A. Act 3573
B. R.A. 3753
C. R.A. 1054
D. R.A. 1082
27. According to Freeman and Heinrich, community health nursing is a developmental
service. Which of the following best illustrates this statement?
A. Poliomyelitis
B. Measles
C. Rabies
D. Neonatal tetanus
29. The public health nurse is responsible for presenting the municipal health statistics
using graphs and tables. To compare the frequency of the leading causes of mortality
in the municipality, which graph will you prepare?
A. Line
B. Bar
C. Pie
D. Scatter diagram
30. Which step in community organizing involves training of potential leaders in the
community?
A. Integration
B. Community organization
C. Community study
D. Core group formation
Answers and Rationales 20. Answer: (A) Mayor. The local executive serves as the chairman of the Municipal
1. Answer: (B) To enhance the capacity of individuals, families and Health Board.
communities to cope with their health needs 21. Answer: (A) Primary. The entry of a person into the health care delivery system is
2. Answer: (B) The nurse has to conduct community diagnosis to determine usually through a consultation in out-patient services.
nursing needs and problems. 22. Answer: (B) Providing technical guidance to the midwife. The nurse provides
3. Answer: (C) Community diagnosis. Population-focused nursing care means technical guidance to the midwife in the care of clients, particularly in the
providing care based on the greater need of the majority of the population. The implementation of management guidelines, as in Integrated Management of
greater need is identified through community diagnosis. Childhood Illness.
4. Answer: (B) Location of the workplace in relation to health facilities. Based 23. Answer: (C) Municipal Health Officer. A public health nurse and rural health
on R.A. 1054, an occupational nurse must be employed when there are 30 to 100 midwife can provide care during normal childbirth. A physician should attend to a
employees and the workplace is more than 1 km. away from the nearest health woman with a complication during labor.
center. 24. Answer: (A) 1. Each rural health midwife is given a population assignment of about
5. Answer: (B) 101. Again, this is based on R.A. 1054. 5,000.
6. Answer: (D) Environmental manager. Ergonomics is improving efficiency of 25. Answer: (D) Municipal Health Board. As mandated by R.A. 7160, basic health
workers by improving the worker’s environment through appropriately designed services have been devolved from the national government to local government units.
furniture, for example. 26. Answer: (A) Act 3573. Act 3573, the Law on Reporting of Communicable Diseases,
7. Answer: (C) Public health nurse of the RHU of their municipality. You’re right! enacted in 1929, mandated the reporting of diseases listed in the law to the nearest
This question is based on R.A.1054. health station.
8. Answer: (B) The statement is false; people pay indirectly for public health 27. Answer: (B) Health education and community organizing are necessary in
services. Community health services, including public health services, are pre-paid providing community health services. The community health nurse develops the
services, though taxation, for example. health capability of people through health education and community organizing
9. Answer: (A) For people to attain their birthrights of health and activities.
longevity. According to Winslow, all public health efforts are for people to realize 28. Answer: (B) Measles. Presidential Proclamation No. 4 is on the Ligtas Tigdas
their birthrights of health and longevity. Program.
10. Answer: (C) Swaroop’s index. Swaroop’s index is the percentage of the deaths 29. Answer: (B) Bar. A bar graph is used to present comparison of values, a line graph
aged 50 years or older. Its inverse represents the percentage of untimely deaths for trends over time or age, a pie graph for population composition or distribution,
(those who died younger than 50 years). and a scatter diagram for correlation of two variables.
11. Answer: (D) Public health nursing focuses on preventive, not curative, 30. Answer: (D) Core group formation. In core group formation, the nurse is able to
services.The catchment area in PHN consists of a residential community, many of transfer the technology of community organizing to the potential or informal
whom are well individuals who have greater need for preventive rather than curative community leaders through a training program
services.
12. Answer: (D) The worth and dignity of man. This is a direct quote from Dr.
Margaret Shetland’s statements on Public Health Nursing.
13. Answer: (B) Ensure the accessibility and quality of health care
14. Answer: (D) Tertiary. Regional hospitals are tertiary facilities because they serve as
training hospitals for the region.
15. Answer: (B) Their services are provided on an out-patient basis. Primary
facilities government and non-government facilities that provide basic out-patient
services.
16. Answer: (B) Conducting random classroom inspection during a measles
epidemic. Random classroom inspection is assessment of pupils/students and
teachers for signs of a health problem prevalent in the community.
