CHN Reviewer
CHN Reviewer
CHN Reviewer
inverse represents the percentage of untimely deaths (those who died younger than 50 years).
Answer: (B) To enhance the capacity of individuals, families and communities to cope with their health needs
to contribute to national development through promotion of family welfare, focusing particularly on mothers 11. Which of the following is the most prominent feature of public health nursing?
and children. 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
2. CHN is a community-based practice. Which best explains this statement? preventive rather than curative services.
Answer: (B) The nurse has to conduct community diagnosis to determine nursing needs and problems.
12. According to Margaret Shetland, the philosophy of public health nursing is based on which of the
3. Population-focused nursing practice requires which of the following processes? following?
Answer: (C) Community diagnosis Population-focused nursing care means providing care based on the Answer: (D) The worth and dignity of man This is a direct quote from Dr. Margaret Shetland’s statements
greater need of the majority of the population. The greater need is identified through community diagnosis. on Public Health Nursing.
4. R.A. 1054 is also known as the Occupational Health Act. Aside from number of employees, what 13. Which of the following is the mission of the Department of Health?
other factor must be considered in determining the occupational health privileges to which the Answer: (B) Ensure the accessibility and quality of health care (none)
workers will be entitled?
Answer: (B) Location of the workplace in relation to health facilities Based on R.A. 1054, an occupational 14. Region IV Hospital is classified as what level of facility?
nurse must be employed when there are 30 to 100 employees and the workplace is more than 1 km. away Answer: (D) Tertiary Regional hospitals are tertiary facilities because they serve as training hospitals for
from the nearest health center. the region.
5. A business firm must employ an occupational health nurse when it has at least how many 15. Which is true of primary facilities?
employees? Answer: (B) Their services are provided on an out-patient basis. Primary facilities government and non-
Answer: (B) 101 Again, this is based on R.A. 1054. government facilities that provide basic out-patient services.
6. When the occupational health nurse employs ergonomic principles, she is performing which of her 16. Which is an example of the school nurse’s health care provider functions?
roles? Answer: (B) Conducting random classroom inspection during a measles epidemic Random classroom
Answer: (D) Environmental manager Ergonomics is improving efficiency of workers by improving the inspection is assessment of pupils/students and teachers for signs of a health problem prevalent in the
worker’s environment through appropriately designed furniture, for example. community.
7. A garment factory does not have an occupational nurse. Who shall provide the occupational health 17. When the nurse determines whether resources were maximized in implementing Ligtas Tigdas,
needs of the factory workers? she is evaluating
Answer: (C) Public health nurse of the RHU of their municipality You’re right! This question is based on Answer: (B) Efficiency Efficiency is determining whether the goals were attained at the least possible cost.
R.A.1054.
18. You are a new B.S.N. graduate. You want to become a Public Health Nurse. Where will you
8. “Public health services are given free of charge.” Is this statement true or false? apply?
Answer: (B) The statement is false; people pay indirectly for public health services. Community health Answer: (D) Rural Health Unit R.A. 7160 devolved basic health services to local government units (LGU’s
services, including public health services, are pre-paid services, though taxation, for example. ). The public health nurse is an employee of the LGU.
19. R.A. 7160 mandates devolution of basic services from the national government to local
9. According to C.E.Winslow, which of the following is the goal of Public Health government units. Which of the following is the major goal of devolution?
Answer: (A) For people to attain their birthrights of health and longevity According to Winslow, all public Answer: (C) To empower the people and promote their self-reliance People empowerment is the basic
health efforts are for people to realize their birthrights of health and longevity. motivation behind devolution of basic services to LGU’s.
10. We say that a Filipino has attained longevity when he is able to reach the average lifespan of 20. Who is the Chairman of the Municipal Health Board?
Filipinos. What other statistic may be used to determine attainment of longevity? Answer: (A) Mayor The local executive serves as the chairman of the Municipal Health Board.
Answer: (C) Swaroop’s index Swaroop’s index is the percentage of the deaths aged 50 years or older. Its
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21. Which level of health facility is the usual point of entry of a client into the health care delivery Answer: (B) Bar A bar graph is used to present comparison of values, a line graph for trends over time or
system? age, a pie graph for population composition or distribution, and a scatter diagram for correlation of two
Answer: (A) Primary The entry of a person into the health care delivery system is usually through a variables.
consultation in out-patient services.
