Community Health Nursing Exam (145 Questions) 6.

When the occupational health nurse employs ergonomic

principles, she is performing which of her roles?
Questions
1. Which is the primary goal of community health nursing? A. Health care provider
B. Health educator
A. To support and supplement the efforts of the medical C. Health care coordinator
profession in the promotion of health and prevention of D. Environment manager
B. To enhance the capacity of individuals, families and
communities to cope with their health needs 7. A garment factory does not have an occupational nurse.
C. To increase the productivity of the people by providing Who shall provide the occupational health needs of the
them with services that will increase their level of health factory workers?
D. To contribute to national development through promotion
of family welfare, focusing particularly on mothers and A. Occupational health nurse at the Provincial Health Office
children B. Physician employed by the factory
C. Public Health nurse of the RHU of their municipality
2. CHN is a community-based practice. Which best explains D. Rural Sanitary inspector of the RHU in their municipality
this statement?
8. “Public health services are given free of charge”. Is this
A. The service is provided in the natural environment of statement true or false?
people
B. The nurse has to conduct community diagnosis to A. The statement is true; it is the responsibility of
determine nursing needs and problems government to provide haste services
C. The service are based on the available resources within B. The statement is false; people pay indirectly for public
the community health services
D. Priority setting is based on the magnitude of the health C. The statement may be true or false; depending on the
problems identified Specific service required
D. The statement may be true or false; depending on policies
3. Population- focused nursing practice requires which of of the government concerned.
the following processes?
9. According to C.E. Winslow, which of the following is the
A. Community organizing . goal of Public Health?
B. Nursing, process
C. Community diagnosis A. For people to attain their birthrights and longevity
D. Epidemiologic process B. For promotion of health and prevention and diseases
C. For people to have access to basic health services
4. RA 1054 is also known as the Occupational Health Act. D. For people to be organized in their health efforts
Aside from the number of employees, what other factor
must be considered in determining the occupational health 10. We say that a Filipino has attained longevity when he is
privileges to which the workers will be entitled? able to reach the average life span of Filipinos. What other
statistic may be used to determine attainment of longevity?
A. Type of occupation,: agriculture, commercial, industrial
B. Location of the workplace in relation to health facilities A. Age-specific mortality rate
C. Classification of the business enterprise based on net B. Proportionate mortality rate
profit C. Swaroop’s index
D. Sex and age composition of employees D. Case fatality rate

5. A business firm must employ an occupational health 11. Which of the following is the most prominent feature of
nurse when it has at least how many employees. public health nursing?

A. 21 A. It involves providing home care to sick people who are

B. 101 not confined in the hospital
C. 201 B. Services are provided free of charge to people within the
D. 301 catchment area
C. The public health nurse functions as part of a team
providing a public health nursing service
D. Public health nursing focuses on preventive, not curative
services
12. According to Margaret Shetland, the philosophy of A. Department of Health
public health nursing is based on which of the following? B. Provincial Health Office
C. Regional Health Office
A. Health and longevity as birthrights D. Rural Health Unit
B. The mandate of the state to protect the birthrights of its
citizens 19. RA 7160 mandates devolution of basic services from the
C. Public health nursing as a specialized field of nursing national government to local government units. Which of
D. The worth and dignity of man the following is the major goal of devolution?

13. Which of the following is the mission of the Department A. To strengthen local government units
of Health? B. To allow greater autonomy to local government units.
C. To empower the people and promote their self-reliance
A. Health for all Filipinos D. To make basic services more accessible to the people
B. Ensure the accessibility and quality of health
C. Improve the general health status of the population 20. Who is the Chairman of the Municipal Health Board?
D. Health in the hands of the Filipino people by the year
2020 A. Mayor
B. Municipal Health Officer
14. Region IV Hospital is classified as what level of facility? C. Public Health Nurse
D. Any qualified physician
A. Primary
B. Secondary 21. Which level of health facility is the usual point of entry
C. Intermediate of a client into the health care delivery system?
D. Tertiary
A. Primary
15. What is true of primary facilities? B. Secondary
C. Intermediate
A. They are usually government-run D. Tertiary
B. Their services are provided on an out-patient basis
C. They are training facilities for health professionals 22. The public health nurse is the supervisor of rural health
D. A community hospital is an example of this level of midwives. Which of the following is a supervisory function
health facilities of the pubic health nurse?

16. Which is an example of the school nurse’s health care A. Referring cases or patients to the midwife
provider function? B. Providing technical guidance to the midwife
C. Proving nursing care to cases referred by the midwife
A. Requesting for BCG from the RHU for school entrance D. Formulating and implementing training programs for
immunization midwives
B. Conducting random classroom inspection during measles
epidemic 23. One of the participants in a hilot training class asked you
C. Taking remedial action on an accident hazard in the to whom she should refer a patient in labor who develops a
school playground complication. You will answer, to the;
D. Observing places in the school where pupils spend their
free times A. Public health nurse
B. Rural health midwife
17. When the nurse determines whether resources were C. Municipal health officer
maximized in implementing Ligtas Tigdas, she is D. Any of these health professionals
evaluating:
24. You are the public health nurse in a municipality with a
A. Effectiveness total population of about 20,000. There are3 health
B. Efficiency midwives among the RHU personnel. How many more
C. Adequacy midwife items will the RHU need?
D. Appropriateness A. 1
B. 2
18. You are a new B.S.N. graduate. You want to become a C. 3
Public Health Nurse. Where will you apply? D. 4
25. If the RHU needs additional midwife items, you will
submit the request for additional midwife items for approval 31. In which step are plans formulated for solving
to the: community problems?

A. Rural Health Unit A. Mobilization

B. District Health Office B. Community organization
C. Provincial Health Office C. Follow-up/extension
D. Municipal Health Board D. Core group formation

26. As an epidemiologist, the nurse is responsible for 32. The public health nurse takes an active role in
reporting cases or notifiable diseases. What law mandates community participation. What is the primary goal of
reporting cases of notifiable diseases? community organizing?

A. Act 3573 A. To educate the people regarding community health

B. RA.3753 problems
C. RA 1054 B. To mobilize the people to resolve community health
D. RA 1082 problems
C. To maximize the community’s resources in dealing with
27. According to Freeman and Heinrich, community health health problems
nursing is a developmental service. Which of the following
best illustrates this statement? 33. An indicator of success in community organizing is
when people are able to:
A. The community health nurse continuously develops
himself personally and professionally A. Participate in community activities for the solution of a
B. Health education and community organizing are community problem
necessary in providing community health services B. Implement activities for the solution of the community
C. Community health nursing in intended primarily for problem
health promotion and prevention and treatment of disease. C. Plan activities for the solution of the community problem
D. The goal of community health nursing is to provide D. Identify the health problem as a common concern
nursing services to people in their own place of .residence
34. Tertiary prevention is needed in which stage of the
28. Which disease was declared through Presidential natural history of disease?
Proclamation No. 4 as a target for, eradication in the
Philippines? A. Pre-pathogenesis
B. Pathogenesis
A. Pioliomyelitis C. Predromal
B. Measles D. Terminal
C. Rabies
D. Neonatal Tetanus 35. Isolation of a child with measles belongs to what level of
prevention?
29. The public health nurse is responsible for presenting the
municipal health statistics using graphs and tables. To A. Primary
compare the frequency of the leading causes of mortality in B. Secondary
the municipality, which graph will you prepare? C. Intermediate
D. Tertiary
A. Line
B. Bar 36. On the other hand, Operation Timbang is_____
C. Pie prevention?
D. Scatter diagram
A. Primary
30. Which step in community organizing involves training B. Secondary
of potential leaders in the community? C. Intermediate
D. Tertiary
A. Integration
B. Community organization 37. Which type of family-nurse contact will provide you
C. Community study with the best opportunity to observe family dynamics?
D. Core group formation
A. Clinic consultation 43. To maintain the cleanliness of the bag and its contents,
B. Group conferences which of the following must the nurse do?
C. Home visit
D. Written communication A. Wash his/her hands before and after providing nursing
care to the family members
38. The typology of family nursing problems is used in the B. In the care of family member’s, as much as possible, use
statement of nursing diagnosis in the care of families. The only articles taken from the bag
youngest child of the delos Reyes family has been diagnosed C. Put on an apron to protect her uniform and fold it with the
as mentally retarded. This is classified as: right side out before putting it back into the bag.
D. At the end of the visit, fold the lining on which the bag
A. Health threat was placed, ensuring that the contaminated side is on the
B. Health deficit outside.
C. Foreseeable crisis
D. Stress point 44. The public health conducts a study on the factors
contributing to the high morality rate due to heart diseases in
39. The delos Reyes couple have 6-year old child entering the municipality where she works. Which branch of
school for the first time. The delos Reyes family has a: epidemiology does the nurse practice in this situation?