17. Answer: (B) Efficiency. Efficiency is determining whether the goals were attained
at the least possible cost.
18. Answer: (D) Rural Health Unit. R.A. 7160 devolved basic health services to local
government units (LGU’s ). The public health nurse is an employee of the LGU.
19. Answer: (C) To empower the people and promote their self-reliance. People
empowerment is the basic motivation behind devolution of basic services to LGU’s.
1. In which step are plans formulated for solving community problems? 8. The typology of family nursing problems is used in the statement of nursing
diagnosis in the care of families. The youngest child of the de los Reyes family has
A. Mobilization been diagnosed as mentally retarded. This is classified as a:
B. Community organization
C. Follow-up/extension A. Health threat
D. Core group formation B. Health deficit
2. The public health nurse takes an active role in community participation. What is the C. Foreseeable crisis
primary goal of community organizing? D. Stress point
9. The de los Reyes couple have a 6-year old child entering school for the first time.
A. To educate the people regarding community health problems The de los Reyes family has a:
B. To mobilize the people to resolve community health problems
C. To maximize the community’s resources in dealing with health problems A. Health threat
D. To maximize the community’s resources in dealing with health problems B. Health deficit
3. An indicator of success in community organizing is when people are able to C. Foreseeable crisis
D. Stress point
A. Participate in community activities for the solution of a community problem 10. Which of the following is an advantage of a home visit?
B. Implement activities for the solution of the community problem
C. Plan activities for the solution of the community problem A. It allows the nurse to provide nursing care to a greater number of people.
D. Identify the health problem as a common concern B. It provides an opportunity to do first hand appraisal of the home situation.
4. Tertiary prevention is needed in which stage of the natural history of disease? C. It allows sharing of experiences among people with similar health problems.
D. It develops the family’s initiative in providing for health needs of its members.
A. Pre-pathogenesis 11. Which is CONTRARY to the principles in planning a home visit?
B. Pathogenesis
C. Prodromal A. A home visit should have a purpose or objective.
D. Terminal B. The plan should revolve around family health needs.
5. Isolation of a child with measles belongs to what level of prevention? C. A home visit should be conducted in the manner prescribed by the RHU.
D. Planning of continuing care should involve a responsible family member.
A. Primary 12. The PHN bag is an important tool in providing nursing care during a home visit.
B. Secondary The most important principle of bag technique states that it
C. Intermediate
D. Tertiary A. Should save time and effort.
6. On the other hand, Operation Timbang is _____ prevention. B. Should minimize if not totally prevent the spread of infection.
C. Should not overshadow concern for the patient and his family.
A. Primary D. May be done in a variety of ways depending on the home situation, etc.
B. Secondary 13. To maintain the cleanliness of the bag and its contents, which of the following
C. Intermediate must the nurse do?
D. Tertiary
7. Which type of family-nurse contact will provide you with the best opportunity to A. Wash his/her hands before and after providing nursing care to the family members.
observe family dynamics? B. In the care of family members, as much as possible, use only articles taken from the
bag.
A. Clinic consultation C. Put on an apron to protect her uniform and fold it with the right side out before
B. Group conference putting it back into the bag.
C. Home visit D. At the end of the visit, fold the lining on which the bag was placed, ensuring that the
D. Written communication contaminated side is on the outside.
14. The public health nurse conducts a study on the factors contributing to the high 20. The number of cases of Dengue fever usually increases towards the end of the
mortality rate due to heart disease in the municipality where she works. Which branch rainy season. This pattern of occurrence of Dengue fever is best described as
of epidemiology does the nurse practice in this situation?
A. Epidemic occurrence
A. Descriptive B. Cyclical variation
B. Analytical C. Sporadic occurrence
C. Therapeutic D. Secular variation
D. Evaluation 21. In the year 1980, the World Health Organization declared the Philippines, together
15. Which of the following is a function of epidemiology? with some other countries in the Western Pacific Region, “free” of which disease?
A. Identifying the disease condition based on manifestations presented by a client A. Pneumonic plague
B. Determining factors that contributed to the occurrence of pneumonia in a 3 year old B. Poliomyelitis
C. Determining the efficacy of the antibiotic used in the treatment of the 3 year old client C. Small pox
with pneumonia D. Anthrax
D. Evaluating the effectiveness of the implementation of the Integrated Management of 22. In the census of the Philippines in 1995, there were about 35,299,000 males and
Childhood Illness about 34,968,000 females. What is the sex ratio?