30. Which step in community organizing involves training of potential leaders in the community?
22. The public health nurse is the supervisor of rural health midwives. Which of the following is a Answer: (D) Core group formation In core group formation, the nurse is able to transfer the technology of
supervisory function of the public health nurse? community organizing to the potential or informal community leaders through a training program.
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 31. In which step are plans formulated for solving community problems?
Management of Childhood Illness. 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
23. One of the participants in a hilot training class asked you to whom she should refer a patient in and make plans for community action to resolve a community health problem.
labor who develops a complication. You will answer, to the
Answer: (C) Municipal Health Officer A public health nurse and rural health midwife can provide care 32. The public health nurse takes an active role in community participation. What is the primary
during normal childbirth. A physician should attend to a woman with a complication during labor. goal of community organizing?
Answer: (D) To maximize the community’s resources in dealing with health problems Community
24. You are the public health nurse in a municipality with a total population of about 20,000. There organizing is a developmental service, with the goal of developing the people’s self-reliance in dealing with
are 3 rural health midwives among the RHU personnel. How many more midwife items will the RHU community health problems. A, B and C are objectives of contributory objectives to this goal.
need?
Answer: (A) 1 Each rural health midwife is given a population assignment of about 5,000. 33. An indicator of success in community organizing is when people are able to
Answer: (A) Participate in community activities for the solution of a community problem Participation in
25. If the RHU needs additional midwife items, you will submit the request for additional midwife community activities in resolving a community problem may be in any of the processes mentioned in the
items for approval to the other choices.
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. 34. Tertiary prevention is needed in which stage of the natural history of disease?
Answer: (D) Terminal Tertiary prevention involves rehabilitation, prevention of permanent disability and
26. As an epidemiologist, the nurse is responsible for reporting cases of notifiable diseases. What law disability limitation appropriate for convalescents, the disabled, complicated cases and the terminally ill
mandates reporting of cases of notifiable diseases? (those in the terminal stage of a disease)
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. 35. Isolation of a child with measles belongs to what level of prevention?
Answer: (A) Primary The purpose of isolating a client with a communicable disease is to protect those who
27. According to Freeman and Heinrich, community health nursing is a developmental service. are not sick (specific disease prevention).
Which of the following best illustrates this statement?
Answer: (B) Health education and community organizing are necessary in providing community health 36. On the other hand, Operation Timbang is _____ prevention.
services. The community health nurse develops the health capability of people through health education Answer: (B) Secondary Operation Timbang is done to identify members of the susceptible population who
and community organizing activities. are malnourished. Its purpose is early diagnosis and, subsequently, prompt treatment.
28. Which disease was declared through Presidential Proclamation No. 4 as a target for eradication 37. Which type of family-nurse contact will provide you with the best opportunity to observe family
in the Philippines? dynamics?
Answer: (B) Measles Presidential Proclamation No. 4 is on the Ligtas Tigdas Program. Answer: (C) Home visit Dynamics of family relationships can best be observed in the family’s natural
environment, which is the home.
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 38. The typology of family nursing problems is used in the statement of nursing diagnosis in the care
graph will you prepare? of families. The youngest child of the de los Reyes family has been diagnosed as mentally retarded.
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This is classified as a 47. The primary purpose of conducting an epidemiologic investigation is to
Answer: (B) Health deficit Failure of a family member to develop according to what is expected, as in Answer: (A) Delineate the etiology of the epidemic Delineating the etiology of an epidemic is identifying
mental retardation, is a health deficit. its source.
39. The de los Reyes couple have a 6-year old child entering school for the first time. The de los Reyes 48. Which is a characteristic of person-to-person propagated epidemics?
family has a Answer: (D) There is a gradual build up of cases before the epidemic becomes easily noticeable. A gradual
Answer: (C) Foreseeable crisis Entry of the 6-year old into school is an anticipated period of unusual or insidious onset of the epidemic is usually observable in person-to- person propagated epidemics.
demand on the family.
49. In the investigation of an epidemic, you compare the present frequency of the disease with the
40. Which of the following is an advantage of a home visit? usual frequency at this time of the year in this community. This is done during which stage of the
Answer: (B) It provides an opportunity to do first hand appraisal of the home situation. Choice A is not investigation?
correct since a home visit requires that the nurse spend so much time with the family. Choice C is an Answer: (A) Establishing the epidemic Establishing the epidemic is determining whether there is an
advantage of a group conference, while choice D is true of a clinic consultation. 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.
