PNLE: Community Health Nursing Exam 5

1. In the Philippines, which condition is the A. 45

most frequent cause of death associated with B. 50
schistosomiasis? C. 55
D. 60
A. Liver cancer 7. In Integrated Management of Childhood
B. Liver cirrhosis Illness, severe conditions generally require
C. Bladder cancer urgent referral to a hospital. Which of the
D. Intestinal perforation following severe conditions DOES NOT always
2. What is the most effective way of controlling require urgent referral to a hospital?
schistosomiasis in an endemic area?
A. Mastoiditis
A. Use of molluscicides B. Severe dehydration
B. Building of foot bridges C. Severe pneumonia
C. Proper use of sanitary toilets D. Severe febrile disease
D. Use of protective footwear, such as rubber 8. A client was diagnosed as having Dengue
boots fever. You will say that there is slow capillary
3. When residents obtain water from an refill when the color of the nailbed that you
artesian well in the neighborhood, the level of pressed does not return within how many
this approved type of water facility is seconds?

A. I A. 3
B. II B. 5
C. III C. 8
D. IV D. 10
4. For prevention of hepatitis A, you decided to 9. A 3-year old child was brought by his mother
conduct health education activities. Which of to the health center because of fever of 4-day
the following is IRRELEVANT? duration. The child had a positive tourniquet
test result. In the absence of other signs, which
A. Use of sterile syringes and needles is the most appropriate measure that the PHN
B. Safe food preparation and food handling may carry out to prevent Dengue shock
by vendors syndrome?
C. Proper disposal of human excreta and
personal hygiene A. Insert an NGT and give fluids per NGT.
D. Immediate reporting of water pipe leaks B. Instruct the mother to give the child
and illegal water connections Oresol.
5. Which biological used in Expanded Program C. Start the patient on intravenous fluids
on Immunization (EPI) should NOT be stored in STAT.
the freezer? D. Refer the client to the physician for
appropriate management.
A. DPT 10. The pathognomonic sign of measles is
B. Oral polio vaccine Koplik’s spot. You may see Koplik’s spot by
C. Measles vaccine inspecting the _____.
D. MMR
6. You will conduct outreach immunization in a A. Nasal mucosa
barangay with a population of about 1500. B. Buccal mucosa
Estimate the number of infants in the barangay. C. Skin on the abdomen
D. Skin on the antecubital surface
PNLE: Community Health Nursing Exam 5

11. Among the following diseases, which is The client is most probably suffering from which
airborne? condition?

A. Viral conjunctivitis A. Giardiasis

B. Acute poliomyelitis B. Cholera
C. Diphtheria C. Amebiasis
D. Measles D. Dysentery
12. Among children aged 2 months to 3 years, 17. In the Philippines, which specie of
the most prevalent form of meningitis is caused schistosoma is endemic in certain regions?
by which microorganism?
A. S. mansoni
A. Hemophilus influenzae B. S. japonicum
B. Morbillivirus C. S. malayensis
C. Steptococcus pneumoniae D. S. haematobium
D. Neisseria meningitidis 18. A 32-year old client came for consultation at
13. Human beings are the major reservoir of the health center with the chief complaint of
malaria. Which of the following strategies in fever for a week. Accompanying symptoms
malaria control is based on this fact? were muscle pains and body malaise. A week
after the start of fever, the client noted
A. Stream seeding yellowish discoloration of his sclera. History
B. Stream clearing showed that he waded in flood waters about 2
C. Destruction of breeding places weeks before the onset of symptoms. Based on
D. Zooprophylaxis his history, which disease condition will you
14. The use of larvivorous fish in malaria control suspect?
is the basis for which strategy of malaria
control? A. Hepatitis A
B. Hepatitis B
A. Stream seeding C. Tetanus
B. Stream clearing D. Leptospirosis
C. Destruction of breeding places 19. MWSS provides water to Manila and other
D. Zooprophylaxis cities in Metro Manila. This is an example of
15. Mosquito-borne diseases are prevented which level of water facility?
mostly with the use of mosquito control
measures. Which of the following is NOT A. I
appropriate for malaria control? B. II
C. III
A. Use of chemically treated mosquito nets D. IV
B. Seeding of breeding places with larva- 20. You are the PHN in the city health center. A
eating fish client underwent screening for AIDS using
C. Destruction of breeding places of the ELISA. His result was positive. What is the best
mosquito vector course of action that you may take?
D. Use of mosquito-repelling soaps, such as
those with basil or citronella A. Get a thorough history of the client,
16. A 4-year old client was brought to the health focusing on the practice of high risk
center with the chief complaint of severe behaviors.
diarrhea and the passage of “rice water” stools.
PNLE: Community Health Nursing Exam 5