16. Which of the following is an epidemiologic function of the nurse during an
epidemic? A. 99.06:100
B. 100.94:100
A. Conducting assessment of suspected cases to detect the communicable disease C. 50.23%
B. Monitoring the condition of the cases affected by the communicable disease D. 49.76%
C. Participating in the investigation to determine the source of the epidemic 23. Primary health care is a total approach to community development. Which of the
D. Teaching the community on preventive measures against the disease following is an indicator of success in the use of the primary health care approach?
17. The primary purpose of conducting an epidemiologic investigation is to
A. Health services are provided free of charge to individuals and families.
A. Delineate the etiology of the epidemic B. Local officials are empowered as the major decision makers in matters of health.
B. Encourage cooperation and support of the community C. Health workers are able to provide care based on identified health needs of the
C. Identify groups who are at risk of contracting the disease people.
D. Identify geographical location of cases of the disease in the community D. Health programs are sustained according to the level of development of the
18. Which is a characteristic of person-to-person propagated epidemics? community.
24. Sputum examination is the major screening tool for pulmonary tuberculosis.
A. There are more cases of the disease than expected. Clients would sometimes get false negative results in this exam. This means that the
B. The disease must necessarily be transmitted through a vector. test is not perfect in terms of which characteristic of a diagnostic examination?
C. The spread of the disease can be attributed to a common vehicle.
D. There is a gradual build up of cases before the epidemic becomes easily noticeable. A. Effectiveness
19. In the investigation of an epidemic, you compare the present frequency of the B. Efficacy
disease with the usual frequency at this time of the year in this community. This is C. Specificity
done during which stage of the investigation? D. Sensitivity
25. Use of appropriate technology requires knowledge of indigenous technology.
A. Establishing the epidemic Which medicinal herb is given for fever, headache and cough?
B. Testing the hypothesis
C. Formulation of the hypothesis A. Sambong
D. Appraisal of facts B. Tsaang gubat
C. Akapulko
D. Lagundi
26. What law created the Philippine Institute of Traditional and Alternative Health
Care?
A. R.A. 8423
B. R.A. 4823
C. R.A. 2483
D. R.A. 3482
27. In traditional Chinese medicine, the yielding, negative and feminine force is
termed
A. Yin
B. Yang
C. Qi
D. Chai
28. What is the legal basis for Primary Health Care approach in the Philippines?
A. 1,500
B. 1,800
C. 2,000
D. 2,300
Answers and Rationales 16. Answer: (C) Participating in the investigation to determine the source of
1. Answer: (B) Community organization. Community organization is the step when the epidemic. Epidemiology is the study of patterns of occurrence and distribution of
community assemblies take place. During the community assembly, the people may disease in the community, as well as the factors that affect disease patterns. The
opt to formalize the community organization and make plans for community action to purpose of an epidemiologic investigation is to identify the source of an epidemic, i.e.,
resolve a community health problem. what brought about the epidemic.
2. Answer: (D) To maximize the community’s resources in dealing with health 17. Answer: (A) Delineate the etiology of the epidemic. Delineating the etiology of
problems. Community organizing is a developmental service, with the goal of an epidemic is identifying its source.
developing the people’s self-reliance in dealing with community health problems. A, B 18. Answer: (D) There is a gradual build up of cases before the epidemic
and C are objectives of contributory objectives to this goal. becomes easily noticeable. A gradual or insidious onset of the epidemic is usually
3. Answer: (A) Participate in community activities for the solution of a observable in person-to-person propagated epidemics.
community problem. Participation in community activities in resolving a community 19. Answer: (A) Establishing the epidemic. Establishing the epidemic is determining
problem may be in any of the processes mentioned in the other choices. whether there is an epidemic or not. This is done by comparing the present number of
4. Answer: (D) Terminal. Tertiary prevention involves rehabilitation, prevention of cases with the usual number of cases of the disease at the same time of the year, as
permanent disability and disability limitation appropriate for convalescents, the well as establishing the relatedness of the cases of the disease.
disabled, complicated cases and the terminally ill (those in the terminal stage of a 20. Answer: (B) Cyclical variation. A cyclical variation is a periodic fluctuation in the
disease) number of cases of a disease in the community.
5. Answer: (A) Primary. The purpose of isolating a client with a communicable disease 21. Answer: (C) Small pox. The last documented case of Small pox was in 1977 at
is to protect those who are not sick (specific disease prevention). Somalia.
