Questions

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

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

B. To enhance the capacity of individuals, families and communities to cope with their health needs

C. To increase the productivity of the people by providing them with services that will increase their
level of health

D. To contribute to national development through promotion of family welfare, focusing

particularly on mothers and children

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

N

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

ex

B. The nurse has to conduct community diagnosis to determine nursing needs and problems
tg

C. The service are based on the available resources within the community
en

D. Priority setting is based on the magnitude of the health problems identified

N

3. Population- focused nursing practice requires which of the following processes?

ur

A. Community organizing .
se

B. Nursing, process

C. Community diagnosis

D. Epidemiologic process

4. RA 1054 is also known as the Occupational Health Act. Aside from the number of
employees, what other factor must be considered in determining the occupational
health privileges to which the workers will be entitled?

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

B. Location of the workplace in relation to health facilities

C. Classification of the business enterprise based on net profit

D. Sex and age composition of employees

5. A business firm must employ an occupational health nurse when it has at least how
many employees.

A. 21

B. 101

C. 201

D. 301

6. When the occupational health nurse employs ergonomic principles, she is

performing which of her roles?

A. Health care provider

B. Health educator
N

C. Health care coordinator

ex

D. Environment manager
tg
en

7. A garment factory does not have an occupational nurse. Who shall provide the
occupational health needs of the factory workers?
N

A. Occupational health nurse at the Provincial Health Office

ur

B. Physician employed by the factory

se

C. Public Health nurse of the RHU of their municipality

D. Rural Sanitary inspector of the RHU in their municipality

8. “Public health services are given free of charge”. Is this statement true or false?

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

B. The statement is false; people pay indirectly for public health services

C. The statement may be true or false; depending on the Specific service required

D. The statement may be true or false; depending on policies of the government concerned.

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

A. For people to attain their birthrights and longevity

B. For promotion of health and prevention and diseases

C. For people to have access to basic health services

D. For people to be organized in their health efforts

10. We say that a Filipino has attained longevity when he is able to reach the average
life span of Filipinos. What other statistic may be used to determine attainment of
longevity?

A. Age-specific mortality rate

B. Proportionate mortality rate

C. Swaroop’s index

D. Case fatality rate

N

11. Which of the following is the most prominent feature of public health nursing?
ex

A. It involves providing home care to sick people who are not confined in the hospital
tg

B. Services are provided free of charge to people within the catchment area
en

C. The public health nurse functions as part of a team providing a public health nursing service
N

D. Public health nursing focuses on preventive, not curative services

ur
se

12. According to Margaret Shetland, the philosophy of public health nursing is based
on which of the following?

A. Health and longevity as birthrights

B. The mandate of the state to protect the birthrights of its citizens

C. Public health nursing as a specialized field of nursing

D. The worth and dignity of man

13. Which of the following is the mission of the Department of Health?

A. Health for all Filipinos

B. Ensure the accessibility and quality of health

C. Improve the general health status of the population

D. Health in the hands of the Filipino people by the year 2020

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

A. Primary

B. Secondary

C. Intermediate

D. Tertiary

15. What is true of primary facilities?

A. They are usually government-run

B. Their services are provided on an out-patient basis

N

C. They are training facilities for health professionals

ex

D. A community hospital is an example of this level of health facilities

tg

16. Which is an example of the school nurse’s health care provider function?
en

A. Requesting for BCG from the RHU for school entrance immunization
N

B. Conducting random classroom inspection during measles epidemic

ur

C. Taking remedial action on an accident hazard in the school playground

se

D. Observing places in the school where pupils spend their free times

17. When the nurse determines whether resources were maximized in implementing
Ligtas Tigdas, she is evaluating:

A. Effectiveness

B. Efficiency

C. Adequacy

D. Appropriateness

18. You are a new B.S.N. graduate. You want to become a Public Health Nurse. Where
will you apply?

A. Department of Health
B. Provincial Health Office

C. Regional Health Office

D. Rural Health Unit

19. RA 7160 mandates devolution of basic services from the national government to
local government units. Which of the following is the major goal of devolution?

A. To strengthen local government units

B. To allow greater autonomy to local government units.

C. To empower the people and promote their self-reliance

D. To make basic services more accessible to the people

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

N
ex

A. Mayor
tg

B. Municipal Health Officer

en

C. Public Health Nurse

D. Any qualified physician

N
ur

21. Which level of health facility is the usual point of entry of a client into the health
se

care delivery system?

A. Primary

B. Secondary

C. Intermediate

D. Tertiary

22. The public health nurse is the supervisor of rural health midwives. Which of the
following is a supervisory function of the pubic health nurse?

A. Referring cases or patients to the midwife

B. Providing technical guidance to the midwife

C. Proving nursing care to cases referred by the midwife

D. Formulating and implementing training programs for midwives

23. One of the participants in a hilot training class asked you to whom she should refer
a patient in labor who develops a complication. You will answer, to the;

A. Public health nurse

B. Rural health midwife

C. Municipal health officer

D. Any of these health professionals

24. You are the public health nurse in a municipality with a total population of about
20,000. There are3 health midwives among the RHU personnel. How many more
midwife items will the RHU need?
N

A. 1
ex

B. 2
tg

C. 3
en

D. 4
N

25. If the RHU needs additional midwife items, you will submit the request for additional
ur

midwife items for approval to the:

se

A. Rural Health Unit

B. District Health Office

C. Provincial Health Office

D. Municipal Health Board

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

diseases. What law mandates reporting cases of notifiable diseases?

A. Act 3573

B. RA.3753

C. RA 1054

D. RA 1082
27. According to Freeman and Heinrich, community health nursing is a developmental
service. Which of the following best illustrates this statement?

A. The community health nurse continuously develops himself personally and professionally

B. Health education and community organizing are necessary in providing community health
services

C. Community health nursing in intended primarily for health promotion and prevention and
treatment of disease.

D. The goal of community health nursing is to provide nursing services to people in their own place
of .residence

28. Which disease was declared through Presidential Proclamation No. 4 as a target
for, eradication in the Philippines?
N

A. Pioliomyelitis
ex

B. Measles
tg

C. Rabies
en

D. Neonatal Tetanus
N
ur

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
se

in the municipality, which graph will you prepare?

A. Line

B. Bar

C. Pie

D. Scatter diagram

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

A. Integration

B. Community organization

C. Community study
D. Core group formation

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

A. Mobilization

B. Community organization

C. Follow-up/extension

D. Core group formation

32. The public health nurse takes an active role in community participation. What is
the primary goal of community organizing?

A. To educate the people regarding community health problems

B. To mobilize the people to resolve community health problems

N
ex

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

tg

33. An indicator of success in community organizing is when people are able to:
en

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

B. Implement activities for the solution of the community problem

N
ur

C. Plan activities for the solution of the community problem

se

D. Identify the health problem as a common concern

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

A. Pre-pathogenesis

B. Pathogenesis

C. Predromal

D. Terminal

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

A. Primary

B. Secondary
C. Intermediate

D. Tertiary

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

A. Primary

B. Secondary

C. Intermediate

D. Tertiary

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

A. Clinic consultation
N
ex

B. Group conferences
tg

C. Home visit
en

D. Written communication
N

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

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

A. Health threat

B. Health deficit

C. Foreseeable crisis

D. Stress point

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

A. Health threat

B. Health deficit

C. Foreseeable crisis
D. Stress point

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

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

B. It provides an opportunity to do first hand appraisal of the home situation

C. It allows sharing of experience among people with similar health problems

D. It develops the family’s initiative in providing for health needs of its members

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

A. A home visit should have a purpose of objective

B. The plan should revolve around the family health .needs

N

C. A home visit should be conducted in the manner prescribed by RHU

ex

D. Planning of continuing care should involve a responsible-family member

tg

42. The PHN bag is an important tool in providing nursing care during a home visit.
en

The most important principle in bag technique states that it;

A. Should save time and effort

N
ur

B. Should minimize if not totally prevent the spread of infection

se

C. Should not overshadow concern for the patient and his family

D. May be done in variety of ways depending on the home situation, etc.

43. To maintain the cleanliness of the bag and its contents, which of the following must
the nurse do?

A. Wash his/her hands before and after providing nursing care to the family members

B. In the care of family member’s, as much as possible, use only articles taken from the bag

C. Put on an apron to protect her uniform and fold it with the right side out before putting it back
into the bag.

D. At the end of the visit, fold the lining on which the bag was placed, ensuring that the
contaminated side is on the outside.
44. The public health conducts a study on the factors contributing to the high morality
rate due to heart diseases in the municipality where she works. Which branch of
epidemiology does the nurse practice in this situation?

A. Descriptive

B. Analytical

C. Therapeutic

D. Evaluation

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

A. Identifying the disease condition based on manifestations presented by a client

B. Determining factors that contributed to the occurrence of pneumonia in a 3 year old

N

C. Determining the efficacy of the antibiotic used in the treatment of the 3 year old client with
ex

pneumonia
tg

D. Evaluating the effectiveness of the implementation of the Integrated Management of Childhood

en

Illness
N

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

ur

epidemic?
se

A Conducting assessment of suspected cases to detect the communicable diseases

B. Monitoring the condition of the cases affected by the communicable disease

C. Participating in the investigation to determine the source of epidemic

D. Teaching the community on preventive measures against the disease

47. The primary purpose of conducting an epidemiologic investigation is to;

A. Delineate the etiology of the epidemic

B. Encourage cooperation and support of the community

C. Identify groups who are at risk of contracting the disease

D. Identify geographical location of cases of the disease in the community

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

A. There are more cases of the disease than expected

B. The disease must necessarily be transmitted through a vector

C. The spread of the disease can be attributed to a common vehicle

D. There is gradual build up of cases before we epidemic becomes easily noticeable

49. In the investigation of an epidemic, you compare the present frequency of the
disease with the usual frequency at this time of the year in this community. This is
done during which stage of the investigation?

