Question 1

WRONG

If a child with diarrhea registers two signs in the yellow row in the IMCI chart, we can classify the
patient as:

Moderate dehydration

Some dehydration

Severe dehydration

No dehydration

Question 2

WRONG

Shelly has had diarrhea for 8 days. There is no blood in the stool, he is irritable, his eyes are sunken,
the nurse offers fluid to Shelly and he drinks eagerly. When the nurse pinched the abdomen it goes
back slowly. How will you classify Shellys Illness?

Moderate dehydration

Some dehydration

Severe dehydration

No dehydration

Question 3

WRONG

A child who is 7 weeks has had diarrhea for 14 days but has no sign of dehydration is classified as?

Persistent diarrhea
 Severe dysentery

Dysentery

Severe Persistent diarrhea

Question 4

WRONG

The child with no dehydration needs home treatment. Which of the following is not included in the
rules for home treatment in this case?

Forced fluids

When to return

Give Vitamin A supplement

Feeding more

Question 5

WRONG

Fever as used in IMCI includes:

Axillary temperature of 37.5 or higher

Rectal temperature of 38 or higher

Feeling hot to touch

All of the above

 A and C only

Question 6

WRONG

An important role of the community health nurse in the prevention and control of Dengue
Hemorrhagic-fever includes:

Advising the elimination of vectors by keeping water containers covered

Conducting strong health education drives/campaign directed toward proper garbage disposal

Explaining to the individuals, families, groups and community the nature of the disease and its
causation.

Practicing residual spraying with insecticides

Question 7

WRONG

Community health nurses should be alert in observing a Dengue suspect. The following is NOT an
indicator for hospitalization of H-fever suspects?

Marked anorexia, abdominal pain and vomiting

Increasing hematocrit count

Cough of 30 days

Persistent headache

Question 8

WRONG
The community health nurses primary concern in the immediate control of hemorrhage among
patients with dengue is:

Advising low fiber and non-fat diet

Providing warmth through light weight covers

Observing closely the patient for vital signs leading to shock

Keeping the patient at rest.

Question 9

WRONG

Which of these signs may NOT be REGARDED as a truly positive signs indicative of Dengue H-fever?

Prolonged Bleeding Time

Appearance of at least 20 petechiae within 1 cm square

Steadily increasing hematocrit count

Fall in the platelet count

Question 10

WRONG

Which of the following is the most important treatment of patients with Dengue H-fever?

Give aspirin for fever

Replacement of body fluids

Avoid unnecessary movement

 Ice cap over abdomen in case of melena

Question 11

WRONG

In correcting misconception and myths about certain diseases and their management, the health
worker should first:

Identify the myths and misconceptions prevailing in the community

Identify the source of these myths and misconceptions

Explain how and why these myths came about

Select the appropriate IEC strategies to correct them.

Question 12

WRONG

How many percent of measles are prevented by immunization at 9 months age?

85%

90%

99 %

95 %

Question 13

WRONG

After TT3 vaccination a mother is said to be protected to tetanus by around?

 80 %

85 %

99 %

95 %

Question 14

WRONG

If ever convulsion occurs after administering DPT, what should nurse best suggest to the mother?

Do not continue DPT vaccination anymore

Advise mother to come back aster 1 week

Give DT instead of DPT

Give pertussis of the DPT and remove DT

Question 15

WRONG

These vaccines are given 3 doses at one month intervals:

DPT, BCG, TT

DPT, TT, OPV

OPV, Hep. B, DPT

 Measles, OPV, DPT

Question 16

WRONG

Which among the following is the primary focus of prevention of cancer?

Elimination of conditions causing cancer

Diagnosis and treatment

Treatment at early stage

Early detection

Question 17

WRONG

In the prevention and control of cancer, which of the following activity is the most important function
of the community health nurse?

Conduct community assemblies

Referral to cancer specialist those clients with symptoms of cancer

Use the nine warning signs of cancer as parameters in our process of detection; control and
treatment modalities.

Teach woman about proper/correct nutrition.

Question 18

WRONG

Who among the following are recipients of the secondary level of care for cancer cases?
 Those under early case detection

Those under supportive care

Those scheduled for surgery

Those under going treatment

Question 19

WRONG

Who among the following are recipients of the tertiary level of care for cancer cases?

Those under early treatment

Those under supportive care

Those under early detection

Those scheduled for surgery

Question 20

WRONG

In Community Health Nursing, despite the availability and use of many equipment and devices to
facilitate the job of the community health nurse, the nurse should be prepared to apply is a scientific
approach. This approach ensures quality of care even at the community setting. This nursing
parlance is nothing less than the:

Nursing diagnosis

Nursing protocol
 Nursing research

Nursing process

Question 21

WRONG

Carlina is 15 months old and weighs 5.5 kgs and it is her initial visit. Her mother says that Carlina is
not eating well and unable to breastfeed, he has no vomiting, has no convulsion and not abnormally
sleepy or difficult to awaken. Her temperature is 38.9 deg C. Using the IMCI strategy, if you were the
nurse in charge of Carlina, how will you classify her illness?

a child at a general danger sign

very severe febrile disease

severe pneumonia

severe malnutrition

Question 22

WRONG

Why are small for gestational age newborns at risk for difficulty maintaining body temperature?

their skin is more susceptible to conduction of cold

they are preterm so are born relatively small in size

they do not have as many fat stored as other infants

they are more active than usual so they throw off comes

Question 23
 WRONG

Oxytocin is administered to Rinna to augment labor. What are the first symptoms of water
intoxication to observe for during this procedure?

headache and vomiting

a swollen tender tongue

a high choking voice

abdominal bleeding and pain

Question 24

WRONG

Which of the following treatment should NOT be considered if the child has severe dengue
hemorrhagic fever?

use plan C if there is bleeding from the nose or gums

give ORS if there is skin Petechiae, persistent vomiting, and positive tourniquet test

give aspirin

prevent low blood sugar

Question 25

WRONG

In assessing the patients condition using the Integrated Management of Childhood Illness approach
strategy, the first thing that a nurse should do is to:

ask what are the childs problem

 check the patients level of consciousness

check for the four main symptoms

check for the general danger signs

Question 26

WRONG

A child with diarrhea is observed for the following EXCEPT:

how long the child has diarrhea

skin Petechiae

presence of blood in the stool

signs of dehydration

Question 27

WRONG

The child with no dehydration needs home treatment. Which of the following is NOT included in the
care for home management at this case?

give drugs every 4 hours

continue feeding the child

give the child more fluids

inform when to return to the health center

Question 28
 WRONG

Ms. Jordine, RN, believes that a patient should be treated as individual. This ethical principle that the
patient referred to:

beneficence

nonmaleficence

respect for person

autonomy

Question 29

WRONG

When patients cannot make decisions for themselves, the nurse advocate relies on the ethical
principle of:

justice and beneficence

fidelity and nonmaleficence

beneficence and nonmaleficence

fidelity and justice

Question 30

WRONG

Being a community health nurse, you have the responsibility of participating in protecting the health
of people. Consider this situation: Vendors selling bread with their bare hands. They receive money
with these hands. You do not see them washing their hands. What should you say/do?
 Miss, may I get the bread myself because you have not washed your hands

All of these

Miss, it is better to use a pick up forceps/ bread tong

Miss, your hands are dirty. Wash your hands first before getting the bread

uestions

1. Which is the primary goal of community health nursing?

A. To support and supplement the efforts of the medical profession in

the promotion of health and prevention of
B. To enhance the capacity of individuals, families and communities to
cope with their health needs
C. To increase the productivity of the people by providing them with
services that will increase their level of health
D. To contribute to national development through promotion of family
welfare, focusing particularly on mothers and children

2. CHN is a community-based practice. Which best explains this

statement?

A. The service is provided in the natural environment of people

B. The nurse has to conduct community diagnosis to determine nursing
needs and problems
C. The service are based on the available resources within the
community
D. Priority setting is based on the magnitude of the health problems
identified

3. Population- focused nursing practice requires which of the

following processes?

A. Community organizing .
B. Nursing, process
C. Community diagnosis
D. Epidemiologic process

4. RA 1054 is also known as the Occupational Health Act. Aside

from the number of employees, what other factor must be
considered in determining the occupational health privileges to
which the workers will be entitled?

A. Type of occupation,: agriculture, commercial, industrial

B. Location of the workplace in relation to health facilities
C. Classification of the business enterprise based on net profit
D. Sex and age composition of employees

5. A business firm must employ an occupational health nurse

when it has at least how many employees.

A. 21
B. 101
C. 201
D. 301

6. When the occupational health nurse employs ergonomic

principles, she is performing which of her roles?
A. Health care provider
B. Health educator
C. Health care coordinator
D. Environment manager

7. A garment factory does not have an occupational nurse. Who

shall provide the occupational health needs of the factory
workers?

A. Occupational health nurse at the Provincial Health Office

B. Physician employed by the factory
C. Public Health nurse of the RHU of their municipality
D. Rural Sanitary inspector of the RHU in their municipality

8. Public health services are given free of charge. Is this

statement true or false?