6. Answer: (B) Secondary. Operation Timbang is done to identify members of the 22. Answer: (B) 100.94:100. Sex ratio is the number of males for every 100 females in
susceptible population who are malnourished. Its purpose is early diagnosis and, the population.
subsequently, prompt treatment. 23. Answer: (D) Health programs are sustained according to the level of
7. Answer: (C) Home visit. Dynamics of family relationships can best be observed in development of the community. Primary health care is essential health care that
the family’s natural environment, which is the home. can be sustained in all stages of development of the community.
8. Answer: (B) Health deficit. Failure of a family member to develop according to 24. Answer: (D) Sensitivity. Sensitivity is the capacity of a diagnostic examination to
what is expected, as in mental retardation, is a health deficit. detect cases of the disease. If a test is 100% sensitive, all the cases tested will have a
9. Answer: (C) Foreseeable crisis. Entry of the 6-year old into school is an positive result, i.e., there will be no false negative results.
anticipated period of unusual demand on the family. 25. Answer: (D) Lagundi. Sambong is used as a diuretic. Tsaang gubat is used to
10. Answer: (B) It provides an opportunity to do first hand appraisal of the relieve diarrhea. Akapulko is used for its antifungal property.
home situation.. Choice A is not correct since a home visit requires that the nurse 26. Answer: (A) R.A. 8423
spend so much time with the family. Choice C is an advantage of a group conference, 27. Answer: (A) Yin. Yang is the male dominating, positive and masculine force.
while choice D is true of a clinic consultation. 28. Answer: (B) Letter of Instruction No. 949. Letter of Instruction 949 was issued
11. Answer: (C) A home visit should be conducted in the manner prescribed by by then President Ferdinand Marcos, directing the formerly called Ministry of Health,
the RHU.The home visit plan should be flexible and practical, depending on factors, now the Department of Health, to utilize Primary Health Care approach in planning
such as the family’s needs and the resources available to the nurse and the family. and implementing health programs.
12. Answer: (B) Should minimize if not totally prevent the spread of 29. Answer: (D) Cooperation between the PHN and public school
infection. Bag technique is performed before and after handling a client in the home teacher. Intersectoral linkages refer to working relationships between the health
to prevent transmission of infection to and from the client. sector and other sectors involved in community development.
13. Answer: (A) Wash his/her hands before and after providing nursing care to 30. Answer: (D) 2,300. Based on the Philippine population composition, to estimate the
the family members. Choice B goes against the idea of utilizing the family’s number of 1-4 year old children, multiply total population by 11.5%.
resources, which is encouraged in CHN. Choices C and D goes against the principle of
asepsis of confining the contaminated surface of objects.
14. Answer: (B) Analytical. Analytical epidemiology is the study of factors or
determinants affecting the patterns of occurrence and distribution of disease in a
community.
15. Answer: (D) Evaluating the effectiveness of the implementation of the
Integrated Management of Childhood Illness. Epidemiology is used in the
assessment of a community or evaluation of interventions in community health
practice.
1. Estimate the number of pregnant women who will be given tetanus toxoid during 7. In the past year, Barangay A had an average population of 1655. 46 babies were
an immunization outreach activity in a barangay with a population of about 1,500. born in that year, 2 of whom died less than 4 weeks after they were born. There were
4 recorded stillbirths. What is the neonatal mortality rate?
A. 265
B. 300 A. 27.8/1,000
C. 375 B. 43.5/1,000
D. 400 C. 86.9/1,000
2. To describe the sex composition of the population, which demographic tool may be D. 130.4/1,000
used? 8. Which statistic best reflects the nutritional status of a population?
A. Tally report A. Information dissemination about the need for family planning
B. Output report B. Support of research and development in family planning methods
C. Target/client list C. Adequate information for couples regarding the different methods
D. Individual health record D. Encouragement of couples to take family planning as a joint responsibility
14. Civil registries are important sources of data. Which law requires registration of 20. A woman, 6 months pregnant, came to the center for consultation. Which of the
births within 30 days from the occurrence of the birth? following substances is contraindicated?
A. 3 months
B. 6 months
C. 1 year
D. 2 years
28. What is given to a woman within a month after the delivery of a baby?
A. Malunggay capsule
B. Ferrous sulfate 100 mg. OD
C. Retinol 200,000 I.U., 1 capsule
D. Potassium iodate 200 mg, 1 capsule
29. Which biological used in Expanded Program on Immunization (EPI) is stored in the
freezer?