B. Ask the client to be accompanied by a D. They are able to bring about a cure of the
significant person before revealing the disease condition.
result. 25. A barangay had an outbreak of German
C. Refer the client to the physician since he is measles. To prevent congenital rubella, what is
the best person to reveal the result to the the BEST advice that you can give to women in
client. the first trimester of pregnancy in the
D. Refer the client for a supplementary test, barangay?
such as Western blot, since the ELISA
result may be false. A. Advice them on the signs of German
21. Which is the BEST control measure for AIDS? measles.
B. Avoid crowded places, such as markets
A. Being faithful to a single sexual partner and moviehouses.
B. Using a condom during each sexual contact C. Consult at the health center where rubella
C. Avoiding sexual contact with commercial vaccine may be given.
sex workers D. Consult a physician who may give them
D. Making sure that one’s sexual partner does rubella immunoglobulin.
not have signs of AIDS 26. You were invited to be the resource person
22. The most frequent causes of death among in a training class for food handlers. Which of
clients with AIDS are opportunistic diseases. the following would you emphasize regarding
Which of the following opportunistic infections prevention of staphylococcal food poisoning?
is characterized by tonsillopharyngitis?
A. All cooking and eating utensils must be
A. Respiratory candidiasis thoroughly washed.
B. Infectious mononucleosis B. Food must be cooked properly to destroy
C. Cytomegalovirus disease staphylococcal microorganisms.
D. Pneumocystis carinii pneumonia C. Food handlers and food servers must have
23. To determine possible sources of sexually a negative stool examination result.
transmitted infections, which is the BEST D. Proper handwashing during food
method that may be undertaken by the public preparation is the best way of preventing
health nurse? the condition.
27. In a mothers’ class, you discussed childhood
A. Contact tracing diseases such as chicken pox. Which of the
B. Community survey following statements about chicken pox is
C. Mass screening tests correct?
D. Interview of suspects
24. Antiretroviral agents, such as AZT, are used A. The older one gets, the more susceptible
in the management of AIDS. Which of the he becomes to the complications of
following is NOT an action expected of these chicken pox.
drugs. B. A single attack of chicken pox will prevent
future episodes, including conditions such
A. They prolong the life of the client with as shingles.
AIDS. C. To prevent an outbreak in the community,
B. They reduce the risk of opportunistic quarantine may be imposed by health
infections authorities.
C. They shorten the period of D. Chicken pox vaccine is best given when
communicability of the disease. there is an impending outbreak in the
community.
PNLE: Community Health Nursing Exam 5

28. Complications to infectious parotitis

(mumps) may be serious in which type of
clients?