A. The statement is true; it is the responsibility of government to

provide haste services
B. The statement is false; people pay indirectly for public health
services
C. The statement may be true or false; depending on the Specific
service required
D. The statement may be true or false; depending on policies of the
government concerned.

9. According to C.E. Winslow, which of the following is the goal

of Public Health?

A. For people to attain their birthrights and longevity

B. For promotion of health and prevention and diseases
C. For people to have access to basic health services
D. For people to be organized in their health efforts

10. We say that a Filipino has attained longevity when he is

able to reach the average life span of Filipinos. What other
statistic may be used to determine attainment of longevity?

A. Age-specific mortality rate

B. Proportionate mortality rate
C. Swaroops index
D. Case fatality rate

11. Which of the following is the most prominent feature of

public health nursing?

A. It involves providing home care to sick people who are not confined
in the hospital
B. Services are provided free of charge to people within the catchment
area
C. The public health nurse functions as part of a team providing a
public health nursing service
D. Public health nursing focuses on preventive, not curative services

12. According to Margaret Shetland, the philosophy of public

health nursing is based on which of the following?

A. Health and longevity as birthrights

B. The mandate of the state to protect the birthrights of its citizens
C. Public health nursing as a specialized field of nursing
D. The worth and dignity of man
13. Which of the following is the mission of the Department of
Health?

A. Health for all Filipinos

B. Ensure the accessibility and quality of health
C. Improve the general health status of the population
D. Health in the hands of the Filipino people by the year 2020

14. Region IV Hospital is classified as what level of facility?

A. Primary
B. Secondary
C. Intermediate
D. Tertiary

15. What is true of primary facilities?

A. They are usually government-run

B. Their services are provided on an out-patient basis
C. They are training facilities for health professionals
D. A community hospital is an example of this level of health facilities

16. Which is an example of the school nurses health care

provider function?

A. Requesting for BCG from the RHU for school entrance immunization
B. Conducting random classroom inspection during 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 times
17. When the nurse determines whether resources were
maximized in implementing Ligtas Tigdas, she is evaluating:

A. Effectiveness
B. Efficiency
C. Adequacy
D. Appropriateness

18. You are a new B.S.N. graduate. You want to become a

Public Health Nurse. Where will you apply?

A. Department of Health
B. Provincial Health Office
C. Regional Health Office
D. Rural Health Unit

19. 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

20. Who is the Chairman of the Municipal Health Board?

A. Mayor
B. Municipal Health Officer
C. Public Health Nurse
D. Any qualified physician
21. Which level of health facility is the usual point of entry of a
client into the health care delivery system?

A. Primary
B. Secondary
C. Intermediate
D. Tertiary

22. The public health nurse is the supervisor of rural health

midwives. Which of the following is a supervisory function of
the pubic health nurse?

A. Referring cases or patients to the midwife

B. Providing technical guidance to the midwife
C. Proving nursing care to cases referred by the midwife
D. Formulating and implementing training programs for midwives

23. One of the participants in a hilot training class asked you to

whom she should refer a patient in labor who develops a
complication. You will answer, to the;

A. Public health nurse

B. Rural health midwife
C. Municipal health officer
D. Any of these health professionals

24. You are the public health nurse in a municipality with a

total population of about 20,000. There are3 health midwives
among the RHU personnel. How many more midwife items will
the RHU need?
A. 1
B. 2
C. 3
D. 4

25. If the RHU needs additional midwife items, you will submit
the request for additional midwife items for approval to the:

A. Rural Health Unit

B. District Health Office
C. Provincial Health Office
D. Municipal Health Board

26. As an epidemiologist, the nurse is responsible for reporting

cases or notifiable diseases. What law mandates reporting
cases of notifiable diseases?

A. Act 3573
B. RA.3753
C. RA 1054
D. RA 1082

27. According to Freeman and Heinrich, community health

nursing is a developmental service. Which of the following best
illustrates this statement?

A. The community health nurse continuously develops himself

personally and professionally
B. Health education and community organizing are necessary in
providing community health services
C. Community health nursing in intended primarily for health
promotion and prevention and treatment of disease.
D. The goal of community health nursing is to provide nursing services
to people in their own place of .residence

28. Which disease was declared through Presidential

Proclamation No. 4 as a target for, eradication in the
Philippines?

A. Pioliomyelitis
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

31. In which step are plans formulated for solving community

problems?
A. Mobilization
B. Community organization
C. Follow-up/extension
D. Core group formation

32. The public health nurse takes an active role in community

participation. What is the primary goal of community
organizing?

A. To educate the people regarding community health problems

B. To mobilize the people to resolve community health problems
C. To maximize the communitys resources in dealing with health
problems

33. An indicator of success in community organizing is when

people are able to:

A. Participate in community activities for the solution of a community

problem
B. Implement activities for the solution of the community problem
C. Plan activities for the solution of the community problem
D. Identify the health problem as a common concern

34. Tertiary prevention is needed in which stage of the natural

history of disease?

A. Pre-pathogenesis
B. Pathogenesis
C. Predromal
D. Terminal
35. Isolation of a child with measles belongs to what level of
prevention?

A. Primary
B. Secondary
C. Intermediate
D. Tertiary

36. On the other hand, Operation Timbang is_____ prevention?

A. Primary
B. Secondary
C. Intermediate
D. Tertiary

37. Which type of family-nurse contact will provide you with

the best opportunity to observe family dynamics?

A. Clinic consultation
B. Group conferences
C. Home visit
D. Written communication

38. The typology of family nursing problems is used in the

statement of nursing diagnosis in the care of families. The
youngest child of the delos Reyes family has been diagnosed as
mentally retarded. This is classified as:

A. Health threat
B. Health deficit
C. Foreseeable crisis
D. Stress point
39. The delos Reyes couple have 6-year old child entering
school for the first time. The delos Reyes family has a:

A. Health threat
B. Health deficit
C. Foreseeable crisis
D. Stress point

40. Which of the following is an advantage of a home visit?

A. It allows the nurse to provide nursing care to a greater number of

people
B. It provides an opportunity to do first hand appraisal of the home
situation
C. It allows sharing of experience among people with similar health
problems
D. It develops the familys initiative in providing for health needs of its
members

41. Which is CONTRARY to the principles in planning a home

visit?

A. A home visit should have a purpose of objective

B. The plan should revolve around the family health .needs
C. A home visit should be conducted in the manner prescribed by RHU
D. Planning of continuing care should involve a responsible-family
member

42. The PHN bag is an important tool in providing nursing care

during a home visit. The most important principle in bag
technique states that it;
A. Should save time and effort
B. Should minimize if not totally prevent the spread of infection
C. Should not overshadow concern for the patient and his family
D. May be done in variety of ways depending on the home situation,
etc.

43. To maintain the cleanliness of the bag and its contents,

which of the following must the nurse do?

A. Wash his/her hands before and after providing nursing care to the
family members
B. In the care of family members, as much as possible, use only
articles taken from the bag
C. Put on an apron to protect her uniform and fold it with the right side
out before putting it back into the bag.
D. At the end of the visit, fold the lining on which the bag was placed,
ensuring that the contaminated side is on the outside.

44. The public health conducts a study on the factors

contributing to the high morality rate due to heart diseases in
the municipality where she works. Which branch of
epidemiology does the nurse practice in this situation?

A. Descriptive
B. Analytical
C. Therapeutic
D. Evaluation

45. Which of the following is a function of epidemiology?

A. Identifying the disease condition based on manifestations presented

by a client
B. Determining factors that contributed to the occurrence
of pneumonia in a 3 year old
C. Determining the efficacy of the antibiotic used in the treatment of
the 3 year old client with pneumonia
D. Evaluating the effectiveness of the implementation of the Integrated
Management of Childhood Illness

46. Which of the following is an epidemiologic function of the

nurse during an epidemic?

A Conducting assessment of suspected cases to detect the

communicable 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

47. The primary purpose of conducting an epidemiologic

investigation is to;

A. Delineate the etiology of the epidemic

B. Encourage cooperation and support of the community
C. Identify groups who are at risk of contracting the disease
D. Identify geographical location of cases of the disease in the
community

48. Which is a characteristic of person-to-person propagated

epidemic?
A. There are more cases of the disease than expected
B. The disease must necessarily be transmitted through a vector
C. The spread of the disease can be attributed to a common vehicle
D. There is gradual build up of cases before we epidemic becomes
easily noticeable

49. In the investigation of an epidemic, you compare the

present frequency of the disease with the usual frequency at
this time of the year in this community. This is done during
which stage of the investigation?

A. Establishing the epidemic

B. Testing the hypothesis
C. Formulation of the hypothesis
D. Appraisal of facts

50. The number of cases of Dengue fever usually increases

towards the end of the rainy season. This pattern of occurrence
of Dengue fever is best described as;

A. Epidemic occurrence
B. Cyclical variation
C. Sporadic occurrence
D. Secular occurrence

51. In the year 1980, the World Health Organization declared

the Philippines, together with some other countries in the
Western Pacific Region, free of which disease?