A. Establishing the epidemic

B. Testing the hypothesis

C. Formulation of the hypothesis

N

D. Appraisal of facts
ex

50. The number of cases of Dengue fever usually increases towards the end of the
tg

rainy season. This pattern of occurrence of Dengue fever is best described as;
en

A. Epidemic occurrence
N

B. Cyclical variation
ur

C. Sporadic occurrence
se

D. Secular occurrence

51. In the year 1980, the World Health Organization declared the Philippines, together
with some other countries in the Western Pacific Region, “free” of which disease?

A. Pneumonic plaque

B. Poliomyelitis

C. Small pox

D. Anthrax

52. In the census of the Philippines in 1995, there were about 35,299,000 males and
about 34,968,000 females. What is the sex ratio?

A. 99.06:100
B. 100.94:100

C. 50.23%

D. 49.76%

53. Primary health care is a total approach to community development. Which of the
following is an indicator of success in the use of the primary health care approach?

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

B. Local officials are empowered as the major decision makers in matters of health

C. Health workers are able too provide care based on identified health needs of the people

D. Health programs are sustained according to the level of development of the community

54. Sputum examination is the major screening tool for pulmonary tuberculosis.
N

Clients would sometimes get false negative results in this exam. This means that the
ex

test is not perfect in terms of which characteristic of a diagnostic examination?

tg

A. Effectiveness
en

B. Efficacy
N

C. Specificity
ur

D. Sensitivity
se

55. Use of appropriate technology requires knowledge of indigenous technology.

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

A. Sambong

B. Tsaang gubat

C. Akapulko

D. Lagundi

56. What law created the Philippine institute of Traditional and Alternative Health Care?

A. RA 8483

B. RA4823
C. RA 2483

D. RA 3482

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

A. Yin

B. Yang

C. Qi

D. Chai

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

A. Alma Ata Declaration of PHC

N

B. Letter of Instruction No 949

ex

C. Presidential Decree No. 147

tg

D. Presidential Decree 996

en

59. Which of the following demonstrates inter-sectoral linkages?

N

A. Two-way referral system

ur

B. Team approach
se

C. Endorsement done by a midwife to another midwife

D. Cooperation between PHN and public school teacher

60. The municipality assigned to you has a population of about 20/000. Estimate the
number of 1-4 year old children who be given Retinol capsule 200.000 every 6 months.

A. 1,500

B. 1,800

C. 2,000

D. 2,300

61. Estimate the number of pregnant women who will be given tetanus toxoid during
an immunization outreach activity in a barangay with a population of about 1,500.
A. 265

B. 300

C. 375

D. 400

62. To describe the sex composition of the population, which demographic tool may
be used?

A. Sex ratio

B. Sex proportion

C. Population pyramid

D. Any of these maybe used

N
ex

63. Which of the following is a natality rate?

tg

A. Crude birth rate

en

B. Neonatal mortality rate

C. Infant mortality rate

N
ur

D. General fertility rate

se

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

A. 4.1/1000

B. 5.2/1000

C. 6.3/1000

D. 7.3/1000

65. Knowing that malnutrition is a frequent community health problem, you decided to
conduct nutritional assessment. What population is particularly susceptible to protein
energy malnutrition (PEM)?
A. Pregnant women and the elderly

B. Under 5 year old children

C. 1-4 year old children

D. School age children

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

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

B. Infant mortality rate

C. Swaroop’s index

D. Crude death rate

N
ex

67. In the past year, Barangay A had an average population of 1655. 46 babies were
born in that year, 2 of whom died less than 4 weeks after they were born. They were 4
tg

recorded stillbirths. What is the neonatal mortality rate?

en

A. 27.8/1000
N

B. 43.5/1000
ur

C. 86.9/1000
se

D. 130.4/1000

68. Which statistic best reflects the nutritional status of a population?

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

B. Proportionate mortality rate

C. Infant mortality rate

D. Swaroop’s index

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

A. Estimated midyear population

B. Number of registered live births

C. Number of pregnancies in the year

D. Number of females of reproductive age

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

A. Census

B. Survey

C. Record Review

D. Review of civil registry

71. In the conduct of a census, the method of population assignment based on the
N

actual physical location of the people is termed;

ex

A. De jure
tg

B. De locus
en

C. De facto
N

D. De novo
ur

72. The Field Health Services and information System (FHSIS) is the recording and
se

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

A. Tally report

B. Output report

C. Target/client list

D. Individual health record

73. To monitor clients registered in long-term regimens, such as the Multi-Drug

Therapy, which component will be most useful?

A. Tally report

B. Output report
C. Target/client list

D. Individual health record

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

A. PD 651

B. Act 3573

C. RA 3753

D. RA 3375

75. Which of the following professionals can sign the birth certificate?

A. Public health nurse

N
ex

B. Rural health midwife

tg

C. Municipal health officer

en

D. Any of these health professionals

N

76. Which criterion in priority setting of health problems is used only in community
ur

health care?
se

A. Modifiability of the problem

B. Nature of the problem presented

C. Magnitude of the health problem

D. Preventive potential of the health problem

77. The Sentrong Sigla Movement has been launched to improve health service
delivery. Which of the following is/are true of this movement?

A. This is a project spearheaded by local government units

B. It is a basis for increasing funding from local government units

C. It encourages health centers to focus on disease prevention and control

D. Its main strategy is certification of health centers able to comply with standards
78. Which of the following women should be considered as special targets for family
planning?

A. Those who have two children or more

B. Those with medical conditions such as anemia

C. Those younger than 20 years and older than 35 years

D. Those who just had a delivery within the past 15 months

79. Freedom of choice in one of the policies of the Family Planning Program of the
Philippines. Which of the following illustrates this principle?

A. Information dissemination about the need for family planning

B. Support of research and development in family planning methods

N

C. Adequate information for couples regarding the different methods

ex

D. Encouragement of couples to take family planning as a joint responsibility

tg
en

80. A woman, 6 months pregnant, came to the center for consultation. Which of the
following substances is contraindicated?
N

A. Tetanus toxoid
ur

B. Retinol 200,000 IU
se

C. Ferrous sulfate 200mg

D. Potassium iodate 200 mg, capsule

81. During prenatal consultation, a client asked you if she can have her delivery at
home. After history taking and physical examination, you advised her against a home
delivery. Which of the following findings disqualifies her for a home delivery?

A. Her OB score is G5P3

B. She has some palmar pallor

C. Her blood pressure is 130/80

D. Her baby is in cephalic presentation

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

A. Niacin

B. Riboflavin

C. Folic Acid

D. Thiamine

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

A. Set up a sterile area

B. Put on a clean gown and apron

N

C. Cleanse the client’s vulva with soap and water

ex

D. Note the interval, duration and intensity of labor and contractions

tg
en

84. In preparing a primigravida for breastfeeding, which of the following will you do?

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

N

B. Teach her nipple stretching exercises if her nipples are everted

ur
se

C. Instruct her to wash her nipples before and after each breastfeeding

D. Explain to her that putting the baby to breast will lessen blood loss after delivery

85. A primigravida is instructed to offer her breast to the baby for the first time within
30 minutes after delivery. What is the purpose of offering the breast this early?

A. To initiate the occurrence of milk letdown

B. To stimulate milk production by the mammary acini

C. To make sure that the baby is able to get the colustrum

D. To allow the woman to practice breastfeeding in the presence of the health worker

86. In a mother’s class, you discuss proper breastfeeding technique. Which of these is
a sign that the baby has “lactated on” the breast property?
A. The baby takes shallow, rapid sucks

B. The mother does not feel nipple pain

C. The baby’s mouth is only partly open

D. Only the mother’s nipple is inside the baby’s mouth

87. You explain to a breastfeeding mother that breastmilk is sufficient for all of the
baby’s nutrient needs only up to:

A. 3 months

B. 6 months

C. 1 year

D. 2 years
N
ex

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

A. Malunggay capsule
en

B. Ferrous sutfate l00mg O.D.

C. Retinol 200.000 IU 1 capsule

N
ur

D. Potassium Iodate 200 mg, 1 capsule

se

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

A. DPT

B. Tetanus toxoid

C. Measles vaccine

D. Hepatitis B vaccine

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

A. 2

B. 4

C. 6
D. At the end of the day

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

A. PD 996

B. RA 7864

C. Presidential Proclamation No. 6

D. Presidential Proclamation No. 46

92. Which immunization produces a permanent scar?

A. DPT

B. BCG
N
ex

C. Measles vaccination
tg

D. Hepatitis B vaccination
en

93. A 4 week old baby was brought to the health center for his first immunization.
Which can be given to him?
N

A. DPT1
ur
se

B. OPV1

C. Infant BCG

D. Hepatitis B Vaccin

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

A. Seizures a day after DPT1

B. Fever for 3 days after DPT1

C. Abscess formation after DPT1

D. Local tenderness for 3 days after DPT1

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

A. Go on with the infants immunization

B. Give paracetamol and wait for his fever to subside

C. Refer the infant to the physician for further assessment

D. Advise the infant’s mother to bring him back for immunization when he is well

96. A pregnant woman had just received her 4th dose of tetanus toxoid. Subsequently,
her baby will have protection against tetanus for how long?

