
information and reflect on the issues important to the client's well-being.
Gathering health data from the family members is not the starting point for a
family assessment. Testing a family's ability to cope is not where the nurse
should begin a family assessment. Evaluating communication barriers would not
be an initial action of the nurse when completing a client's family assessment.

9. Nurse Sheena is visiting the client and family in the home after the client’s discharge
from the Changi Medical Center. Nurse Sheena seeks to assist the client to return to the
home environment. In implementing family-centered care, the nurse:
a. Assists family members to assume dependent roles
b. Provides his or her own beliefs on how to solve problems
c. Offers information about necessary self-care abilities
d. Works with clients to help them accept blame for their interactions
ANSWER: C.
RATIONALE: The nurse must first ask the client if she able to do self-care
activities, and if she says yes then proceed with teaching her then the family for
assistance.

10. Nurse Robert is observing the interaction of family members during a home visit.
Nurse Robert recognizes that the optimal goal of effective communication within the
family is:
a. Better financial conditions for the family
b. Socialization among individual members
c. Problem solving and psychological support
d. Role development of individual members
ANSWER: C.
RATIONALE: Communication is essential in a family as this will help incorporate
physical, psychosocial and cultural aspects of the family along with interacting
relationships.
SAS 11
Check for Understanding
1. A nurse is preparing to conduct interview survey. Which of the following data should
the nurse collect as a component of the assessment (Select that all Apply:
a. Family structure, characteristics and dynamic
b. Individual who holds power within the community
c. ethnic background and religious affiliation
d. stress management of other healthy lifestyle activities
ANSWER: A., C., D.
RATIONALE: Another major method of data gathering is the interview and they
can be through completing a health history and/or collecting data by personally
asking significant family members or relatives.

2. A nurse is completing a need assessment and beginning analysis of data. Which of

the following actions should the nurse take first?
a. Determine health patterns within collected data
b. Compile collected data into a database
c. Ensure data collection is complete
d. Identify health needs of the family
ANSWER: B.
RATIONALE: Utilizing the data generated from the tool on initial base in family
nursing practice, the nurse goes through data analysis. She sorts out and
classify or group data by type or nature (e.g., which are wellness states, threats,
deficits or stress points/foreseeable crisis. She relates them with each other and
determines patterns or reoccurring themes among data. She then compares
these data and the patterns or reoccurring themes with norms or standards.

3. A nurse is collecting data to identify health needs in the family. Which of the following
examples should the nurse identify as secondary data? Select that all apply.
a. Birth statistics
b. Previous heath survey
c. Interview survey
d. Community forum
e. Health records
ANSWER: A., B., E.
RATIONALE: Second-level assessment data includes: specify or describe the
family’s realities, perceptions about and attitudes, and performance of health task
on each health condition or problem identified during the first level assessment.

4. A nurse is conducting a family assessment. Which of the following data collection

methods is the nurse using when having direct conversation with individual in the
family?
a. Key informant interview
b. Participant observation
c. Focus group
d. Health survey
ANSWER: A.
RATIONALE: This is the second type interview is collecting data by personally
asking significant family members or relatives questions regarding health, family
life experiences and home environment to generate data on what wellness
condition and health problems exist in the family (first level and second level of
assessment). Informant interviews are direct conversations with individual
community members for the purpose of obtaining ideas and opinions.

5. A nurse is planning a family health program. Which of the following actions should the
nurse include as part of the evaluation plan?
a. Determine availability of resources to initiate the plan
b. Gain approval for the program from the family leaders
c. Establish a timeline for implementation of intervention
d. Compare program impact to similar programs
ANSWER: D.
RATIONALE: The nurse should include a comparison of program impact to
similar programs as part of the evaluation plan. This comparison assists with
determining the efficiency of the program.
SAS 12
Check for Understanding
Determine the family health problems in a given situation (Cues/Data)
Cues and Data First Level Second Level
1. 37 years old mother of 1. Presence of stress 1. Inability to recognize
seven at 21 weeks AOG, points/foreseeable presence of a possible
with BP of 140/90 and crisis situations complication of
slight pedal edema; wt.: - Possible pregnancy due to lack of
118 lbs. Complicated knowledge
 Mother verbalized “… Pregnancy 2. Inability to provide
I did not have adequate nursing care to
problems during my Rationale: By age 35, the a pregnant member due
previous pregnancies, odds of conceiving after 3 to:
and even with my months of trying are about A. Lack of knowledge on
present pregnancy… 12 percent. The risk for the nature and
It just happens that I miscarriage and genetic management of the
passes by the health abnormalities also begins health condition
center on my way to to rise after age 35. The B. Lack of knowledge on
my in-laws so I mother might face more the nature and extent
thought of dropping by complications in her of nursing care needed
the clinic…. But pregnancy or during 3. Failure to utilize
actually, I feel delivery having a baby community resources for
alright…... I don’t think later in life. health care due to:
I have to worry A. Failure to perceive
because I have had benefits of health care
seven pregnancies B. Physical inaccessibility
and they were all of required
normal
 Busy with work as fish
vendor, hardly has to
go to the health center
for follow up
 Health center is 3 km.
from the house
 Laboratory for
urinalysis is 10 km
away, not situated
within the community
2. Rina, three-year-old, 2. Presence of health 1. Inability to recognize the
weighs 10 kgs, look pale, deficit presence of malnutrition
lethargic and apathetic, - Malnutrition as a in a dependent member
markedly underweight and health deficit due to lack of knowledge
undernourished 2. Inability to decide about
 Mother verbalized Rationale: Three-year-old taking appropriate health
“Rina is really small girls range from 35 to 40 action due to failure to
built since she was a inches in height and 25.5 comprehend the nature,
 baby. She is not fond to 38.5 pounds in weight. magnitude and scope of
of eating too.” Malnutrition includes the problem
 Three preschooler undernutrition and 3. Inability to provide
members usually are overnutrition, both of adequate nursing care to
left to care of eight- which can lead to health a member suffering from
year-old sister when problems and nutrition malnutrition due to:
parents are working deficiencies if not A. Lack of knowledge
and other children are addressed. about the health
in school condition
B. Lack of knowledge on
the nature and extent
of nursing care
needed
C. Inadequate resources
for care, i.e.,
responsible family
member and financial
constraints
3. Three preschoolers 3. Presence of health 1. Inability to provide
have scabies deficit adequate nursing care to
 Mother verbalized, - Scabies as health preschoolers with scabies
“I have such a lot of deficit due to:
things to attend to A. Lack of knowledge
as a fish vendor Rationale: Scabies is about the health
that I could primarily the instance of condition
hardly see the failure and health B. Inadequate
needs of the maintenance because it knowledge of the
children…… presents clinically as nature and extent of
 Family income is extremely pruritic nursing care needed
P500.00 a day excoriated papules and C. Inadequate family
 Water supply is linear burrows and the resources for care,
taken from a public skin. This infestation specifically:
well ½ km, from the predisposes to bacterial  Responsible
house skin infections that can family member
result in serious  Financial
complications affecting the resources
kidneys and possibly the  Physical
heart. resources i.e.,
water supply
facilities
SAS 13
Check for Understanding
Health Family Nursing Goals Objectives
Problems Problems
Scabies as 1. Inability to After nursing After nursing
Health Deficit provide adequate intervention, the intervention, he
nursing care to following are following should be
preschoolers with expected to take achieved:
scabies due to: place: 1. The family
a. Lack of knowledge 1. The chances of should acquire
about the health spreading adequate
condition communicable information
b. Inadequate diseases to the about the
knowledge of the other member disease,
nature and extent of of the family including signs
nursing care 2. The and symptoms
needed reoccurrence of of the disease,
c. Inadequate family scabies among immediate
resources for care, family members health care
specifically: will be assistance and
- Responsible family prevented or preventive
member minimized measures.
- Financial 2. Discuss with
resources the family the
- Physical resources consequences
i.e., water supply of failing to
facilities take
appropriate
health actions
at the earliest
possible time.