A. Health threat A. Descriptive

B. Health deficit B. Analytical
C. Foreseeable crisis C. Therapeutic
D. Stress point D. Evaluation

40. Which of the following is an advantage of a home visit? 45. Which of the following is a function of epidemiology?

A. It allows the nurse to provide nursing care to a greater A. Identifying the disease condition based on manifestations
number of people presented by a client
B. It provides an opportunity to do first hand appraisal of the B. Determining factors that contributed to the occurrence of
home situation pneumonia in a 3 year old
C. It allows sharing of experience among people with C. Determining the efficacy of the antibiotic used in the
similar health problems treatment of the 3 year old client with pneumonia
D. It develops the family’s initiative in providing for health D. Evaluating the effectiveness of the implementation of the
needs of its members Integrated Management of Childhood Illness

41. Which is CONTRARY to the principles in planning a 46. Which of the following is an epidemiologic function of
home visit? the nurse during an epidemic?

A. A home visit should have a purpose of objective A Conducting assessment of suspected cases to detect the
B. The plan should revolve around the family health .needs communicable diseases
C. A home visit should be conducted in the manner B. Monitoring the condition of the cases affected by the
prescribed by RHU communicable disease
D. Planning of continuing care should involve a C. Participating in the investigation to determine the source
responsible-family member of epidemic
D. Teaching the community on preventive measures against
42. The PHN bag is an important tool in providing nursing the disease
care during a home visit. The most important principle in
bag technique states that it; 47. The primary purpose of conducting an epidemiologic
investigation is to;
A. Should save time and effort
B. Should minimize if not totally prevent the spread of A. Delineate the etiology of the epidemic
infection B. Encourage cooperation and support of the community
C. Should not overshadow concern for the patient and his C. Identify groups who are at risk of contracting the disease
family D. Identify geographical location of cases of the disease in
D. May be done in variety of ways depending on the home the community
situation, etc.
48. Which is a characteristic of person-to-person propagated
epidemic?
A. There are more cases of the disease than expected 54. Sputum examination is the major screening tool for
B. The disease must necessarily be transmitted through a pulmonary tuberculosis. Clients would sometimes get false
vector negative results in this exam. This means that the test is not
C. The spread of the disease can be attributed to a common perfect in terms of which characteristic of a diagnostic
vehicle examination?
D. There is gradual build up of cases before we epidemic
becomes easily noticeable A. Effectiveness
B. Efficacy
49. In the investigation of an epidemic, you compare the C. Specificity
present frequency of the disease with the usual frequency at D. Sensitivity
this time of the year in this community. This is done during
which stage of the investigation? 55. Use of appropriate technology requires knowledge of
indigenous technology. Which medical herb is given for
A. Establishing the epidemic fever, headache and cough?
B. Testing the hypothesis
C. Formulation of the hypothesis A. Sambong
D. Appraisal of facts B. Tsaang gubat
C. Akapulko
50. The number of cases of Dengue fever usually increases D. Lagundi
towards the end of the rainy season. This pattern of
occurrence of Dengue fever is best described as; 56. What law created the Philippine institute of Traditional
and Alternative Health Care?
A. Epidemic occurrence
B. Cyclical variation A. RA 8483
C. Sporadic occurrence B. RA4823
D. Secular occurrence C. RA 2483
D. RA 3482
51. In the year 1980, the World Health Organization
declared the Philippines, together with some other countries 57. In traditional Chinese medicine, the yielding, negative
in the Western Pacific Region, “free” of which disease? and feminine force is termed:

A. Pneumonic plaque A. Yin

B. Poliomyelitis B. Yang
C. Small pox C. Qi
D. Anthrax D. Chai

52. In the census of the Philippines in 1995, there were 58. What is the legal basis of Primary Health Care approach
about 35,299,000 males and about 34,968,000 females. in the Philippines?
What is the sex ratio?
A. Alma Ata Declaration of PHC
A. 99.06:100 B. Letter of Instruction No 949
B. 100.94:100 C. Presidential Decree No. 147
C. 50.23% D. Presidential Decree 996
D. 49.76%
59. Which of the following demonstrates inter-sectoral
53. Primary health care is a total approach to community linkages?
development. Which of the following is an indicator of
success in the use of the primary health care approach? A. Two-way referral system
B. Team approach
A. Health services are provided free of charge to individuals C. Endorsement done by a midwife to another midwife
and families D. Cooperation between PHN and public school teacher
B. Local officials are empowered as the major decision
makers in matters of health 60. The municipality assigned to you has a population of
C. Health workers are able too provide care based on about 20/000. Estimate the number of 1-4 year old children
identified health needs of the people who be given Retinol capsule 200.000 every 6 months.
D. Health programs are sustained according to the level of
development of the community A. 1,500
B. 1,800 67. In the past year, Barangay A had an average population
C. 2,000 of 1655. 46 babies were born in that year, 2 of whom died
D. 2,300 less than 4 weeks after they were born. They were 4
recorded stillbirths. What is the neonatal mortality rate?
61. Estimate the number of pregnant women who will be
given tetanus toxoid during an immunization outreach A. 27.8/1000
activity in a barangay with a population of about 1,500. B. 43.5/1000
C. 86.9/1000
A. 265 D. 130.4/1000
B. 300
C. 375 68. Which statistic best reflects the nutritional status of a
D. 400 population?

62. To describe the sex composition of the population, A. 1-4 year old age-specific mortality rate
which demographic tool may be used? B. Proportionate mortality rate
C. Infant mortality rate
A. Sex ratio D. Swaroop’s index
B. Sex proportion
C. Population pyramid 69. What numerator is used in computing general fertility
D. Any of these maybe used rate?