A. 1 year
N

B. 3 years
ex

C. 10 years
tg

D. Lifetime
en

97. A 4-month old infant was brought to the health center of cough. Her respiratory
N

rate is 42/minute. Using the IMCI guidelines of assessment, her breathing is

ur

considered;
se

A. Fast

B. Slow

C. Normal

D. Insignificant

98. Which of the following signs will indicate that a young child is suffering from severe
pneumonia?

A. Dyspnea

B. Wheezing

C. Fast breathing

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

A. Prescribe antibiotic

B. Refer him urgently to the hospital

C. Instruct the mother to increase fluid intake

D. Instruct the mother to continue breastfeeding

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

A. No signs of dehydration
N
ex

B. Some dehydration
tg

C. Severe dehydration
en

D. The data is insufficient

N

101. Based on the assessment, you classified a 3-month old infant with the chief
ur

complaint of diarrhea in the category of SOME DEHYDRATION. Based on the IMCI

management guidelines, which of the following will you do?
se

A. Bring the infant to the nearest facility where IV fluids can be given

B. Supervise the mother in giving 200 to 400 ml of Oresol in 4 hours

C. Give the infant’s mother instructions on home management

D. Keep the infant in your health center for close observation

102. A mother is using Oresol’ in the management of diarrhea of her 3-year old child.
She asked you what to do if her child vomits. You will tell her to:

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

B. Bring the child to the health center for IV therapy

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

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

A. Voracious appetite

B. Wasting

C. Apathy

D. Edema

104. Assessment of a 2-year old child revealed “baggy pants”. Using the IMCI
guidelines, how will you manage this child?
N

A. Refer the child urgently to a hospital for confinement

ex

B. Coordinate with the social worker to enroll the child in a feeding program
tg

C. Make a teaching plan for the mother, focusing on the menu planning for her child
en

D. Assess and treat the child for health problems like infections and intestinal parasitism
N

105. During the physical examination of a young child, what is the earliest sign of
ur

xerophthalmia that may observe?

se

A. Keratomalacia

B. Corneal opacity

C. Night blindness

D. Conjunctival xerosis

106. To prevent xerophthalmia, young children are given Retinol capsule every 6
months. What is the dose given to preschoolers?

A. 10, 000 IU

B. 20, 000 IU

C. 100, 000 IU

D. 200, 000 IU
107. The major sign of iron deficiency anemia is pallor. What part is best examined for
pallor?

A. Palms

B. Nailbeds

C. Around the lips

D. Lower conjunctival sac

108. Food fortification is one of the strategies to prevent micronutrient deficiency

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

A. Sugar
N

B. Bread
ex

C. Margarine
tg

D. Filled milk
en

109. What is the best course of action when there is a measles epidemic in a nearby
N

municipality?
ur

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

se

B. Give babies aged 6 to 11 months one dose of 100,000 IU of Retinol

C. Instruct mother to keep their babies at home to prevent disease transmission

D. Instruct mothers to feed their babies adequately to enhance their babies resistance

110. A mother brought her daughter, 4 years old, to the RHU because of cough and
colds. Following the IMCI assessment guide, which of the following is a danger sign
that indicates the need for urgent referral to a hospital?

A. Inability to drink

B. High grade fever

C. Signs of severe dehydration

D. Cough for more than 30 days

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

A. Gentian violet on mouth lesions

B. Antibiotic to prevent pneumonia

C. Tetracycline eye ointment for corneal opacity

D. Retinol capsule regardless of when the last dose was given

112. A mother brought her 10 month old infant for consultation because of fever which
started 4 days prior to consultation. To determine malaria risk, what will you do?

A. Do a tourniquet test

B. Ask where the family resides

N

C. Get a specimen for blood smear

ex

D. Ask if the fever is present everyday

tg
en

113. The following are strategies implemented by the DOH to prevent mosquito-borne
diseases. Which of these is most effective in the control of Dengue fever?
N

A. Stream seeding with larva-eating fish

ur

B. Destroying breeding places of mosquitoes

se

C. Chemoprophylaxis of non-immune persons going to endemic areas

D. Teaching people in endemic areas to use chemically treated mosquito nets

114. Secondary prevention for malaria includes?

A. Planting of neem or eucalyptus trees

B. Residual spraying of insecticides at night

C. Determining whether a place is endemic or not

D. Growing larva-eating fish in mosquito breeding places

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

A. Ascaris
B. Pinworm

C. Hookworm

D. Schistosoma

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

A. Hematemesis

B. Fever for 1 week

C. Cough for 3 weeks

D. Chest pain for 1 week

117. Which clients are considered targets for DOTS category?

N

A. Sputum negative cavitary cases

ex

B. Clients returning after default

tg

C. Relapses and failures of previous PTB treatment regimens

en

D. Clients diagnosed for the first time through a positive sputum exam
N

118. To improve compliance to treatment, what innovation is being implemented in

ur

DOTS?
se

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

B. Having the health worker or a responsible family member monitor drug intake

C. Having the patient come to the health center every month to get his medications

D. Having a target list to check on whether the patient has collected his monthly supply of drugs

119. Diagnosis of leprosy is highly dependent on recognition of symptoms. Which of

the following is an early sign of leprosy?

A. Macular lesions

B. Inability to close eyelids

C. Thickened painful nerves

D. Sinking of the nose bridge

120. Which of the following clients should be classified as a case of mutibacillary
leprosy?

A. 3 skin lesions, negative slit skin smear

B. 3 skin lesions, positive slit skin smear

C. 5 skin lesions, negative slit skin smear

D. 5 skin lesions, positive slit skin smear

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

A. Liver cancer

B. Liver cirrhosis
N

C. Bladder cancer
ex

D. Intestinal perforation
tg
en

122. What is the most effective way of controlling schistosomiasis in an endemic area?

A. Use of molluscicides
N

B. Building of foot bridges

ur
se

C. Proper use of sanitary toilets

D. Use of protective footwear, such as rubber boots

123. When residents obtain water from an artesian well in the neighborhood, the level
of this approved type of water facility is:

A. I

B. II

C. III

D. IV

124. For prevention of Hepatitis A, you decided to conduct health education activities.
Which of the following is Irrelevant?
A. Use of sterile syringes and needles

B. Safe food preparation and food handling by vendors

C. Proper disposal of human excreta and personal hygiene

D. Immediate reporting of water pipe leaks and illegal water connections

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

A. DPT

B. OPV

C. Measles vaccine

D. MMR
N

126. You will conduct outreach immunization in a barangay with a population of about
ex

1500. Estimate the number of infants in the barangay.

tg

A. 45
en

B. 50

C. 55
N
ur

D. 60
se

127. In IMCI, severe conditions generally require urgent referral to a hospital. Which of
the following severe conditions Does not always require urgent referral to hospital?

A. Mastoiditis

B. Severe dehydration

C. Severe pneumonia

D. Severe febrile disease.

128. A client was diagnosed as having Dengue Fever. You will say that there is slow
capillary refill when the color of the nailbed that you pressed does not return within
how many seconds?

A. 3
B. 5

C. 8

D. 10

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

A. Insert an NGT and give fluids per NGT

B. Instruct the mother to give the child Oresol

C. Start the patient on IV Stat

N

D. Refer the client to the physician for appropriate management

ex

130. The pathognomonic sign of measles is Koplik’s spot. You may see Koplik’s spot
tg

by inspecting the:
en

A. Nasal Mucosa

B. Buccal mucosa
N
ur

C. Skin on the abdomen

se

D. Skin on the antecubital surface

131. Among the following diseases, which is airborne?

A. Viral conjunctivitis

B. Acute poliomyelitis

C. Diphtheria

D. Measles

132. Among children aged 2 months to 3 years, the most prevalent form of meningitis
is caused by which microorganism?

A. Hemophilus Influenzae

B. Morbillivirus
C. Streptococcus Pneumoniae

D. Neisseria meningitides

133. Human beings are the major reservoir of malaria. Which of the following strategies
in malaria control is based on this fact?

A. Stream seeding

B. Stream clearing

C. Destruction of breeding places

D. Zooprophylaxis

134. The use of larvivorous fish in malaria control is the basis for which strategy of
malaria control?
N

A. Stream seeding
ex

B. Stream clearing
tg

C. Destruction of breeding places

en

D. Zooprophylaxis .
N
ur

135. Mosquito-borne diseases are prevented mostly with the use of mosquito control
measures. Which of the following is NOT appropriate for malaria control?
se

A. Use of chemically treated mosquito nets

B. Seeding of breeding places with larva-eating fish

C. Destruction of breeding places of the mosquito vector

D. Use of mosquito-repelling soaps, such as those with basil or citronella

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

A. Giardiasis

B. Cholera

C. Amebiasis
D. Dysentery

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

A. S. mansoni

B. S. japonicum

C. S. malayensis

D. S. haematobium

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

A. Hepatitis A
tg

B. Hepatitis B
en

C. Tetanus

D. Leptospirosis
N
ur

139. MWSS provides water to Manila and other cities in Metro Manila. This is an
se

example of which level of water facility?