41. Which is CONTRARY to the principles in planning a home visit?
Answer: (C) A home visit should be conducted in the manner prescribed by the RHU. The home visit plan 50. The number of cases of Dengue fever usually increases towards the end of the rainy season. This
should be flexible and practical, depending on factors, such as the family’s needs and the resources available pattern of occurrence of Dengue fever is best described as
to the nurse and the family. Answer: (B) Cyclical variation
A cyclical variation is a periodic fluctuation in the number of cases of a disease in the community.
42. 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 51. In the year 1980, the World Health Organization declared the Philippines, together with some
Answer: (B) Should minimize if not totally prevent the spread of infection. Bag technique is performed other countries in the Western Pacific Region, “free” of which disease?
before and after handling a client in the home to prevent transmission of infection to and from the client. Answer: (C) Small pox The last documented case of Small pox was in 1977 at Somalia.
43. To maintain the cleanliness of the bag and its contents, which of the following must the nurse do? 52. In the census of the Philippines in 1995, there were about 35,299,000 males and about 34,968,000
Answer: (A) Wash his/her hands before and after providing nursing care to the family members. females. What is the sex ratio?
Answer: (B) 100.94:100 Sex ratio is the number of males for every 100 females in the population.
44. 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 53. Primary health care is a total approach to community development. Which of the following is an
nurse practice in this situation? indicator of success in the use of the primary health care approach?
Answer: (B) Analytical Analytical epidemiology is the study of factors or determinants affecting the Answer: (D) Health programs are sustained according to the level of development of the community.
patterns of occurrence and distribution of disease in a community. Primary health care is essential health care that can be sustained in all stages of development of the
community.
45. Which of the following is a function of epidemiology?
Answer: (D) Evaluating the effectiveness of the implementation of the Integrated Management of 54. Sputum examination is the major screening tool for pulmonary tuberculosis. Clients would
Childhood Illness Epidemiology is used in the assessment of a community or evaluation of interventions in sometimes get false negative results in this exam. This means that the test is not perfect in terms of
community health practice. which characteristic of a diagnostic examination?
Answer: (D) Sensitivity Sensitivity is the capacity of a diagnostic examination to detect cases of the disease.
46. Which of the following is an epidemiologic function of the nurse during an epidemic? If a test is 100% sensitive, all the cases tested will have a positive result, i.e., there will be no false negative
Answer: (C) Participating in the investigation to determine the source of the epidemic Epidemiology is the results.
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 55. Use of appropriate technology requires knowledge of indigenous technology. Which medicinal
epidemic, i.e., what brought about the epidemic. herb is given for fever, headache and cough?
Answer: (D) Lagundi Sambong is used as a diuretic. Tsaang gubat is used to relieve diarrhea. Akapulko is
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used for its antifungal property. generally been weaned. Also, this is the population who, unable to feed themselves, are often the victims
of poor intrafamilial food distribution.
56. What law created the Philippine Institute of Traditional and Alternative Health Care?
Answer: (A) R.A. 8423 (none) 66. Which statistic can give the most accurate reflection of the health status of a community?
Answer: (C) Swaroop’s index Swaroop’s index is the proportion of deaths aged 50 years and above. The
57. In traditional Chinese medicine, the yielding, negative and feminine force is termed higher the Swaroop’s index of a population, the greater the proportion of the deaths who were able to reach
Answer: (A) Yin Yang is the male dominating, positive and masculine force. the age of at least 50 years, i.e., more people grew old before they died.
58. What is the legal basis for Primary Health Care approach in the Philippines? 67. In the past year, Barangay A had an average population of 1655. 46 babies were born in that year,
Answer: (B) Letter of Instruction No. 949. Letter of Instruction 949 was issued by then President Ferdinand 2 of whom died less than 4 weeks after they were born. There were 4 recorded stillbirths. What is the
Marcos, directing the formerly called Ministry of Health, now the Department of Health, to utilize Primary neonatal mortality rate?
Health Care approach in planning and implementing health programs. 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.
