COMMUNITY HEALTH NURSING EXAM.

Community Health Nursing Exam 1

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 illness
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 services 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. R.A. 1054 is also known as the Occupational Health Act. Aside from 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: agricultural, 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. Environmental 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 of 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 basic 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 of health and longevity

B. For promotion of health and prevention of disease
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 lifespan of Filipinos. What
other statistic may be used to determine attainment of longevity?

A. Age-specific mortality rate

B. Proportionate mortality rate
C. Swaroop’s 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 services.
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 care
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. Which 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 nurse’s health care provider functions?

A. Requesting for BCG from the RHU for school entrant immunization
B. Conducting random classroom inspection during a measles epidemic
C. Taking remedial action on an accident hazard in the school playground
D. Observing places in the school where pupils spend their free time
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. R.A. 7160 mandates devolution of basic services from the national government to local government units.
Which of the following is the major goal of devolution?

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 public health nurse?

A. Referring cases or patients to the midwife

B. Providing technical guidance to the midwife
C. Providing nursing care to cases referred by the midwife
D. Formulating and implementing training programs for midwives
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 are 3 rural
health midwives among the RHU personnel. How many more midwife items will the RHU need?

A. 1
B. 2
C. 3
D. The RHU does not need any more midwife item.

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

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

27. According to Freeman and Heinrich, community health nursing is a developmental service. Which of the
following best illustrates this statement?

A. 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 is 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 places of
residence.
28. Which disease was declared through Presidential Proclamation No. 4 as a target for eradication in the
Philippines?

A. Poliomyelitis
B. Measles
C. Rabies
D. Neonatal tetanus

29. The public health nurse is responsible for presenting the municipal health statistics using graphs and tables.
To compare the frequency of the leading causes of mortality in the municipality, which graph will you prepare?

A. Line
B. Bar
C. Pie
D. Scatter diagram

30. Which step in community organizing involves training of potential leaders in the community?

A. Integration
B. Community organization
C. Community study
D. Core group formation
Answers and Rationales
1. Answer: (B) To enhance the capacity of individuals, families and communities to cope with their
health needs
2. Answer: (B) The nurse has to conduct community diagnosis to determine nursing needs and
problems.
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. Again, this is based on R.A. 1054.
6. Answer: (D) Environmental manager. Ergonomics is improving efficiency of workers by improving
the worker’s environment through appropriately designed furniture, for example.
7. Answer: (C) Public health nurse of the RHU of their municipality. You’re right! This question is based
on R.A.1054.
8. Answer: (B) The statement is false; people pay indirectly for public health services. Community
health services, including public health services, are pre-paid services, though 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) Swaroop’s index. Swaroop’s 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 Shetland’s
statements on Public Health Nursing.
13. Answer: (B) Ensure the accessibility and quality of health care
14. Answer: (D) Tertiary. Regional hospitals are tertiary facilities because they serve as training hospitals
for the region.
15. Answer: (B) Their services are provided on an out-patient basis. Primary facilities government and
non-government facilities that provide basic out-patient services.
16. Answer: (B) Conducting random classroom inspection during a measles epidemic. Random
classroom inspection is assessment of pupils/students and teachers for signs of a health problem
prevalent in the community.
17. Answer: (B) Efficiency. Efficiency is determining whether the goals were attained at the least
possible cost.
18. Answer: (D) Rural Health Unit. R.A. 7160 devolved basic health services to local government units
(LGU’s ). The public health nurse is an employee of the LGU.
19. Answer: (C) To empower the people and promote their self-reliance. People empowerment is the
basic motivation behind devolution of basic services to LGU’s.
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.
Community Health Nursing Exam 2

1. In which step are plans formulated for solving community problems?

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

2. 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 community’s resources in dealing with health problems
D. To maximize the community’s resources in dealing with health problems

3. 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

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

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

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

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

6. On the other hand, Operation Timbang is _____ prevention.

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

7. Which type of family-nurse contact will provide you with the best opportunity to observe family dynamics?

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

8. The typology of family nursing problems is used in the statement of nursing diagnosis in the care of families.
The youngest child of the de los Reyes family has been diagnosed as mentally retarded. This is classified as a:

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

9. The de los Reyes couple have a 6-year old child entering school for the first time. The de los Reyes family has
a:

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

10. 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 experiences among people with similar health problems.
D. It develops the family’s initiative in providing for health needs of its members.