A. I

B. II

C. III

D. IV

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

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

B. Ask the client to be accompanied by a significant person before revealing the result.
C. Refer the client to the physician since he is the best person to reveal the result to the client

D. Refer the client for a supplementary test, such as Western blot, since the ELISA result maybe false

141. Which is the BEST control measure for AIDS?

A. Being faithful to a single sexual partner

B. Using a condom during each sexual contact

C. Avoiding sexual contact with commercial sex workers

D. Making sure that one’s sexual partner does not have signs of AIDS

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

A. Respiratory candidiasis
ex

B. Infectious mononucleosis
tg

C. Cytomegalovirus disease
en

D. Pneumocystis carinii pneumonia

N
ur

143. To determine the possible sources of sexually transmitted infections, which is the
BEST method that may be undertaken by the public health nurse?
se

A. Contact tracing

B. Community survey

C. Mass screening tests

D. Interview suspects

144. Antiretroviral agents, such as AZT are used in the management of AIDS. Which of
the following is not an action expected of these drugs?

A. They prolong the life of the client with AIDS

B. They reduce the risk of opportunistic infections

C. They shorten the period of communicability of the disease

D. They are able to bring about a cure of the disease condition

145. A barangay had an outbreak of German measles. To prevent congenital rubella,

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

a. Advice them on the sign of German Measles

b. Avoid crowded places, such as markets and moviehouses

c. Consult at the health center where rubella vaccine may be given

d. Consult a physician who may give them rubella immunoglobulin

Answers and Rationale

Gauge your performance by counter-checking your answers to those below. If you have disputes
N

or further questions, please direct them to the comments section.

ex

1. Answer: (B) To enhance the capacity of individuals, families and communities to cope with their
tg

health needs.
en

To contribute to national development through promotion of family welfare, focusing particularly

on mothers and children.
N

2. Answer: (B) The nurse has to conduct community diagnosis to determine nursing needs and
ur

problems.
se

Community-based practice means providing care to people in their own natural environments: the
home, school and workplace, for example.

3. Answer: (C) Community diagnosis

Population-focused nursing care means providing care based on the greater need of the majority
of the population. The greater need is identified through community diagnosis.

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

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

5. Answer: (B) 101

6. Answer: (D) Environmental manager

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

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

8. Answer: (B) The statement is false; people pay indirectly for public health services.

Community health services, including public health services, are prepaid paid services, through
taxation, for example.

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

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

10. Answer: (C) Swaroop’s index

N

Swaroop’s index is the percentage of the deaths aged 50 years or older. Its inverse represents the
ex

percentage of untimely deaths (those who died younger than 50 years).

tg

11. Answer: (D) Public health nursing focuses on preventive, not curative, services.
en

The catchment area in PHN consists of a residential community, many of whom are well individuals
who have greater need for preventive rather than curative services.
N

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

ur
se

This is a direct quote from Dr. Margaret Shetland’s statements on Public Health Nursing.

13. Answer: (B) Ensure the accessibility and quality of health care

14. Answer: (D) Tertiary

Regional hospitals are tertiary facilities because they serve as training hospitals for the region.

15. Answer: (B) Their services are provided on an out-patient basis.

Primary facilities government and non-government facilities that provide basic out-patient
services.

16. Answer: (B) Conducting random classroom inspection during a measles epidemic

Random classroom inspection is assessment of pupils/students and teachers for signs of a health
problem prevalent in the community.
17. Answer: (B) Efficiency

Efficiency is determining whether the goals were attained at the least possible cost.

18. Answer: (D) Rural Health Unit

R.A. 7160 devolved basic health services to local government units (LGU’s). The public health nurse
is an employee of the LGU.

19. Answer: (C) To empower the people and promote their self-reliance

People empowerment is the basic motivation behind devolution of basic services to LGU’s.

20. Answer: (A) Mayor

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

21. Answer: (A) Primary

N
ex

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

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

en

The nurse provides technical guidance to the midwife in the care of clients, particularly in the
N

implementation of management guidelines, as in Integrated Management of Childhood Illness.

ur

23. Answer: (C) Municipal Health Officer

se

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

24. Answer: (A) 1

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

25. Answer: (D) Municipal Health Board

As mandated by R.A. 7160, basic health services have been devolved from the national government
to local government units.

26. Answer: (A) Act 3573

Act 3573, the Law on Reporting of Communicable Diseases, enacted in 1929, mandated the
reporting of diseases listed in the law to the nearest health station.
27. Answer: (B) Health education and community organizing are necessary in providing community
health services.

The community health nurse develops the health capability of people through health education
and community organizing activities.

28. Answer: (B) Measles

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

29. Answer: (B) Bar

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

30. Answer: (D) Core group formation

N
ex

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

31. Answer: (B) Community organization

en

Community organization is the step when community assemblies take place. During the
N

community assembly, the people may opt to formalize the community organization and make
ur

plans for community action to resolve a community health problem.

se

32. Answer: (D) To maximize the community’s resources in dealing with health problems

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

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

Participation in community activities in resolving a community problem may be in any of the

processes mentioned in the other choices.

34. Answer: (D) Terminal

Tertiary prevention involves rehabilitation, prevention of permanent disability and disability

limitation appropriate for convalescents, the disabled, complicated cases and the terminally ill
(those in the terminal stage of a disease)
35. Answer: (A) Primary

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

36. Answer: (B) Secondary

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

37. Answer: (C) Home visit

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

38. Answer: (B) Health deficit

N

Failure of a family member to develop according to what is expected, as in mental retardation, is a

ex

health deficit.
tg

39. Answer: (C) Foreseeable crisis

en

Entry of the 6-year old into school is an anticipated period of unusual demand on the family.

40. Answer: (B) It provides an opportunity to do first hand appraisal of the home situation.
N
ur

Choice A is not correct since a home visit requires that the nurse spend so much time with the
se

family. Choice C is an advantage of a group conference, while choice D is true of a clinic

consultation.

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

The home visit plan should be flexible and practical, depending on factors, such as the family’s
needs and the resources available to the nurse and the family.

42. Answer: (B) Should minimize if not totally prevent the spread of infection.

Bag technique is performed before and after handling a client in the home to prevent transmission
of infection to and from the client.

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

44. Answer: (B) Analytical

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

45. Answer: (D) Evaluating the effectiveness of the implementation of the Integrated Management
of Childhood Illness

Epidemiology is used in the assessment of a community or evaluation of interventions in

community health practice.

46. Answer: (C) Participating in the investigation to determine the source of the epidemic
N

Epidemiology is the study of patterns of occurrence and distribution of disease in the community,
ex

as well as the factors that affect disease patterns. The purpose of an epidemiologic investigation is
tg

to identify the source of an epidemic, i.e., what brought about the epidemic.
en

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

Delineating the etiology of an epidemic is identifying its source.

N
ur

48. Answer: (D) There is a gradual build up of cases before the epidemic becomes easily noticeable.
se

A gradual or insidious onset of the epidemic is usually observable in person-to-person propagated

epidemics.

49. Answer: (A) Establishing the epidemic

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

50. Answer: (B) Cyclical variation

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

51. Answer: (C) Smallpox

The last documented case of Smallpox was in 1977 at Somalia.

52. Answer: (B) 100.94:100

Sex ratio is the number of males for every 100 females in the population.

53. Answer: (D) Health programs are sustained according to the level of development of the
community.

Primary health care is essential health care that can be sustained in all stages of development of
the community.

54. Answer: (D) Sensitivity

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

55. Answer: (D) Lagundi

N

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

antifungal property.
tg

56. Answer: (A) R.A. 8423 or “AN ACT CREATING THE PHILIPPINE INSTITUTE OF TRADITIONAL AND
ALTERNATIVE HEALTH CARE (PITAHC) TO ACCELERATE THE DEVELOPMENT OF TRADITIONAL AND
en

ALTERNATIVE HEALTH CARE IN THE PHILIPPINES, PROVIDING FOR A TRADITIONAL AND

ALTERNATIVE HEALTH CARE DEVELOPMENT FUND AND FOR OTHER PURPOSES” signed to a law on
N

December 9, 1997.
ur
se

57. Answer: (A) Yin

Yang is the male dominating, positive and masculine force.

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

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

59. Answer: (D) Cooperation between the PHN and public school teacher

Intersectoral linkages refer to working relationships between the health sector and other sectors
involved in community development.

60. Answer: (D) 2,300

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

61. Answer: (A) 265

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

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

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

63. Answer: (A) Crude birth rate

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

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

N

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

multiply by 1,000.
tg

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

en

Preschoolers are the most susceptible to PEM because they have generally been weaned. Also, this
is the population who, unable to feed themselves, are often the victims of poor intrafamilial food
N

distribution.
ur
se

66. Answer: (C) Swaroop’s index

Swaroop’s index is the proportion of deaths aged 50 years and above. The higher the Swaroop’s
index of a population, the greater the proportion of the deaths who were able to reach the age of
at least 50 years, i.e., more people grew old before they died.

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

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

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

Since preschoolers are the most susceptible to the effects of malnutrition, a population with poor
nutritional status will most likely have a high 1-4 year old age-specific mortality rate, also known
as child mortality rate.
69. Answer: (B) Number of registered live births

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

70. Answer: (B) Survey

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

71. Answer: (C) De facto

The other method of population assignment, de jure, is based on the usual place of residence of
the people.

72. Answer: (A) Tally report

A tally report is prepared monthly or quarterly by the RHU personnel and transmitted to the
N

Provincial Health Office.

ex

73. Answer: (C) Target/client list

tg

The MDT Client List is a record of clients enrolled in MDT and other relevant data, such as dates
en

when clients collected their monthly supply of drugs.

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

N
ur

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

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

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

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

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

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

Sentrong Sigla Movement is a joint project of the DOH and local government units. Its main strategy
is certification of health centers that are able to comply with standards set by the DOH.