59. Which of the following demonstrates intersectoral linkages?
Answer: (D) Cooperation between the PHN and public school teacher Intersectoral linkages refer to 68. Which statistic best reflects the nutritional status of a population?
working relationships between the health sector and other sectors involved in community development. 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
60. The municipality assigned to you has a population of about 20,000. Estimate the number of 1-4 age-specific mortality rate, also known as child mortality rate.
year old children who will be given Retinol capsule 200,000 I.U. every 6 months.
Answer: (D) 2,300 Based on the Philippine population composition, to estimate the number of 1-4 year old 69. What numerator is used in computing general fertility rate?
children, multiply total population by 11.5%. 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.
61. Estimate the number of pregnant women who will be given tetanus toxoid during an
immunization outreach activity in a barangay with a population of about 1,500. 70. You will gather data for nutritional assessment of a purok. You will gather information only from
Answer: (A) 265 To estimate the number of pregnant women, multiply the total population by 3.5%. families with members who belong to the target population for PEM. What method of data gathering
is best for this purpose?
62. To describe the sex composition of the population, which demographic tool may be used? Answer: (B) Survey A survey, also called sample survey, is data gathering about a sample of the population.
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 71. In the conduct of a census, the method of population assignment based on the actual physical
pyramid is used to present the composition of a population by age and sex. location of the people is termed
Answer: (C) De facto The other method of population assignment, de jure, is based on the usual place of
63. Which of the following is a natality rate? residence of the people.
Answer: (A) Crude birth rate Natality means birth. A natality rate is a birth rate.
72. The Field Health Services and Information System (FHSIS) is the recording and reporting system
64. You are computing the crude death rate of your municipality, with a total population of about in public health care in the Philippines. The Monthly Field Health Service Activity Report is a form
18,000, for last year. There were 94 deaths. Among those who died, 20 died because of diseases of the used in which of the components of the FHSIS?
heart and 32 were aged 50 years or older. What is the crude death rate? Answer: (A) Tally report A tally report is prepared monthly or quarterly by the RHU personnel and
Answer: (B) 5.2/1,000 To compute crude death rate divide total number of deaths (94) by total population transmitted to the Provincial Health Office.
(18,000) and multiply by 1,000.
73. To monitor clients registered in long-term regimens, such as the Multi-Drug Therapy, which
65. Knowing that malnutrition is a frequent community health problem, you decided to conduct component will be most useful?
nutritional assessment. What population is particularly susceptible to protein energy malnutrition Answer: (C) Target/client list The MDT Client List is a record of clients enrolled in MDT and other relevant
(PEM)? data, such as dates when clients collected their monthly supply of drugs.
Answer: (C) 1-4 year old children Preschoolers are the most susceptible to PEM because they have
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74. Civil registries are important sources of data. Which law requires registration of births within 30 pregnant women have an adequate intake of folic acid.
days from the occurrence of the birth?
Answer: (A) P.D. 651 P.D. 651 amended R.A. 3753, requiring the registry of births within 30 days from 83. You are in a client’s home to attend to a delivery. Which of the following will you do first?
their occurrence. 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.
75. Which of the following professionals can sign the birth certificate?
Answer: (D) Any of these health professionals D. R.A. 3753 states that any birth attendant may sign the 84. In preparing a primigravida for breastfeeding, which of the following will you do?
certificate of live birth. 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
76. Which criterion in priority setting of health problems is used only in community health care? contraction. Lactation begins 1 to 3 days after delivery. Nipple stretching exercises are done when the
Answer: (C) Magnitude of the health problem Magnitude of the problem refers to the percentage of the nipples are flat or inverted. Frequent washing dries up the nipples, making them prone to the formation of
population affected by a health problem. The other choices are criteria considered in both family and fissures.
community health care.
85. A primigravida is instructed to offer her breast to the baby for the first time within 30 minutes
77. The Sentrong Sigla Movement has been launched to improve health service delivery. Which of after delivery. What is the purpose of offering the breast this early?
the following is/are true of this movement? Answer: (B) To stimulate milk production by the mammary acini Suckling of the nipple stimulates prolactin
Answer: (D) Its main strategy is certification of health centers able to comply with standards. Sentrong reflex (the release of prolactin by the anterior pituitary gland), which initiates lactation.
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. 86. 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?