11. Which is CONTRARY to the principles in planning a home visit?

A. A home visit should have a purpose or objective.

B. The plan should revolve around family health needs.
C. A home visit should be conducted in the manner prescribed by the RHU.
D. Planning of continuing care should involve a responsible family member.
12. The PHN bag is an important tool in providing nursing care during a home visit. The most important principle
of 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 a variety of ways depending on the home situation, etc.

13. 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.

14. The public health nurse conducts a study on the factors contributing to the high mortality rate due to heart
disease 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

15. 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

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

A. Conducting assessment of suspected cases to detect the communicable disease

B. Monitoring the condition of the cases affected by the communicable disease
C. Participating in the investigation to determine the source of the epidemic
D. Teaching the community on preventive measures against the disease
17. 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
18. Which is a characteristic of person-to-person propagated epidemics?

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 a gradual build up of cases before the epidemic becomes easily noticeable.

19. 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

20. 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 variation

21. 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 plague
B. Poliomyelitis
C. Small pox
D. Anthrax

22. 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%

23. 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 to provide care based on identified health needs of the people.
D. Health programs are sustained according to the level of development of the community.

24. 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

25. Use of appropriate technology requires knowledge of indigenous technology. Which medicinal herb is given
for fever, headache and cough?

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

26. What law created the Philippine Institute of Traditional and Alternative Health Care?

A. R.A. 8423
B. R.A. 4823
C. R.A. 2483
D. R.A. 3482

27. In traditional Chinese medicine, the yielding, negative and feminine force is termed

A. Yin
B. Yang
C. Qi
D. Chai
28. What is the legal basis for Primary Health Care approach in the Philippines?

A. Alma Ata Declaration on PHC

B. Letter of Instruction No. 949
C. Presidential Decree No. 147
D. Presidential Decree 996

29. Which of the following demonstrates intersectoral linkages?

A. Two-way referral system

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

30. The municipality assigned to you has a population of about 20,000. Estimate the number of 1-4 year old
children who will be given Retinol capsule 200,000 I.U. every 6 months.

A. 1,500
B. 1,800
C. 2,000
D. 2,300
Answers and Rationales
1. 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.
2. Answer: (D) To maximize the community’s resources in dealing with health problems. Community
organizing is a developmental service, with the goal of developing the people’s self-reliance in
dealing with community health problems. A, B and C are objectives of contributory objectives to
this goal.
3. 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.
4. 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)
5. Answer: (A) Primary. The purpose of isolating a client with a communicable disease is to protect
those who are not sick (specific disease prevention).
6. 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.
7. Answer: (C) Home visit. Dynamics of family relationships can best be observed in the family’s natural
environment, which is the home.
8. Answer: (B) Health deficit. Failure of a family member to develop according to what is expected, as
in mental retardation, is a health deficit.
9. Answer: (C) Foreseeable crisis. Entry of the 6-year old into school is an anticipated period of unusual
demand on the family.
10. 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.
11. 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.
12. 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.
13. 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.
14. Answer: (B) Analytical. Analytical epidemiology is the study of factors or determinants affecting the
patterns of occurrence and distribution of disease in a community.
15. Answer: (D) Evaluating the effectiveness of the implementation of the Integrated Management of
Childhood Illness. Epidemiology is used in the assessment of a community or evaluation of
interventions in community health practice.
16. 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.
17. Answer: (A) Delineate the etiology of the epidemic. Delineating the etiology of an epidemic is
identifying its source.
18. 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.
19. 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.
20. Answer: (B) Cyclical variation. A cyclical variation is a periodic fluctuation in the number of cases of
a disease in the community.
21. Answer: (C) Small pox. The last documented case of Small pox was in 1977 at Somalia.
22. Answer: (B) 100.94:100. Sex ratio is the number of males for every 100 females in the population.
23. 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.
24. 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.
25. Answer: (D) Lagundi. Sambong is used as a diuretic. Tsaang gubat is used to relieve diarrhea.
Akapulko is used for its antifungal property.
26. Answer: (A) R.A. 8423
27. Answer: (A) Yin. Yang is the male dominating, positive and masculine force.
28. 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.
29. 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.
30. 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%.
Community Health Nursing Exam 3

1. 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

2. 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 may be used.