63. Which of the following is a natality rate? A. Estimated midyear population

B. Number of registered live births
A. Crude birth rate C. Number of pregnancies in the year
B. Neonatal mortality rate D. Number of females of reproductive age
C. Infant mortality rate
D. General fertility rate 70. You will gather data for nutritional assessment of a
purok. You will gather information only from families with
64. You are computing the crude rate of your municipality, members who belong to the target population for PEM.
with a total population o about 18,000 for last year. There What method of delta gathering is best for this purpose?
were 94 deaths. Among those who died, 20 died because of
diseases of the heart and 32 were aged 50 years or older. A. Census
What is the crude death rate? B. Survey
C. Record Review
A. 4.1/1000 D. Review of civil registry
B. 5.2/1000
C. 6.3/1000 71. In the conduct of a census, the method of population
D. 7.3/1000 assignment based on the actual physical location of the
people is termed;
65. Knowing that malnutrition is a frequent community
health problem, you decided to conduct nutritional A. De jure
assessment. What population is particularly susceptible to B. De locus
protein energy malnutrition (PEM)? C. De facto
D. De novo
A. Pregnant women and the elderly
B. Under 5 year old children 72. The Field Health Services and information System
C. 1-4 year old children (FHSIS) is the recording and reporting system in public
D. School age children health) care in the Philippines. The monthly field health
service activity report is a form used in which of the
66. Which statistic can give the most accurate reflection of components of the FHSIS?
the health status of a community?
A. Tally report
A. 1-4 year old age-specific mortality rate B. Output report
B. Infant mortality rate C. Target/client list
C. Swaroop’s index D. Individual health record
D. Crude death rate
73. To monitor clients registered in long-term regimens, A. Information dissemination about the need for family
such as the Multi-Drug Therapy, which component will be planning
most useful? B. Support of research and development in family planning
methods
A. Tally report C. Adequate information for couples regarding the different
B. Output report methods
C. Target/client list D. Encouragement of couples to take family planning as a
D. Individual health record joint responsibility

74. Civil registries are important sources of data. Which law 80. A woman, 6 months pregnant, came to the center for
requires registration of births within 30 days from the consultation. Which of the following substances is
occurrence of the birth? contraindicated?

A. PD 651 A. Tetanus toxoid

B. Act 3573 B. Retinol 200,000 IU
C. RA 3753 C. Ferrous sulfate 200mg
D. RA 3375 D. Potassium iodate 200 mg, capsule

75. Which of the following professionals can sign the birth 81. During prenatal consultation, a client asked you if she
certificate? can have her delivery at home. After history taking and
physical examination, you advised her against a home
A. Public health nurse delivery. Which of the following findings disqualifies her
B. Rural health midwife for a home delivery?
C. Municipal health officer
D. Any of these health professionals A. Her OB score is G5P3
B. She has some palmar pallor
76. Which criterion in priority setting of health problems is C. Her blood pressure is 130/80
used only in community health care? D. Her baby is in cephalic presentation

A. Modifiability of the problem 82. Inadequate intake by the pregnant woman of which
B. Nature of the problem presented vitamin may cause neural tube defects?
C. Magnitude of the health problem
D. Preventive potential of the health problem A. Niacin
B. Riboflavin
77. The Sentrong Sigla Movement has been launched to C. Folic Acid
improve health service delivery. Which of the following D. Thiamine
is/are true of this movement?
83. You are in a client’s home to attend to a delivery. Which
A. This is a project spearheaded by local government units of the following will you do first?
B. It is a basis for increasing funding from local government
units A. Set up a sterile area
C. It encourages health centers to focus on disease B. Put on a clean gown and apron
prevention and control C. Cleanse the client’s vulva with soap and water
D. Its main strategy is certification of health centers able to D. Note the interval, duration and intensity of labor and
comply with standards contractions

78. Which of the following women should be considered as 84. In preparing a primigravida for breastfeeding, which of
special targets for family planning? the following will you do?
A. Those who have two children or more
B. Those with medical conditions such as anemia A. Tell her that lactation begins within a day after delivery
C. Those younger than 20 years and older than 35 years B. Teach her nipple stretching exercises if her nipples are
D. Those who just had a delivery within the past 15 months everted
C. Instruct her to wash her nipples before and after each
79. Freedom of choice in one of the policies of the Family breastfeeding
Planning Program of the Philippines. Which of the D. Explain to her that putting the baby to breast will lessen
following illustrates this principle? blood loss after delivery
85. A primigravida is instructed to offer her breast to the D. Presidential Proclamation No. 46
baby for the first time within 30 minutes after delivery.
What is the purpose of offering the breast this early? 92. Which immunization produces a permanent scar?

A. To initiate the occurrence of milk letdown A. DPT

B. To stimulate milk production by the mammary acini B. BCG
C. To make sure that the baby is able to get the colustrum C. Measles vaccination
D. To allow the woman to practice breastfeeding in the D. Hepatitis B vaccination
presence of the health worker
93. A 4 week old baby was brought to the health center for
86. In a mother’s class, you discuss proper breastfeeding his first immunization. Which can be given to him?
technique. Which of these is a sign that the baby has
“lactated on” the breast property? A. DPT1
B. OPV1
A. The baby takes shallow, rapid sucks C. Infant BCG
B. The mother does not feel nipple pain D. Hepatitis B Vaccin
C. The baby’s mouth is only partly open
D. Only the mother’s nipple is inside the baby’s mouth 94. You will not give DPT 2 if the mother says that the
infant had?
87. You explain to a breastfeeding mother that breastmilk is
sufficient for all of the baby’s nutrient needs only up to: A. Seizures a day after DPT1
B. Fever for 3 days after DPT1
A. 3 months C. Abscess formation after DPT1
B. 6 months D. Local tenderness for 3 days after DPT1
C. 1 year
D. 2 years 95. A 2-month old infant was brought to the health center
for immunization. During assessment, the infant’s
88. What is given to a woman within a month after the temperature registered at 38.1 C. Which is the best course of
delivery of a baby? action that you will take?

A. Malunggay capsule A. Go on with the infants immunization

B. Ferrous sutfate l00mg O.D. B. Give paracetamol and wait for his fever to subside
C. Retinol 200.000 IU 1 capsule C. Refer the infant to the physician for further assessment
D. Potassium Iodate 200 mg, 1 capsule D. Advise the infant’s mother to bring him back for
immunization when he is well
89. Which biological used in EPI is stored in the freezer?
96. A pregnant woman had just received her 4th dose of
A. DPT tetanus toxoid. Subsequently, her baby will have protection
B. Tetanus toxoid against tetanus for how long?
C. Measles vaccine
D. Hepatitis B vaccine A. 1 year
B. 3 years
90. Unused BCG should be discarded how many hours after C. 10 years
reconstitution? D. Lifetime

A. 2 97. A 4-month old infant was brought to the health center of

B. 4 cough. Her respiratory rate is 42/minute. Using the IMCI
C. 6 guidelines of assessment, her breathing is considered;
D. At the end of the day
A. Fast
91. In immunity school entrants with BCG, you not obliged B. Slow
to secure parental consent. This is because of which legal C. Normal
document? D. Insignificant

A. PD 996 98. Which of the following signs will indicate that a young
B. RA 7864 child is suffering from severe pneumonia?
C. Presidential Proclamation No. 6
A. Dyspnea C. Apathy
B. Wheezing D. Edema
C. Fast breathing
D. Chest indrawing 104. Assessment of a 2-year old child revealed “baggy
pants”. Using the IMCI guidelines, how will you manage
99. Using IMCI guidelines, you classify a child as having this child?
severe pneumonia. What is the best management for the A. Refer the child urgently to a hospital for confinement
child? B. Coordinate with the social worker to enroll the child in a
feeding program
A. Prescribe antibiotic C. Make a teaching plan for the mother, focusing on the
B. Refer him urgently to the hospital menu planning for her child
C. Instruct the mother to increase fluid intake D. Assess and treat the child for health problems like
D. Instruct the mother to continue breastfeeding infections and intestinal parasitism