Intervention Methods of Nursing Resources Evaluation

Methods Family Contract Required
1. Discuss with Home Visit 1. Visual Aid After 3 weeks of
the family 2. Time and effort nursing
members the Clinic Visit of both nurse intervention,
importance of and family goal was met as
knowing the 3. Monetary manifested by:
necessary allowance for - Healed skin
information nurse’s rashes
about the transportation - Moist and less
disease to expenses scaly skin
 prevent
spreading
them.
These include the
following:
a. Monitor for
signs and
symptoms of
infection
b. Monitor
susceptibility
to infection
c. Limit visitors
when
necessary
d. Instruct
visitors to
wash their
hands when
visiting
remedy and
after leaving
patient
e. Maintain
aseptic
environment
during the
installation of
equipment
f. Give skin care
in the area
epidema
g. Inspection of
skin and
mucous
membranes
of the
redness, heat
h. Inspection of
the wound
condition
i. Provide
antibiotic
 therapy if
necessary
j. Teach how to
avoid
infection
SAS 14
Check for Understanding
1. With regards to illness prevention activities as part of nursing care, which of the
following will help clients most?
a. Maintain maximum functions
b. Identify disease symptoms
c. Reduce the cost of health care
d. Promote health habits
ANSWER: D.
RATIONALE: Education for health is one of the potent methodologies for
information dissemination. It promotes the partnership of both the family
members and health workers in the promotion of health as well as prevention of
illness.

2. Nurse Febe is scheduled for a home visit to achieve the best of health care in the
home. The first step during a home visit is one of the following:
a. Count the available appliances
b. Explain purpose of the visit
c. Greet client and introduce self
d. Wash hands and perform procedures
ANSWER: C.
RATIONALE: In a home visit, the nurse must first great the clients and introduce
herself for formalities and to build rapport. The nurse must establish a good
interpersonal relationship between families and be polite, courage, friendly.

3. Which one of the following is an important principle during a home visit?

a. Inquiry about health and welfare
b. Performance for health assessment
c. Use of available information about the client
d. Evaluation of past services to the family
ANSWER: C.
RATIONALE: A home visit must have a purpose or objective. Planning for a home
visit should make use of all available information about the patient and his family
through family records. In planning for a home visit, we should consider and give
priority to the essential needs if the individual and his family. Planning and
delivery of care should involve the individual and family.

4. The frequency of a home visit is determined by which one of the following?

a. Administration of medication
b. Need for health teaching
c. Result of health studied
d. Acceptance of the family
ANSWER: B.
RATIONALE: The physical needs, psychological needs, and educational needs of
the individual and family is one of the guidelines regarding the frequency of home
visits. Followed by the acceptance of the family for the services to be rendered,
their interest and the willingness to cooperate.

5. The procedure of the proper bag technique during a home visit is to implement which
one of the following principles?
a. Replace supplies fully every visit
b. Avoid transfer of infection
c. Clean supplies ready for use
d. PHN bag is an indispensable equipment
ANSWER: B.
RATIONALE: Use of the PHN bag, or any receptacle for health care paraphernalia
brought by the health care personnel to the patient’s home should be governed
by the principle that anything that are outside the bag is considered
contaminated, and therefore, should not touch what are inside the bag.

Tue or False
1. Health Education is a cooperative effort requiring all nurses to work together in close
teamwork with families, groups, and the community.
ANSWER: HEALTH
RATIONALE: Health Education is a cooperative effort requiring all categories of
health personnel to work together in close teamwork with families, groups, and
the community.

2. Health Education aims to help people make use of their own efforts and education to
improve their conditions of living.
ANSWER: FAMILY
RATIONALE: Health Educations aims to tech independence to everyone so that
they will be able to protect themselves from harm and any types of diseases.

3. Health Education makes careful evaluation of the planning, organization, and

implementation of all health education programs and activities.
ANSWER: FAMILY
RATIONALE: Health Education utilizes community resources by careful
evaluation of the different services and resources found in the community.

4. Health Education makes use of supplementary aids and devices to help with the
verbal instructions
ANSWER: FAMILY
RATIONALE: In order for everyone to further understand the importance of health
and risk reductions, different supplementary aids are used.

5. Health Education meets the needs, interests, and problems of all people.
ANSWER: HEALTH
RATIONALE: Health Education meets the needs, interests, and problems of the
people affected
SAS 15
Check for Understanding
1. Which of the following personnel do not have the “right to know” medical information?
A. The facility’s Performance Improvement Director who is not a healthcare person and
has no direct contact with clients.
B. A nursing student who is caring for a client under the supervision of the nursing
instructor.
C. The facility’s Safety Officer who is not a healthcare person and who has no direct
contact with clients
D.A department supervisor with no direct or indirect care duties
ANSWER: D.
RATIONALE: A department supervisor with no direct or indirect care duties does
not have the "right to know" medical information; all of the others have the "right
to know" medical information because they provide direct or indirect care to
clients. For example, both the facility's Performance Improvement Director who is
not a healthcare person and who has no direct contact with clients and the
facility's Safety Officer who is not a healthcare person and who has no direct
contact with clients provide indirect care to clients. For example, they collect and
analyze client data in order to fulfill their role and responsibilities in terms of
process improvements and the prevention of incidents and accidents,
respectively. Nursing and other healthcare students also have the "need to know"
medical information so that they can provide direct client care to their assigned
client(s).

2.The nurse is talking with the family of an 18 months-old newly diagnosed with
retinoblastoma. A priority in communicating with the parents is for recording and
reporting to the respective health professional
A. Discuss the need for genetic counseling
B. Inform them that combined therapy is seldom effective
C. Prepare for the child's permanent disfigurement
D. Suggest that total blindness may follow surgery
ANSWER: A.
RATIONALE: Genetic counseling and genetic testing should be provided to all
patients with retinoblastoma. A germline mutation is present in 15% of patients
with unilateral retinoblastoma and 100% of patients with bilateral retinoblastoma.
Individuals with hereditary retinoblastoma have an elevated risk of extraocular
malignancy.

3.The patient records obtained by the nurse should be reported to the concerned health
agency to protects clients in terms of their rights to what? Select all that apply.
A. Privacy and to have their medical information confidential unless the client formally
approves the sharing of this information with others such as family members.
B. Make healthcare decisions and to have these decisions protected and communicated
to others when they are no longer competent to do so.
C. Be fully informed about all treatments in term of their benefits, risks and alternatives
to them so the client can make a knowledgeable and informed decision about whether
or not to agree to having it.
D. Make decisions about who their health care provider is without any coercion or
undue influence of others including healthcare providers.
ANSWER: B., D
RATIONALE: The Patient Self Determination Act, which was passed by the US
Congress in 1990, gives Americans the right to make healthcare decisions and to
have these decisions protected and communicated to others when they are no
longer competent to do so. These decisions can also include rejections for future
care and treatment and these decisions are reflect in advance directives. This Act
also supports the rights of the client to be free of any coercion or any undue
influence of others including healthcare providers.
The Health Insurance Portability and Accountability Act (HIPAA) supports and
upholds the clients’ rights to confidentially and the privacy of their medical
related information regardless of its form. It covers hard copy and electronic
medical records unless the client has formally approved the sharing of this
information with others such as family members.
The elements of informed consent which includes information about possible
treatments and procedures in terms of their benefits, risks and alternatives to
them so the client can make a knowledgeable and informed decision about
whether or not to agree to having it may be part of these advanced directives, but
the law that protects these advance directives is the Patient Self Determination
Act.