3. Which of the following is a natality rate?

A. Crude birth rate

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

4. You are computing the crude death rate of your municipality, with a total population of 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. 4.2/1,000
B. 5.2/1,000
C. 6.3/1,000
D. 7.3/1,000

5. 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
6. 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. Swaroop’s index
D. Crude death rate

7. 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. There were 4 recorded stillbirths. What is the neonatal mortality
rate?

A. 27.8/1,000
B. 43.5/1,000
C. 86.9/1,000
D. 130.4/1,000

8. 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. Swaroop’s index

9. 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

10. 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 data gathering is best for this
purpose?

A. Census
B. Survey
C. Record review
D. Review of civil registry
11. 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

12. 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

13. 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

14. Civil registries are important sources of data. Which law requires registration of births within 30 days from
the occurrence of the birth?

A. P.D. 651
B. Act 3573
C. R.A. 3753
D. R.A. 3375

15. 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
16. 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

17. 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.

18. 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

19. Freedom of choice is 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

20. 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 200 mg
D. Potassium iodate 200 mg. capsule
21. 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.

22. Inadequate intake by the pregnant woman of which vitamin may cause neural tube defects?

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

23. You are in a client’s home to attend to a delivery. Which of the following will you do first?

A. Set up the sterile area.

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

24. 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.

25. 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 colostrum
D. To allow the woman to practice breastfeeding in the presence of the health worker
26. In a mothers’ class, you discuss proper breastfeeding technique. Which is of these is a sign that the baby has
“latched on” to the breast properly?

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.

27. You explain to a breastfeeding mother that breast milk 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

28. What is given to a woman within a month after the delivery of a baby?

A. Malunggay capsule
B. Ferrous sulfate 100 mg. OD
C. Retinol 200,000 I.U., 1 capsule
D. Potassium iodate 200 mg, 1 capsule

29. Which biological used in Expanded Program on Immunization (EPI) is stored in the freezer?

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

30. Unused BCG should be discarded how many hours after reconstitution?

A. 2
B. 4
C. 6
D. At the end of the day
Answers and Rationales
1. Answer: (A) 265. To estimate the number of pregnant women, multiply the total population by 3.5%.
2. 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.
3. Answer: (A) Crude birth rate. Natality means birth. A natality rate is a birth rate.
4. 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.
5. 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.
6. Answer: (C) Swaroop’s index. Swaroop’s index is the proportion of deaths aged 50 years and above.
The higher the Swaroop’s 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.
7. 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.
8. 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.
9. 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.
10. Answer: (B) Survey. A survey, also called sample survey, is data gathering about a sample of the
population.
11. Answer: (C) De facto. The other method of population assignment, de jure, is based on the usual
place of residence of the people.
12. Answer: (A) Tally report. A tally report is prepared monthly or quarterly by the RHU personnel and
transmitted to the Provincial Health Office.
13. 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.
14. Answer: (A) P.D. 651. P.D. 651 amended R.A. 3753, requiring the registry of births within 30 days
from their occurrence.
15. Answer: (D) Any of these health professionals. D. R.A. 3753 states that any birth attendant may sign
the certificate of live birth.
16. 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.
17. 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.
18. 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.
19. 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.
20. Answer: (B) Retinol 200,000 IU. Retinol 200,000 IU is a form of megadose Vitamin A. This may have
a teratogenic effect.
21. 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.
22. 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.
23. 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.
24. 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.
25. 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.
26. 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.
27. 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.
28. 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.
29. 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.
30. 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.
Community Health Nursing Exam 4

1. In immunizing school entrants with BCG, you are not obliged to secure parental consent. This is because of
which legal document?

A. P.D. 996
B. R.A. 7846
C. Presidential Proclamation No. 6
D. Presidential Proclamation No. 46

2. Which immunization produces a permanent scar?

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

3. 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 vaccine 1

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

A. Seizures a day after DPT 1.

B. Fever for 3 days after DPT 1.
C. Abscess formation after DPT 1.
D. Local tenderness for 3 days after DPT 1.

5. A 2-month old infant was brought to the health center for immunization. During assessment, the infant’s
temperature registered at 38.1°C. Which is the best course of action that you will take?