A. DPT
B. Tetanus toxoid
C. Measles vaccine
D. Hepatitis B vaccine
30. Unused BCG should be discarded how many hours after reconstitution?
A. 2
B. 4
C. 6
D. At the end of the day
Answers and Rationales 18. Answer: (D) Those who just had a delivery within the past 15 months. The
1. Answer: (A) 265. To estimate the number of pregnant women, multiply the total ideal birth spacing is at least two years. 15 months plus 9 months of pregnancy = 2
population by 3.5%. years.
2. Answer: (D) Any of these may be used. Sex ratio and sex proportion are used to 19. Answer: (C) Adequate information for couples regarding the different
determine the sex composition of a population. A population pyramid is used to methods. To enable the couple to choose freely among different methods of family
present the composition of a population by age and sex. planning, they must be given full information regarding the different methods that are
3. Answer: (A) Crude birth rate. Natality means birth. A natality rate is a birth rate. available to them, considering the availability of quality services that can support their
4. Answer: (B) 5.2/1,000. To compute crude death rate divide total number of deaths choice.
(94) by total population (18,000) and multiply by 1,000. 20. Answer: (B) Retinol 200,000 IU. Retinol 200,000 IU is a form of megadose
5. Answer: (C) 1-4 year old children. Preschoolers are the most susceptible to PEM Vitamin A. This may have a teratogenic effect.
because they have generally been weaned. Also, this is the population who, unable to 21. Answer: (A) Her OB score is G5P3. Only women with less than 5 pregnancies are
feed themselves, are often the victims of poor intrafamilial food distribution. qualified for a home delivery. It is also advisable for a primigravida to have delivery at
6. Answer: (C) Swaroop’s index. Swaroop’s index is the proportion of deaths aged 50 a childbirth facility.
years and above. The higher the Swaroop’s index of a population, the greater the 22. Answer: (C) Folic acid. It is estimated that the incidence of neural tube defects can
proportion of the deaths who were able to reach the age of at least 50 years, i.e., be reduced drastically if pregnant women have an adequate intake of folic acid.
more people grew old before they died. 23. Answer: (D) Note the interval, duration and intensity of labor
7. Answer: (B) 43.5/1,000. To compute for neonatal mortality rate, divide the contractions.. Assessment of the woman should be done first to determine whether
number of babies who died before reaching the age of 28 days by the total number of she is having true labor and, if so, what stage of labor she is in.
live births, then multiply by 1,000. 24. Answer: (D) Explain to her that putting the baby to breast will lessen blood
8. Answer: (A) 1-4 year old age-specific mortality rate. Since preschoolers are the loss after delivery. Suckling of the nipple stimulates the release of oxytocin by the
most susceptible to the effects of malnutrition, a population with poor nutritional posterior pituitary gland, which causes uterine contraction. Lactation begins 1 to 3
status will most likely have a high 1-4 year old age-specific mortality rate, also known days after delivery. Nipple stretching exercises are done when the nipples are flat or
as child mortality rate. inverted. Frequent washing dries up the nipples, making them prone to the formation
9. Answer: (B) Number of registered live births. To compute for general or total of fissures.
fertility rate, divide the number of registered live births by the number of females of 25. Answer: (B) To stimulate milk production by the mammary acini. Suckling of
reproductive age (15-45 years), then multiply by 1,000. the nipple stimulates prolactin reflex (the release of prolactin by the anterior pituitary
10. Answer: (B) Survey. A survey, also called sample survey, is data gathering about a gland), which initiates lactation.
sample of the population. 26. Answer: (B) The mother does not feel nipple pain.. When the baby has properly
11. Answer: (C) De facto. The other method of population assignment, de jure, is latched on to the breast, he takes deep, slow sucks; his mouth is wide open; and
based on the usual place of residence of the people. much of the areola is inside his mouth. And, you’re right! The mother does not feel
12. Answer: (A) Tally report. A tally report is prepared monthly or quarterly by the nipple pain.
RHU personnel and transmitted to the Provincial Health Office. 27. Answer: (B) 6 months. After 6 months, the baby’s nutrient needs, especially the
13. Answer: (C) Target/client list. The MDT Client List is a record of clients enrolled in baby’s iron requirement, can no longer be provided by mother’s milk alone.