100. A 5-month old infant was brought by his mother to the 105. During the physical examination of a young child, what
health center because of diarrhea occurring 4 to 5 times a is the earliest sign of xerophthalmia that may observe?
day. His skin goes back slowly after a skin pinch and his
eyes are sunken. Using the IMCI guidelines, you will A. Keratomalacia
classify this infant in which category? B. Corneal opacity
C. Night blindness
A. No signs of dehydration D. Conjunctival xerosis
B. Some dehydration
C. Severe dehydration 106. To prevent xerophthalmia, young children are given
D. The data is insufficient Retinol capsule every 6 months. What is the dose given to
preschoolers?
101. Based on the assessment, you classified a 3-month old
infant with the chief complaint of diarrhea in the category of A. 10, 000 IU
SOME DEHYDRATION. Based on the IMCI management B. 20, 000 IU
guidelines, which of the following will you do? C. 100, 000 IU
D. 200, 000 IU
A. Bring the infant to the nearest facility where IV fluids can
be given 107. The major sign of iron deficiency anemia is pallor.
B. Supervise the mother in giving 200 to 400 ml of Oresol in What part is best examined for pallor?
4 hours
C. Give the infant’s mother instructions on home A. Palms
management B. Nailbeds
D. Keep the infant in your health center for close C. Around the lips
observation D. Lower conjunctival sac

102. A mother is using Oresol’ in the management of 108. Food fortification is one of the strategies to prevent
diarrhea of her 3-year old child. She asked you what to do if micronutrient deficiency conditions. RA 8976 mandates
her child vomits. You will tell her to: fortification of certain food items. Which of the following is
among these food items?
A. Bring the child to the nearest hospital for further
assessment A. Sugar
B. Bring the child to the health center for IV therapy B. Bread
C. Bring the child to the health center for assessment by the C. Margarine
physician D. Filled milk
D. Let the child rest for 10 minutes then continue giving
Oresol more slowly 109. What is the best course of action when there is a
measles epidemic in a nearby municipality?
103. A 1 1/2 year old child was classified as having 3rd
degree of protein energy malnutrition, kwashjorkor. Which A. Give measles vaccine to babies aged 6 to 3 months
of the following signs will be most apparent in this child? B. Give babies aged 6 to 11 months one dose of 100,000 IU
of Retinol
A. Voracious appetite C. Instruct mother to keep their babies at home to prevent
B. Wasting disease transmission
D. Instruct mothers to feed their babies adequately to 116. Which of the following signs indicates the need for
enhance their babies resistance sputum examination for AFB?

110. A mother brought her daughter, 4 years old, to the RHU A. Hematemesis
because of cough and colds. Following the IMCI assessment B. Fever for 1 week
guide, which of the following is a danger sign that indicates C. Cough for 3 weeks
the need for urgent referral to a hospital? D. Chest pain for 1 week

A. Inability to drink 117. Which clients are considered targets for DOTS
B. High grade fever category?
C. Signs of severe dehydration
D. Cough for more than 30 days A. Sputum negative cavitary cases
B. Clients returning after default
111. Management of a child with measles includes the C. Relapses and failures of previous PTB treatment
administration of which of the following? regimens
D. Clients diagnosed for the first time through a positive
A. Gentian violet on mouth lesions sputum exam
B. Antibiotic to prevent pneumonia
C. Tetracycline eye ointment for corneal opacity 118. To improve compliance to treatment, what innovation
D. Retinol capsule regardless of when the last dose was is being implemented in DOTS?
given
A. Having the health worker follow up the client at home
112. A mother brought her 10 month old infant for B. Having the health worker or a responsible family member
consultation because of fever which started 4 days prior to monitor drug intake
consultation. To determine malaria risk, what will you do? C. Having the patient come to the health center every month
to get his medications
A. Do a tourniquet test D. Having a target list to check on whether the patient has
B. Ask where the family resides collected his monthly supply of drugs
C. Get a specimen for blood smear
D. Ask if the fever is present everyday 119. Diagnosis of leprosy is highly dependent on recognition
of symptoms. Which of the following is an early sign of
113. The following are strategies implemented by the DOH leprosy?
to prevent mosquito-borne diseases. Which of these is most
effective in the control of Dengue fever? A. Macular lesions
B. Inability to close eyelids
A. Stream seeding with larva-eating fish C. Thickened painful nerves
B. Destroying breeding places of mosquitoes D. Sinking of the nose bridge
C. Chemoprophylaxis of non-immune persons going to
endemic areas 120. Which of the following clients should be classified as a
D. Teaching people in endemic areas to use chemically case of mutibacillary leprosy?
treated mosquito nets
A. 3 skin lesions, negative slit skin smear
114. Secondary prevention for malaria includes? B. 3 skin lesions, positive slit skin smear
C. 5 skin lesions, negative slit skin smear
A. Planting of neem or eucalyptus trees D. 5 skin lesions, positive slit skin smear
B. Residual spraying of insecticides at night
C. Determining whether a place is endemic or not 121. In the Philippines, which condition is the most frequent
D. Growing larva-eating fish in mosquito breeding places cause of death associated by schistosomiasis?

115. Scotch tape swab is done to check for which intestinal A. Liver cancer
parasite? B. Liver cirrhosis
C. Bladder cancer
A. Ascaris D. Intestinal perforation
B. Pinworm
C. Hookworm 122. What is the most effective way of controlling
D. Schistosoma schistosomiasis in an endemic area?
A. Use of molluscicides B. 5
B. Building of foot bridges C. 8
C. Proper use of sanitary toilets D. 10
D. Use of protective footwear, such as rubber boots
129. A 3-year old child was brought by his mother to the
123. When residents obtain water from an artesian well in health center because of fever of 4-day duration. The child
the neighborhood, the level of this approved type of water had a positive tourniquet test result. In the absence of other
facility is: signs, which of the most appropriate measure that the PHN
may carry out to prevent Dengue shock syndrome?
A. I
B. II A. Insert an NGT and give fluids per NGT
C. III B. Instruct the mother to give the child Oresol
D. IV C. Start the patient on IV Stat
D. Refer the client to the physician for appropriate
124. For prevention of Hepatitis A, you decided to conduct management
health education activities. Which of the following is
Irrelevant? 130. The pathognomonic sign of measles is Koplik’s spot.
You may see Koplik’s spot by inspecting the:
A. Use of sterile syringes and needles
B. Safe food preparation and food handling by vendors A. Nasal Mucosa
C. Proper disposal of human excreta and personal hygiene B. Buccal mucosa
D. Immediate reporting of water pipe leaks and illegal water C. Skin on the abdomen
connections D. Skin on the antecubital surface