78. Which of the following women should be considered as special targets for family planning? Answer: (B) The mother does not feel nipple pain. When the baby has properly latched on to the breast, he
Answer: (D) Those who just had a delivery within the past 15 months The ideal birth spacing is at least two takes deep, slow sucks; his mouth is wide open; and much of the areola is inside his mouth. And, you’re
years. 15 months plus 9 months of pregnancy = 2 years. right! The mother does not feel nipple pain.
79. Freedom of choice is one of the policies of the Family Planning Program of the Philippines. Which 87. You explain to a breastfeeding mother that breast milk is sufficient for all of the baby’s nutrient
of the following illustrates this principle? needs only up to ____.
Answer: (C) Adequate information for couples regarding the different methods To enable the couple to Answer: (B) 6 months After 6 months, the baby’s nutrient needs, especially the baby’s iron requirement,
choose freely among different methods of family planning, they must be given full information regarding can no longer be provided by mother’s milk alone.
the different methods that are available to them, considering the availability of quality services that can
support their choice. 88. What is given to a woman within a month after the delivery of a baby?
Answer: (C) Retinol 200,000 I.U., 1 capsule A capsule of Retinol 200,000 IU is given within 1 month after
80. A woman, 6 months pregnant, came to the center for consultation. Which of the following delivery. Potassium iodate is given during pregnancy; malunggay capsule is not routinely administered after
substances is contraindicated? delivery; and ferrous sulfate is taken for two months after delivery.
Answer: (B) Retinol 200,000 IU Retinol 200,000 IU is a form of megadose Vitamin A. This may have a
teratogenic effect. 89. Which biological used in Expanded Program on Immunization (EPI) is stored in the freezer?
Answer: (C) Measles vaccine. Among the biologicals used in the Expanded Program on Immunization,
81. During prenatal consultation, a client asked you if she can have her delivery at home. After history measles vaccine and OPV are highly sensitive to heat, requiring storage in the freezer.
taking and physical examination, you advised her against a home delivery. Which of the following
findings disqualifies her for a home delivery? 90. Unused BCG should be discarded how many hours after reconstitution?
Answer: (A) Her OB score is G5P3. Only women with less than 5 pregnancies are qualified for a home Answer: (B) 4 While the unused portion of other biologicals in EPI may be given until the end of the day,
delivery. It is also advisable for a primigravida to have delivery at a childbirth facility. only BCG is discarded 4 hours after reconstitution. This is why BCG immunization is scheduled only in
the morning.
82. Inadequate intake by the pregnant woman of which vitamin may cause neural tube defects?
Answer: (C) Folic acid It is estimated that the incidence of neural tube defects can be reduced drastically if 91. In immunizing school entrants with BCG, you are not obliged to secure parental consent. This is
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because of which legal document?
Answer: (A) P.D. 996 Presidential Decree 996, enacted in 1976, made immunization in the EPI compulsory 100. A 5-month old infant was brought by his mother to the health center because of diarrhea
for children under 8 years of age. Hepatitis B vaccination was made compulsory for the same age group by occurring 4 to 5 times a day. His skin goes back slowly after a skin pinch and his eyes are sunken.
R.A. 7846. Using the IMCI guidelines, you will classify this infant in which category?
Answer: (B) Some dehydration Using the assessment guidelines of IMCI, a child (2 months to 5 years old)
92. Which immunization produces a permanent scar? with diarrhea is classified as having SOME DEHYDRATION if he shows 2 or more of the following signs:
Answer: (B) BCG BCG causes the formation of a superficial abscess, which begins 2 weeks after restless or irritable, sunken eyes, the skin goes back slow after a skin pinch.
immunization. The abscess heals without treatment, with the formation of a permanent scar.
101. Based on assessment, you classified a 3-month old infant with the chief complaint of diarrhea in
93. A 4-week old baby was brought to the health center for his first immunization. Which can be the category of SOME DEHYDRATION.
given to him? Based on IMCI management guidelines, which of the following will you do?
Answer: (C) Infant BCG. All the other immunizations mentioned can be given at 6 weeks of age. 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.