A. Pneumonic plaque
B. Poliomyelitis
C. Small pox
D. Anthrax

52. In the census of the Philippines in 1995, there were about

35,299,000 males and about 34,968,000 females. What is the
sex ratio?

A. 99.06:100
B. 100.94:100
C. 50.23%
D. 49.76%

53. Primary health care is a total approach to community

development. Which of the following is an indicator of success
in the use of the primary health care approach?

A. Health services are provided free of charge to individuals and

families
B. Local officials are empowered as the major decision makers in
matters of health
C. Health workers are able too provide care based on identified health
needs of the people
D. Health programs are sustained according to the level of
development of the community

54. Sputum examination is the major screening tool for

pulmonary tuberculosis. Clients would sometimes get false
negative results in this exam. This means that the test is not
perfect in terms of which characteristic of a diagnostic
examination?
A. Effectiveness
B. Efficacy
C. Specificity
D. Sensitivity

55. Use of appropriate technology requires knowledge of

indigenous technology. Which medical herb is given for fever,
headache and cough?

A. Sambong
B. Tsaang gubat
C. Akapulko
D. Lagundi

56. What law created the Philippine institute of Traditional and

Alternative Health Care?

A. RA 8483
B. RA4823
C. RA 2483
D. RA 3482

57. In traditional Chinese medicine, the yielding, negative and

feminine force is termed:

A. Yin
B. Yang
C. Qi
D. Chai

58. What is the legal basis of Primary Health Care approach in

the Philippines?
A. Alma Ata Declaration of PHC
B. Letter of Instruction No 949
C. Presidential Decree No. 147
D. Presidential Decree 996

59. Which of the following demonstrates inter-sectoral

linkages?

A. Two-way referral system

B. Team approach
C. Endorsement done by a midwife to another midwife
D. Cooperation between PHN and public school teacher

60. The municipality assigned to you has a population of about

20/000. Estimate the number of 1-4 year old children who be
given Retinol capsule 200.000 every 6 months.

A. 1,500
B. 1,800
C. 2,000
D. 2,300

61. Estimate the number of pregnant women who will be given

tetanus toxoid during an immunization outreach activity in a
barangay with a population of about 1,500.

A. 265
B. 300
C. 375
D. 400
62. To describe the sex composition of the population, which
demographic tool may be used?

A. Sex ratio
B. Sex proportion
C. Population pyramid
D. Any of these maybe used

63. Which of the following is a natality rate?

A. Crude birth rate

B. Neonatal mortality rate
C. Infant mortality rate
D. General fertility rate

64. You are computing the crude rate of your municipality, with
a total population o about 18,000 for last year. There were 94
deaths. Among those who died, 20 died because of diseases of
the heart and 32 were aged 50 years or older. What is the
crude death rate?

A. 4.1/1000
B. 5.2/1000
C. 6.3/1000
D. 7.3/1000

65. Knowing that malnutrition is a frequent community health

problem, you decided to conduct nutritional assessment. What
population is particularly susceptible to protein energy
malnutrition (PEM)?
A. Pregnant women and the elderly
B. Under 5 year old children
C. 1-4 year old children
D. School age children

66. Which statistic can give the most accurate reflection of the
health status of a community?

A. 1-4 year old age-specific mortality rate

B. Infant mortality rate
C. Swaroops index
D. Crude death rate

67. In the past year, Barangay A had an average population of

1655. 46 babies were born in that year, 2 of whom died less
than 4 weeks after they were born. They were 4 recorded
stillbirths. What is the neonatal mortality rate?

A. 27.8/1000
B. 43.5/1000
C. 86.9/1000
D. 130.4/1000

68. Which statistic best reflects the nutritional status of a

population?

A. 1-4 year old age-specific mortality rate

B. Proportionate mortality rate
C. Infant mortality rate
D. Swaroops index

69. What numerator is used in computing general fertility rate?

A. Estimated midyear population
B. Number of registered live births
C. Number of pregnancies in the year
D. Number of females of reproductive age

70. You will gather data for nutritional assessment of a purok.

You will gather information only from families with members
who belong to the target population for PEM. What method of
delta gathering is best for this purpose?

A. Census
B. Survey
C. Record Review
D. Review of civil registry

71. In the conduct of a census, the method of population

assignment based on the actual physical location of the people
is termed;

A. De jure
B. De locus
C. De facto
D. De novo

72. The Field Health Services and information System (FHSIS)

is the recording and reporting system in public health) care in
the Philippines. The monthly field health service activity report
is a form used in which of the components of the FHSIS?

A. Tally report
B. Output report
C. Target/client list
D. Individual health record

73. To monitor clients registered in long-term regimens, such

as the Multi-Drug Therapy, which component will be most
useful?

A. Tally report
B. Output report
C. Target/client list
D. Individual health record

74. Civil registries are important sources of data. Which law

requires registration of births within 30 days from the
occurrence of the birth?

A. PD 651
B. Act 3573
C. RA 3753
D. RA 3375

75. Which of the following professionals can sign the birth

certificate?

A. Public health nurse

B. Rural health midwife
C. Municipal health officer
D. Any of these health professionals

76. Which criterion in priority setting of health problems is

used only in community health care?
A. Modifiability of the problem
B. Nature of the problem presented
C. Magnitude of the health problem
D. Preventive potential of the health problem

77. The Sentrong Sigla Movement has been launched to

improve health service delivery. Which of the following is/are
true of this movement?

A. This is a project spearheaded by local government units

B. It is a basis for increasing funding from local government units
C. It encourages health centers to focus on disease prevention and
control
D. Its main strategy is certification of health centers able to comply
with standards

78. Which of the following women should be considered as

special targets for family planning?
A. Those who have two children or more
B. Those with medical conditions such as anemia
C. Those younger than 20 years and older than 35 years
D. Those who just had a delivery within the past 15 months

79. Freedom of choice in one of the policies of the Family

Planning Program of the Philippines. Which of the following
illustrates this principle?

A. Information dissemination about the need for family planning

B. Support of research and development in family planning methods
C. Adequate information for couples regarding the different methods
D. Encouragement of couples to take family planning as a joint
responsibility
80. A woman, 6 months pregnant, came to the center for
consultation. Which of the following substances is
contraindicated?

A. Tetanus toxoid
B. Retinol 200,000 IU
C. Ferrous sulfate 200mg
D. Potassium iodate 200 mg, capsule

81. During prenatal consultation, a client asked you if she can

have her deliveryat home. After history taking and physical
examination, you advised her against a home delivery. Which of
the following findings disqualifies her for a home delivery?

A. Her OB score is G5P3

B. She has some palmar pallor
C. Her blood pressure is 130/80
D. Her baby is in cephalic presentation

82. Inadequate intake by the pregnant woman of which vitamin

may cause neural tube defects?

A. Niacin
B. Riboflavin
C. Folic Acid
D. Thiamine

83. You are in a clients home to attend to a delivery. Which of

the following will you do first?

A. Set up a sterile area

B. Put on a clean gown and apron
C. Cleanse the clients vulva with soap and water
D. Note the interval, duration and intensity of labor and contractions

84. In preparing a primigravida for breastfeeding, which of the

following will you do?

A. Tell her that lactation begins within a day after delivery

B. Teach her nipple stretching exercises if her nipples are everted
C. Instruct her to wash her nipples before and after each breastfeeding
D. Explain to her that putting the baby to breast will lessen blood loss
after delivery

85. A primigravida is instructed to offer her breast to the baby

for the first time within 30 minutes after delivery. What is the
purpose of offering the breast this early?

A. To initiate the occurrence of milk letdown

B. To stimulate milk production by the mammary acini
C. To make sure that the baby is able to get the colustrum
D. To allow the woman to practice breastfeeding in the presence of the
health worker

86. In a mothers class, you discuss proper breastfeeding

technique. Which of these is a sign that the baby has lactated
on the breast property?

A. The baby takes shallow, rapid sucks

B. The mother does not feel nipple pain
C. The babys mouth is only partly open
D. Only the mothers nipple is inside the babys mouth
87. You explain to a breastfeeding mother that breastmilk is
sufficient for all of the babys nutrient needs only up to:

A. 3 months
B. 6 months
C. 1 year
D. 2 years

88. What is given to a woman within a month after

the delivery of a baby?

A. Malunggay capsule
B. Ferrous sutfate l00mg O.D.
C. Retinol 200.000 IU 1 capsule
D. Potassium Iodate 200 mg, 1 capsule

89. Which biological used in EPI is stored in the freezer?

A. DPT
B. Tetanus toxoid
C. Measles vaccine
D. Hepatitis B vaccine

90. Unused BCG should be discarded how many hours after

reconstitution?

A. 2
B. 4
C. 6
D. At the end of the day
91. In immunity school entrants with BCG, you not obliged to
secure parental consent. This is because of which legal
document?