4. The community health nurse 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.
RATIONALE: 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.

5. Which of the following is the mission of the Department of Health?

A. Health for all Filipinos
B. Ensure the accessibility of recording and reporting the result of health care delivery
system.
C. Improve the general health status of the population
D. Health in the hands of the Filipino people by the year 2020
ANSWER: C.
RATIONALE: The Department of Health, as the nation's leader in health, is
committed to guarantee equitable, accessible and quality health services for all
Filipinos. And shall continually improve our quality management systems to the
satisfaction of our citizens.
6. RA 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.
RATIONALE: 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? People empowerment is the basic motivation behind devolution of
basic services to LGU's.

7. As an epidemiologist, the nurse is responsible for reporting cases or notifiable

diseases. What law mandates reporting cases of notifiable diseases?
A. R.A 11332
B. RA.3753
C. RA 1054
D. RA 1082
ANSWER: A.
RATIONALE: Duterte signed Republic Act 11332 or the Mandatory Reporting of
Notifiable Diseases and Health Events of Public Health Concern Act on April 26
but was released only to the media three months after it was signed.

8. Which type of family-nurse contact will provide you with the best opportunity to
observe family dynamics during the collection of family information for data purposes?
A. Clinic consultation
B. Group conferences
C. Home visit
D. Written communication
ANSWER: C.
RATIONALE: Dynamics of family relationships can best be observed in the
family's natural environment, which is the home.

9. Which of the following is an epidemiologic function of the nurse during an epidemic?

A Conducting assessment of suspected cases to detect the communicable diseases
B. Monitoring the condition of the cases affected by the communicable disease
C. Participating in the investigation to determine the source of epidemic
D. Teaching the community on preventive measures against the disease
ANSWER: C.
RATIONALE: Epidemiology is the study of patterns of occurrence and
distribution of disease in the community, as well as the factors that affect disease
patterns. The purpose of an epidemiologic investigation is to identify the source
of an epidemic, i.e., what brought about the epidemic.
10. 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.
RATIONALE: A tally report is prepared monthly or quarterly by the RHU
personnel and transmitted to the Provincial Health Office.
SAS 16
Check for Understanding
1. Which minerals and vitamins usually are recommended to supplement a pregnant
woman's diet?
a. Fat-soluble vitamins A and D
b. Water-soluble vitamins C and B6
c. Iron and folate
d. Calcium and zinc
ANSWER: C.
RATIONALE: Iron generally should be supplemented, and folic acid supplements
often are needed because folate is so important. Fat-soluble vitamins should be
supplemented as a medical prescription, as vitamin D might be for lactose-
intolerant women. Water-soluble vitamin C sometimes is consumed in excess
naturally; vitamin B6 is prescribed only if the woman has a very poor diet. Zinc is
sometimes supplemented; most women get enough calcium.

2. With regard to nutritional needs during lactation, a maternity nurse should be aware
that:
a. The mother's intake of vitamin C, zinc, and protein now can be lower than during
pregnancy.
b. Caffeine consumed by the mother accumulates in the infant, who therefore may be
unusually active and wakeful.
c. Critical iron and folic acid levels must be maintained.
d. Lactating women can go back to their prepregnant calorie intake
ANSWER: B.
RATIONALE: A lactating woman needs to avoid consuming too much caffeine.
Vitamin C, zinc, and protein levels need to be moderately higher during lactation
than during pregnancy. The recommendations for iron and folic acid are
somewhat lower during lactation. Lactating women should consume about 500
kcal more than their pre-pregnancy intake, at least 1800 kcal daily overall.

3. When counseling a client about getting enough iron in her diet, the maternity nurse
should tell her that:
a. Milk, coffee, and tea aid iron absorption if consumed at the same time as iron.
b. Iron absorption is inhibited by a diet rich in vitamin C.
c. Iron supplements are permissible for children in small doses.
d. Constipation is common with iron supplements.
ANSWER: D.
RATIONALE: Constipation can be a problem with iron supplements. Milk, coffee,
and tea actually inhibit iron absorption when consumed at the same time as iron.
Vitamin C promotes iron absorption. Children who ingest iron can get very sick
and even die.

4. Which suggestions should the nurse include when teaching about appropriate weight
gain in pregnancy? Select all that apply.
a. Underweight women should gain 12.5 to 18 kg.
b. Obese women should gain at least 7 to 11.5 kg.
c. Adolescents are encouraged to strive for weight gains at the upper end of the
recommended scale.
d. In twin gestations, the weight gain recommended for a single fetus pregnancy should
simply be doubled.
e. Normal weight women should gain 11.5 to 16 kg.
ANSWER: A., B., C., E.
RATIONALE: Underweight women need to gain the most. Obese women need to
gain weight during pregnancy to equal the weight of the products of conception.
Adolescents are still growing; therefore, their bodies naturally compete for
nutrients with the fetus. Women bearing twins need to gain more weight (usually
16 to 20 kg) but not necessarily twice as much. Normal weight women should
gain 11.5 to 16kg.

5. The nurse is discussing storage of breast milk with a mother whose infant is preterm
and in the special care unit. What statement would indicate that the mother needs
additional teaching?
a. "I can store my breast milk in the refrigerator for 3 months."
b. "I can store my breast milk in the freezer for 3 months."
c. "I can store my breast milk at room temperature for 8 hours."
d. "I can store my breast milk in the refrigerator for 3 to 5 days."
ANSWER: D.
RATIONALE: Freshly expressed breast milk can be stored in the back of the
refrigerator for up to four days in clean conditions. However, it's optimal to use or
freeze the milk within three days.

6. With regard to the nutrient needs of breastfed and formula-fed infants, nurses should
understand that:
a. Breastfed infants need extra water in hot climates.
b. During the first 3 months breastfed infants consumes more energy than do formula-
fed infants.
c. Breastfeeding infants should receive oral vitamin D drops daily at least during the first
2 months.
d. Vitamin K injections at birth are not needed for infants fed on specially enriched
formula.
ANSWER: C.
RATIONALE: Breastfed babies from birth to one year of age should be given a
daily supplement containing 8.5 to 10mcg of vitamin D as a precaution (SACN,
2016). The recommendation is that the baby should receive its own oral vitamin D
drops containing 7-8.5µg per day from 4 weeks of birth until the age of 5 years.
Waiting until the baby is 6 months may be too late to prevent development of
symptoms.

7. All parents are entitled to a birthing environment in which breastfeeding is promoted

and supported. The Baby Friendly Hospital Initiative endorsed by WHO and UNICEF
was founded to encourage institutions to offer optimal levels of care for lactating
mothers. Which instruction is not included in the "Ten Steps to Successful
Breastfeeding for Hospitals"?
a. Give newborns no food or drink other than breast milk.
b. Have a written breastfeeding policy that is communicated to all staff.
c. Help mothers initiate breastfeeding within one half hour of birth.
d. Give artificial teats or pacifiers as necessary.
ANSWER: D.
RATIONALE: Artificial treats or pacifiers is not included in the “Ten Steps to
Successful Breastfeeding for Hospitals”.

8. Nutrition is an alterable and important preventive measure for a variety of potential

problems such as low birth weight and prematurity. While completing the physical
assessment of the pregnant client, the nurse is able to evaluate the client's nutritional
status by observing a number of physical signs. Which physical sign indicates to the
nurse that the client has unmet nutritional needs?
a. Normal heart rate, rhythm, and blood pressure
b. Bright, clear, and shiny eyes
c. Alert and responsive with good endurance
d. Edema, tender calves, and tingling
ANSWER: D.
RATIONALE: Edema, tender calves, and tingling are signs of nutrient deficiencies
in clients, the other option are all signs of met nutritional needs.