78. Answer: (D) Those who just had a delivery within the past 15 months

The ideal birth spacing is at least two years. 15 months plus 9 months of pregnancy = 2 years.
79. Answer: (C) Adequate information for couples regarding the different methods

To enable the couple to choose freely among different methods of family planning, they must be
given full information regarding the different methods that are available to them, considering the
availability of quality services that can support their choice.

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

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

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

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

82. Answer: (C) Folic acid

N

It is estimated that the incidence of neural tube defects can be reduced drastically if pregnant
ex

women have an adequate intake of folic acid.

tg

83. Answer: (D) Note the interval, duration and intensity of labor contractions.
en

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.
N

84. Answer: (D) Explain to her that putting the baby to breast will lessen blood loss after delivery.
ur
se

Suckling of the nipple stimulates the release of oxytocin by the posterior pituitary gland, which
causes uterine contraction. Lactation begins 1 to 3 days after delivery. Nipple stretching exercises
are done when the nipples are flat or inverted. Frequent washing dries up the nipples, making them
prone to the formation of fissures.

85. Answer: (B) To stimulate milk production by the mammary acini

Suckling of the nipple stimulates prolactin reflex (the release of prolactin by the anterior pituitary
gland), which initiates lactation.

86. Answer: (B) The mother does not feel nipple pain.

When the baby has properly latched on to the breast, he takes deep, slow sucks; his mouth is wide
open; and much of the areola is inside his mouth. And, you’re right! The mother does not feel nipple
pain.

87. Answer: (B) 6 months

After 6 months, the baby’s nutrient needs, especially the baby’s iron requirement, can no longer be
provided by mother’s milk alone.

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

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

89. Answer: (C) Measles vaccine

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

90. Answer: (B) 4

While the unused portion of other biologicals in EPI may be given until the end of the day, only BCG
N

is discarded 4 hours after reconstitution. This is why BCG immunization is scheduled only in the
ex

morning.
tg

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

en

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

7846.
ur
se

92. Answer: (B) BCG

BCG causes the formation of a superficial abscess, which begins 2 weeks after immunization. The
abscess heals without treatment, with the formation of a permanent scar.

93. Answer: (C) Infant BCG

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

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

Seizures within 3 days after administration of DPT is an indication of hypersensitivity to pertussis

vaccine, a component of DPT. This is considered a specific contraindication to subsequent doses
of DPT.

95. Answer: (A) Go on with the infant’s immunizations.

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

96. Answer: (A) 1 year

The baby will have passive natural immunity by placental transfer of antibodies. The mother will
have active artificial immunity lasting for about 10 years. 5 doses will give the mother lifetime
protection.

97. Answer: (C) Normal

In IMCI, a respiratory rate of 50/minute or more is fast breathing for an infant aged 2 to 12 months.

98. Answer: (D) Chest indrawing

In IMCI, chest indrawing is used as the positive sign of dyspnea, indicating severe pneumonia.
N

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

ex

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

classified as having pneumonia.

en

100. Answer: (B) Some dehydration

Using the assessment guidelines of IMCI, a child (2 months to 5 years old) with diarrhea is classified
N

as having SOME DEHYDRATION if he shows 2 or more of the following signs: restless or irritable,
ur

sunken eyes, the skin goes back slow after a skin pinch.
se

101. Answer: (B) Supervise the mother in giving 200 to 400 ml. of Oresol in 4 hours.

In the IMCI management guidelines, SOME DEHYDRATION is treated with the administration of
Oresol within a period of 4 hours. The amount of Oresol is best computed on the basis of the child’s
weight (75 ml/kg body weight). If the weight is unknown, the amount of Oresol is based on the
child’s age.

102. Answer: (D) Let the child rest for 10 minutes then continue giving Oresol more slowly.

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

103. Answer: (D) Edema

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

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

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

105. Answer: (D) Conjunctival xerosis

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

106. Answer: (D) 200,000 IU

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

107. Answer: (A) Palms

tg

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

108. Answer: (A) Sugar

N

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

and/or iodine.
se

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

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

110. Answer: (A) Inability to drink

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

111. Answer: (D) Retinol capsule regardless of when the last dose was given

An infant 6 to 12 months classified as a case of measles is given Retinol 100,000 IU; a child is given
200,000 IU regardless of when the last dose was given.
112. Answer: (B) Ask where the family resides.

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

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

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

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

This is diagnostic and therefore secondary level prevention. The other choices are for primary
prevention.
N

115. Answer: (B) Pinworm

ex

Pinworm ova are deposited around the anal orifice.

tg

116. Answer: (C) Cough for 3 weeks

en

A client is considered a PTB suspect when he has cough for 2 weeks or more, plus one or more of
N

the following signs: fever for 1 month or more; chest pain lasting for 2 weeks or more not attributed
ur

to other conditions; progressive, unexplained weight loss; night sweats; and hemoptysis.
se

117. Answer: (D) Clients diagnosed for the first time through a positive sputum exam

Category I is for new clients diagnosed by sputum examination and clients diagnosed to have a
serious form of extrapulmonary tuberculosis, such as TB osteomyelitis.

118. Answer: (B) Having the health worker or a responsible family member monitor drug intake

Directly Observed Treatment Short Course is so-called because a treatment partner, preferably a
health worker accessible to the client, monitors the client’s compliance to the treatment.

119. Answer: (C) Thickened painful nerves

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

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

A multibacillary leprosy case is one who has a positive slit skin smear and at least 5 skin lesions.

121. Answer: (B) Liver cirrhosis

The etiologic agent of schistosomiasis in the Philippines is Schistosoma japonicum, which affects
the small intestine and the liver. Liver damage is a consequence of fibrotic reactions to schistosoma
eggs in the liver.

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

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

123. Answer: (B) II

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

N

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

ex

Hepatitis A is transmitted through the fecal oral route. Hepatitis B is transmitted through infected
tg

body secretions like blood and semen.

en

125. Answer: (A) DPT

DPT is sensitive to freezing. The appropriate storage temperature of DPT is 2 to 8° C only. OPV and
N

measles vaccine are highly sensitive to heat and require freezing. MMR is not an immunization in
ur

the Expanded Program on Immunization.

se

126. Answer: (A) 45

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

127. Answer: (B) Severe dehydration

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

128. Answer: (A) 3

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

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

130. Answer: (B) Buccal mucosa

Koplik’s spot may be seen on the mucosa of the mouth or the throat.

131. Answer: (D) Measles

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

132. Answer: (A) Hemophilus influenzae

Hemophilus meningitis is unusual over the age of 5 years. In developing countries, the peak
incidence is in children less than 6 months of age. Morbillivirus is the etiology of measles.
N

Streptococcus pneumoniae and Neisseria meningitidis may cause meningitis, but age distribution
ex

is not specific in young children.

tg

133. Answer: (D) Zooprophylaxis

en

Zooprophylaxis is done by putting animals like cattle or dogs close to windows or doorways just
before nightfall. The Anopheles mosquito takes his blood meal from the animal and goes back to
N

its breeding place, thereby preventing infection of humans.

ur
se

134. Answer: (A) Stream seeding

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

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

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

136. Answer: (B) Cholera

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

137. Answer: (B) S. japonicum

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

138. Answer: (D) Leptospirosis

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

139. Answer: (C) III

Waterworks systems, such as MWSS, are classified as level III.

140. Answer: (D) Refer the client for a supplementary test, such as Western blot, since the ELISA
result may be false.

A client having a reactive ELISA result must undergo a more specific test, such as Western blot. A
negative supplementary test result means that the ELISA result was false and that, most probably,
N

the client is not infected.

ex

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

tg

Sexual fidelity rules out the possibility of getting the disease by sexual contact with another
en

infected person. Transmission occurs mostly through sexual intercourse and exposure to blood or
tissues.
N
ur

142. Answer: (B) Infectious mononucleosis

se

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

143. Answer: (A) Contact tracing

Contact tracing is the most practical and reliable method of finding possible sources of person-to-
person transmitted infections, such as sexually transmitted diseases.

144. Answer: (D) They are able to bring about a cure of the disease condition.

There is no known treatment for AIDS. Antiretroviral agents reduce the risk of opportunistic
infections and prolong life, but does not cure the underlying immunodeficiency.

145. Answer: (D) Consult a physician who may give them rubella immunoglobulin.
Rubella vaccine is made up of attenuated German measles viruses. This is contraindicated in
pregnancy. Immune globulin, a specific prophylactic against German measles, may be given to
pregnant women.

N
ex
tg
en
N
ur
se
Community Health Nursing Exam 1
1. Which is the primary goal of community health nursing?

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

the promotion of health and prevention of illness
B. To enhance the capacity of individuals, families and communities to
cope with their health needs
C. To increase the productivity of the people by providing them with
services that will increase their level of health
D. To contribute to national development through promotion of family
welfare, focusing particularly on mothers and children.
2. CHN is a community-based practice. Which best explains this statement?
N
ex

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

B. The nurse has to conduct community diagnosis to determine nursing
tg

needs and problems.

en

C. The services are based on the available resources within the

community.
D. Priority setting is based on the magnitude of the health problems
N

identified.
ur

3. Population-focused nursing practice requires which of the following

se

processes?

A. Community organizing
B. Nursing process
C. Community diagnosis
D. Epidemiologic process
4. R.A. 1054 is also known as the Occupational Health Act. Aside from number
of employees, what other factor must be considered in determining the
occupational health privileges to which the workers will be entitled?

A. Type of occupation: agricultural, commercial, industrial

B. Location of the workplace in relation to health facilities
C. Classification of the business enterprise based on net profit
D. Sex and age composition of employees
5. A business firm must employ an occupational health nurse when it has at
least how many employees?