A. Go on with the infant’s immunizations.

B. Give Paracetamol and wait for his fever to subside.
C. Refer the infant to the physician for further assessment.
D. Advise the infant’s mother to bring him back for immunization when he is well.
6. A pregnant woman had just received her 4th dose of tetanus toxoid. Subsequently, her baby will have
protection against tetanus for how long?

A. 1 year
B. 3 years
C. 10 years
D. Lifetime

7. A 4-month old infant was brought to the health center because of cough. Her respiratory rate is 42/minute.
Using the Integrated Management of Child Illness (IMCI) guidelines of assessment, her breathing is considered

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

8. 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

9. Using IMCI guidelines, you classify a child as having severe pneumonia. What is the best management for the
child?

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

10. 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.
11. Based on assessment, you classified a 3-month old infant with the chief complaint of diarrhea in the category
of SOME DEHYDRATION. Based on 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.

12. 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 intravenous fluid 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.

13. A 1 ½ year old child was classified as having 3rd degree protein energy malnutrition, kwashiorkor. Which of
the following signs will be most apparent in this child?

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

14. 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 menu planning for her child.
D. Assess and treat the child for health problems like infections and intestinal parasitism.

15. During the physical examination of a young child, what is the earliest sign of xerophthalmia that you may
observe?

A. Keratomalacia
B. Corneal opacity
C. Night blindness
D. Conjunctival xerosis
16. 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

17. 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

18. Food fortification is one of the strategies to prevent micronutrient deficiency conditions. R.A. 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

19. 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 8 months.

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

20. 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
21. Management of a child with measles includes the administration of which of the following?

A. Gentian violet on mouth lesions

B. Antibiotics to prevent pneumonia
C. Tetracycline eye ointment for corneal opacity
D. Retinol capsule regardless of when the last dose was given

22. A mother brought her 10 month old infant for consultation because of fever, which 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.

23. The following are strategies implemented by the Department of Health 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

24. 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

25. Scotch tape swab is done to check for which intestinal parasite?

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

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

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

27. Which clients are considered targets for DOTS Category I?

A. Sputum negative cavitary cases

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

28. 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

29. 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 nosebridge

30. Which of the following clients should be classified as a case of multibacillary 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
Answers and Rationales
1. 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.
2. 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.
3. Answer: (C) Infant BCG. Infant BCG may be given at birth. All the other immunizations mentioned
can be given at 6 weeks of age.
4. 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.
5. 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.
6. 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.
7. Answer: (C) Normal. In IMCI, a respiratory rate of 50/minute or more is fast breathing for an infant
aged 2 to 12 months.
8. Answer: (D) Chest indrawing. In IMCI, chest indrawing is used as the positive sign of dyspnea,
indicating severe pneumonia.
9. 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.
10. 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.
11. 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.
12. 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.
13. 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.
14. 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.
15. 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.
16. 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.
17. Answer: (A) Palms. The anatomic characteristics of the palms allow a reliable and convenient basis
for examination for pallor.
18. Answer: (A) Sugar. R.A. 8976 mandates fortification of rice, wheat flour, sugar and cooking oil with
Vitamin A, iron and/or iodine.
19. 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.
20. 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.
21. 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.
22. Answer: (B) Ask where the family resides. Because malaria is endemic, the first question to
determine malaria risk is where the client’s 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.
23. 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.
24. 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.
25. Answer: (B) Pinworm. Pinworm ova are deposited around the anal orifice.
26. 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.
27. 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.
28. 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 client’s compliance to the treatment.
29. 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.
30. 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.
Community Health Nursing Exam 5

1. In the Philippines, which condition is the most frequent cause of death associated with schistosomiasis?

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

2. 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

3. 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

4. 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

5. Which biological used in Expanded Program on Immunization (EPI) should NOT be stored in the freezer?

A. DPT
B. Oral polio vaccine
C. Measles vaccine
D. MMR
6. 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

7. In Integrated Management of Childhood Illness, severe conditions generally require urgent referral to a
hospital. Which of the following severe conditions DOES NOT always require urgent referral to a hospital?

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

8. 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

9. 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 is 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 intravenous fluids STAT.
D. Refer the client to the physician for appropriate management.

10. The pathognomonic sign of measles is Koplik’s spot. You may see Koplik’s spot by inspecting the _____.

A. Nasal mucosa
B. Buccal mucosa
C. Skin on the abdomen
D. Skin on the antecubital surface
11. Among the following diseases, which is airborne?