9. What are the breast milk composition? Select that all apply
a. Triglycerides
b. Lactose
c. Whey proteins
d. Vitamins, Minerals, and Trace Elements
ANSWER: A., B., C., D.
RATIONALE: Mature human milk is made up of 3%-5% fat, 0.8%-0.0% protein,
6.9%-7.2% carbohydrate calculated as lactose, and 0.2% mineral constituents
expressed as ash. The energy content is 60-75 kcal/100ml. Protein content is
considerably higher and carbohydrate content lower in colostrum than in mature
milk.

10. What deficiencies to be aware of during the complementary feeding stage?

a. Vitamin A and iron
b. A
c. E
d. Vit D
ANSWER: A.
RATIONALE: Vitamin A deficiency is the main cause of blindness in children, and
iodine deficiency can reduce a child's intellectual capacity and harm his or her
ability to learn.
SAS 17
Check for Understanding
1. Which of the following vaccines are used in Expanded Program on Immunization
(EPI) that must be stored in the freezer?
A. DPT
B. Tetanus toxoid
C. Measles vaccine
D. Hepatitis B vaccine
ANSWER: C.
RATIONALE: The Measles-Mumps-rubella (MMR) Vaccine is stored in the
refrigerator or freezer. The other vaccines are only stored in the refrigerator and
should not be freeze or exposed to freezing temperature.

2. Jimmy, a community nurse is aware that an unused BCG should be discarded how
many hours after reconstitution?
A. 2
B. 4
C. 6
D. At the end of the day
ANSWER: C.
RATIONALE: Reconstituted BCG, measles and yellow fever vaccines must be
kept cooled and must be discarded after 6 hours after reconstitution.

3. In immunizing children less than eight years of age with BCG, as a nurse, 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.
RATIONALE: 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.

4. Holly, a senior nurse is aware that this type of immunization will produce a permanent
scar.
A. DPT
B. BCG
C. Measles vaccination
D. Hepatitis B vaccination
ANSWER: B.
RATIONALE: BCG causes the formation of a superficial abscess, which begins 2
weeks after immunization. The abscess heals without treatment, with the
formation of a permanent scar.
5. A 4-week-old baby boy was brought to the health center for his first immunization.
Which can be given to him?
A. DPT1
B. OPV1
C. Infant BCG
D. Hepatitis B vaccine 1
ANSWER: C.
RATIONALE: Infant BCG may be given at birth. All the other immunizations
mentioned can be given at 6 weeks of age.

6. As a nurse, you will not give DPT 2 if the mother says that the infant had
A. 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.
RATIONALE: Seizures within 3 days after administration of DPT is an indication
of hypersensitivity to pertussis vaccine, a component of DPT. This is considered
a specific contraindication to subsequent doses of DPT.

7. A 2-month-old baby girl 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
ANSWER: A.
RATIONALE: In the EPI, fever up to 38.5°C is not a contraindication to
immunization. Mild acute respiratory tract infection, simple diarrhea and
malnutrition are not contraindications either.

8. Nora, a 28-year-old pregnant woman had just received her 4th dose of tetanus
toxoid. Subsequently, her baby will have protection against tetanus for how long?
A. 1 year
B. 3 years
C. 10 years
D. Lifetime
ANSWER: A.
RATIONALE: The baby will have passive natural immunity by placental transfer of
antibodies. The mother will have active artificial immunity lasting for about 10
years. 5 doses will give the mother lifetime protection.

9. Juan, a 4-year-old boy is scheduled for routine immunizations. As the nurse, you
know that the doctor will most likely order what vaccinations? Select all that apply.
A. DTaP (diphtheria, Tetanus, Pertussis)
B. Polio
C. Hepatitis B
D. RV (Rotavirus)
E. MMR (Measles, Mumps, Rubella)
F. Hib (Hemophilus Influenzae Type B)
ANSWER: A., B., E., G.
RATIONALE: The answers are A, B, E, and G. The immunizations ordered at 4-6
years of age include: DTaP, Polio, MMR, and Varicella.

10. Elrita, a mother of a 12-month-old baby girl calls the pediatric clinic to ask when her
daughter will receive the Varicella vaccine. As the nurse, your answer to her question is:
A. at 2, 4, and 6 months
B. at 12 months and 4-6 years
C. at 6 and 12 months
D. at 4 months and 4-6 years
ANSWER: B.
RATIONALE: The answer is B. The child will receive the Varicella vaccine at 12
months and 4-6 years of age.
SAS 18
Check for Understanding
1. You can classify that a child aged 2 years has fast breathing if he has a respiratory
rate of
A. 60 bpm or more
B. 50 bpm or more
C. 40 bpm or more
D. Any of the above
ANSWER: C.
RATIONALE: If the child is 12 months up to 5 years the child has fast breathing if
you count 40 breaths per minute or more.

2. Baby Yuki, 4 months old is not able to breastfeed and chest indrawing is present.
This can be classified as
A. Pneumonia
B. Severe Pneumonia
C. No Pneumonia: cough or cold
D. Mild Pneumonia
ANSWER: A.
RATIONALE: The signs of pneumonia include any danger sign or chest indrawing
or stridor in calm child.

3. These are all possible treatments for severe pneumonia except:

A. Giver first dose of an appropriate antibiotic
B. Soothe the throat and relieve the cough with a safe remedy
C. Give vitamin A
D. Treat the child to prevent low blood sugar
ANSWER: B.
RATIONALE: Letter B is included in the home management of pneumonia; the
rest of the choices belong in the severe pneumonia or very severe disease.

4. What color is "NO PNEUMONIA: COUGH OR COLD" classified as?

A. Green
B. Pink
C. Yellow
D. Red
ANSWER: C.
RATIONALE: No pneumonia: cough or cold belongs in e the yellow color coding
in which treatment is Outpatient Health Facility.

5. If the child has wheezing and either fast breathing or chest indrawing present, the
nurse should:
A. Refer URGENTLY to hospital
B. Give a trial acting inhaled bronchodilator for up to 3 times
C. Assess vital signs
D. Give Vitamin A
ANSWER: A.
RATIONALE: These are danger signs which belongs in the pink color coding
marked as urgent referral.

6. Dysentery is classified if:

A. There is Dehydration
B. Stools are watery
C. Fast breathing is present
D. There is blood in the stool
ANSWER: D.
RATIONALE: Dysentery is an infection of the intestines that causes diarrhea
containing blood or mucus. Other symptoms of dysentery can include: painful
stomach cramps. feeling sick or being sick (vomiting) a high temperature.

7. All are signs of severe dehydration except

A. Restlessness
B. Sunken eyes
C. Skin pinch goes back very slowly
D. Abnormally sleepy
ANSWER: A.
RATIONALE: Restlessness is one of the signs of some dehydration.

8. Which type of plan would the nurse instruct to a child who was classified with severe
dehydration?
A. Plan A
B. Plan B
C. Plan C
D. Plan D
ANSWER: C.
RATIONALE: Plan C includes giving fluid for severe dehydration.

9. If child has not enough signs to classify as some or severe dehydration, the child will
be classified as what?
A. Severe Dehydration
B. Mild Dehydration
C. Some Dehydration
D. No Dehydration
ANSWER: C.
RATIONALE: Some Dehydration is the classification before severe dehydration,
with less weaker signs.