A. Pregnant women
B. Elderly clients
C. Young adult males
D. Young infants
PNLE: Community Health Nursing Exam 5

Answers and Rationales 10. Answer: (B) Buccal mucosa. Koplik’s spot
may be seen on the mucosa of the mouth
1. Answer: (B) Liver cirrhosis. The etiologic or the throat.
agent of schistosomiasis in the Philippines 11. Answer: (D) Measles. Viral conjunctivitis is
is Schistosoma japonicum, which affects transmitted by direct or indirect contact
the small intestine and the liver. Liver with discharges from infected eyes. Acute
damage is a consequence of fibrotic poliomyelitis is spread through the fecal-
reactions to schistosoma eggs in the liver. oral route and contact with throat
2. Answer: (C) Proper use of sanitary secretions, whereas diphtheria is through
toilets. The ova of the parasite get out of direct and indirect contact with respiratory
the human body together with feces. secretions.
Cutting the cycle at this stage is the most 12. Answer: (A) Hemophilus
effective way of preventing the spread of influenzae. Hemophilus meningitis is
the disease to susceptible hosts. unusual over the age of 5 years. In
3. Answer: (B) II. A communal faucet or developing countries, the peak incidence is
water standpost is classified as Level II. in children less than 6 months of age.
4. Answer: (A) Use of sterile syringes and Morbillivirus is the etiology of measles.
needles. Hepatitis A is transmitted through Streptococcus pneumoniae and Neisseria
the fecal oral route. Hepatitis B is meningitidis may cause meningitis, but age
transmitted through infected body distribution is not specific in young
secretions like blood and semen. children.
5. Answer: (A) DPT. DPT is sensitive to 13. Answer: (D)
freezing. The appropriate storage Zooprophylaxis. Zooprophylaxis is done by
temperature of DPT is 2 to 8° C only. OPV putting animals like cattle or dogs close to
and measles vaccine are highly sensitive to windows or doorways just before nightfall.
heat and require freezing. MMR is not an The Anopheles mosquito takes his blood
immunization in the Expanded Program on meal from the animal and goes back to its
Immunization. breeding place, thereby preventing
6. Answer: (A) 45. To estimate the number of infection of humans.
infants, multiply total population by 3%. 14. Answer: (A) Stream seeding. Stream
7. Answer: (B) Severe dehydration. The order seeding is done by putting tilapia fry in
of priority in the management of severe streams or other bodies of water identified
dehydration is as follows: intravenous fluid as breeding places of the Anopheles
therapy, referral to a facility where IV mosquito
fluids can be initiated within 30 minutes, 15. Answer: (C) Destruction of breeding places
Oresol/nasogastric tube, Oresol/orem. of the mosquito vector. Anopheles
When the foregoing measures are not mosquitoes breed in slow-moving, clear
possible or effective, tehn urgent referral water, such as mountain streams.
to the hospital is done. 16. Answer: (B) Cholera. Passage of profuse
8. Answer: (A) 3. Adequate blood supply to watery stools is the major symptom of
the area allows the return of the color of cholera. Both amebic and bacillary
the nailbed within 3 seconds. dysentery are characterized by the
9. Answer: (B) Instruct the mother to give the presence of blood and/or mucus in the
child Oresol. Since the child does not stools. Giardiasis is characterized by fat
manifest any other danger sign, malabsorption and, therefore, steatorrhea.
maintenance of fluid balance and 17. Answer: (B) S. japonicum. S. mansoni is
replacement of fluid loss may be done by found mostly in Africa and South America;
giving the client Oresol. S. haematobium in Africa and the Middle
PNLE: Community Health Nursing Exam 5

East; and S. malayensis only in peninsular 26. Answer: (D) Proper handwashing during
Malaysia. food preparation is the best way of
18. Answer: (D) Leptospirosis. Leptospirosis is preventing the condition. Symptoms of
transmitted through contact with the skin this food poisoning are due to
or mucous membrane with water or moist staphylococcal enterotoxin, not the
soil contaminated with urine of infected microorganisms themselves.
animals, like rats. Contamination is by food handling by
19. Answer: (C) III. Waterworks systems, such persons with staphylococcal skin or eye
as MWSS, are classified as level III. infections.
20. Answer: (D) Refer the client for a 27. Answer: (A) The older one gets, the more
supplementary test, such as Western blot, susceptible he becomes to the
since the ELISA result may be false. A client complications of chicken pox. Chicken pox
having a reactive ELISA result must is usually more severe in adults than in
undergo a more specific test, such as children. Complications, such as
Western blot. A negative supplementary pneumonia, are higher in incidence in
test result means that the ELISA result was adults.
false and that, most probably, the client is 28. Answer: (C) Young adult
not infected. males. Epididymitis and orchitis are
21. Answer: (A) Being faithful to a single sexual possible complications of mumps. In post-
partner. Sexual fidelity rules out the adolescent males, bilateral inflammation
possibility of getting the disease by sexual of the testes and epididymis may cause
contact with another infected person. sterility.
Transmission occurs mostly through sexual
intercourse and exposure to blood or
tissues.
22. Answer: (B) Infectious
mononucleosis. Cytomegalovirus disease is
an acute viral disease characterized by
fever, sore throat and lymphadenopathy.
23. Answer: (A) Contact tracing. Contact
tracing is the most practical and reliable
method of finding possible sources of
person-to-person transmitted infections,
such as sexually transmitted diseases.
24. Answer: (D) They are able to bring about a
cure of the disease condition. There is no
known treatment for AIDS. Antiretroviral
agents reduce the risk of opportunistic
infections and prolong life, but does not
cure the underlying immunodeficiency.
25. Answer: (D) Consult a physician who may
give them rubella immunoglobulin. Rubella
vaccine is made up of attenuated German
measles viruses. This is contraindicated in
pregnancy. Immune globulin, a specific
prophylactic against German measles, may
be given to pregnant women.