125. Which biological used in EPI should not be stored in 131. Among the following diseases, which is airborne?
the freezer?
A. Viral conjunctivitis
A. DPT B. Acute poliomyelitis
B. OPV C. Diphtheria
C. Measles vaccine D. Measles
D. MMR
132. Among children aged 2 months to 3 years, the most
126. You will conduct outreach immunization in a barangay prevalent form of meningitis is caused by which
with a population of about 1500. Estimate the number of microorganism?
infants in the barangay.
A. Hemophilus Influenzae
A. 45 B. Morbillivirus
B. 50 C. Streptococcus Pneumoniae
C. 55 D. Neisseria meningitides
D. 60
133. Human beings are the major reservoir of malaria.
127. In IMCI, severe conditions generally require urgent Which of the following strategies in malaria control is based
referral to a hospital. Which of the following severe on this fact?
conditions Does not always require urgent referral to
hospital? A. Stream seeding
B. Stream clearing
A. Mastoiditis C. Destruction of breeding places
B. Severe dehydration D. Zooprophylaxis
C. Severe pneumonia
D. Severe febrile disease. 134. The use of larvivorous fish in malaria control is the
basis for which strategy of malaria control?
128. A client was diagnosed as having Dengue Fever. You
will say that there is slow capillary refill when the color of A. Stream seeding
the nailbed that you pressed does not return within how B. Stream clearing
many seconds? C. Destruction of breeding places
D. Zooprophylaxis .
A. 3
135. Mosquito-borne diseases are prevented mostly with the A. Get a thorough history of the client, focusing on the
use of mosquito control measures. Which of the following is practice of high risk behavior
NOT appropriate for malaria control? B. Ask the client to be accompanied by a significant person
before revealing the result.
A. Use of chemically treated mosquito nets C. Refer the client to the physician since he is the best
B. Seeding of breeding places with larva-eating fish person to reveal the result to the client
C. Destruction of breeding places of the mosquito vector D. Refer the client for a supplementary test, such as Western
D. Use of mosquito-repelling soaps, such as those with basil blot, since the ELISA result maybe false
or citronella
141. Which is the BEST control measure for AIDS?
136. A 4-year old client was brought to the health center
with chief complaint of severe diarrhea and the passage of A. Being faithful to a single sexual partner
“rice water”. The client is most probably suffering from B. Using a condom during each sexual contact
which condition? C. Avoiding sexual contact with commercial sex workers
D. Making sure that one’s sexual partner does not have signs
A. Giardiasis of AIDS
B. Cholera
C. Amebiasis 142. The most frequent causes of death among clients with
D. Dysentery AIDS are opportunistic diseases. Which of the following
opportunistic infections is characterized by
137. In the Philippines, which specie of schistosoma is tonsilllopharyngitis?
endemic in certain regions?
A. Respiratory candidiasis
A. S. mansoni B. Infectious mononucleosis
B. S. japonicum C. Cytomegalovirus disease
C. S. malayensis D. Pneumocystis carinii pneumonia
D. S. haematobium
143. To determine the possible sources of sexually
138. A 32 year old client came for consultation at the health transmitted infections, which is the BEST method that may
center with the chief complaint of fever for a week. be undertaken by the public health nurse?
Accompanying symptoms were muscle pains and body
malaise. A week after the start of fever, the client noted A. Contact tracing
yellowish discoloration of his sclera. History showed that he B. Community survey
waded in flood waters about 2 weeks before the onset of C. Mass screening tests
symptoms. Based on this history/ which disease condition D. Interview suspects
will you suspect?
144. Antiretroviral agents, such as AZT are used in the
A. Hepatitis A management of AIDS. Which of the following is not an
B. Hepatitis B action expected of these drugs?
C. Tetanus
D. Leptospirosis A. They prolong the life of the client with AIDS
B. They reduce the risk of opportunistic infections
139. MWSS provides water to Manila and other cities in C. They shorten the period of communicability of the
Metro Manila. This is an example of which level of water disease
facility? D. They are able to bring about a cure of the disease
condition
A. I
B. II 145. A barangay had an outbreak of German measles. To
C. III prevent congenital rubella, what is the BEST advice that you
D. IV can give to women in the first trimester of pregnancy in the
barangay?
140. You are the PHN in the city health center. A client a. Advice them on the sign of German Measles
underwent screening for AIDS using ELISA. His result was b. Avoid crowded places, such as markets and moviehouses
positive. What is the best course of action that you may c. Consult at the health center where rubella vaccine may be
take? given
d. Consult a physician who may give them rubella
immunoglobulin
Answers and Rationale This is a direct quote from Dr. Margaret Shetland’s
1. Answer: (B) To enhance the capacity of individuals, statements on Public Health Nursing.
families and communities to cope with their health needs.
To contribute to national development through promotion of 13. Answer: (B) Ensure the accessibility and quality of
family welfare, focusing particularly on mothers and health care
children.
14. Answer: (D) Tertiary
2. Answer: (B) The nurse has to conduct community Regional hospitals are tertiary facilities because they serve
diagnosis to determine nursing needs and problems. as training hospitals for the region.
Community-based practice means providing care to people
in their own natural environments: the home, school and 15. Answer: (B) Their services are provided on an
workplace, for example. out-patient basis.
Primary facilities government and non-government facilities
3. Answer: (C) Community diagnosis that provide basic out-patient services.
Population-focused nursing care means providing care based
on the greater need of the majority of the population. The 16. Answer: (B) Conducting random classroom inspection
greater need is identified through community diagnosis. during a measles epidemic
Random classroom inspection is assessment of
4. Answer: (B) Location of the workplace in relation to pupils/students and teachers for signs of a health problem
health facilities prevalent in the community.
Based on R.A. 1054, an occupational nurse must be
employed when there are 30 to 100 employees and the 17. Answer: (B) Efficiency
workplace is more than 1 km. away from the nearest health Efficiency is determining whether the goals were attained at
center. the least possible cost.
5. Answer: (B) 101
18. Answer: (D) Rural Health Unit
6. Answer: (D) Environmental manager R.A. 7160 devolved basic health services to local
Ergonomics is improving efficiency of workers by government units (LGU’s). The public health nurse is an
improving the worker’s environment through appropriately employee of the LGU.
designed furniture, for example.
19. Answer: (C) To empower the people and promote their
7. Answer: (C) Public health nurse of the RHU of their self-reliance
municipality People empowerment is the basic motivation behind
devolution of basic services to LGU’s.
8. Answer: (B) The statement is false; people pay indirectly
for public health services. 20. Answer: (A) Mayor
Community health services, including public health services, The local executive serves as the chairman of the Municipal
are prepaid paid services, through taxation, for example. Health Board.

9. Answer: (A) For people to attain their birthrights of health 21. Answer: (A) Primary
and longevity The entry of a person into the health care delivery system is
According to Winslow, all public health efforts are for usually through a consultation in out-patient services.
people to realize their birthrights of health and longevity.
22. Answer: (B) Providing technical guidance to the
10. Answer: (C) Swaroop’s index midwife
Swaroop’s index is the percentage of the deaths aged 50 The nurse provides technical guidance to the midwife in the
years or older. Its inverse represents the percentage of care of clients, particularly in the implementation of
untimely deaths (those who died younger than 50 years). management guidelines, as in Integrated Management of
Childhood Illness.
11. Answer: (D) Public health nursing focuses on
preventive, not curative, services. 23. Answer: (C) Municipal Health Officer
The catchment area in PHN consists of a residential A public health nurse and rural health midwife can provide
community, many of whom are well individuals who have care during normal childbirth. A physician should attend to a
greater need for preventive rather than curative services. woman with a complication during labor.