A. PD 996
B. RA 7864
C. Presidential Proclamation No. 6
D. Presidential Proclamation No. 46

92. Which immunization produces a permanent scar?

A. DPT
B. BCG
C. Measles vaccination
D. Hepatitis B vaccination

93. A 4 week old baby 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 Vaccin

94. You will not give DPT 2 if the mother says that the infant
had?

A. Seizures a day after DPT1

B. Fever for 3 days after DPT1
C. Abscess formation after DPT1
D. Local tenderness for 3 days after DPT1
95. A 2-month old infant was brought to the health center for
immunization. During assessment, the infants temperature
registered at 38.1 C. Which is the best course of action that you
will take?

A. Go on with the infants immunization

B. Give paracetamol and wait for his fever to subside
C. Refer the infant to the physician for further assessment
D. Advise the infants mother to bring him back for immunization when
he is well

96. A 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

97. A 4-month old infant was brought to the health center of

cough. Her respiratory rate is 42/minute. Using the IMCI
guidelines of assessment, her breathing is considered;

A. Fast
B. Slow
C. Normal
D. Insignificant

98. Which of the following signs will indicate that a young child
is suffering from severe pneumonia?
A. Dyspnea
B. Wheezing
C. Fast breathing
D. Chest indrawing

99. Using IMCI guidelines, you classify a child as having

severe pneumonia. What is the best management for the child?

A. Prescribe antibiotic
B. Refer him urgently to the hospital
C. Instruct the mother to increase fluid intake
D. Instruct the mother to continue breastfeeding

100. A 5-month old infant was brought by his mother to the

health center because of diarrhea occurring 4 to 5 times a day.
His skin goes back slowly after a skin pinch and his eyes are
sunken. Using the IMCI guidelines, you will classify this infant
in which category?

A. No signs of dehydration
B. Some dehydration
C. Severe dehydration
D. The data is insufficient

101. Based on the assessment, you classified a 3-month old

infant with the chief complaint of diarrhea in the category of
SOME DEHYDRATION. Based on the IMCI management
guidelines, which of the following will you do?

A. Bring the infant to the nearest facility where IV fluids can be given
B. Supervise the mother in giving 200 to 400 ml of Oresol in 4 hours
C. Give the infants mother instructions on home management
D. Keep the infant in your health center for close observation

102. A mother is using Oresol in the management

of diarrhea of her 3-year old child. She asked you what to do if
her child vomits. You will tell her to:

A. Bring the child to the nearest hospital for further assessment

B. Bring the child to the health center for IV therapy
C. Bring the child to the health center for assessment by the physician
D. Let the child rest for 10 minutes then continue giving Oresol more
slowly

103. A 1 1/2 year old child was classified as having 3rd degree
of protein energy malnutrition, kwashjorkor. Which of the
following signs will be most apparent in this child?

A. Voracious appetite
B. Wasting
C. Apathy
D. Edema

104. Assessment of a 2-year old child revealed baggy pants.

Using the IMCI guidelines, how will you manage this child?
A. Refer the child urgently to a hospital for confinement
B. Coordinate with the social worker to enroll the child in a feeding
program
C. Make a teaching plan for the mother, focusing on the menu planning
for her child
D. Assess and treat the child for health problems like infections and
intestinal parasitism
105. During the physical examination of a young child, what is
the earliest sign of xerophthalmia that may observe?

A. Keratomalacia
B. Corneal opacity
C. Night blindness
D. Conjunctival xerosis

106. To prevent xerophthalmia, young children are given

Retinol capsule every 6 months. What is the dose given to
preschoolers?

A. 10, 000 IU
B. 20, 000 IU
C. 100, 000 IU
D. 200, 000 IU

107. The major sign of iron deficiency anemia is pallor. What

part is best examined for pallor?

A. Palms
B. Nailbeds
C. Around the lips
D. Lower conjunctival sac

108. Food fortification is one of the strategies to prevent

micronutrient deficiency conditions. RA 8976 mandates
fortification of certain food items. Which of the following is
among these food items?

A. Sugar
B. Bread
C. Margarine
D. Filled milk

109. What is the best course of action when there is a measles

epidemic in a nearby municipality?

A. Give measles vaccine to babies aged 6 to 3 months

B. Give babies aged 6 to 11 months one dose of 100,000 IU of Retinol
C. Instruct mother to keep their babies at home to prevent disease
transmission
D. Instruct mothers to feed their babies adequately to enhance their
babies resistance

110. A mother brought her daughter, 4 years old, to the RHU

because of cough and colds. Following the IMCI assessment
guide, which of the following is a danger sign that indicates the
need for urgent referral to a hospital?

A. Inability to drink
B. High grade fever
C. Signs of severe dehydration
D. Cough for more than 30 days

111. Management of a child with measles includes the

administration of which of the following?

A. Gentian violet on mouth lesions

B. Antibiotic to prevent pneumonia
C. Tetracycline eye ointment for corneal opacity
D. Retinol capsule regardless of when the last dose was given
112. A mother brought her 10 month old infant for consultation
because of feverwhich started 4 days prior to consultation. To
determine malaria risk, what will you do?

A. Do a tourniquet test
B. Ask where the family resides
C. Get a specimen for blood smear
D. Ask if the fever is present everyday

113. The following are strategies implemented by the DOH to

prevent mosquito-borne diseases. Which of these is most
effective in the control of Dengue fever?

A. Stream seeding with larva-eating fish

B. Destroying breeding places of mosquitoes
C. Chemoprophylaxis of non-immune persons going to endemic areas
D. Teaching people in endemic areas to use chemically treated
mosquito nets

114. Secondary prevention for malaria includes?

A. Planting of neem or eucalyptus trees

B. Residual spraying of insecticides at night
C. Determining whether a place is endemic or not
D. Growing larva-eating fish in mosquito breeding places

115. Scotch tape swab is done to check for which intestinal

parasite?

A. Ascaris
B. Pinworm
C. Hookworm
D. Schistosoma

116. Which of the following signs indicates the need for sputum
examination for AFB?

A. Hematemesis
B. Fever for 1 week
C. Cough for 3 weeks
D. Chest pain for 1 week

117. Which clients are considered targets for DOTS category?

A. Sputum negative cavitary cases

B. Clients returning after default
C. Relapses and failures of previous PTB treatment regimens
D. Clients diagnosed for the first time through a positive sputum exam

118. To improve compliance to treatment, what innovation is

being implemented in DOTS?

A. Having the health worker follow up the client at home

B. Having the health worker or a responsible family member monitor
drug intake
C. Having the patient come to the health center every month to get his
medications
D. Having a target list to check on whether the patient has collected
his monthly supply of drugs

119. Diagnosis of leprosy is highly dependent on recognition of

symptoms. Which of the following is an early sign of leprosy?
A. Macular lesions
B. Inability to close eyelids
C. Thickened painful nerves
D. Sinking of the nose bridge

120. Which of the following clients should be classified as a

case of mutibacillary leprosy?

A. 3 skin lesions, negative slit skin smear

B. 3 skin lesions, positive slit skin smear
C. 5 skin lesions, negative slit skin smear
D. 5 skin lesions, positive slit skin smear

121. In the Philippines, which condition is the most frequent

cause of death associated by schistosomiasis?

A. Liver cancer
B. Liver cirrhosis
C. Bladder cancer
D. Intestinal perforation

122. What is the most effective way of controlling

schistosomiasis in an endemic area?

A. Use of molluscicides
B. Building of foot bridges
C. Proper use of sanitary toilets
D. Use of protective footwear, such as rubber boots

123. When residents obtain water from an artesian well in the

neighborhood, the level of this approved type of water facility
is:
A. I
B. II
C. III
D. IV

124. For prevention of Hepatitis A, you decided to conduct

health education activities. Which of the following is
Irrelevant?

A. Use of sterile syringes and needles

B. Safe food preparation and food handling by vendors
C. Proper disposal of human excreta and personal hygiene
D. Immediate reporting of water pipe leaks and illegal water
connections

125. Which biological used in EPI should not be stored in the

freezer?

A. DPT
B. OPV
C. Measles vaccine
D. MMR

126. You will conduct outreach immunization in a barangay

with a population of about 1500. Estimate the number of
infants in the barangay.

A. 45
B. 50
C. 55
D. 60
127. In IMCI, severe conditions generally require urgent
referral to a hospital. Which of the following severe conditions
Does not always require urgent referral to hospital?

A. Mastoiditis
B. Severe dehydration
C. Severe pneumonia
D. Severe febrile disease.

128. A client was diagnosed as having Dengue Fever. You will

say that there is slow capillary refill when the color of the
nailbed that you pressed does not return within how many
seconds?

A. 3
B. 5
C. 8
D. 10

129. A 3-year old child was brought by his mother to the health
center because of fever of 4-day duration. The child had a
positive tourniquet test result. In the absence of other signs,
which of the most appropriate measure that the PHN may carry
out to prevent Dengue shock syndrome?

