CENTRAL LUZON DOCTORS’ HOSPITAL EDUCATIONAL INSTITUTION

Romulo Highway, San Pablo, Tarlac City

COMMUNITY HEALTH NURSING

Evaluation Examination

Second Semester
School Year 2021-2022

Name:_________________________________________________ Score:_______

MULTIPLE CHOICE. Select the correct answer for each of the following questions. Shade
properly your answers on your scantrons.

1. Tertiary prevention is needed in which stage of the natural history of disease? 

A. Pre-pathogenesis
B. Pathogenesis
C. Predromal
D. Terminal

2. Isolation of a child with measles belongs to what level of prevention?

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

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

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

4. 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

5. 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

6. 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
7. 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 family’s initiative in providing for health needs of its members

8. 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

9. 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.

10. 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 member’s, 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.

11. 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

12. 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

13. 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

14. 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
15. 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

16. 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

17. 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

18. 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

19. 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

20. 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

21. 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
22. 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

23. During prenatal consultation, a client asked you if she can have her delivery at home. After
history taking and physical examination, you advised her against a home delivery. Which of the
following findings disqualifies her for a home delivery?
A. Her OB score is G5P3
B. She has some palmar pallor
C. Her blood pressure is 130/80
D. Her baby is in cephalic presentation

24. Inadequate intake by the pregnant woman of which vitamin may cause neural tube defects?
A. Niacin
B. Riboflavin
C. Folic Acid
D. Thiamine

25. You are in a client’s 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 client’s vulva with soap and water
D. Note the interval, duration and intensity of labor and contractions

26. 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

27. 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

28. In a mother’s 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 baby’s mouth is only partly open
D. Only the mother’s nipple is inside the baby’s mouth

29. You explain to a breastfeeding mother that breastmilk is sufficient for all of the baby’s
nutrient needs only up to:
A. 3 months
B. 6 months
C. 1 year
D. 2 years
30. 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

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

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

32. Unused BCG should be discarded how many hours after reconstitution?
A. 2
B. 4
C. 6
D. At the end of the day

33. 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

34. Which immunization produces a permanent scar?

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

35. 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

36. 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

37. A 2-month old infant was brought to the health center for immunization. During assessment,
the infant’s temperature registered at 38.1 C. Which is the best course of action that you will
take?
A. Go on with the 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 infant’s mother to bring him back for immunization when he is well
38. 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

39. 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

40. 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

41. 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

42. 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

43. 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 infant’s mother instructions on home management
D. Keep the infant in your health center for close observation

44. 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
45. 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

46. 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

47. 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

48. 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

49. 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

50. 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
ANSWER KEY Community Nursing Evaluation Exam 2019:
1. 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)
2. Answer: (A) Primary
The purpose of isolating a client with a communicable disease is to protect those who are not
sick (specific disease prevention).
3. 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.
4. Answer: (C) Home visit
Dynamics of family relationships can best be observed in the family’s natural environment,
which is the home.
5. Answer: (B) Health deficit
Failure of a family member to develop according to what is expected, as in mental retardation, is
a health deficit.
6. Answer: (C) Foreseeable crisis
Entry of the 6-year old into school is an anticipated period of unusual demand on the family.
7. 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.
8. 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 family’s
needs and the resources available to the nurse and the family.
9. 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.
10. 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 family’s resources, which is encouraged in CHN.
Choices C and D goes against the principle of asepsis of confining the contaminated surface of
objects.
11. 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.
12. 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.
13. Answer: (A) Delineate the etiology of the epidemic
Delineating the etiology of an epidemic is identifying its source.
14. 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.
15. 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.
16. Answer: (B) Cyclical variation
A cyclical variation is a periodic fluctuation in the number of cases of a disease in the
community.
17. 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.
18. 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.
19. Answer: (D) Lagundi
Sambong is used as a diuretic. Tsaang gubat is used to relieve diarrhea. Akapulko is used for
its antifungal property.
20. 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.
21. 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.
22. Answer: (B) Retinol 200,000 IU
Retinol 200,000 IU is a form of megadose Vitamin A. This may have a teratogenic effect.
23. 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.
24. 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.
25. 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 laborshe is in.
26. 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.
27. 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.
28. 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, you’re right! The mother does not
feel nipple pain.
29. Answer: (B) 6 months
After 6 months, the baby’s nutrient needs, especially the baby’s iron requirement, can no longer
be provided by mother’s milk alone.
30. 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.
31. 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.
32. 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.
33. 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.
34. 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.
35. Answer: (C) Infant BCG
Infant BCG may be given at birth. All the other immunizations mentioned can be given at 6
weeks of age.
36. 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.
37. Answer: (A) Go on with the infant’s immunizations.
In the EPI, fever up to 38.5°C is not a contraindication to immunization. Mild acute respiratory
tract infection, simple diarrhea and malnutrition are not contraindications either.
38. 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.
39. Answer: (C) Normal
In IMCI, a respiratory rate of 50/minute or more is fast breathing for an infant aged 2 to 12
months.
40. Answer: (D) Chest indrawing
In IMCI, chest indrawing is used as the positive sign of dyspnea, indicating severe pneumonia.
41. 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.
42. 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.
43. 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
child’s weight (75 ml/kg body weight). If the weight is unknown, the amount of Oresol is based
on the child’s age.
44. 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.
45. 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.
46. 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.
47. 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.
48. 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.
49. Answer: (A) Palms
The anatomic characteristics of the palms allow a reliable and convenient basis for examination
for pallor.
50. 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.