A. 21
B. 101
C. 201
D. 301
6. When the occupational health nurse employs ergonomic principles, she is
performing which of her roles?

A. Health care provider

B. Health educator
C. Health care coordinator
D. Environmental manager
7. A garment factory does not have an occupational nurse. Who shall provide
the occupational health needs of the factory workers?
N
ex

A. Occupational health nurse at the Provincial Health Office

B. Physician employed by the factory
tg

C. Public health nurse of the RHU of their municipality

en

D. Rural sanitary inspector of the RHU of their municipality

8. “Public health services are given free of charge.” Is this statement true or
N

false?
ur

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

se

basic services.
B. The statement is false; people pay indirectly for public health
services.
C. The statement may be true or false, depending on the specific service
required.
D. The statement may be true or false, depending on policies of the
government concerned.
9. According to C.E.Winslow, which of the following is the goal of Public Health?

A. For people to attain their birthrights of health and longevity

B. For promotion of health and prevention of disease
C. For people to have access to basic health services
D. For people to be organized in their health efforts
10. We say that a Filipino has attained longevity when he is able to reach the
average lifespan of Filipinos. What other statistic may be used to determine
attainment of longevity?

A. Age-specific mortality rate

B. Proportionate mortality rate
C. Swaroop’s index
D. Case fatality rate
11. Which of the following is the most prominent feature of public health
nursing?

A. It involves providing home care to sick people who are not confined
in the hospital.
B. Services are provided free of charge to people within the catchment
area.
C. The public health nurse functions as part of a team providing a public
N

health nursing services.

ex

D. Public health nursing focuses on preventive, not curative, services.

12. According to Margaret Shetland, the philosophy of public health nursing is
tg

based on which of the following?

en

A. Health and longevity as birthrights

N

B. The mandate of the state to protect the birthrights of its citizens

ur

C. Public health nursing as a specialized field of nursing

D. The worth and dignity of man
se

13. Which of the following is the mission of the Department of Health?

A. Health for all Filipinos

B. Ensure the accessibility and quality of health care
C. Improve the general health status of the population
D. Health in the hands of the Filipino people by the year 2020
14. Region IV Hospital is classified as what level of facility?

A. Primary
B. Secondary
C. Intermediate
D. Tertiary
15. Which is true of primary facilities?

A. They are usually government-run.

 B. Their services are provided on an out-patient basis.
C. They are training facilities for health professionals.
D. A community hospital is an example of this level of health facilities.
16. Which is an example of the school nurse’s health care provider functions?

A. Requesting for BCG from the RHU for school entrant immunization
B. Conducting random classroom inspection during a measles
epidemic
C. Taking remedial action on an accident hazard in the school
playground
D. Observing places in the school where pupils spend their free time
17. When the nurse determines whether resources were maximized in
implementing Ligtas Tigdas, she is evaluating

A. Effectiveness
B. Efficiency
N

C. Adequacy
ex

D. Appropriateness
18. You are a new B.S.N. graduate. You want to become a Public Health Nurse.
tg

Where will you apply?

en

A. Department of Health
N

B. Provincial Health Office

ur

C. Regional Health Office

D. Rural Health Unit
se

19. R.A. 7160 mandates devolution of basic services from the national
government to local government units. Which of the following is the major goal
of devolution?

A. To strengthen local government units

B. To allow greater autonomy to local government units
C. To empower the people and promote their self-reliance
D. To make basic services more accessible to the people
20. Who is the Chairman of the Municipal Health Board?

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

A. Primary
B. Secondary
C. Intermediate
D. Tertiary
22. The public health nurse is the supervisor of rural health midwives. Which of
the following is a supervisory function of the public health nurse?

A. Referring cases or patients to the midwife

B. Providing technical guidance to the midwife
C. Providing nursing care to cases referred by the midwife
D. Formulating and implementing training programs for midwives
23. One of the participants in a hilot training class asked you to whom she
should refer a patient in labor who develops a complication. You will answer, to
N

the
ex

A. Public Health Nurse

tg

B. Rural Health Midwife

en

C. Municipal Health Officer

D. Any of these health professionals
N

24. You are the public health nurse in a municipality with a total population of
ur

about 20,000. There are 3 rural health midwives among the RHU personnel.
How many more midwife items will the RHU need?
se

A. 1
B. 2
C. 3
D. The RHU does not need any more midwife item.
25. If the RHU needs additional midwife items, you will submit the request for
additional midwife items for approval to the

A. Rural Health Unit

B. District Health Office
C. Provincial Health Office
D. Municipal Health Board
26. As an epidemiologist, the nurse is responsible for reporting cases of
notifiable diseases. What law mandates reporting of cases of notifiable
diseases?
 A. Act 3573
B. R.A. 3753
C. R.A. 1054
D. R.A. 1082
27. According to Freeman and Heinrich, community health nursing is a
developmental service. Which of the following best illustrates this statement?

A. The community health nurse continuously develops himself

personally and professionally.
B. Health education and community organizing are necessary in
providing community health services.
C. Community health nursing is intended primarily for health promotion
and prevention and treatment of disease.
D. The goal of community health nursing is to provide nursing services
to people in their own places of residence.
28. Which disease was declared through Presidential Proclamation No. 4 as a
N

target for eradication in the Philippines?

ex

A. Poliomyelitis
tg

B. Measles
en

C. Rabies
D. Neonatal tetanus
N

29. The public health nurse is responsible for presenting the municipal health
ur

statistics using graphs and tables. To compare the frequency of the leading
causes of mortality in the municipality, which graph will you prepare?
se

A. Line
B. Bar
C. Pie
D. Scatter diagram
30. Which step in community organizing involves training of potential leaders
in the community?

A. Integration
B. Community organization
C. Community study
D. Core group formation
Answers and Rationales
1. Answer: (B) To enhance the capacity of individuals, families and
communities to cope with their health needs
2. Answer: (B) The nurse has to conduct community diagnosis to
determine nursing needs and problems.
3. Answer: (C) Community diagnosis. Population-focused nursing care
means providing care based on the greater need of the majority of
the population. The greater need is identified through community
diagnosis.
4. Answer: (B) Location of the workplace in relation to health
facilities. Based on R.A. 1054, an occupational nurse must be
employed when there are 30 to 100 employees and the workplace is
more than 1 km. away from the nearest health center.
5. Answer: (B) 101. Again, this is based on R.A. 1054.
6. Answer: (D) Environmental manager. Ergonomics is improving
N

efficiency of workers by improving the worker’s environment through

ex

appropriately designed furniture, for example.

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

municipality. You’re right! This question is based on R.A.1054.

en

8. Answer: (B) The statement is false; people pay indirectly for public
health services. Community health services, including public health
N

services, are pre-paid services, though taxation, for example.

ur

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

longevity. According to Winslow, all public health efforts are for
se

people to realize their birthrights of health and longevity.

10. Answer: (C) Swaroop’s index. Swaroop’s index is the percentage of
the deaths aged 50 years or older. Its inverse represents the
percentage of untimely deaths (those who died younger than 50
years).
11. Answer: (D) Public health nursing focuses on preventive, not
curative, services.The catchment area in PHN consists of a residential
community, many of whom are well individuals who have greater
need for preventive rather than curative services.
12. Answer: (D) The worth and dignity of man. This is a direct quote
from Dr. Margaret Shetland’s statements on Public Health Nursing.
13. Answer: (B) Ensure the accessibility and quality of health care
14. Answer: (D) Tertiary. Regional hospitals are tertiary facilities
because they serve as training hospitals for the region.
15. Answer: (B) Their services are provided on an out-patient
basis. Primary facilities government and non-government facilities
that provide basic out-patient services.
16. Answer: (B) Conducting random classroom inspection during a
measles epidemic. Random classroom inspection is assessment of
pupils/students and teachers for signs of a health problem prevalent
in the community.
17. Answer: (B) Efficiency. Efficiency is determining whether the goals
were attained at the least possible cost.
18. Answer: (D) Rural Health Unit. R.A. 7160 devolved basic health
services to local government units (LGU’s ). The public health nurse
is an employee of the LGU.
19. Answer: (C) To empower the people and promote their self-
reliance. People empowerment is the basic motivation behind
devolution of basic services to LGU’s.
20. Answer: (A) Mayor. The local executive serves as the chairman of
N

the Municipal Health Board.

ex

21. Answer: (A) Primary. The entry of a person into the health care
tg

delivery system is usually through a consultation in out-patient

services.
en

22. Answer: (B) Providing technical guidance to the midwife. The nurse
provides technical guidance to the midwife in the care of clients,
N

particularly in the implementation of management guidelines, as in

ur

Integrated Management of Childhood Illness.

23. Answer: (C) Municipal Health Officer. A public health nurse and
se

rural health midwife can provide care during normal childbirth. A

physician should attend to a woman with a complication during labor.
24. Answer: (A) 1. Each rural health midwife is given a population
assignment of about 5,000.
25. Answer: (D) Municipal Health Board. As mandated by R.A. 7160,
basic health services have been devolved from the national
government to local government units.
26. Answer: (A) Act 3573. Act 3573, the Law on Reporting of
Communicable Diseases, enacted in 1929, mandated the reporting of
diseases listed in the law to the nearest health station.
27. Answer: (B) Health education and community organizing are
necessary in providing community health services. The community
health nurse develops the health capability of people through health
education and community organizing activities.
28. Answer: (B) Measles. Presidential Proclamation No. 4 is on the
Ligtas Tigdas Program.
29. Answer: (B) Bar. A bar graph is used to present comparison of
values, a line graph for trends over time or age, a pie graph for
population composition or distribution, and a scatter diagram for
correlation of two variables.
30. Answer: (D) Core group formation. In core group formation, the
nurse is able to transfer the technology of community organizing to
the potential or informal community leaders through a training
program.
N
ex
tg
en
N
ur
se
Community Health Nursing Exam 2
1. In which step are plans formulated for solving community problems?