MDT and other relevant data, such as dates when clients collected their monthly 28. Answer: (C) Retinol 200,000 I.U., 1 capsule. A capsule of Retinol 200,000 IU is
supply of drugs. given within 1 month after delivery. Potassium iodate is given during pregnancy;
14. Answer: (A) P.D. 651. P.D. 651 amended R.A. 3753, requiring the registry of births malunggay capsule is not routinely administered after delivery; and ferrous sulfate is
within 30 days from their occurrence. taken for two months after delivery.
15. Answer: (D) Any of these health professionals. D. R.A. 3753 states that any 29. Answer: (C) Measles vaccine. Among the biologicals used in the Expanded
birth attendant may sign the certificate of live birth. Program on Immunization, measles vaccine and OPV are highly sensitive to heat,
16. Answer: (C) Magnitude of the health problem. Magnitude of the problem refers requiring storage in the freezer.
to the percentage of the population affected by a health problem. The other choices 30. Answer: (B) 4. While the unused portion of other biologicals in EPI may be given
are criteria considered in both family and community health care. until the end of the day, only BCG is discarded 4 hours after reconstitution. This is
17. Answer: (D) Its main strategy is certification of health centers able to why BCG immunization is scheduled only in the morning.
comply with standards. Sentrong Sigla Movement is a joint project of the DOH and
local government units. Its main strategy is certification of health centers that are able
to comply with standards set by the DOH.
1. In immunizing school entrants with BCG, you are not obliged to secure parental 7. A 4-month old infant was brought to the health center because of cough. Her
consent. This is because of which legal document? respiratory rate is 42/minute. Using the Integrated Management of Child Illness
(IMCI) guidelines of assessment, her breathing is considered
A. P.D. 996
B. R.A. 7846 A. Fast
C. Presidential Proclamation No. 6 B. Slow
D. Presidential Proclamation No. 46 C. Normal
2. Which immunization produces a permanent scar? D. Insignificant
8. Which of the following signs will indicate that a young child is suffering from severe
A. DPT pneumonia?
B. BCG
C. Measles vaccination A. Dyspnea
D. Hepatitis B vaccination B. Wheezing
3. A 4-week old baby was brought to the health center for his first immunization. C. Fast breathing
Which can be given to him? D. Chest indrawing
9. Using IMCI guidelines, you classify a child as having severe pneumonia. What is the
A. DPT1 best management for the child?
B. OPV1
C. Infant BCG A. Prescribe an antibiotic.
D. Hepatitis B vaccine 1 B. Refer him urgently to the hospital.
4. You will not give DPT 2 if the mother says that the infant had C. Instruct the mother to increase fluid intake.
D. Instruct the mother to continue breastfeeding.
A. Seizures a day after DPT 1. 10. A 5-month old infant was brought by his mother to the health center because of
B. Fever for 3 days after DPT 1. diarrhea occurring 4 to 5 times a day. His skin goes back slowly after a skin pinch and
C. Abscess formation after DPT 1. his eyes are sunken. Using the IMCI guidelines, you will classify this infant in which
D. Local tenderness for 3 days after DPT 1. category?
5. A 2-month old infant was brought to the health center for immunization. During
assessment, the infant’s temperature registered at 38.1°C. Which is the best course of A. No signs of dehydration
action that you will take? B. Some dehydration
C. Severe dehydration
A. Go on with the infant’s immunizations. D. The data is insufficient.
B. Give Paracetamol and wait for his fever to subside. 11. Based on assessment, you classified a 3-month old infant with the chief complaint
C. Refer the infant to the physician for further assessment. of diarrhea in the category of SOME DEHYDRATION. Based on IMCI management
D. Advise the infant’s mother to bring him back for immunization when he is well. guidelines, which of the following will you do?
6. A pregnant woman had just received her 4th dose of tetanus toxoid. Subsequently,
her baby will have protection against tetanus for how long? A. Bring the infant to the nearest facility where IV fluids can be given.
B. Supervise the mother in giving 200 to 400 ml. of Oresol in 4 hours.
A. 1 year C. Give the infant’s mother instructions on home management.
B. 3 years D. Keep the infant in your health center for close observation.
C. 10 years 12. A mother is using Oresol in the management of diarrhea of her 3-year old child.
D. Lifetime She asked you what to do if her child vomits. You will tell her to
A. Ascaris
B. Pinworm
C. Hookworm
D. Schistosoma
26. Which of the following signs indicates the need for sputum examination for AFB?
A. Hematemesis
B. Fever for 1 week
C. Cough for 3 weeks
D. Chest pain for 1 week
27. Which clients are considered targets for DOTS Category I?
A. Macular lesions
B. Inability to close eyelids
C. Thickened painful nerves
D. Sinking of the nosebridge
30. Which of the following clients should be classified as a case of multibacillary
leprosy?