A. Insert an NGT and give fluids per NGT

B. Instruct the mother to give the child Oresol
C. Start the patient on IV Stat
D. Refer the client to the physician for appropriate management

130. The pathognomonic sign of measles is Kopliks spot. You

may see Kopliks spot by inspecting the:
A. Nasal Mucosa
B. Buccal mucosa
C. Skin on the abdomen
D. Skin on the antecubital surface

131. Among the following diseases, which is airborne?

A. Viral conjunctivitis
B. Acute poliomyelitis
C. Diphtheria
D. Measles

132. Among children aged 2 months to 3 years, the most

prevalent form of meningitis is caused by which
microorganism?

A. Hemophilus Influenzae
B. Morbillivirus
C. Streptococcus Pneumoniae
D. Neisseria meningitides

133. Human beings are the major reservoir of malaria. Which of

the following strategies in malaria control is based on this fact?

A. Stream seeding
B. Stream clearing
C. Destruction of breeding places
D. Zooprophylaxis

134. The use of larvivorous fish in malaria control is the basis

for which strategy of malaria control?
A. Stream seeding
B. Stream clearing
C. Destruction of breeding places
D. Zooprophylaxis .

135. Mosquito-borne diseases are prevented mostly with the

use of mosquito control measures. Which of the following is
NOT appropriate for malaria control?

A. Use of chemically treated mosquito nets

B. Seeding of breeding places with larva-eating fish
C. Destruction of breeding places of the mosquito vector
D. Use of mosquito-repelling soaps, such as those with basil or
citronella

136. 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. Amebiasis
D. Dysentery

137. In the Philippines, which specie of schistosoma is endemic

in certain regions?

A. S. mansoni
B. S. japonicum
C. S. malayensis
D. S. haematobium
138. A 32 year old client came for consultation at the health
center with the chief complaint of fever for a week.
Accompanying symptoms were muscle pains and body malaise.
A week after the start of fever, the client noted yellowish
discoloration of his sclera. History showed that he waded in
flood waters about 2 weeks before the onset of symptoms.
Based on this history/ which disease condition will you
suspect?

A. Hepatitis A
B. Hepatitis B
C. Tetanus
D. Leptospirosis

139. MWSS provides water to Manila and other cities in Metro

Manila. This is an example of which level of water facility?

A. I
B. II
C. III
D. IV

140. You are the PHN in the city health center. A client
underwent screening for AIDS using ELISA. His result was
positive. What is the best course of action that you may take?

A. Get a thorough history of the client, focusing on the practice of high

risk behavior
B. Ask the client to be accompanied by a significant person before
revealing the result.
C. Refer the client to the physician since he is the best person to reveal
the result to the client
D. Refer the client for a supplementary test, such as Western blot,
since the ELISA result maybe false

141. Which is the BEST control measure for AIDS?

A. Being faithful to a single sexual partner

B. Using a condom during each sexual contact
C. Avoiding sexual contact with commercial sex workers
D. Making sure that ones sexual partner does not have signs of AIDS

142. The most frequent causes of death among clients

with AIDS are opportunistic diseases. Which of the following
opportunistic infections is characterized by
tonsilllopharyngitis?

A. Respiratory candidiasis
B. Infectious mononucleosis
C. Cytomegalovirus disease
D. Pneumocystis carinii pneumonia

143. To determine the possible sources of sexually transmitted

infections, which is the BEST method that may be undertaken
by the public health nurse?

A. Contact tracing
B. Community survey
C. Mass screening tests
D. Interview suspects

144. Antiretroviral agents, such as AZT are used in the

management of AIDS. Which of the following is not an action
expected of these drugs?
A. They prolong the life of the client with AIDS
B. They reduce the risk of opportunistic infections
C. They shorten the period of communicability of the disease
D. They are able to bring about a cure of the disease condition

145. A barangay had an outbreak of German measles. To

prevent congenital rubella, what is the BEST advice that you
can give to women in the first trimester of pregnancy in the
barangay?

a. Advice them on the sign of German Measles

b. Avoid crowded places, such as markets and moviehouses
c. Consult at the health center where rubella vaccine may be given
d. Consult a physician who may give them rubella immunoglobulin

Answers and Rationale

Gauge your performance by counter-checking your answers to those

below. If you have disputes or further questions, please direct them to
the comments section.

1. Answer: (B) To enhance the capacity of individuals, families and

communities to cope with their health needs.
To contribute to national development through promotion of family
welfare, focusing particularly on mothers and children.

2. Answer: (B) The nurse has to conduct community diagnosis to

determine nursing needs and problems.
Community-based practice means providing care to people in their own
natural environments: the home, school and workplace, for example.
3. Answer: (C) Community diagnosis
Population-focused nursing care means providing care based on the
greater need of the majority of the population. The greater need is
identified through community diagnosis.

4. Answer: (B) Location of the workplace in relation to health facilities

Based on R.A. 1054, an occupational nurse must be employed when
there are 30 to 100 employees and the workplace is more than 1 km.
away from the nearest health center.
5. Answer: (B) 101

6. Answer: (D) Environmental manager

Ergonomics is improving efficiency of workers by improving the
workers environment through appropriately designed furniture, for
example.

7. Answer: (C) Public health nurse of the RHU of their municipality

8. Answer: (B) The statement is false; people pay indirectly for public
health services.
Community health services, including public health services, are
prepaid paid services, through taxation, for example.

9. Answer: (A) For people to attain their birthrights of health and

longevity
According to Winslow, all public health efforts are for people to realize
their birthrights of health and longevity.

10. Answer: (C) Swaroops index

Swaroops index is the percentage of the deaths aged 50 years or
older. Its inverse represents the percentage of untimely deaths (those
who died younger than 50 years).
11. Answer: (D) Public health nursing focuses on preventive, not
curative, services.
The catchment area in PHN consists of a residential community, many
of whom are well individuals who have greater need for preventive
rather than curative services.

12. Answer: (D) The worth and dignity of man

This is a direct quote from Dr. Margaret Shetlands 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
(LGUs). 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 LGUs.

20. Answer: (A) Mayor

The local executive serves as the chairman of the Municipal Health
Board.

21. Answer: (A) Primary

The entry of a person into the health care delivery system is usually
through a consultation in out-patient services.

22. Answer: (B) Providing technical guidance to the midwife

The nurse provides technical guidance to the midwife in the care of
clients, particularly in the implementation of management guidelines,
as in Integrated Management of Childhood Illness.

23. Answer: (C) Municipal Health Officer

A public health nurse and rural health midwife can provide care during
normal childbirth. A physician should attend to a woman with a
complication during labor.

24. Answer: (A) 1

Each rural health midwife is given a population assignment of about
5,000.

25. Answer: (D) Municipal Health Board

As mandated by R.A. 7160, basic health services have been devolved
from the national government to local government units.
26. Answer: (A) Act 3573
Act 3573, the Law on Reporting of Communicable Diseases, enacted in
1929, mandated the reporting of diseases listed in the law to the
nearest health station.

27. Answer: (B) Health education and community organizing are

necessary in providing community health services.
The community health nurse develops the health capability of people
through health education and community organizing activities.

28. Answer: (B) Measles

Presidential Proclamation No. 4 is on the Ligtas Tigdas Program.

29. Answer: (B) Bar

A bar graph is used to present comparison of values, a line graph for
trends over time or age, a pie graph for population composition or
distribution, and a scatter diagram for correlation of two variables.

30. Answer: (D) Core group formation

In core group formation, the nurse is able to transfer the technology of
community organizing to the potential or informal community leaders
through a training program.

31. Answer: (B) Community organization

Community organization is the step when community assemblies take
place. During the community assembly, the people may opt to
formalize the community organization and make plans for community
action to resolve a community health problem.

32. Answer: (D) To maximize the communitys resources in dealing

with health problems
Community organizing is a developmental service, with the goal of
developing the peoples self-reliance in dealing with community health
problems. A, B and C are objectives of contributory objectives to this
goal.

33. Answer: (A) Participate in community activities for the solution of a

community problem
Participation in community activities in resolving a community problem
may be in any of the processes mentioned in the other choices.

34. Answer: (D) Terminal

Tertiary prevention involves rehabilitation, prevention of permanent
disability and disability limitation appropriate for convalescents, the
disabled, complicated cases and the terminally ill (those in the terminal
stage of a disease)

35. Answer: (A) Primary

The purpose of isolating a client with a communicable disease is to
protect those who are not sick (specific disease prevention).

36. Answer: (B) Secondary

Operation Timbang is done to identify members of the susceptible
population who are malnourished. Its purpose is early diagnosis and,
subsequently, prompt treatment.

37. Answer: (C) Home visit

Dynamics of family relationships can best be observed in the familys
natural environment, which is the home.

38. Answer: (B) Health deficit

Failure of a family member to develop according to what is expected,
as in mental retardation, is a health deficit.
39. Answer: (C) Foreseeable crisis
Entry of the 6-year old into school is an anticipated period of unusual
demand on the family.

40. Answer: (B) It provides an opportunity to do first hand appraisal of

the home situation.
Choice A is not correct since a home visit requires that the nurse spend
so much time with the family. Choice C is an advantage of a group
conference, while choice D is true of a clinic consultation.

41. Answer: (C) A home visit should be conducted in the manner

prescribed by the RHU.
The home visit plan should be flexible and practical, depending on
factors, such as the familys needs and the resources available to the
nurse and the family.