A. Mobilization
B. Community organization
C. Follow-up/extension
D. Core group formation
2. The public health nurse takes an active role in community participation. What
is the primary goal of community organizing?

A. To educate the people regarding community health problems

B. To mobilize the people to resolve community health problems
N

C. To maximize the community’s resources in dealing with health

ex

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

problems
en

3. An indicator of success in community organizing is when people are able to

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

N

problem
ur

B. Implement activities for the solution of the community problem

se

C. Plan activities for the solution of the community problem

D. Identify the health problem as a common concern
4. Tertiary prevention is needed in which stage of the natural history of disease?

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

A. Primary
B. Secondary
C. Intermediate
D. Tertiary
6. On the other hand, Operation Timbang is _____ prevention.
 A. Primary
B. Secondary
C. Intermediate
D. Tertiary
7. Which type of family-nurse contact will provide you with the best opportunity
to observe family dynamics?

A. Clinic consultation
B. Group conference
C. Home visit
D. Written communication
8. The typology of family nursing problems is used in the statement of nursing
diagnosis in the care of families. The youngest child of the de los Reyes family
has been diagnosed as mentally retarded. This is classified as a:

A. Health threat
N

B. Health deficit
ex

C. Foreseeable crisis
D. Stress point
tg

9. The de los Reyes couple have a 6-year old child entering school for the first
en

time. The de los Reyes family has a:

N

A. Health threat
ur

B. Health deficit
C. Foreseeable crisis
se

D. Stress point
10. Which of the following is an advantage of a home visit?

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

people.
B. It provides an opportunity to do first hand appraisal of the home
situation.
C. It allows sharing of experiences among people with similar health
problems.
D. It develops the family’s initiative in providing for health needs of its
members.
11. Which is CONTRARY to the principles in planning a home visit?

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

B. The plan should revolve around family health needs.
 C. A home visit should be conducted in the manner prescribed by the
RHU.
D. Planning of continuing care should involve a responsible family
member.
12. The PHN bag is an important tool in providing nursing care during a home
visit. The most important principle of bag technique states that it

A. Should save time and effort.

B. Should minimize if not totally prevent the spread of infection.
C. Should not overshadow concern for the patient and his family.
D. May be done in a variety of ways depending on the home situation,
etc.
13. To maintain the cleanliness of the bag and its contents, which of the
following must the nurse do?

A. Wash his/her hands before and after providing nursing care to the
N

family members.
ex

B. In the care of family members, as much as possible, use only articles

taken from the bag.
tg

C. Put on an apron to protect her uniform and fold it with the right side
en

out before putting it back into the bag.

D. At the end of the visit, fold the lining on which the bag was placed,
N

ensuring that the contaminated side is on the outside.

ur

14. The public health nurse conducts a study on the factors contributing to the
high mortality rate due to heart disease in the municipality where she works.
se

Which branch of epidemiology does the nurse practice in this situation?

A. Descriptive
B. Analytical
C. Therapeutic
D. Evaluation
15. Which of the following is a function of epidemiology?

A. Identifying the disease condition based on manifestations presented

by a client
B. Determining factors that contributed to the occurrence of pneumonia
in a 3 year old
C. Determining the efficacy of the antibiotic used in the treatment of the
3 year old client with pneumonia
 D. Evaluating the effectiveness of the implementation of the Integrated
Management of Childhood Illness
16. Which of the following is an epidemiologic function of the nurse during an
epidemic?

A. Conducting assessment of suspected cases to detect the

communicable disease
B. Monitoring the condition of the cases affected by the communicable
disease
C. Participating in the investigation to determine the source of the
epidemic
D. Teaching the community on preventive measures against the disease
17. The primary purpose of conducting an epidemiologic investigation is to

A. Delineate the etiology of the epidemic

B. Encourage cooperation and support of the community
N

C. Identify groups who are at risk of contracting the disease

ex

D. Identify geographical location of cases of the disease in the

community
tg

18. Which is a characteristic of person-to-person propagated epidemics?

en

A. There are more cases of the disease than expected.

N

B. The disease must necessarily be transmitted through a vector.

ur

C. The spread of the disease can be attributed to a common vehicle.

D. There is a gradual build up of cases before the epidemic becomes
se

easily noticeable.
19. In the investigation of an epidemic, you compare the present frequency of
the disease with the usual frequency at this time of the year in this community.
This is done during which stage of the investigation?

A. Establishing the epidemic

B. Testing the hypothesis
C. Formulation of the hypothesis
D. Appraisal of facts
20. The number of cases of Dengue fever usually increases towards the end of
the rainy season. This pattern of occurrence of Dengue fever is best described
as

A. Epidemic occurrence
B. Cyclical variation
 C. Sporadic occurrence
D. Secular variation
21. In the year 1980, the World Health Organization declared the Philippines,
together with some other countries in the Western Pacific Region, “free” of
which disease?

A. Pneumonic plague
B. Poliomyelitis
C. Small pox
D. Anthrax
22. In the census of the Philippines in 1995, there were about 35,299,000 males
and about 34,968,000 females. What is the sex ratio?

A. 99.06:100
B. 100.94:100
C. 50.23%
N

D. 49.76%
ex

23. Primary health care is a total approach to community development. Which

of the following is an indicator of success in the use of the primary health care
tg

approach?
en

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

N

families.
ur

B. Local officials are empowered as the major decision makers in

matters of health.
se

C. Health workers are able to provide care based on identified health

needs of the people.
D. Health programs are sustained according to the level of development
of the community.
24. Sputum examination is the major screening tool for pulmonary
tuberculosis. Clients would sometimes get false negative results in this exam.
This means that the test is not perfect in terms of which characteristic of a
diagnostic examination?

A. Effectiveness
B. Efficacy
C. Specificity
D. Sensitivity
25. Use of appropriate technology requires knowledge of indigenous
technology. Which medicinal herb is given for fever, headache and cough?
 A. Sambong
B. Tsaang gubat
C. Akapulko
D. Lagundi
26. What law created the Philippine Institute of Traditional and Alternative
Health Care?

A. R.A. 8423
B. R.A. 4823
C. R.A. 2483
D. R.A. 3482
27. In traditional Chinese medicine, the yielding, negative and feminine force is
termed

A. Yin
B. Yang
N

C. Qi
ex

D. Chai
28. What is the legal basis for Primary Health Care approach in the Philippines?
tg
en

A. Alma Ata Declaration on PHC

B. Letter of Instruction No. 949
N

C. Presidential Decree No. 147

ur

D. Presidential Decree 996

29. Which of the following demonstrates intersectoral linkages?
se

A. Two-way referral system

B. Team approach
C. Endorsement done by a midwife to another midwife
D. Cooperation between the PHN and public school teacher
30. The municipality assigned to you has a population of about 20,000.
Estimate the number of 1-4 year old children who will be given Retinol capsule
200,000 I.U. every 6 months.

A. 1,500
B. 1,800
C. 2,000
D. 2,300
Answers and Rationales
1. Answer: (B) Community organization. Community organization is the
step when community assemblies take place. During the community
assembly, the people may opt to formalize the community
organization and make plans for community action to resolve a
community health problem.
2. Answer: (D) To maximize the community’s resources in dealing with
health problems. Community organizing is a developmental service,
with the goal of developing the people’s self-reliance in dealing with
community health problems. A, B and C are objectives of contributory
objectives to this goal.
3. Answer: (A) Participate in community activities for the solution of a
community problem. Participation in community activities in resolving
a community problem may be in any of the processes mentioned in
the other choices.
N

4. Answer: (D) Terminal. Tertiary prevention involves rehabilitation,

ex

prevention of permanent disability and disability limitation

appropriate for convalescents, the disabled, complicated cases and
tg

the terminally ill (those in the terminal stage of a disease)

en

5. Answer: (A) Primary. The purpose of isolating a client with a

communicable disease is to protect those who are not sick (specific
N

disease prevention).
ur

6. Answer: (B) Secondary. Operation Timbang is done to identify

members of the susceptible population who are malnourished. Its
se

purpose is early diagnosis and, subsequently, prompt treatment.

7. Answer: (C) Home visit. Dynamics of family relationships can best be
observed in the family’s natural environment, which is the home.
8. Answer: (B) Health deficit. Failure of a family member to develop
according to what is expected, as in mental retardation, is a health
deficit.
9. Answer: (C) Foreseeable crisis. Entry of the 6-year old into school is
an anticipated period of unusual demand on the family.
10. Answer: (B) It provides an opportunity to do first hand appraisal of
the home situation.. Choice A is not correct since a home visit requires
that the nurse spend so much time with the family. Choice C is an
advantage of a group conference, while choice D is true of a clinic
consultation.
11. Answer: (C) A home visit should be conducted in the manner
prescribed by the RHU.The home visit plan should be flexible and
 practical, depending on factors, such as the family’s needs and the
resources available to the nurse and the family.
12. Answer: (B) Should minimize if not totally prevent the spread of
infection. Bag technique is performed before and after handling a
client in the home to prevent transmission of infection to and from
the client.
13. Answer: (A) Wash his/her hands before and after providing nursing
care to the family members. Choice B goes against the idea of utilizing
the family’s resources, which is encouraged in CHN. Choices C and D
goes against the principle of asepsis of confining the contaminated
surface of objects.
14. Answer: (B) Analytical. Analytical epidemiology is the study of
factors or determinants affecting the patterns of occurrence and
distribution of disease in a community.
15. Answer: (D) Evaluating the effectiveness of the implementation of
the Integrated Management of Childhood Illness. Epidemiology is used
N

in the assessment of a community or evaluation of interventions in

ex

community health practice.