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

12. 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. Steptococcus pneumoniae
D. Neisseria meningitidis

13. 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

14. 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

15. 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
16. A 4-year old client was brought to the health center with the chief complaint of severe diarrhea and the
passage of “rice water” stools. The client is most probably suffering from which condition?

A. Giardiasis
B. Cholera
C. Amebiasis
D. Dysentery

17. In the Philippines, which specie of schistosoma is endemic in certain regions?

A. S. mansoni
B. S. japonicum
C. S. malayensis
D. S. haematobium

18. 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 his history, which disease condition will you suspect?

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

19. 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

20. 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 behaviors.
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 may be false.
21. 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 one’s sexual partner does not have signs of AIDS

22. The most frequent causes of death among clients with AIDS are opportunistic diseases. Which of the
following opportunistic infections is characterized by tonsillopharyngitis?

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

23. To determine 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 of suspects

24. 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.

25. 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 signs 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.
26. You were invited to be the resource person in a training class for food handlers. Which of the following
would you emphasize regarding prevention of staphylococcal food poisoning?

A. All cooking and eating utensils must be thoroughly washed.

B. Food must be cooked properly to destroy staphylococcal microorganisms.
C. Food handlers and food servers must have a negative stool examination result.
D. Proper handwashing during food preparation is the best way of preventing the condition.

27. In a mothers’ class, you discussed childhood diseases such as chicken pox. Which of the following statements
about chicken pox is correct?

A. The older one gets, the more susceptible he becomes to the complications of chicken pox.
B. A single attack of chicken pox will prevent future episodes, including conditions such as shingles.
C. To prevent an outbreak in the community, quarantine may be imposed by health authorities.
D. Chicken pox vaccine is best given when there is an impending outbreak in the community.

28. Complications to infectious parotitis (mumps) may be serious in which type of clients?

A. Pregnant women
B. Elderly clients
C. Young adult males
D. Young infants
Answers and Rationales
1. 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.
2. 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.
3. Answer: (B) II. A communal faucet or water standpost is classified as Level II.
4. 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.
5. 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.
6. Answer: (A) 45. To estimate the number of infants, multiply total population by 3%.
7. 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.
8. Answer: (A) 3. Adequate blood supply to the area allows the return of the color of the nailbed within
3 seconds.
9. 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.
10. Answer: (B) Buccal mucosa. Koplik’s spot may be seen on the mucosa of the mouth or the throat.
11. 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.
12. 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.
13. 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.
14. 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
15. Answer: (C) Destruction of breeding places of the mosquito vector. Anopheles mosquitoes breed in
slow-moving, clear water, such as mountain streams.
16. 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.
17. 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.
18. 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.
19. Answer: (C) III. Waterworks systems, such as MWSS, are classified as level III.
20. 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.
21. 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.
22. Answer: (B) Infectious mononucleosis. Cytomegalovirus disease is an acute viral disease
characterized by fever, sore throat and lymphadenopathy.
23. Answer: (A) Contact tracing. Contact tracing is the most practical and reliable method of finding
possible sources of person-to-person transmitted infections, such as sexually transmitted diseases.
24. Answer: (D) They are able to bring about a cure of the disease condition. There is no known
treatment for AIDS. Antiretroviral agents reduce the risk of opportunistic infections and prolong life,
but does not cure the underlying immunodeficiency.
25. Answer: (D) Consult a physician who may give them rubella immunoglobulin. Rubella vaccine is
made up of attenuated German measles viruses. This is contraindicated in pregnancy. Immune
globulin, a specific prophylactic against German measles, may be given to pregnant women.
26. Answer: (D) Proper handwashing during food preparation is the best way of preventing the
condition. Symptoms of this food poisoning are due to staphylococcal enterotoxin, not the
microorganisms themselves. Contamination is by food handling by persons with staphylococcal skin
or eye infections.
27. Answer: (A) The older one gets, the more susceptible he becomes to the complications of chicken
pox. Chicken pox is usually more severe in adults than in children. Complications, such as
pneumonia, are higher in incidence in adults.
28. Answer: (C) Young adult males. Epididymitis and orchitis are possible complications of mumps. In
post-adolescent males, bilateral inflammation of the testes and epididymis may cause sterility.