10. Patient Tifa, 5 months old has diarrhea for already 16 days. You also notice that
dehydration is present. This could be classified as?
A. Severe Dehydration
B. Severe Persistent Diarrhea
C. Some Dehydration
D. Persistent Diarrhea
ANSWER: B.
RATIONALE: Severe Persistent Diarrhea has dehydration as its signs.
SAS 19
Check for Understanding
1. BEmoNC facility that had each of following functions at the time of survey was
considered as provider of the basic EmNC which of the following. select that all apply;
a. Incubator available
A. Warmth (drying and skin-to-skin contact)
B. Pediatrics nursery available
C. Eye prophylaxis (tetracycline eye ointment).
D. Clean cord care.
E. Early and exclusive breast feeding
F. Basic newborn resuscitation.
ANSWER: A., C., D., E.
RATIONALE: A facility that had each of following functions at the time of survey
was considered as provider of the basic EmNC: basic newborn resuscitation,
warmth (drying and skin-to-skin contact), eye prophylaxis (tetracycline eye
ointment), clean cord care, and early and exclusive breast feeding. Health
facilities providing services both round the clock or day time was taken as
providing the services.

2. To qualify as a CEmONC facility, all of the above services must be offered in # 1, but
in addition the following functions which of the following.
A. Neonatal resuscitation with bag and mask
B. Hypothermia Management (rewarming)
C. Antibiotics for neonatal sepsis
D. Essential newborn care
ANSWER: A.
RATIONALE: Comprehensive Emergency Neonatal Care includes intubation and
ventilation, narcain, and surgery. Though there are no clear guidelines on content
of and coverage standards for EmNC, the MNH Road map has set out a package
of interventions to form B/CEmNC.

3. A nurse in a delivery room is assisting with the delivery of a newborn infant. After the
delivery, the nurse prepares to prevent heat loss in the newborn resulting from
evaporation by:
A. Warming the crib pad
B. Turning on the overhead radiant warmer
C. Closing the doors to the room
D. Drying the infant in a warm blanket
ANSWER: D.
RATIONALE: Evaporation of moisture from a wet body dissipates heat along with
the moisture. Keeping the newborn dry by drying the wet newborn infant will
prevent hypothermia via evaporation.

4. Soon after delivery a neonate is admitted to the central nursery. The nursery nurse
begins the initial assessment by
A. Auscultate bowel sounds.
B. Determining chest circumference.
C. Inspecting the posture, color, and respiratory effort.
D. Checking for identifying birthmarks.
ANSWER: C.
RATIONALE: Each newborn baby is carefully checked at birth for signs of
problems or complications. The healthcare provider will do a complete physical
exam that includes every body system. The Apgar score helps find breathing
problems and other health issues. It is part of the special attention given to a
baby in the first few minutes after birth. The baby is checked at 1 minute and 5
minutes after birth for heart and respiratory rates, muscle tone, reflexes, and
color.

5. The head nurse is presenting education to COC nursing student to promote

consistency in the interventions used with lactating mothers. She emphasizes that the
optimum time to initiate lactation is.
A. as soon as possible after the infant’s birth.
B. after the mother has rested for 4-6 hours.
C. during the infant’s second period of reactivity.
D. after the infant has taken sterile water without complications.
ANSWER: A.
RATIONALE: Breastfeeding should ideally start soon after your baby is born. A
baby is usually alert after birth and will spontaneously seek the breast if left
undisturbed in skin-to-skin contact with their mother's body. Research suggests
that a mother should allow her baby to feed when the baby shows it is ready.

6. As a CEmONC facility nurse, assessing a newborn infant following circumcision and

notes that the circumcised area is red with a small amount of bloody drainage. Which of
the following nursing actions would be most appropriate?
A. Document the findings
B. Contact the physician
C. Circle the amount of bloody drainage on the dressing and reassess in 30 minutes
D. Reinforce the dressing
ANSWER: A.
RATIONALE: The penis is normally red during the healing process. A yellow
exudate may be noted in 24 hours, and this is a part of normal healing. The nurse
would expect that the area would be red with a small amount of bloody drainage.
If the bleeding is excessive, the nurse would apply gentle pressure with sterile
gauze. If bleeding is not controlled, then the blood vessel may need to be ligated,
and the nurse would contact the physician. Because the findings identified in the
question are normal, the nurse would document the assessment.

7. Vitamin K is prescribed for a neonate. A nurse prepares to administer the medication

in which muscle site?
A. Deltoid
B. Triceps
C. Vastus lateralis
D. Biceps
ANSWER: C.
RATIONALE: The most reliable way to give babies vitamin K is by one injection
into the muscle in the leg (intramuscular injection). One injection just after birth
will protect your baby for many months.

8. If mother with PKU is not actively treated during pregnancy (nutrition

monitoring/restriction, etc) what might be seen in the offspring? Select that all apply.
A. Microcephaly,
B. Congenital heart disease,
C. Seizures
D. Facial dysmorphia (resembles FAS)
ANSWER: A., B., C., D.
RATIONALE: This is due to circulating maternal metabolites in fetus.

9. Newborn screening is mandated (100% compliance expected) and is an example of

population screening. The purposes are: Select that all apply
A. To prevent at least half of newborn death without additional cost
B. Undetected disorders (could affect life, medical, and/or mental fxn)
C. To quickly separate apparently well babies who probably have the disorder from
those who probably do not
D. To further evaluate presumed positive cases
ANSWER: B., C., D.
RATIONALE: The purpose of newborn screening is to detect potentially fatal or
disabling conditions in newborns as early as possible, often before the infant
displays any signs or symptoms of a disease or condition.

10. What specific enzyme deficiency accounts for 95% of all cases of congenital adrenal
hyperplasia?
A. 21-hydroxylase deficiency
B. Estrogen synthetase deficiency
C. Beta-glucuronidase deficiency
D. 7-alpha-hydroxylase deficiency
ANSWER: A.
RATIONALE: 21-hydroxylase deficiency is one of a group of disorders known as
congenital adrenal hyperplasias that impair hormone production and disrupt
sexual development. 21-hydroxylase deficiency is responsible for about 95
percent of all cases of congenital adrenal hyperplasia.
SAS 20
Check for Understanding
1. A foodborne outbreak of salmonellosis has twice occurred at a day-treatment
program. The environmental health worker has requested that an advanced public
health nurse be included in the next inspection of the program's kitchen. During the visit,
the nurse’s primary concern is to:
A. Educate kitchen workers about safe and food preparation.
B. Ensure the workers understanding of various microorganism.
C. Identify other resources for providing various microorganism.
D. Promote the health of clients affected by the previous outbreak.
ANSWER: A.
RATIONALE: Food safety and food hygiene are important as they ensure that the
food you handle and produce is safe for consumption. If food safety and hygiene
are not maintained, consumers could become seriously ill with food poisoning
and foodborne illnesses.

2. A resident in one of the communities complained of unacceptable smell on their areas

which lead to lots of fleas on their surroundings. To whom does the rural health nurse
approach?
A. Municipal health officer
B. Rural health midwife
C. Rural sanitation inspector
D. Barangay health workers.
ANSWER: C.
RATIONALE: A Rural Sanitation Inspector is an official appointed to oversee
public hygiene and health; a public health inspector. The nurse act as an
advocate or facilitator to families in the community in matters of
program/projects/activities on environmental health in coordination with other
members of Rural Health Unit (RHU) especially the Rural Sanitary Inspectors.

3. Clean Air Act has been clearly defined in what Republic Act?
A. R.A. 8749
B. R.A. 9003
C. R.A. 8746
D. All of the above
ANSWER: A.
RATIONALE: Clean Air Act (R.A.8749) the government's measures to reduce air
pollution and incorporate environmental protection into its development plans.