94. You will not give DPT 2 if the mother says that the infant had The amount of Oresol is best computed on the basis of the child’s weight (75 ml/kg body weight). If the
Answer: (A) Seizures a day after DPT 1. Seizures within 3 days after administration of DPT is an indication weight is unknown, the amount of Oresol is based on the child’s age.
of hypersensitivity to pertussis vaccine, a component of DPT. This is considered a specific contraindication
to subsequent doses of DPT. 102. A mother is using Oresol in the management of diarrhea of her 3- year old child. She asked you
what to do if her child vomits. You will tell her to
95. A 2-month old infant was brought to the health center for immunization. During assessment, the Answer: (D) Let the child rest for 10 minutes then continue giving Oresol more slowly. If the child vomits
infant’s temperature registered at 38.1°C. Which is the best course of action that you will take? persistently, that is, he vomits everything that he takes in, he has to be referred urgently to a hospital.
Answer: (A) Go on with the infant’s immunizations. In the EPI, fever up to 38.5°C is not a contraindication Otherwise, vomiting is managed by letting the child rest for 10 minutes and then continuing with Oresol
to immunization. Mild acute respiratory tract infection, simple diarrhea and malnutrition are not administration. Teach the mother to give Oresol more slowly.
contraindications either.
103. A 1 1 2 year old child was classified as having 3rd degree protein energy malnutrition,
96. A pregnant woman had just received her 4th dose of tetanus toxoid. Subsequently, her baby will kwashiorkor. Which of the following signs will be most apparent in this child?
have protection against tetanus for how long? Answer: (D) Edema Edema, a major sign of kwashiorkor, is caused by decreased colloidal osmotic pressure
Answer: (A) 1 year The baby will have passive natural immunity by placental transfer of antibodies. The of the blood brought about by hypoalbuminemia. Decreased blood albumin level is due a protein-deficient
mother will have active artificial immunity lasting for about 10 years. 5 doses will give the mother lifetime diet.
protection.
104. Assessment of a 2-year old child revealed “baggy pants”. Using the IMCI guidelines, how will
97. A 4-month old infant was brought to the health center because of cough. Her respiratory rate is you manage this child?
42/minute. Using the Integrated Management of Child Illness (IMCI) guidelines of assessment, her Answer: (A) Refer the child urgently to a hospital for confinement. “Baggy pants” is a sign of severe
breathing is considered marasmus. The best management is urgent referral to a hospital.
Answer: (C) Normal In IMCI, a respiratory rate of 50/minute or more is fast breathing for an infant aged 2
to 12 months. 105. During the physical examination of a young child, what is the earliest sign of xerophthalmia that
you may observe?
98. Which of the following signs will indicate that a young child is suffering from severe pneumonia? Answer: (D) Conjunctival xerosis The earliest sign of Vitamin A deficiency (xerophthalmia) is night
Answer: (D) Chest indrawing In IMCI, chest indrawing is used as the positive sign of dyspnea, indicating blindness. However, this is a functional change, which is not observable during physical examination.The
severe pneumonia. earliest visible lesion is conjunctival xerosis or dullness of the conjunctiva due to inadequate tear
production.
99. Using IMCI guidelines, you classify a child as having severe pneumonia. What is the best
management for the child? 106. To prevent xerophthalmia, young children are given Retinol capsule every 6 months. What is
Answer: (B) Refer him urgently to the hospital. Severe pneumonia requires urgent referral to a hospital. the dose given to preschoolers?
Answers A, C and D are done for a client classified as having pneumonia. Answer: (D) 200,000 IU Preschoolers are given Retinol 200,000 IU every 6 months. 100,000 IU is given
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once to infants aged 6 to 12 months. The dose for pregnant women is 10,000 IU.
115. Scotch tape swab is done to check for which intestinal parasite?
107. The major sign of iron deficiency anemia is pallor. What part is best examined for pallor? Answer: (B) Pinworm. Pinworm ova are deposited around the anal orifice.
Answer: (A) Palms The anatomic characteristics of the palms allow a reliable and convenient basis for
examination for pallor. 116. Which of the following signs indicates the need for sputum examination for AFB?
Answer: (C) Cough for 3 weeks A client is considered a PTB suspect when he has cough for 2 weeks or
108. Food fortification is one of the strategies to prevent micronutrient deficiency conditions. R.A. more, plus one or more of the following signs: fever for 1 month or more; chest pain lasting for 2 weeks or
8976 mandates fortification of certain food items. Which of the following is among these food items? more not attributed to other conditions; progressive, unexplained weight loss; night sweats; and hemoptysis.
Answer: (A) Sugar R.A. 8976 mandates fortification of rice, wheat flour, sugar and cooking oil with
Vitamin A, iron and/or iodine. 117. Which clients are considered targets for DOTS Category I?