12. Answer: (D) The worth and dignity of man 24. Answer: (A) 1
Each rural health midwife is given a population assignment Tertiary prevention involves rehabilitation, prevention of
of about 5,000. permanent disability and disability limitation appropriate for
convalescents, the disabled, complicated cases and the
25. Answer: (D) Municipal Health Board terminally ill (those in the terminal stage of a disease)
As mandated by R.A. 7160, basic health services have been
devolved from the national government to local government 35. Answer: (A) Primary
units. The purpose of isolating a client with a communicable
disease is to protect those who are not sick (specific disease
26. Answer: (A) Act 3573 prevention).
Act 3573, the Law on Reporting of Communicable Diseases,
enacted in 1929, mandated the reporting of diseases listed in 36. Answer: (B) Secondary
the law to the nearest health station. Operation Timbang is done to identify members of the
susceptible population who are malnourished. Its purpose is
27. Answer: (B) Health education and community early diagnosis and, subsequently, prompt treatment.
organizing are necessary in providing community health
services. 37. Answer: (C) Home visit
The community health nurse develops the health capability Dynamics of family relationships can best be observed in
of people through health education and community the family’s natural environment, which is the home.
organizing activities.
38. Answer: (B) Health deficit
28. Answer: (B) Measles Failure of a family member to develop according to what is
Presidential Proclamation No. 4 is on the Ligtas Tigdas expected, as in mental retardation, is a health deficit.
Program.
39. Answer: (C) Foreseeable crisis
29. Answer: (B) Bar Entry of the 6-year old into school is an anticipated period
A bar graph is used to present comparison of values, a line of unusual demand on the family.
graph for trends over time or age, a pie graph for population
composition or distribution, and a scatter diagram for 40. Answer: (B) It provides an opportunity to do first hand
correlation of two variables. appraisal of the home situation.
Choice A is not correct since a home visit requires that the
30. Answer: (D) Core group formation nurse spend so much time with the family. Choice C is an
In core group formation, the nurse is able to transfer the advantage of a group conference, while choice D is true of a
technology of community organizing to the potential or clinic consultation.
informal community leaders through a training program.
41. Answer: (C) A home visit should be conducted in the
31. Answer: (B) Community organization manner prescribed by the RHU.
Community organization is the step when community The home visit plan should be flexible and practical,
assemblies take place. During the community assembly, the depending on factors, such as the family’s needs and the
people may opt to formalize the community organization resources available to the nurse and the family.
and make plans for community action to resolve a
community health problem. 42. Answer: (B) Should minimize if not totally prevent the
spread of infection.
32. Answer: (D) To maximize the community’s resources in Bag technique is performed before and after handling a
dealing with health problems client in the home to prevent transmission of infection to and
Community organizing is a developmental service, with the from the client.
goal of developing the people’s self-reliance in dealing with
community health problems. A, B and C are objectives of 43. Answer: (A) Wash his/her hands before and after
contributory objectives to this goal. providing nursing care to the family members.
Choice B goes against the idea of utilizing the family’s
33. Answer: (A) Participate in community activities for the resources, which is encouraged in CHN. Choices C and D
solution of a community problem goes against the principle of asepsis of confining the
Participation in community activities in resolving a contaminated surface of objects.
community problem may be in any of the processes
mentioned in the other choices. 44. Answer: (B) Analytical
Analytical epidemiology is the study of factors or
34. Answer: (D) Terminal determinants affecting the patterns of occurrence and
distribution of disease in a community.
 Sambong is used as a diuretic. Tsaang gubat is used to
45. Answer: (D) Evaluating the effectiveness of the relieve diarrhea. Akapulko is used for its antifungal
implementation of the Integrated Management of Childhood property.
Illness
Epidemiology is used in the assessment of a community or 56. Answer: (A) R.A. 8423 or “AN ACT CREATING THE
evaluation of interventions in community health practice. PHILIPPINE INSTITUTE OF TRADITIONAL AND
ALTERNATIVE HEALTH CARE (PITAHC) TO
46. Answer: (C) Participating in the investigation to ACCELERATE THE DEVELOPMENT OF
determine the source of the epidemic TRADITIONAL AND ALTERNATIVE HEALTH CARE
Epidemiology is the study of patterns of occurrence and IN THE PHILIPPINES, PROVIDING FOR A
distribution of disease in the community, as well as the TRADITIONAL AND ALTERNATIVE HEALTH CARE
factors that affect disease patterns. The purpose of an DEVELOPMENT FUND AND FOR OTHER PURPOSES”
epidemiologic investigation is to identify the source of an signed to a law on December 9, 1997.
epidemic, i.e., what brought about the epidemic.
57. Answer: (A) Yin
47. Answer: (A) Delineate the etiology of the epidemic Yang is the male dominating, positive and masculine force.
Delineating the etiology of an epidemic is identifying its
source. 58. Answer: (B) Letter of Instruction No. 949
Letter of Instruction 949 was issued by then President
48. Answer: (D) There is a gradual build up of cases before Ferdinand Marcos, directing the formerly called Ministry of
the epidemic becomes easily noticeable. Health, now the Department of Health, to utilize Primary
A gradual or insidious onset of the epidemic is usually Health Care approach in planning and implementing health
observable in person-to-person propagated epidemics. programs.

49. Answer: (A) Establishing the epidemic 59. Answer: (D) Cooperation between the PHN and public
Establishing the epidemic is determining whether there is an school teacher
epidemic or not. This is done by comparing the present Intersectoral linkages refer to working relationships between
number of cases with the usual number of cases of the the health sector and other sectors involved in community
disease at the same time of the year, as well as establishing development.
the relatedness of the cases of the disease.
60. Answer: (D) 2,300
50. Answer: (B) Cyclical variation Based on the Philippine population composition, to estimate
A cyclical variation is a periodic fluctuation in the number the number of 1-4 year old children, multiply total
of cases of a disease in the community. population by 11.5%.

51. Answer: (C) Smallpox 61. Answer: (A) 265

The last documented case of Smallpox was in 1977 at To estimate the number of pregnant women, multiply the
Somalia. total population by 3.5%.

52. Answer: (B) 100.94:100 62. Answer: (D) Any of these may be used.
Sex ratio is the number of males for every 100 females in Sex ratio and sex proportion are used to determine the sex
the population. composition of a population. A population pyramid is used
to present the composition of a population by age and sex.
53. Answer: (D) Health programs are sustained according to
the level of development of the community. 63. Answer: (A) Crude birth rate
Primary health care is essential health care that can be Natality means birth. A natality rate is a birth rate.
sustained in all stages of development of the community.
64. Answer: (B) 5.2/1,000
54. Answer: (D) Sensitivity To compute crude death rate divide total number of deaths
Sensitivity is the capacity of a diagnostic examination to (94) by total population (18,000) and multiply by 1,000.
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 65. Answer: (C) 1-4 year old children
false negative results. Preschoolers are the most susceptible to PEM because they
have generally been weaned. Also, this is the population
55. Answer: (D) Lagundi who, unable to feed themselves, are often the victims of
poor intrafamilial food distribution.
66. Answer: (C) Swaroop’s index Sentrong Sigla Movement is a joint project of the DOH and
Swaroop’s index is the proportion of deaths aged 50 years local government units. Its main strategy is certification of
and above. The higher the Swaroop’s index of a population, health centers that are able to comply with standards set by
the greater the proportion of the deaths who were able to the DOH.
reach the age of at least 50 years, i.e., more people grew old
before they died. 78. Answer: (D) Those who just had a delivery within the
past 15 months
67. Answer: (B) 43.5/1,000 The ideal birth spacing is at least two years. 15 months plus
To compute for neonatal mortality rate, divide the number of 9 months of pregnancy = 2 years.
babies who died before reaching the age of 28 days by the
total number of live births, then multiply by 1,000. 79. Answer: (C) Adequate information for couples regarding
the different methods
68. Answer: (A) 1-4 year old age-specific mortality rate To enable the couple to choose freely among different
Since preschoolers are the most susceptible to the effects of methods of family planning, they must be given full
malnutrition, a population with poor nutritional status will information regarding the different methods that are
most likely have a high 1-4 year old age-specific mortality available to them, considering the availability of quality
rate, also known as child mortality rate. services that can support their choice.