42. Answer: (B) Should minimize if not totally prevent the spread
of infection.
Bag technique is performed before and after handling a client in the
home to prevent transmission of infection to and from the client.

43. Answer: (A) Wash his/her hands before and after providing nursing
care to the family members.
Choice B goes against the idea of utilizing the familys resources, which
is encouraged in CHN. Choices C and D goes against the principle of
asepsis of confining the contaminated surface of objects.

44. Answer: (B) Analytical

Analytical epidemiology is the study of factors or determinants
affecting the patterns of occurrence and distribution of disease in a
community.
45. 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.

46. Answer: (C) Participating in the investigation to determine the

source of the epidemic
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.

47. Answer: (A) Delineate the etiology of the epidemic

Delineating the etiology of an epidemic is identifying its source.

48. Answer: (D) There is a gradual build up of cases before the

epidemic becomes easily noticeable.
A gradual or insidious onset of the epidemic is usually observable in
person-to-person propagated epidemics.

49. Answer: (A) Establishing the epidemic

Establishing the epidemic is determining whether there is an epidemic
or not. This is done by comparing the present number of cases with
the usual number of cases of the disease at the same time of the year,
as well as establishing the relatedness of the cases of the disease.

50. Answer: (B) Cyclical variation

A cyclical variation is a periodic fluctuation in the number of cases of a
disease in the community.

51. Answer: (C) Smallpox

The last documented case of Smallpox was in 1977 at Somalia.
52. Answer: (B) 100.94:100
Sex ratio is the number of males for every 100 females in the
population.

53. Answer: (D) Health programs are sustained according to the level
of development of the community.
Primary health care is essential health care that can be sustained in all
stages of development of the community.

54. Answer: (D) Sensitivity

Sensitivity is the capacity of a diagnostic examination to detect cases
of the disease. If a test is 100% sensitive, all the cases tested will
have a positive result, i.e., there will be no false negative results.

55. Answer: (D) Lagundi

Sambong is used as a diuretic. Tsaang gubat is used to relieve
diarrhea. Akapulko is used for its antifungal property.

56. Answer: (A) R.A. 8423 or AN ACT CREATING THE PHILIPPINE

INSTITUTE OF TRADITIONAL AND ALTERNATIVE HEALTH CARE
(PITAHC) TO ACCELERATE THE DEVELOPMENT OF TRADITIONAL AND
ALTERNATIVE HEALTH CARE IN THE PHILIPPINES, PROVIDING FOR A
TRADITIONAL AND ALTERNATIVE HEALTH CARE DEVELOPMENT FUND
AND FOR OTHER PURPOSES signed to a law on December 9, 1997.

57. Answer: (A) Yin

Yang is the male dominating, positive and masculine force.

58. Answer: (B) Letter of Instruction No. 949

Letter of Instruction 949 was issued by then President Ferdinand
Marcos, directing the formerly called Ministry of Health, now the
Department of Health, to utilize Primary Health Care approach in
planning and implementing health programs.

59. Answer: (D) Cooperation between the PHN and public school
teacher
Intersectoral linkages refer to working relationships between the health
sector and other sectors involved in community development.

60. Answer: (D) 2,300

Based on the Philippine population composition, to estimate the
number of 1-4 year old children, multiply total population by 11.5%.

61. Answer: (A) 265

To estimate the number of pregnant women, multiply the total
population by 3.5%.

62. Answer: (D) Any of these may be used.

Sex ratio and sex proportion are used to determine the sex
composition of a population. A population pyramid is used to present
the composition of a population by age and sex.

63. Answer: (A) Crude birth rate

Natality means birth. A natality rate is a birth rate.

64. Answer: (B) 5.2/1,000

To compute crude death rate divide total number of deaths (94) by
total population (18,000) and multiply by 1,000.

65. Answer: (C) 1-4 year old children

Preschoolers are the most susceptible to PEM because they have
generally been weaned. Also, this is the population who, unable to feed
themselves, are often the victims of poor intrafamilial food distribution.
66. Answer: (C) Swaroops index
Swaroops index is the proportion of deaths aged 50 years and above.
The higher the Swaroops index of a population, the greater the
proportion of the deaths who were able to reach the age of at least 50
years, i.e., more people grew old before they died.

67. Answer: (B) 43.5/1,000

To compute for neonatal mortality rate, divide the number of babies
who died before reaching the age of 28 days by the total number of
live births, then multiply by 1,000.

68. Answer: (A) 1-4 year old age-specific mortality rate

Since preschoolers are the most susceptible to the effects of
malnutrition, a population with poor nutritional status will most likely
have a high 1-4 year old age-specific mortality rate, also known as
child mortality rate.

69. Answer: (B) Number of registered live births

To compute for general or total fertility rate, divide the number of
registered live births by the number of females of reproductive age
(15-45 years), then multiply by 1,000.

70. Answer: (B) Survey

A survey, also called sample survey, is data gathering about a sample
of the population.

71. Answer: (C) De facto

The other method of population assignment, de jure, is based on the
usual place of residence of the people.
72. Answer: (A) Tally report
A tally report is prepared monthly or quarterly by the RHU personnel
and transmitted to the Provincial Health Office.

73. Answer: (C) Target/client list

The MDT Client List is a record of clients enrolled in MDT and other
relevant data, such as dates when clients collected their monthly
supply of drugs.

74. Answer: (A) P.D. 651

P.D. 651 amended R.A. 3753, requiring the registry of births within 30
days from their occurrence.

75. Answer: (D) Any of these health professionals

R.A. 3753 states that any birth attendant may sign the certificate of
live birth.

76. Answer: (C) Magnitude of the health problem

Magnitude of the problem refers to the percentage of the population
affected by a health problem. The other choices are criteria considered
in both family and community health care.

77. Answer: (D) Its main strategy is certification of health centers able
to 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.

78. Answer: (D) Those who just had a delivery within the past 15
months
The ideal birth spacing is at least two years. 15 months plus 9 months
of pregnancy = 2 years.
79. Answer: (C) Adequate information for couples regarding the
different methods
To enable the couple to choose freely among different methods
of family planning, they must be given full information regarding the
different methods that are available to them, considering the
availability of quality services that can support their choice.

80. Answer: (B) Retinol 200,000 IU

Retinol 200,000 IU is a form of megadose Vitamin A. This may have a
teratogenic effect.

81. Answer: (A) Her OB score is G5P3.

Only women with less than 5 pregnancies are qualified for a
home delivery. It is also advisable for a primigravida to
have delivery at a childbirth facility.

82. Answer: (C) Folic acid

It is estimated that the incidence of neural tube defects can be reduced
drastically if pregnant women have an adequate intake of folic acid.

83. Answer: (D) Note the interval, duration and intensity

of labor contractions.
Assessment of the woman should be done first to determine whether
she is having true labor and, if so, what stage of labor she is in.

84. Answer: (D) Explain to her that putting the baby to breast will
lessen blood loss after delivery.
Suckling of the nipple stimulates the release of oxytocin by the
posterior pituitary gland, which causes uterine contraction. Lactation
begins 1 to 3 days after delivery. Nipple stretching exercises are done
when the nipples are flat or inverted. Frequent washing dries up the
nipples, making them prone to the formation of fissures.
85. Answer: (B) To stimulate milk production by the mammary acini
Suckling of the nipple stimulates prolactin reflex (the release of
prolactin by the anterior pituitary gland), which initiates lactation.

86. Answer: (B) The mother does not feel nipple pain.
When the baby has properly latched on to the breast, he takes deep,
slow sucks; his mouth is wide open; and much of the areola is inside
his mouth. And, youre right! The mother does not feel nipple pain.

87. Answer: (B) 6 months

After 6 months, the babys nutrient needs, especially the babys iron
requirement, can no longer be provided by mothers milk alone.

88. Answer: (C) Retinol 200,000 I.U., 1 capsule

A capsule of Retinol 200,000 IU is given within 1 month
after delivery. Potassium iodate is given during pregnancy; malunggay
capsule is not routinely administered after delivery; and ferrous sulfate
is taken for two months after delivery.

89. Answer: (C) Measles vaccine

Among the biologicals used in the Expanded Program on
Immunization, measles vaccine and OPV are highly sensitive to heat,
requiring storage in the freezer.

90. Answer: (B) 4

While the unused portion of other biologicals in EPI may be given until
the end of the day, only BCG is discarded 4 hours after reconstitution.
This is why BCG immunization is scheduled only in the morning.

91. Answer: (A) P.D. 996

Presidential Decree 996, enacted in 1976, made immunization in the
EPI compulsory for children under 8 years of age. Hepatitis B
vaccination was made compulsory for the same age group by R.A.
7846.

92. Answer: (B) BCG

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.

93. Answer: (C) Infant BCG

Infant BCG may be given at birth. All the other immunizations
mentioned can be given at 6 weeks of age.

94. Answer: (A) Seizures a day after DPT 1.

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.