Answer: (D) Clients diagnosed for the first time through a positive sputum exam Category I is for new
109. What is the best course of action when there is a measles epidemic in a nearby municipality? clients diagnosed by sputum examination and clients diagnosed to have a serious form of extrapulmonary
Answer: (A) Give measles vaccine to babies aged 6 to 8 months. Ordinarily, measles vaccine is given at 9 tuberculosis, such as TB osteomyelitis.
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. 118. To improve compliance to treatment, what innovation is being implemented in DOTS?
Answer: (B) Having the health worker or a responsible family member monitor drug intake Directly
110. A mother brought her daughter, 4 years old, to the RHU because of cough and colds. Following Observed Treatment Short Course is so-called because a treatment partner, preferably a health worker
the IMCI assessment guide, which of the following is a danger sign that indicates the need for urgent accessible to the client, monitors the client’s compliance to the treatment.
referral to a hospital?
Answer: (A) Inability to drink A sick child aged 2 months to 5 years must be referred urgently to a hospital 119. Diagnosis of leprosy is highly dependent on recognition of symptoms. Which of the following is
if he/she has one or more of the following signs: not able to feed or drink, vomits everything, convulsions, an early sign of leprosy?
abnormally sleepy or difficult to awaken. 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.
111. Management of a child with measles includes the administration of which of the following? Inability to close the eyelids (lagophthalmos) and sinking of the nose bridge are late symptoms.
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 120. Which of the following clients should be classified as a case of multibacillary leprosy?
dose was given. 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.
112. 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? 121. In the Philippines, which condition is the most frequent cause of death associated with
Answer: (B) Ask where the family resides. Because malaria is endemic, the first question to determine schistosomiasis?
malaria risk is where the client’s family resides. If the area of residence is not a known endemic area, ask Answer: (B) Liver cirrhosis. The etiologic agent of schistosomiasis in the Philippines is Schistosoma
if the child had traveled within the past 6 months, where he/she was brought and whether he/she stayed japonicum, which affects the small intestine and the liver. Liver damage is a consequence of fibrotic
overnight in that area. reactions to schistosoma eggs in the liver.
113. The following are strategies implemented by the Department of Health to prevent mosquito- 122. What is the most effective way of controlling schistosomiasis in an endemic area?
borne diseases. Which of these is most effective in the control of Dengue fever? Answer: (C) Proper use of sanitary toilets. The ova of the parasite get out of the human body together with
Answer: (B) Destroying breeding places of mosquitoes Aedes aegypti, the vector of Dengue fever, breeds feces. Cutting the cycle at this stage is the most effective way of preventing the spread of the disease to
in stagnant, clear water. Its feeding time is usually during the daytime. It has a cyclical pattern of occurrence, susceptible hosts. 123. When residents obtain water from an artesian well in the neighborhood, the level of
unlike malaria which is endemic in certain parts of the country. this approved type of water facility is
Answer: (B) II . A communal faucet or water standpost is classified as Level II.
114. Secondary prevention for malaria includes
Answer: (C) Determining whether a place is endemic or not This is diagnostic and therefore secondary 124. For prevention of hepatitis A, you decided to conduct health education activities. Which of the
level prevention. The other choices are for primary prevention. following is IRRELEVANT?
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Answer: (A) Use of sterile syringes and needles Hepatitis A is transmitted through the fecal oral route. Answer: (A) Hemophilus influenzae Hemophilus meningitis is unusual over the age of 5 years. In
Hepatitis B is transmitted through infected body secretions like blood and semen. 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
126. Which biological used in Expanded Program on Immunization (EPI) should NOT be stored in distribution is not specific in young children.
the freezer? A. DPT B. Oral polio vaccine C. Measles vaccine D. MMR
Answer: (A) DPT DPT is sensitive to freezing. The appropriate storage temperature of DPT is 2 to 8° C 134. Human beings are the major reservoir of malaria. Which of the following strategies in malaria
only. OPV and measles vaccine are highly sensitive to heat and require freezing. MMR is not an control is based on this fact?
immunization in the Expanded Program on Immunization. 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
127. You will conduct outreach immunization in a barangay with a population of about 1500. and goes back to its breeding place, thereby preventing infection of humans.
Estimate the number of infants in the barangay.