69. Answer: (B) Number of registered live births 80. Answer: (B) Retinol 200,000 IU
To compute for general or total fertility rate, divide the Retinol 200,000 IU is a form of megadose Vitamin A. This
number of registered live births by the number of females of may have a teratogenic effect.
reproductive age (15-45 years), then multiply by 1,000.
81. Answer: (A) Her OB score is G5P3.
70. Answer: (B) Survey Only women with less than 5 pregnancies are qualified for a
A survey, also called sample survey, is data gathering about home delivery. It is also advisable for a primigravida to have
a sample of the population. delivery at a childbirth facility.

71. Answer: (C) De facto 82. Answer: (C) Folic acid

The other method of population assignment, de jure, is It is estimated that the incidence of neural tube defects can
based on the usual place of residence of the people. be reduced drastically if pregnant women have an adequate
intake of folic acid.
72. Answer: (A) Tally report
A tally report is prepared monthly or quarterly by the RHU 83. Answer: (D) Note the interval, duration and intensity of
personnel and transmitted to the Provincial Health Office. labor contractions.
Assessment of the woman should be done first to determine
73. Answer: (C) Target/client list whether she is having true labor and, if so, what stage of
The MDT Client List is a record of clients enrolled in MDT labor she is in.
and other relevant data, such as dates when clients collected
their monthly supply of drugs. 84. Answer: (D) Explain to her that putting the baby to
breast will lessen blood loss after delivery.
74. Answer: (A) P.D. 651 Suckling of the nipple stimulates the release of oxytocin by
P.D. 651 amended R.A. 3753, requiring the registry of births the posterior pituitary gland, which causes uterine
within 30 days from their occurrence. contraction. Lactation begins 1 to 3 days after delivery.
Nipple stretching exercises are done when the nipples are
75. Answer: (D) Any of these health professionals flat or inverted. Frequent washing dries up the nipples,
R.A. 3753 states that any birth attendant may sign the making them prone to the formation of fissures.
certificate of live birth.
85. Answer: (B) To stimulate milk production by the
76. Answer: (C) Magnitude of the health problem mammary acini
Magnitude of the problem refers to the percentage of the Suckling of the nipple stimulates prolactin reflex (the release
population affected by a health problem. The other choices of prolactin by the anterior pituitary gland), which initiates
are criteria considered in both family and community health lactation.
care.
86. Answer: (B) The mother does not feel nipple pain.
77. Answer: (D) Its main strategy is certification of health When the baby has properly latched on to the breast, he
centers able to comply with standards. 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. 97. Answer: (C) Normal
In IMCI, a respiratory rate of 50/minute or more is fast
87. Answer: (B) 6 months breathing for an infant aged 2 to 12 months.
After 6 months, the baby’s nutrient needs, especially the
baby’s iron requirement, can no longer be provided by 98. Answer: (D) Chest indrawing
mother’s milk alone. In IMCI, chest indrawing is used as the positive sign of
dyspnea, indicating severe pneumonia.
88. Answer: (C) Retinol 200,000 I.U., 1 capsule
A capsule of Retinol 200,000 IU is given within 1 month 99. Answer: (B) Refer him urgently to the hospital.
after delivery. Potassium iodate is given during pregnancy; Severe pneumonia requires urgent referral to a hospital.
malunggay capsule is not routinely administered after Answers A, C and D are done for a client classified as
delivery; and ferrous sulfate is taken for two months after having pneumonia.
delivery.
100. Answer: (B) Some dehydration
89. Answer: (C) Measles vaccine Using the assessment guidelines of IMCI, a child (2 months
Among the biologicals used in the Expanded Program on to 5 years old) with diarrhea is classified as having SOME
Immunization, measles vaccine and OPV are highly DEHYDRATION if he shows 2 or more of the following
sensitive to heat, requiring storage in the freezer. signs: restless or irritable, sunken eyes, the skin goes back
slow after a skin pinch.
90. Answer: (B) 4
While the unused portion of other biologicals in EPI may be 101. Answer: (B) Supervise the mother in giving 200 to 400
given until the end of the day, only BCG is discarded 4 ml. of Oresol in 4 hours.
hours after reconstitution. This is why BCG immunization is In the IMCI management guidelines, SOME
scheduled only in the morning. DEHYDRATION is treated with the administration of
Oresol within a period of 4 hours. The amount of Oresol is
91. Answer: (A) P.D. 996 best computed on the basis of the child’s weight (75 ml/kg
Presidential Decree 996, enacted in 1976, made body weight). If the weight is unknown, the amount of
immunization in the EPI compulsory for children under 8 Oresol is based on the child’s age.
years of age. Hepatitis B vaccination was made compulsory
for the same age group by R.A. 7846. 102. Answer: (D) Let the child rest for 10 minutes then
continue giving Oresol more slowly.
92. Answer: (B) BCG If the child vomits persistently, that is, he vomits everything
BCG causes the formation of a superficial abscess, which that he takes in, he has to be referred urgently to a hospital.
begins 2 weeks after immunization. The abscess heals Otherwise, vomiting is managed by letting the child rest for
without treatment, with the formation of a permanent scar. 10 minutes and then continuing with Oresol administration.
Teach the mother to give Oresol more slowly.
93. Answer: (C) Infant BCG
Infant BCG may be given at birth. All the other 103. Answer: (D) Edema
immunizations mentioned can be given at 6 weeks of age. Edema, a major sign of kwashiorkor, is caused by decreased
colloidal osmotic pressure of the blood brought about by
94. Answer: (A) Seizures a day after DPT 1. hypoalbuminemia. Decreased blood albumin level is due a
Seizures within 3 days after administration of DPT is an protein-deficient diet.
indication of hypersensitivity to pertussis vaccine, a
component of DPT. This is considered a specific 104. Answer: (A) Refer the child urgently to a hospital for
contraindication to subsequent doses of DPT. confinement.
“Baggy pants” is a sign of severe marasmus. The best
95. Answer: (A) Go on with the infant’s immunizations. management is urgent referral to a hospital.
In the EPI, fever up to 38.5°C is not a contraindication to
immunization. Mild acute respiratory tract infection, simple 105. Answer: (D) Conjunctival xerosis
diarrhea and malnutrition are not contraindications either. The earliest sign of Vitamin A deficiency (xerophthalmia) is
night blindness. However, this is a functional change, which
96. Answer: (A) 1 year is not observable during physical examination.The earliest
The baby will have passive natural immunity by placental visible lesion is conjunctival xerosis or dullness of the
transfer of antibodies. The mother will have active artificial conjunctiva due to inadequate tear production.
immunity lasting for about 10 years. 5 doses will give the
mother lifetime protection. 106. Answer: (D) 200,000 IU
Preschoolers are given Retinol 200,000 IU every 6 months. more not attributed to other conditions; progressive,
100,000 IU is given once to infants aged 6 to 12 months. unexplained weight loss; night sweats; and hemoptysis.
The dose for pregnant women is 10,000 IU.
117. Answer: (D) Clients diagnosed for the first time
107. Answer: (A) Palms through a positive sputum exam
The anatomic characteristics of the palms allow a reliable Category I is for new clients diagnosed by sputum
and convenient basis for examination for pallor. examination and clients diagnosed to have a serious form of
extrapulmonary tuberculosis, such as TB osteomyelitis.
108. Answer: (A) Sugar
R.A. 8976 mandates fortification of rice, wheat flour, sugar 118. Answer: (B) Having the health worker or a responsible
and cooking oil with Vitamin A, iron and/or iodine. family member monitor drug intake
Directly Observed Treatment Short Course is so-called
109. Answer: (A) Give measles vaccine to babies aged 6 to because a treatment partner, preferably a health worker
8 months. accessible to the client, monitors the client’s compliance to
Ordinarily, measles vaccine is given at 9 months of age. the treatment.
During an impending epidemic, however, one dose may be
given to babies aged 6 to 8 months. The mother is instructed 119. Answer: (C) Thickened painful nerves
that the baby needs another dose when the baby is 9 months The lesion of leprosy is not macular. It is characterized by a
old. change in skin color (either reddish or whitish) and loss of
sensation, sweating and hair growth over the lesion. Inability
110. Answer: (A) Inability to drink to close the eyelids (lagophthalmos) and sinking of the
A sick child aged 2 months to 5 years must be referred nosebridge are late symptoms.
urgently to a hospital if he/she has one or more of the
following signs: not able to feed or drink, vomits everything, 120. Answer: (D) 5 skin lesions, positive slit skin smear
convulsions, abnormally sleepy or difficult to awaken. A multibacillary leprosy case is one who has a positive slit
skin smear and at least 5 skin lesions.
111. Answer: (D) Retinol capsule regardless of when the last
dose was given 121. Answer: (B) Liver cirrhosis
An infant 6 to 12 months classified as a case of measles is The etiologic agent of schistosomiasis in the Philippines is
given Retinol 100,000 IU; a child is given 200,000 IU Schistosoma japonicum, which affects the small intestine
regardless of when the last dose was given. and the liver. Liver damage is a consequence of fibrotic
reactions to schistosoma eggs in the liver.
112. Answer: (B) Ask where the family resides.
Because malaria is endemic, the first question to determine 122. Answer: (C) Proper use of sanitary toilets
malaria risk is where the client’s family resides. If the area The ova of the parasite get out of the human body together
of residence is not a known endemic area, ask if the child with feces. Cutting the cycle at this stage is the most
had traveled within the past 6 months, where he/she was effective way of preventing the spread of the disease to
brought and whether he/she stayed overnight in that area. susceptible hosts.