95. Answer: (A) Go on with the infants immunizations.

In the EPI, fever up to 38.5C is not a contraindication to
immunization. Mild acute respiratory tract infection, simple diarrhea
and malnutrition are not contraindications either.

96. Answer: (A) 1 year

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.

97. Answer: (C) Normal

In IMCI, a respiratory rate of 50/minute or more is fast breathing for
an infant aged 2 to 12 months.
98. Answer: (D) Chest indrawing
In IMCI, chest indrawing is used as the positive sign of dyspnea,
indicating severe pneumonia.

99. Answer: (B) Refer him urgently to the hospital.

Severe pneumonia requires urgent referral to a hospital. Answers A, C
and D are done for a client classified as having pneumonia.

100. Answer: (B) Some dehydration

Using the assessment guidelines of IMCI, a child (2 months to 5 years
old) with diarrhea is classified as having SOME DEHYDRATION if he
shows 2 or more of the following signs: restless or irritable, sunken
eyes, the skin goes back slow after a skin pinch.

101. Answer: (B) Supervise the mother in giving 200 to 400 ml. of
Oresol in 4 hours.
In the IMCI management guidelines, SOME DEHYDRATION is treated
with the administration of Oresol within a period of 4 hours. The
amount of Oresol is best computed on the basis of the childs weight
(75 ml/kg body weight). If the weight is unknown, the amount of
Oresol is based on the childs age.

102. Answer: (D) Let the child rest for 10 minutes then continue giving
Oresol more slowly.
If the child vomits persistently, that is, he vomits everything that he
takes in, he has to be referred urgently to a hospital. Otherwise,
vomiting is managed by letting the child rest for 10 minutes and then
continuing with Oresol administration. Teach the mother to give Oresol
more slowly.

103. Answer: (D) Edema

Edema, a major sign of kwashiorkor, is caused by decreased colloidal
osmotic pressure of the blood brought about by hypoalbuminemia.
Decreased blood albumin level is due a protein-deficient diet.

104. Answer: (A) Refer the child urgently to a hospital for

confinement.
Baggy pants is a sign of severe marasmus. The best management is
urgent referral to a hospital.

105. Answer: (D) Conjunctival xerosis

The earliest sign of Vitamin A deficiency (xerophthalmia) is night
blindness. However, this is a functional change, which is not
observable during physical examination.The earliest visible lesion is
conjunctival xerosis or dullness of the conjunctiva due to inadequate
tear production.

106. Answer: (D) 200,000 IU

Preschoolers are given Retinol 200,000 IU every 6 months. 100,000 IU
is given once to infants aged 6 to 12 months. The dose for pregnant
women is 10,000 IU.

107. Answer: (A) Palms

The anatomic characteristics of the palms allow a reliable and
convenient basis for examination for pallor.

108. Answer: (A) Sugar

R.A. 8976 mandates fortification of rice, wheat flour, sugar and
cooking oil with Vitamin A, iron and/or iodine.

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

Ordinarily, measles vaccine is given at 9 months of age. During an
impending epidemic, however, one dose may be given to babies aged
6 to 8 months. The mother is instructed that the baby needs another
dose when the baby is 9 months old.

110. Answer: (A) Inability to drink

A sick child aged 2 months to 5 years must be referred urgently to a
hospital if he/she has one or more of the following signs: not able to
feed or drink, vomits everything, convulsions, abnormally sleepy or
difficult to awaken.

111. Answer: (D) Retinol capsule regardless of when the last dose was
given
An infant 6 to 12 months classified as a case of measles is given
Retinol 100,000 IU; a child is given 200,000 IU regardless of when the
last dose was given.

112. Answer: (B) Ask where the family resides.

Because malaria is endemic, the first question to determine malaria
risk is where the clients family resides. If the area of residence is not a
known endemic area, ask if the child had traveled within the past 6
months, where he/she was brought and whether he/she stayed
overnight in that area.

113. Answer: (B) Destroying breeding places of mosquitoes

Aedes aegypti, the vector of Dengue fever, breeds in stagnant, clear
water. Its feeding time is usually during the daytime. It has a cyclical
pattern of occurrence, unlike malaria which is endemic in certain parts
of the country.

114. Answer: (C) Determining whether a place is endemic or not

This is diagnostic and therefore secondary level prevention. The other
choices are for primary prevention.
115. Answer: (B) Pinworm
Pinworm ova are deposited around the anal orifice.

116. Answer: (C) Cough for 3 weeks

A client is considered a PTB suspect when he has cough for 2 weeks or
more, plus one or more of the following signs: fever for 1 month or
more; chest pain lasting for 2 weeks or more not attributed to other
conditions; progressive, unexplained weight loss; night sweats; and
hemoptysis.

117. Answer: (D) Clients diagnosed for the first time through a positive
sputum exam
Category I is for new clients diagnosed by sputum examination and
clients diagnosed to have a serious form of extrapulmonary
tuberculosis, such as TB osteomyelitis.

118. Answer: (B) Having the health worker or a responsible family

member monitor drug intake
Directly Observed Treatment Short Course is so-called because a
treatment partner, preferably a health worker accessible to the client,
monitors the clients compliance to the treatment.

119. Answer: (C) Thickened painful nerves

The lesion of leprosy is not macular. It is characterized by a change in
skin color (either reddish or whitish) and loss of sensation, sweating
and hair growth over the lesion. Inability to close the eyelids
(lagophthalmos) and sinking of the nosebridge are late symptoms.

120. Answer: (D) 5 skin lesions, positive slit skin smear

A multibacillary leprosy case is one who has a positive slit skin smear
and at least 5 skin lesions.
121. Answer: (B) Liver cirrhosis
The etiologic agent of schistosomiasis in the Philippines is Schistosoma
japonicum, which affects the small intestine and the liver. Liver
damage is a consequence of fibrotic reactions to schistosoma eggs in
the liver.

122. Answer: (C) Proper use of sanitary toilets

The ova of the parasite get out of the human body together with feces.
Cutting the cycle at this stage is the most effective way of preventing
the spread of the disease to susceptible hosts.

123. Answer: (B) II

A communal faucet or water standpost is classified as Level II.

124. Answer: (A) Use of sterile syringes and needles

Hepatitis A is transmitted through the fecal oral route. Hepatitis B is
transmitted through infected body secretions like blood and semen.

125. Answer: (A) DPT

DPT is sensitive to freezing. The appropriate storage temperature of
DPT is 2 to 8 C only. OPV and measles vaccine are highly sensitive to
heat and require freezing. MMR is not an immunization in the
Expanded Program on Immunization.

126. Answer: (A) 45

To estimate the number of infants, multiply total population by 3%.

127. Answer: (B) Severe dehydration

The order of priority in the management of severe dehydration is as
follows: intravenous fluid therapy, referral to a facility where IV fluids
can be initiated within 30 minutes, Oresol/nasogastric tube,
Oresol/orem. When the foregoing measures are not possible or
effective, tehn urgent referral to the hospital is done.

128. Answer: (A) 3

Adequate blood supply to the area allows the return of the color of the
nailbed within 3 seconds.

129. Answer: (B) Instruct the mother to give the child Oresol.
Since the child does not manifest any other danger sign, maintenance
of fluid balance and replacement of fluid loss may be done by giving
the client Oresol.

130. Answer: (B) Buccal mucosa

Kopliks spot may be seen on the mucosa of the mouth or the throat.

131. Answer: (D) Measles

Viral conjunctivitis is transmitted by direct or indirect contact with
discharges from infected eyes. Acute poliomyelitis is spread through
the fecal-oral route and contact with throat secretions, whereas
diphtheria is through direct and indirect contact with respiratory
secretions.

132. Answer: (A) Hemophilus influenzae

Hemophilus meningitis is unusual over the age of 5 years. In
developing countries, the peak incidence is in children less than 6
months of age. Morbillivirus is the etiology of measles. Streptococcus
pneumoniae and Neisseria meningitidis may cause meningitis, but age
distribution is not specific in young children.

133. Answer: (D) Zooprophylaxis

Zooprophylaxis is done by putting animals like cattle or dogs close to
windows or doorways just before nightfall. The Anopheles mosquito
takes his blood meal from the animal and goes back to its breeding
place, thereby preventing infection of humans.

134. Answer: (A) Stream seeding

Stream seeding is done by putting tilapia fry in streams or other bodies
of water identified as breeding places of the Anopheles mosquito.

135. Answer: (C) Destruction of breeding places of the mosquito

vector
Anopheles mosquitoes breed in slow-moving, clear water, such as
mountain streams.

136. Answer: (B) Cholera

Passage of profuse watery stools is the major symptom of cholera.
Both amebic and bacillary dysentery are characterized by the presence
of blood and/or mucus in the stools. Giardiasis is characterized by fat
malabsorption and, therefore, steatorrhea.

137. Answer: (B) S. japonicum

S. mansoni is found mostly in Africa and South America; S.
haematobium in Africa and the Middle East; and S. malayensis only in
peninsular Malaysia.

138. Answer: (D) Leptospirosis

Leptospirosis is transmitted through contact with the skin or mucous
membrane with water or moist soil contaminated with urine of infected
animals, like rats.