4. Barangay health workers called for a barangay assembly meeting. The topic
mentioned about ‘Clean Air Act’. One of the citizens asked about, what are some of
their Rights in accordance to Clean Air Act. The RHU staff enumerated the rights
except:
A. Right to breath
B. Right to utilize and enjoy all-natural resources according to principles of sustainable
development.
C. Right to discard non- hazardous household, commercial, institutional waste.
D. Right to access to public records which a citizen may need to exercise his/her rights
effective under this act.
ANSWER: C.
RATIONALE: Letter C is not included. Another right is the right to be informed of
the nature and extent of the potential hazard of any activity, undertaking, or
project and to be served timely notice of any significant rise in the level of
pollution and the accidental or deliberate release into the atmosphere of harmful
or hazardous substances.

5. A newly hired midwife assigned in a remote rural health unit as new RHM. The
following are the functions of the RHM except:
A. Manages BHS and supervises, trains BHW
B. Conducts patient’s assessment and diagnosis for referral or further management
C. Check healthy physical environment
D. Organizes community and facilitates barangay planning and community health
services
ANSWER: A.
RATIONALE: Midwives don’t manage he barangay health stations and doesn’t
train the barangay health workers. A barangay health worker is a person who has
undergone training programs under any accredited government and non-
government organization and who voluntarily renders primary health care
services in the community after having been accredited to function as such by
the local health board in accordance with the guidelines promulgated by the DOH.

6. 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
C. Improve the general health status of the population
D. Health in the hands of the Filipino people by the year 2020
ANSWER: B.
RATIONALE: The Department of Health, as the nation's leader in health, is
committed to guarantee equitable, accessible and quality health services for all
Filipinos. And shall continually improve our quality management systems to the
satisfaction of our citizens.

7. A 4-year-old client was brought to the health center with chief complaint of severe
diarrhea and the passage of “rice water”. The client is most probably suffering from
which condition?
A. Giardiasis
B. Cholera
C. Amoeba
D. Dysentery
ANSWER: B.
RATIONALE: 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.

8. What is the act of cleaning one’s hands with the use of any liquid with or without soap
for the purpose of removing dirt or microorganisms?
A. Aseptic technique
B. Handwashing
C. Medical Asepsis
D. Surgical Asepsis
ANSWER: B.
RATIONALE: Handwashing is the act of cleaning one's hands with the use of any
liquid with or without soap for the purpose of removing dirt or microorganisms. It
is the most effective measure in reducing the risk of transmitting infectious
diseases.

9. The clinical instructor asks her students the rationale for handwashing. The students
are correct if they answered that handwashing is expected to remove:
A. Transient flora from the skin.
B. Resident flora from the skin.
C. All microorganisms from the skin.
D. Media for bacterial growth.
ANSWER: A.
RATIONALE: There are two types of normal flora: transient and resident.
Transient flora are normal flora that a person picks up by coming in contact with
objects or another person (e.g., when you touch a soiled dressing). You can
remove these with hand washing. Resident flora lives deep in skin layers where
they live and multiply harmlessly. They are permanent inhabitants of the skin and
cannot usually be removed with routine hand washing. Removing all
microorganisms from the skin (sterilization) is not possible without damaging the
skin tissues. To live and thrive in humans, microbes must be able to use the
body’s precise balance of food, moisture, nutrients, electrolytes, pH, temperature,
and light. Food, water, and soil that provide these conditions may serve as
nonliving reservoirs. Hand washing does little to make the skin uninhabitable for
microorganisms, except perhaps briefly when an antiseptic agent is used for
cleansing.

10. Nurses should review which of the following reports to determine what pollutants
have been found in the drinking water in a community?
A. Point source report
B. Consumer confidence report
C. Material Safety Data Sheet
D. Environmental standards report
ANSWER: B.
RATIONALE: Consumer Confidence Reports (CCRs), also known as water quality
reports or drinking water quality reports, provide you with important information
about the quality of your drinking water. The U.S. Environmental Protection
Agency (EPA) requires every community water supplier to provide a CCR to its
customers.
SAS 21
Check for Understanding
1. When presenting student health assessment data in a professional meeting or
published document, the school nurse is ethically bound to ensure that:
A. students whose assessment results have been presented are described using only
their defining characteristics.
B. individual students cannot be identified on the basis of any of the data presented.
C. the data is distributed before publication to the families of the students whose
assessment results have been used.
D. data are presented as individual results rather than as aggregate data or data in
summary form
ANSWER: B.
RATIONALE: According to the National Association of School Nurses (NASNN A
S N) code of ethics and standards of professional nursing practice, school nurses
must maintain the confidentiality and protection of individual students when
presenting health-related data or other evidence and research findings. Illinois
school nurses are required to uphold the guarantee of confidentiality of health
information mandated by the Health Insurance Portability and Accountability Act
(HIPAAH I P A A), the Family Education Rights Protection Act (FERPAF E R P A),
and the Illinois School Student Records Act. In addition, school nurses must
adhere to the ethics of professional research and publishing, which specifically
address privacy, confidentiality, and other legal issues.

2. According to state guidelines related to responsibilities of school health program staff,

which of the following functions is most appropriate for a school nurse to assign to a
health services clerk?
A. assessing the nutritional needs of the overall student population in the school
B. overseeing medical treatment regimens that are self-administered by student
C. carrying out developmental screening tests that involve observation and interviewing
D. collecting, maintaining, and updating emergency information for all students
ANSWER: D.
RATIONALE: Effective delegation in school nursing often involves using the "five
rights of delegation" to assess appropriateness (i.e., right task, right
circumstances, right person, right directions and communication, right
supervision and evaluation). While steps in the nursing process should not be
delegated, tasks such as collecting, maintaining, and updating emergency
contact and health information for students are appropriate to delegate. A school
health aide, paraprofessional, or other unlicensed assistive personnel (UAPU A P)
typically carries out clerical duties such as information gathering, record keeping,
filing, contacting students and families, and maintaining health office and medical
supplies.

3. At the beginning of the school year, in addition to developing a diabetic management

plan for the student, it is most important for the school nurse to:
A. confer with the student, his family, and his health-care provider regarding
interventions for blood sugar fluctuations.
B. review with the student and his family current recommended nursing interventions for
treating and monitoring episodes of diabetic ketoacidosis.
C. ensure that the student's family understands the etiology of diabetes as a pancreatic
cell abnormality that is initiated by a viral or autoimmune disorder.
D. discuss the pathology and physiology of diabetes and what the future might hold for
the student in relation to the disease
ANSWER: A.
RATIONALE: Students with type 1 diabetes require a thorough assessment of
their health needs and a specific health plan that addresses schedules and
procedures for blood glucose monitoring and/or carbohydrate monitoring, meal
and snack considerations, treatment and medication protocols, and steps for
responding to fluctuations in blood sugar levels. In addition to reviewing medical
and educational records, it is essential for the school nurse to interview and
consult with the student and his or her parents/guardians to learn about the
student's diabetes regimen, physician recommendations, and how and when the
family and student monitor the student's glucose levels. The process of
developing interventions may involve obtaining materials and medical supplies
necessary for performing diabetes care tasks from the parents/guardians,
identifying the target range for blood glucose levels recommended by the
student's physician, documenting and sending blood glucose levels home to be
assessed by parents/guardians, notifying parents/guardians immediately of
extremely high or low glucose levels, and agreeing on specific interventions for
diabetic emergencies in school settings.