Answer: (A) 45 To estimate the number of infants, multiply total population by 3%. 135. The use of larvivorous fish in malaria control is the basis for which strategy of malaria control?
Answer: (A) Stream seeding Stream seeding is done by putting tilapia fry in streams or other bodies of
128. In Integrated Management of Childhood Illness, severe conditions generally require urgent water identified as breeding places of the Anopheles mosquito
referral to a hospital. Which of the following severe conditions DOES NOT always require urgent
referral to a hospital 136. Mosquito-borne diseases are prevented mostly with the use of mosquito control measures. Which
Answer: (B) Severe dehydration of the following is NOT appropriate for malaria control?
The order of priority in the management of severe dehydration is as follows: intravenous fluid therapy, Answer: (C) Destruction of breeding places of the mosquito vector Anopheles mosquitoes breed in slow-
referral to a facility where IV fluids can be initiated within 30 minutes, Oresol/nasogastric tube, moving, clear water, such as mountain streams.
Oresol/orem. When the foregoing measures are not possible or effective, tehn urgent referral to the hospital
is done. 137. 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?
129. A client was diagnosed as having Dengue fever. You will say that there is slow capillary refill Answer: (B) Cholera Passage of profuse watery stools is the major symptom of cholera. Both amebic and
when the color of the nailbed that you pressed does not return within how many seconds? bacillary dysentery are characterized by the presence of blood and/or mucus in the stools. Giardiasis is
Answer: (A) 3 Adequate blood supply to the area allows the return of the color of the nailbed within 3 characterized by fat malabsorption and, therefore, steatorrhea.
seconds.
138. In the Philippines, which specie of schistosoma is endemic in certain regions?
130. A 3-year old child was brought by his mother to the health center because of fever of 4-day Answer: (B) S. japonicum S. mansoni is found mostly in Africa and South America; S. haematobium in
duration. The child had a positive tourniquet test result. In the absence of other signs, which is the Africa and the Middle East; and S. malayensis only in peninsular Malaysia.
most appropriate measure that the PHN may carry out to prevent Dengue shock syndrome?
Answer: (B) Instruct the mother to give the child Oresol. Since the child does not manifest any other danger 139. A 32-year old client came for consultation at the health center with the chief complaint of fever
sign, maintenance of fluid balance and replacement of fluid loss may be done by giving the client Oresol. 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
131. The pathognomonic sign of measles is Koplik’s spot. You may see Koplik’s spot by inspecting waters about 2 weeks before the onset of symptoms. Based on his history, which disease condition
the _____. will you suspect
Answer: (B) Buccal mucosa Koplik’s spot may be seen on the mucosa of the mouth or the throat. 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.
132. Among the following diseases, which is airborne
Answer: (D) Measles Viral conjunctivitis is transmitted by direct or indirect contact with discharges from 140. MWSS provides water to Manila and other cities in Metro Manila. This is an example of which
infected eyes. Acute poliomyelitis is spread through the fecal-oral route and contact with throat secretions, level of water facility?
whereas diphtheria is through direct and indirect contact with respiratory secretions. Answer: (C) III Waterworks systems, such as MWSS, are classified as level III.
133. Among children aged 2 months to 3 years, the most prevalent form of meningitis is caused by 141. You are the PHN in the city health center. A client underwent screening for AIDS using ELISA.
which microorganism? His result was positive. What is the best course of action that you may take?
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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.
143. The most frequent causes of death among clients with AIDS are opportunistic diseases. Which
of the following opportunistic infections is characterized by tonsillopharyngitis
Answer: (B) Infectious mononucleosis Cytomegalovirus disease is an acute viral disease characterized by
fever, sore throat and lymphadenopathy.
144. To determine possible sources of sexually transmitted infections, which is the BEST method that
may be undertaken by the public health nurse?
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.
145. Antiretroviral agents, such as AZT, are used in the management of AIDS. Which of the following
is NOT an action expected of these drugs.
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.
146. 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?
Answer: (D) Consult a physician who may give them rubella immunoglobulin.
147. 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?
Answer: (D) Proper handwashing during food preparation is the best way of preventing the condition.
148. In a mothers’ class, you discussed childhood diseases such as chicken pox. Which of the following
statements about chicken pox is correct?
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.
149. Complications to infectious parotitis (mumps) may be serious in which type of clients?
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.
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