139. Answer: (C) III

Waterworks systems, such as MWSS, are classified as level III.
140. Answer: (D) Refer the client for a supplementary test, such as
Western blot, since the ELISA result may be false.
A client having a reactive ELISA result must undergo a more specific
test, such as Western blot. A negative supplementary test result
means that the ELISA result was false and that, most probably, the
client is not infected.

141. Answer: (A) Being faithful to a single sexual partner

Sexual fidelity rules out the possibility of getting the disease by sexual
contact with another infected person. Transmission occurs mostly
through sexual intercourse and exposure to blood or tissues.

142. Answer: (B) Infectious mononucleosis

Cytomegalovirus disease is an acute viral disease characterized by
fever, sore throat and lymphadenopathy.

143. 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.

144. 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.

145. 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.

Nursing process

Question 1

WRONG

When establishing realistic goals, the nurse:

Bases the goals on the nurses personal knowledge.

Knows the resources of the health care facility, family, and the client.

Must have a client who is physically and emotionally stable.

Must have the clients cooperation.

Question 2

WRONG

Planning is a category of nursing behaviors in which:

The nurse determines the health care needed for the client.

The Physician determines the plan of care for the client.

Client-centered goals and expected outcomes are established.

The client determines the care needed.

Question 3
 WRONG

Priorities are established to help the nurse anticipate and sequence nursing interventions when a
client has multiple problems or alterations. Priorities are determined by the clients:

Physician

Non Emergent, non-life threatening needs

Future well-being

Urgency of problems

Question 4

WRONG

The nurse writes an expected outcome statement in measurable terms. An example is:

Client will have less pain

Client will be pain free.

Client will report pain acuity less than 4 on a scale of 0-10

Client will take pain medication every 4 hours around the clock

Question 5

WRONG

Which of the following nursing interventions are written correctly? (Select all that apply.)

Apply continuous passive motion machine during day

Perform neurovascular checks

 Elevate head of bed 30 degrees before meals

Change dressing once a shift

Question 5 Explanation:
It is specific in what to do and when.

Question 6

WRONG

Which of the following statements about the nursing process is most accurate?

The nursing process is a four-step procedure for identifying and resolving patient problems.

Beginning in Florence Nightingales days, nursing students learned and practiced the nursing
process.

Use of the nursing process is optional for nurses, since there are many ways to accomplish the
work of nursing.

The state board examinations for professional nursing practice now use the nursing process
rather than medical specialties as an organizing concept.

Question 6 Explanation:
Option A: The nursing process is a five-step process. Option B: The term nursing process was first
used by Hall in 1955. Option C: Nursing process is not optional since standards demand the use of it.

Question 7

WRONG

The primary nurse asked a clinical nurse specialist (CNS) to consult on a difficult nursing problem. The
primary nurse is obligated to:

Implement the specialists recommendations

Report the recommendations to the primary physician

 Clarify the suggestions with the client and family members

Discuss and review advised strategies with CNS

Question 7 Explanation:
Because the primary nurse requested the consultation, it is important that they communicate and
discuss recommendations. The primary nurse can then accept or reject the CNS recommendations.
(a. Some of the recommendations may not be appropriate for this client. The primary nurse would
know this information. A consultation requires review of the recommendations, but not immediate
implementation. b. This would be appropriate after first talking with the CNS about recommended
changes in the plan of care and the rationale. Then the primary nurse should call the physician. c.
The client and family do not have the knowledge to determine whether new strategies are
appropriate or not. Better to wait until the new plan of care is agreed upon by the primary nurse and
physician before talking with the client and/or family.)

Question 8

WRONG

After assessing the client, the nurse formulates the following diagnoses. Place them in order of
priority, with the most important (classified as high) listed first. 1. Constipation 2. Anticipated
grieving 3. Ineffective airway clearance 4. Ineffective tissue perfusion.

3, 4, 2, 1

4, 3, 2, 1

1, 3, 2, 4

3, 4, 1, 2

Question 9

WRONG

Well formulated, client-centered goals should:

Meet immediate client needs.

Include preventative health care.

 Include rehabilitation needs.

All of the above.

Question 10

WRONG

The RN has received her client assignment for the day-shift. After making the initial rounds and
assessing the clients, which client would the RN need to develop a care plan first?

A client who is ambulatory.

A client, who has a fever, is diaphoretic and restless.

A client scheduled for OT at 1300.

A client who just had an appendectomy and has just received pain medication.

Question 11

WRONG

The planning step of the nursing process includes which of the following activities?

Assessing and diagnosing

Evaluating goal achievement

Performing nursing actions and documenting them

Setting goals and selecting interventions

Question 12

WRONG
A client centered goal is a specific and measurable behavior or response that reflects a clients:

Desire for specific health care interventions

Highest possible level of wellness and independence in function.

Physicians goal for the specific client.

Response when compared to another client with a like problem.

Question 13

WRONG

The following statements appear on a nursing care plan for a client after a mastectomy: Incision site
approximated; absence of drainage or prolonged erythema at incision site; and client remains
afebrile. These statements are examples of:

Nursing interventions

Short-term goals

Long-term goals

Expected outcomes

Question 14

WRONG

The nursing care plan is:

A written guideline for implementation and evaluation.

A documentation of client care.

 A projection of potential alterations in client behaviors

A tool to set goals and project outcomes.

Question 15

WRONG

For clients to participate in goal setting, they should be:

Alert and have some degree of independence.

Ambulatory and mobile.

Able to speak and write.

Able to read and write.

Question 16

WRONG

The following statement appears on the nursing care plan for an immunosuppressed client: The
client will remain free from infection throughout hospitalization. This statement is an example of a
(an):

Nursing diagnosis

Short-term goal

Long-term goal

Expected outcome

Question 17
 WRONG

Collaborative interventions are therapies that require:

Physician and nurse interventions.

Nurse and client interventions.

Client and Physician intervention.

Multiple health care professionals.

Question 18

WRONG

When developing a nursing care plan for a client with a fractured right tibia, the nurse includes in the
plan of care independent nursing interventions, including:

Apply a cold pack to the tibia.

Elevate the leg 5 inches above the heart.

Perform range of motion to right leg every 4 hours.

Administer aspirin 325 mg every 4 hours as needed

Question 18 Explanation:
This does not require a physicians order. (A & D require an order; C is not appropriate for a fractured
tibia)

Question 19

WRONG

When calling the nurse consultant about a difficult client-centered problem, the primary nurse is sure
to report the following:
 Length of time the current treatment has been in place

The spouses reaction to the clients dressing change

Clients concern about the current treatment

Physicians reluctance to change the current treatment plan

Question 19 Explanation:
This gives the consulting nurse facts that will influence a new plan. Other choices are all subjective
and emotional issues about the current treatment plant and may cause bias in the decision of a new
treatment plan by the nurse consultant.

Question 20

WRONG

To initiate an intervention the nurse must be competent in three areas, which include:

Knowledge, function, and specific skills

Experience, advanced education, and skills.

Skills, finances, and leadership.

Leadership, autonomy, and skills.

Question 21

WRONG

The nurse is reviewing the critical paths of the clients on the nursing unit. In performing a variance
analysis, which of the following would indicate the need for further action and analysis?

A clients family attending a diabetic teaching session.

Canceling physical therapy sessions on the weekend.

 Normal VS and absence of wound infection in a post-op client.

A client demonstrating accurate medication administration following teaching.

Question 22

WRONG

A clients wound is not healing and appears to be worsening with the current treatment. The nurse
first considers:

Notifying the physician

Calling the wound care nurse

Changing the wound care treatment

Consulting with another nurse

Question 22 Explanation:
Calling in the wound care nurse as a consultant is appropriate because he or she is a specialist in the
area of wound management. Professional and competent nurses recognize limitations and seek
appropriate consultation. (a. This might be appropriate after deciding on a plan of action with the
wound care nurse specialist. The nurse may need to obtain orders for special wound care products. c.
Unless the nurse is knowledgeable in wound management, this could delay wound healing. Also, the
current wound management plan could have been ordered by the physician. d. Another nurse most
likely will not be knowledgeable about wounds, and the primary nurse would know the history of the
wound management plan.)

Question 23

WRONG

Once a nurse assesses a clients condition and identifies appropriate nursing diagnoses, a:

Plan is developed for nursing care.

Physical assessment begins.

 List of priorities is determined.

Review of the assessment is conducted with other team members.

Question 24

WRONG

As goals, outcomes, and interventions are developed, the nurse must:

Be in charge of all care and planning for the client.

Be aware of and committed to accepted standards of practice from nursing and other disciples.

Not change the plan of care for the client.

Be in control of all interventions for the client.

Question 25

WRONG

After determining a nursing diagnosis of acute pain, the nurse develops the following appropriate
client-centered goal:

Encourage client to implement guided imagery when pain begins.

Determine effect of pain intensity on client function.

Administer analgesic 30 minutes before physical therapy treatment.

Pain intensity reported as a 3 or less during hospital stay.

Question 25 Explanation:
This is measurable and objective.