4. The school nurse would like to collaborate with the student's middle school teachers
in managing his health-care needs. Which of the following strategies is the most
appropriate way of involving teachers in a health care plan for this student?
A. suggesting to teachers that they buy and store healthful snacks in the classroom in
case of an acidosis or hypoglycemic reaction
B. increasing teachers' understanding of diabetes, signs of early insulin reaction, and
what to do if symptoms appear
C. asking teachers to designate a private corner or place in the classroom where the
student can test and record his blood levels
D. developing a protocol and training course for teacher administration of medication in
emergencies
ANSWER: B.
RATIONALE: Teachers who have students with diabetes in their classes should
have basic knowledge about the disease and how to assist students in managing
the disease. The school nurse can coordinate conferences with the student who
has diabetes and the student's parents/guardians, teachers, and principal to
discuss the student's health and develop a care plan for the student. The school
nurse should ensure that teachers are familiar with the supplies students may
need during the school day (e.g., testing strips, insulin pen, lancets, blood
glucose meter, glucose tablets, juice boxes), signs and symptoms of low and
high blood sugar, action plans for hypoglycemia and hyperglycemia, and
communication and response considerations (e.g., contacting parents/guardians
in the event of a diabetic emergency, never allowing a student who is
experiencing low blood sugar to walk to the nurse’s office alone). There are also
many professional resources that can support a school nurse's efforts in
educating students about diabetes, including downloadable handouts from the
Web sites of national diabetes organizations.

5. The school nurse checks the emergency care plan on file that outlines steps to take if
the student exhibits signs of hypoglycemia. According to current standards of school
nursing practice, which of the following actions is most appropriate to take first in
response to a hypoglycemic reaction in a conscious student?
A. administering warm clear fluids or diet soda in sips
B. administering a quickly digestible protein source and monitoring the student for 15
minutes
C. administering insulin according to the dose specified in the student's insulin schedule
D. administering glucose tabs or a fast-acting carbohydrate such as juice, cake gel, or
candy
ANSWER: D.
RATIONALE: A hypoglycemic (low blood sugar) reaction can occur in a
conscious student who has type 1 diabetes when the student's insulin level is too
high, when the student misses or delays food intake, or when the student over-
exercises. In these cases, the school nurse should administer a source of sugar,
in the form of glucose tabs or gel/icing, or simple carbohydrates such as juice,
regular soda, candy, or honey. After 10 or 15 minutes and once symptoms have
been alleviated, the school nurse may provide the student with a protein and
carbohydrate snack (e.g., cheese and crackers).

6. The home health nurse visits the home of a client diagnosed with moderate-stage
Alzheimer’s disease. The patient is pleasantly confused and lives with his son-in-law
and daughter. Which of the following observations, if made by the nurse, is MOST
concerning?
A. The rugs are secured safely to the floor.
B. The stovetops do not turn on without activation of a hidden switch in the nearby
drawer.
C. There are extension cords on the floors behind furniture.
D. The door has a lock with a bolt.
ANSWER: D.
RATIONALE: Doors need to have locks in atypical locations (e.g., tops of doors)
to prevent the patient from nighttime confused wandering.

7. The company nurse is caring for a patient who had an attack of vertigo while working
inside the company. The nurse knows that the most important consideration in regard
for patient safety is to:
A. Offer the patient alternative meal choices from the cafeteria.
B. Ask the nursing assistant to walk with the patient when she needs to use the
bathroom.
C. Raise the side rails on the patient’s bed.
D. Remind the patient to wash her hands frequently, especially after voiding or before
meal times.
ANSWER
ANSWER: A.
RATIONALE: The patient may ask the help of a nursing assistant but we need to
be realistic in terms of the business of the nursing assistant as well; putting a
chair in front could actually help. There are foods that should be avoided with
vertigo, this could help the patient. Food rich in sodium like soy sauce, chips,
popcorn, cheese, pickles, papad and canned foods are to be avoided. You may
replace your regular salt with low sodium salt as sodium is the main culprit in
aggravating vertigo.

8. The occupational nurse is correctly implementing the prescribed transmission-based

precaution when she does throat/mouth swab to every company worker. Which of the
following is the correct method?
A. The nurse placed a supply of clean masks in the child’s room.
B. The nurse sends specimens to the laboratory in a zip-closure biohazard bag.
C. The nurse assigned the child in a semi-private room.
D. The nurse wipes the thermometer with alcohol every after use.
ANSWER: B.
RATIONALE: The zip-closure prevents contamination of the environment during
transportation.

9. A nurse working in an occupational health setting will most likely work as a nurse
A. Guardian
B. Clinician/Practitioner
C. Public health nurse
D. Physical therapist
ANSWER: B.
RATIONALE: The majority of occupational health nurses work as nurse
clinicians/practitioners.

10. Which is the best method an occupational health nurse can use when assessing
workplace hazards?
A. Stay in the clinic
B. Wait for the worker to approach the nurse
C. Walk through the work site
D. Work with the workers
ANSWER: C.
RATIONALE: One of the best methods an occupational health nurse can use in
assessing workplace hazards is to walk through the worksite. Reviewing incident
reports, interviewing key employees, and reading the SIC Code do not provide the
nurse with as much information as walking through the worksite.
SAS 22
Check for Understanding
1. A nurse who organizes and establishes a political action committee (PAC) in their
local community to address issues relating to the accessibility and affordability of
healthcare resources in the community is serving in which capacity and role of the
registered nurse?
A. Client advocate
B. Collaborator
C. Politician
D. Entrepreneur
ANSWER: A.
RATIONALE: A nurse who organizes and establishes a political action committee
(PAC) in their local community to address issues relating to the accessibility and
affordability of healthcare resources in the community is serving as the client
advocate. As you should know, the definition of “client” includes not only
individual clients, and families as a unit, but also populations such as the
members of the local community. Although the nurse, as the organizer of this
political action committee (PAC), will have to collaborate with members of the
community to promote the accessibility and affordability of healthcare resources
in the community, this is a secondary role rather than the primary role.
Additionally, although the nurse is serving in a political advocacy effort, the
nurse is not necessarily a politician and there is no evidence that this nurse is an
entrepreneur.

2. Which of these statements related to information technology is accurate?

A. Social networks and cell phone cameras pose low risk in terms of information
technology security and confidentiality.
B. The security of technological data and information in healthcare environments is
most often violated by those who work there.
C. The security of technological data and information in healthcare environments is
most often violated by computer hackers.
D. Computer data deletion destroys all evidence of the data.
ANSWER: B.
RATIONALE: The security of technological data and information in healthcare
environments is most often violated by those who work there. The vast majority
of these violations occur as the result of inadvertent breaches with carelessness
and the lack of thought on the part of employees. Technology is a double-edged
sword. Technological advances such as cell phone cameras, social networks like
Facebook, telephone answering machines and fax machines pose great risk in
terms of the confidentiality and the security of medical information. Computer
data deletion does not always destroy all evidence of the data; data remains.

3. Because several disciplines support the foundation of informatics nursing, it is

important for the informatics nurse to understand that:
A. Informatics nursing differs from other disciplines, as it focuses on supporting the
process of obtaining data.
B. Informatics nursing uses the concepts, tools, and methods of various disciplines to
facilitate nursing process.
C. Information technology and nursing technology are synonymous, as they have the
same goal.
D. The boundaries between the various disciplines are clearly defined
ANSWER: B.
RATIONALE: Informatics nursing is distinguished from other nursing specialties
by its focus on: computerized medical records. data and information content and
representation. data coding and the use of abbreviations. training and education.

4. Adherence to a standardized nursing language will lead to:

A. A barrier in national interoperability.
B. A larger database of interventions.
C. Improved evaluation of nursing outcomes.
D. Increased nursing competencies.
ANSWER: C.
RATIONALE: The benefits of a standardized nursing language include: better
communication among nurses and other health care providers, increased
visibility of nursing interventions, improved patient care, enhanced data
collection to evaluate nursing care outcomes, greater adherence to standards of
care, and facilitated assessment of nursing competency.