A. Stream seeding A. I
B. Stream clearing B. II
C. Destruction of breeding places C. III
D. Zooprophylaxis D. IV
14. The use of larvivorous fish in malaria control is the basis for which strategy of 20. You are the PHN in the city health center. A client underwent screening for AIDS
malaria control? using ELISA. His result was positive. What is the best course of action that you may
take?
A. Stream seeding
B. Stream clearing A. Get a thorough history of the client, focusing on the practice of high risk behaviors.
C. Destruction of breeding places B. Ask the client to be accompanied by a significant person before revealing the result.
D. Zooprophylaxis C. Refer the client to the physician since he is the best person to reveal the result to the
15. Mosquito-borne diseases are prevented mostly with the use of mosquito control client.
measures. Which of the following is NOT appropriate for malaria control? D. Refer the client for a supplementary test, such as Western blot, since the ELISA result
may be false.
A. Use of chemically treated mosquito nets 21. Which is the BEST control measure for AIDS?
B. Seeding of breeding places with larva-eating fish
C. Destruction of breeding places of the mosquito vector A. Being faithful to a single sexual partner
D. Use of mosquito-repelling soaps, such as those with basil or citronella B. Using a condom during each sexual contact
16. A 4-year old client was brought to the health center with the chief complaint of C. Avoiding sexual contact with commercial sex workers
severe diarrhea and the passage of “rice water” stools. The client is most probably D. Making sure that one’s sexual partner does not have signs of AIDS
suffering from which condition? 22. The most frequent causes of death among clients with AIDS are opportunistic
diseases. Which of the following opportunistic infections is characterized by
A. Giardiasis tonsillopharyngitis?
B. Cholera
C. Amebiasis A. Respiratory candidiasis
D. Dysentery B. Infectious mononucleosis
17. In the Philippines, which specie of schistosoma is endemic in certain regions? C. Cytomegalovirus disease
D. Pneumocystis carinii pneumonia
A. S. mansoni 23. To determine possible sources of sexually transmitted infections, which is the
B. S. japonicum BEST method that may be undertaken by the public health nurse?
C. S. malayensis
D. S. haematobium A. Contact tracing
18. A 32-year old client came for consultation at the health center with the chief B. Community survey
complaint of fever for a week. Accompanying symptoms were muscle pains and body C. Mass screening tests
malaise. A week after the start of fever, the client noted yellowish discoloration of his D. Interview of suspects
sclera. History showed that he waded in flood waters about 2 weeks before the onset 24. Antiretroviral agents, such as AZT, are used in the management of AIDS. Which of
of symptoms. Based on his history, which disease condition will you suspect? the following is NOT an action expected of these drugs.
A. The older one gets, the more susceptible he becomes to the complications of chicken
pox.
B. A single attack of chicken pox will prevent future episodes, including conditions such
as shingles.
C. To prevent an outbreak in the community, quarantine may be imposed by health
authorities.
D. Chicken pox vaccine is best given when there is an impending outbreak in the
community.
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
Answers and Rationales 16. Answer: (B) Cholera. Passage of profuse watery stools is the major symptom of
1. Answer: (B) Liver cirrhosis. The etiologic agent of schistosomiasis in the cholera. Both amebic and bacillary dysentery are characterized by the presence of
Philippines is Schistosoma japonicum, which affects the small intestine and the liver. blood and/or mucus in the stools. Giardiasis is characterized by fat malabsorption and,
Liver damage is a consequence of fibrotic reactions to schistosoma eggs in the liver. therefore, steatorrhea.
2. Answer: (C) Proper use of sanitary toilets. The ova of the parasite get out of the 17. Answer: (B) S. japonicum. S. mansoni is found mostly in Africa and South America;
human body together with feces. Cutting the cycle at this stage is the most effective S. haematobium in Africa and the Middle East; and S. malayensis only in peninsular
way of preventing the spread of the disease to susceptible hosts. Malaysia.
3. Answer: (B) II. A communal faucet or water standpost is classified as Level II. 18. Answer: (D) Leptospirosis. Leptospirosis is transmitted through contact with the
4. Answer: (A) Use of sterile syringes and needles. Hepatitis A is transmitted skin or mucous membrane with water or moist soil contaminated with urine of
through the fecal oral route. Hepatitis B is transmitted through infected body infected animals, like rats.
secretions like blood and semen. 19. Answer: (C) III. Waterworks systems, such as MWSS, are classified as level III.