113. Answer: (B) Destroying breeding places of mosquitoes 123. Answer: (B) II
Aedes aegypti, the vector of Dengue fever, breeds in A communal faucet or water standpost is classified as Level
stagnant, clear water. Its feeding time is usually during the II.
daytime. It has a cyclical pattern of occurrence, unlike
malaria which is endemic in certain parts of the country. 124. Answer: (A) Use of sterile syringes and needles
Hepatitis A is transmitted through the fecal oral route.
114. Answer: (C) Determining whether a place is endemic Hepatitis B is transmitted through infected body secretions
or not like blood and semen.
This is diagnostic and therefore secondary level prevention.
The other choices are for primary prevention. 125. Answer: (A) DPT
DPT is sensitive to freezing. The appropriate storage
115. Answer: (B) Pinworm temperature of DPT is 2 to 8° C only. OPV and measles
Pinworm ova are deposited around the anal orifice. vaccine are highly sensitive to heat and require freezing.
MMR is not an immunization in the Expanded Program on
116. Answer: (C) Cough for 3 weeks Immunization.
A client is considered a PTB suspect when he has cough for
2 weeks or more, plus one or more of the following signs: 126. Answer: (A) 45
fever for 1 month or more; chest pain lasting for 2 weeks or
To estimate the number of infants, multiply total population 136. Answer: (B) Cholera
by 3%. Passage of profuse watery stools is the major symptom of
cholera. Both amebic and bacillary dysentery are
127. Answer: (B) Severe dehydration characterized by the presence of blood and/or mucus in the
The order of priority in the management of severe stools. Giardiasis is characterized by fat malabsorption and,
dehydration is as follows: intravenous fluid therapy, referral therefore, steatorrhea.
to a facility where IV fluids can be initiated within 30
minutes, Oresol/nasogastric tube, Oresol/orem. When the 137. Answer: (B) S. japonicum
foregoing measures are not possible or effective, tehn urgent S. mansoni is found mostly in Africa and South America; S.
referral to the hospital is done. haematobium in Africa and the Middle East; and S.
malayensis only in peninsular Malaysia.
128. Answer: (A) 3
Adequate blood supply to the area allows the return of the 138. Answer: (D) Leptospirosis
color of the nailbed within 3 seconds. Leptospirosis is transmitted through contact with the skin or
mucous membrane with water or moist soil contaminated
129. Answer: (B) Instruct the mother to give the child with urine of infected animals, like rats.
Oresol.
Since the child does not manifest any other danger sign, 139. Answer: (C) III
maintenance of fluid balance and replacement of fluid loss Waterworks systems, such as MWSS, are classified as level
may be done by giving the client Oresol. III.

130. Answer: (B) Buccal mucosa 140. Answer: (D) Refer the client for a supplementary test,
Koplik’s spot may be seen on the mucosa of the mouth or such as Western blot, since the ELISA result may be false.
the throat. A client having a reactive ELISA result must undergo a
more specific test, such as Western blot. A negative
131. Answer: (D) Measles supplementary test result means that the ELISA result was
Viral conjunctivitis is transmitted by direct or indirect false and that, most probably, the client is not infected.
contact with discharges from infected eyes. Acute
poliomyelitis is spread through the fecal-oral route and 141. Answer: (A) Being faithful to a single sexual partner
contact with throat secretions, whereas diphtheria is through Sexual fidelity rules out the possibility of getting the disease
direct and indirect contact with respiratory secretions. by sexual contact with another infected person.
Transmission occurs mostly through sexual intercourse and
132. Answer: (A) Hemophilus influenzae exposure to blood or tissues.
Hemophilus meningitis is unusual over the age of 5 years. In
developing countries, the peak incidence is in children less 142. Answer: (B) Infectious mononucleosis
than 6 months of age. Morbillivirus is the etiology of Cytomegalovirus disease is an acute viral disease
measles. Streptococcus pneumoniae and Neisseria characterized by fever, sore throat and lymphadenopathy.
meningitidis may cause meningitis, but age distribution is
not specific in young children. 143. Answer: (A) Contact tracing
Contact tracing is the most practical and reliable method of
133. Answer: (D) Zooprophylaxis finding possible sources of person-to-person transmitted
Zooprophylaxis is done by putting animals like cattle or infections, such as sexually transmitted diseases.
dogs close to windows or doorways just before nightfall.
The Anopheles mosquito takes his blood meal from the 144. Answer: (D) They are able to bring about a cure of the
animal and goes back to its breeding place, thereby disease condition.
preventing infection of humans. There is no known treatment for AIDS. Antiretroviral agents
reduce the risk of opportunistic infections and prolong life,
134. Answer: (A) Stream seeding but does not cure the underlying immunodeficiency.
Stream seeding is done by putting tilapia fry in streams or
other bodies of water identified as breeding places of the 145. Answer: (D) Consult a physician who may give them
Anopheles mosquito. rubella immunoglobulin.
Rubella vaccine is made up of attenuated German measles
135. Answer: (C) Destruction of breeding places of the viruses. This is contraindicated in pregnancy. Immune
mosquito vector globulin, a specific prophylactic against German measles,
Anopheles mosquitoes breed in slow-moving, clear water, may be given to pregnant women.
such as mountain streams.