5. The informatics nurse violates a patient's legal right to privacy and confidentiality
A. discussing a patient's diagnosis with an authorized family member.
B. discussing care-related information with the patient's physical therapist.
C. looking up a colleague's diagnosis and laboratory results while he or she is
hospitalized.
D. providing a handoff report containing patient information to another department.
ANSWER: C.
RATIONALE: Looking up someone’s diagnosis and laboratory results is an
example of a breach of privacy. It doesn’t matter how close you are with the
person, if you are not his nurse or an authorized family member then you can’t
look up a patient’s information.

6. Using parallel strategy for the roll-out of an electronic medication administration

system means that all:
A. Data entries are cosigned by two health care team members.
B. Medications are documented using both the current method and the new system.
C. Notebook computers and bar code scanners are positioned on the same surface.
D. Vital signs are entered on the same screen as is medication administration.
ANSWER: B.
RATIONALE: Nursing documentation is essential for good clinical
communication. Appropriate documentation provides an accurate reflection of
nursing assessments, changes in clinical state, care provided and pertinent
patient information to support the multidisciplinary team to deliver great care.

7. A downtime of the electronic health record (EHR) system is planned for three months
from today. The informatics nurse is formulating a communication plan for the clinical
staff about the downtime. The nurse plans to:
A. Announce the upcoming downtime at system-wide meetings, and at department
meetings of specific system hospitals affected by the downtime.
B. Bring copies of the communication plan to IT meetings, and discuss it with the IT
directors and managers.
C. Present the information at the super-user meetings, department and unit meetings,
and at other specialty clinician meetings, in addition to having a message posted on the
message-of-the-day screen in the EHR.
D. Print fliers with the downtime plan and post them in bathrooms and breakrooms, as
well as on bulletin boards in various locations in the hospitals.
ANSWER: C.
RATIONALE: Clinicians may use information systems (e.g., electronic medical
records) to coordinate care and share information with other clinicians. Patients
and clinicians may use communication tools and information resources to
interact with one another in new ways. Caution in using new information
resources is warranted to avoid reliance on biased or inappropriate data, and
clinicians may need to direct patients to appropriate information resources.

8. Adult learners most effectively learn about a new clinical information system when the
instructor:
A. Assumes that the learner knows nothing about the system.
B. Begins the formal training as early as possible in the implementation process.
C. Emphasizes the technical specifications of the structure of the system.
D. Encourages the learner to use previous experience to interpret new learning
ANSWER: D.
RATIONALE: Students prior experiences, interests, and thought processes can
influence the learning of current content area concepts due to their prior
experiences, stress, perceptions and attitudes that can interfere with or distort
the material that they are trying to learn.

9. The informatics nurse is working on a chart to demonstrate the increasing incidence

of obesity in the patient population at a health clinic. The data will represent patients
who are of normal weight, overweight, obese, and morbidly obese, and it will include the
percentage of the total population for each group. This type of data is most effectively
represented by a:
A. Bar chart.
B. Column chart.
C. Line chart.
D. Pie chart.
ANSWER: D.
RATIONALE: A pie chart is a special chart that uses pie slices to show relative
sizes of data.

10. Integrating clinical practice guidelines with an electronic health record facilitates
quality improvement measurement by:
A. Comparing guideline parameters to clinical outcomes.
B. Presenting results at the point of treatment decisions.
C. Providing reference information to measurement staff.
D. Presenting patient acuity data.
ANSWER: A.
RATIONALE: The strength of the data in an EHR can be augmented through the
use of tools for financials and clinical decision support. These tools provide the
ability to compare or combine data from clinical, financial, and distractive
sources, thus supplying an added benefit to the organization.
SAS 23
Check for Understanding
1. A person, firm or other entity which pays for or hires the services of another person.
A. Co-employee
B. Employer
C. Patient
D. Nursing Orderlies
ANSWER: B.
RATIONALE: An employer is an individual or organization that has employees.
Employers compensate employees for their work. Employers have
responsibilities per federal and state law, including withholding federal, Social
Security, and Medicare taxes.

2. An indicator of success in community organizing about healthcare business is when

people are able to:
A. Participate in community activities for the solution of accepting health care product
with low cost.
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.
RATIONALE: Participation in community activities in resolving a community
problem may be in any of the processes mentioned in the other choices.

3. The various role of entrepreneurship that contribute the socioeconomic development

in the society.
A. Identifying existing opportunities in the market
B. Creating employment opportunities
C. Contributing to national income
D. Contributing to Community Development
ANSWER: B.
RATIONALE: New and improved products, services, or technology from
entrepreneurs enable new markets to be developed and new wealth to be created.
Additionally, increased employment and higher earnings contribute to better
national income in the form of higher tax revenue and higher government
spending.

4. What are the roles and duties of the entrepreneur nurse?

A. Provide health care products.
B. Nursing educator
C. Promote business according to ordinance of the law
D. None of the above
ANSWER: A and B.
RATIONALE: The answer should be A and B. Nurse entrepreneurs may build their
businesses to develop and distribute medical products or devices, offer direct
patient care or patient advocacy, educate or train other professionals or
community members, or provide health care-related consultation, among other
functions. The baby is checked at 1 minute and 5 minutes after birth for heart and
respiratory rates, muscle tone, reflexes, and color.

5. An individual who provides labor to a company or another person.

A. Employer
B. Owner
C. Employee
D. None of the above
ANSWER: C.
RATIONALE: An employee is an individual who works for someone else in
exchange for compensation.

6. Entrepreneur nurse does the work such as

A. Uses his or her background in professional nursing to start their own business within
the healthcare industry
B. The day-to-day responsibilities of a nurse entrepreneur depends upon the specific
venture, but usually includes activities related to running a business including
accounting, marketing or sales, and developing a customer base in the healthcare field.
C. Both A and B
D. None of the above
ANSWER: C.
RATIONALE: The Nurse Entrepreneur does the work by: a) uses his or her
background in professional nursing to start their own business within the
healthcare industry; b) business ventures established by registered nurses run
the gamut from medical devices and home health products to independent
nursing services such as patient care, nursing education, home health services
and consulting work; and c) the day-to-day responsibilities of a nurse
entrepreneur depends upon the specific venture, but usually includes activities
related to running a business including accounting, marketing or sales, and
developing a customer base.

7. What is the business side of health care?

A. Gender issues
B. Personal and ethical conflicts
C. The healthcare field also needs people with expertise in areas like policy analysis,
finance and accounting, budgeting, human resources, marketing, and information
technology.
D. Athletic trainer
ANSWER: C.
RATIONALE: They maintain financial reports, balance sheets, cash flow analyses,
and other records for healthcare organizations like insurance companies and
hospitals. In turn, these organizations rely on these accounting services and
records to remain compliant and make strategic decisions.
8. How do you become a health care entrepreneur?
A. Salesgirl
B. Most healthcare entrepreneurs either have a professional degree or have an
excellent background in sales
C. Factory worker
D. Student
ANSWER: B.
RATIONALE: Successful medical entrepreneurs are those who understand the
market needs and can connect better with the customers by filling in a necessary
gap in available health services. A better way would be to look for regions that
lack quality medical care and offer them quality healthcare solutions.

9. The scope of public health entrepreneurship is the following except:

A. Public health insurance / benefits schemes
B. Health product production establishment
C. Public health consultancy agencies
D. Lack of technical support
ANSWER: D.
RATIONALE: Lack of technical support is one of the main barriers to business
entrepreneurship in nursing.

10. What are the identified entrepreneurship barriers in nursing business?

A. Job career culture
B. Social values
C. Medical-centered model
D. All of the above
ANSWER: D.
RATIONALE: All of these are included in the main barriers to business
entrepreneurship in nursing identifies in the study.