5. Answer: (A) DPT. DPT is sensitive to freezing. The appropriate storage temperature 20. Answer: (D) Refer the client for a supplementary test, such as Western blot,
of DPT is 2 to 8° C only. OPV and measles vaccine are highly sensitive to heat and since the ELISA result may be false. A client having a reactive ELISA result must
require freezing. MMR is not an immunization in the Expanded Program on undergo a more specific test, such as Western blot. A negative supplementary test
Immunization. result means that the ELISA result was false and that, most probably, the client is not
6. Answer: (A) 45. To estimate the number of infants, multiply total population by 3%. infected.
7. Answer: (B) Severe dehydration. The order of priority in the management of 21. Answer: (A) Being faithful to a single sexual partner. Sexual fidelity rules out
severe dehydration is as follows: intravenous fluid therapy, referral to a facility where the possibility of getting the disease by sexual contact with another infected person.
IV fluids can be initiated within 30 minutes, Oresol/nasogastric tube, Oresol/orem. Transmission occurs mostly through sexual intercourse and exposure to blood or
When the foregoing measures are not possible or effective, tehn urgent referral to the tissues.
hospital is done. 22. Answer: (B) Infectious mononucleosis. Cytomegalovirus disease is an acute viral
8. Answer: (A) 3. Adequate blood supply to the area allows the return of the color of disease characterized by fever, sore throat and lymphadenopathy.
the nailbed within 3 seconds. 23. Answer: (A) Contact tracing. Contact tracing is the most practical and reliable
9. Answer: (B) Instruct the mother to give the child Oresol. Since the child does method of finding possible sources of person-to-person transmitted infections, such as
not manifest any other danger sign, maintenance of fluid balance and replacement of sexually transmitted diseases.
fluid loss may be done by giving the client Oresol. 24. Answer: (D) They are able to bring about a cure of the disease
10. Answer: (B) Buccal mucosa. Koplik’s spot may be seen on the mucosa of the condition. There is no known treatment for AIDS. Antiretroviral agents reduce the
mouth or the throat. risk of opportunistic infections and prolong life, but does not cure the underlying
11. Answer: (D) Measles. Viral conjunctivitis is transmitted by direct or indirect contact immunodeficiency.
with discharges from infected eyes. Acute poliomyelitis is spread through the fecal- 25. Answer: (D) Consult a physician who may give them rubella
oral route and contact with throat secretions, whereas diphtheria is through direct and immunoglobulin. Rubella vaccine is made up of attenuated German measles
indirect contact with respiratory secretions. viruses. This is contraindicated in pregnancy. Immune globulin, a specific prophylactic
12. Answer: (A) Hemophilus influenzae. Hemophilus meningitis is unusual over the against German measles, may be given to pregnant women.
age of 5 years. In developing countries, the peak incidence is in children less than 6 26. Answer: (D) Proper handwashing during food preparation is the best way of
months of age. Morbillivirus is the etiology of measles. Streptococcus pneumoniae and preventing the condition. Symptoms of this food poisoning are due to
Neisseria meningitidis may cause meningitis, but age distribution is not specific in staphylococcal enterotoxin, not the microorganisms themselves. Contamination is by
young children. food handling by persons with staphylococcal skin or eye infections.
13. Answer: (D) Zooprophylaxis. Zooprophylaxis is done by putting animals like cattle 27. Answer: (A) The older one gets, the more susceptible he becomes to the
or dogs close to windows or doorways just before nightfall. The Anopheles mosquito complications of chicken pox. Chicken pox is usually more severe in adults than in
takes his blood meal from the animal and goes back to its breeding place, thereby children. Complications, such as pneumonia, are higher in incidence in adults.
preventing infection of humans. 28. Answer: (C) Young adult males. Epididymitis and orchitis are possible
14. Answer: (A) Stream seeding. Stream seeding is done by putting tilapia fry in complications of mumps. In post-adolescent males, bilateral inflammation of the
streams or other bodies of water identified as breeding places of the Anopheles testes and epididymis may cause sterility.
mosquito
15. Answer: (C) Destruction of breeding places of the mosquito
vector. Anopheles mosquitoes breed in slow-moving, clear water, such as mountain
streams.