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

source of the epidemic. Epidemiology is the study of patterns of

en

occurrence and distribution of disease in the community, as well as

the factors that affect disease patterns. The purpose of an
N

epidemiologic investigation is to identify the source of an epidemic,

ur

i.e., what brought about the epidemic.

17. Answer: (A) Delineate the etiology of the epidemic. Delineating the
se

etiology of an epidemic is identifying its source.

18. Answer: (D) There is a gradual build up of cases before the epidemic
becomes easily noticeable. A gradual or insidious onset of the
epidemic is usually observable in person-to-person propagated
epidemics.
19. Answer: (A) Establishing the epidemic. Establishing the epidemic is
determining whether there is an epidemic or not. This is done by
comparing the present number of cases with the usual number of
cases of the disease at the same time of the year, as well as
establishing the relatedness of the cases of the disease.
20. Answer: (B) Cyclical variation. A cyclical variation is a periodic
fluctuation in the number of cases of a disease in the community.
21. Answer: (C) Small pox. The last documented case of Small pox
was in 1977 at Somalia.
22. Answer: (B) 100.94:100. Sex ratio is the number of males for every
100 females in the population.
23. Answer: (D) Health programs are sustained according to the level of
development of the community. Primary health care is essential health
care that can be sustained in all stages of development of the
community.
24. Answer: (D) Sensitivity. Sensitivity is the capacity of a diagnostic
examination to detect cases of the disease. If a test is 100% sensitive,
all the cases tested will have a positive result, i.e., there will be no
false negative results.
25. Answer: (D) Lagundi. Sambong is used as a diuretic. Tsaang gubat
is used to relieve diarrhea. Akapulko is used for its antifungal
property.
26. Answer: (A) R.A. 8423
27. Answer: (A) Yin. Yang is the male dominating, positive and
masculine force.
N

28. Answer: (B) Letter of Instruction No. 949. Letter of Instruction 949
ex

was issued by then President Ferdinand Marcos, directing the

tg

formerly called Ministry of Health, now the Department of Health, to

utilize Primary Health Care approach in planning and implementing
en

health programs.
29. Answer: (D) Cooperation between the PHN and public school
N

teacher. Intersectoral linkages refer to working relationships between

ur

the health sector and other sectors involved in community

development.
se

30. Answer: (D) 2,300. Based on the Philippine population

composition, to estimate the number of 1-4 year old children, multiply
total population by 11.5%.
Community Health Nursing Exam 3
1. Estimate the number of pregnant women who will be given tetanus toxoid
during an immunization outreach activity in a barangay with a population of
about 1,500.

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

A. Sex ratio
ex

B. Sex proportion
C. Population pyramid
tg

D. Any of these may be used.

en

3. Which of the following is a natality rate?

A. Crude birth rate

N

B. Neonatal mortality rate

ur

C. Infant mortality rate

se

D. General fertility rate

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

A. 4.2/1,000
B. 5.2/1,000
C. 6.3/1,000
D. 7.3/1,000
5. Knowing that malnutrition is a frequent community health problem, you
decided to conduct nutritional assessment. What population is particularly
susceptible to protein energy malnutrition (PEM)?

A. Pregnant women and the elderly

 B. Under-5 year old children
C. 1-4 year old children
D. School age children
6. Which statistic can give the most accurate reflection of the health status of
a community?

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

B. Infant mortality rate
C. Swaroop’s index
D. Crude death rate
7. In the past year, Barangay A had an average population of 1655. 46 babies
were born in that year, 2 of whom died less than 4 weeks after they were born.
There were 4 recorded stillbirths. What is the neonatal mortality rate?

A. 27.8/1,000
B. 43.5/1,000
N

C. 86.9/1,000
ex

D. 130.4/1,000
8. Which statistic best reflects the nutritional status of a population?
tg
en

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

B. Proportionate mortality rate
N

C. Infant mortality rate

ur

D. Swaroop’s index
9. What numerator is used in computing general fertility rate?
se

A. Estimated midyear population

B. Number of registered live births
C. Number of pregnancies in the year
D. Number of females of reproductive age
10. You will gather data for nutritional assessment of a purok. You will gather
information only from families with members who belong to the target
population for PEM. What method of data gathering is best for this purpose?

A. Census
B. Survey
C. Record review
D. Review of civil registry
11. In the conduct of a census, the method of population assignment based on
the actual physical location of the people is termed
 A. De jure
B. De locus
C. De facto
D. De novo
12. The Field Health Services and Information System (FHSIS) is the recording
and reporting system in public health care in the Philippines. The Monthly Field
Health Service Activity Report is a form used in which of the components of the
FHSIS?

A. Tally report
B. Output report
C. Target/client list
D. Individual health record
13. To monitor clients registered in long-term regimens, such as the Multi-Drug
Therapy, which component will be most useful?
N

A. Tally report
ex

B. Output report
C. Target/client list
tg

D. Individual health record

en

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

A. P.D. 651
B. Act 3573
se

C. R.A. 3753
D. R.A. 3375
15. Which of the following professionals can sign the birth certificate?

A. Public health nurse

B. Rural health midwife
C. Municipal health officer
D. Any of these health professionals
16. Which criterion in priority setting of health problems is used only in
community health care?

A. Modifiability of the problem

B. Nature of the problem presented
C. Magnitude of the health problem
D. Preventive potential of the health problem
17. The Sentrong Sigla Movement has been launched to improve health service
delivery. Which of the following is/are true of this movement?

A. This is a project spearheaded by local government units.

B. It is a basis for increasing funding from local government units.
C. It encourages health centers to focus on disease prevention and
control.
D. Its main strategy is certification of health centers able to comply with
standards.
18. Which of the following women should be considered as special targets for
family planning?

A. Those who have two children or more

B. Those with medical conditions such as anemia
C. Those younger than 20 years and older than 35 years
D. Those who just had a delivery within the past 15 months
N

19. Freedom of choice is one of the policies of the Family Planning Program of
ex

the Philippines. Which of the following illustrates this principle?

tg

A. Information dissemination about the need for family planning

en

B. Support of research and development in family planning methods

C. Adequate information for couples regarding the different methods
N

D. Encouragement of couples to take family planning as a joint

ur

responsibility
20. A woman, 6 months pregnant, came to the center for consultation. Which
se

of the following substances is contraindicated?

A. Tetanus toxoid
B. Retinol 200,000 IU
C. Ferrous sulfate 200 mg
D. Potassium iodate 200 mg. capsule
21. During prenatal consultation, a client asked you if she can have her delivery
at home. After history taking and physical examination, you advised her against
a home delivery. Which of the following findings disqualifies her for a home
delivery?

A. Her OB score is G5P3.

B. She has some palmar pallor.
C. Her blood pressure is 130/80.
D. Her baby is in cephalic presentation.
22. Inadequate intake by the pregnant woman of which vitamin may cause
neural tube defects?

A. Niacin
B. Riboflavin
C. Folic acid
D. Thiamine
23. You are in a client’s home to attend to a delivery. Which of the following will
you do first?

A. Set up the sterile area.

B. Put on a clean gown or apron.
C. Cleanse the client’s vulva with soap and water.
D. Note the interval, duration and intensity of labor contractions.
24. In preparing a primigravida for breastfeeding, which of the following will you
do?
N
ex

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

B. Teach her nipple stretching exercises if her nipples are everted.
tg

C. Instruct her to wash her nipples before and after each breastfeeding.
en

D. Explain to her that putting the baby to breast will lessen blood loss
after delivery.
N

25. A primigravida is instructed to offer her breast to the baby for the first time
ur

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

A. To initiate the occurrence of milk letdown

B. To stimulate milk production by the mammary acini
C. To make sure that the baby is able to get the colostrum
D. To allow the woman to practice breastfeeding in the presence of the
health worker
26. In a mothers’ class, you discuss proper breastfeeding technique. Which is
of these is a sign that the baby has “latched on” to the breast properly?

A. The baby takes shallow, rapid sucks.

B. The mother does not feel nipple pain.
C. The baby’s mouth is only partly open.
D. Only the mother’s nipple is inside the baby’s mouth.
27. You explain to a breastfeeding mother that breast milk is sufficient for all
of the baby’s nutrient needs only up to ____.
 A. 3 months
B. 6 months
C. 1 year
D. 2 years
28. What is given to a woman within a month after the delivery of a baby?

A. Malunggay capsule
B. Ferrous sulfate 100 mg. OD
C. Retinol 200,000 I.U., 1 capsule
D. Potassium iodate 200 mg, 1 capsule
29. Which biological used in Expanded Program on Immunization (EPI) is
stored in the freezer?

A. DPT
B. Tetanus toxoid
C. Measles vaccine
N

D. Hepatitis B vaccine
ex

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

A. 2
en

B. 4
C. 6
N

D. At the end of the day

ur

Answers and Rationales

se

1. Answer: (A) 265. To estimate the number of pregnant women,

multiply the total population by 3.5%.
2. Answer: (D) Any of these may be used. Sex ratio and sex proportion
are used to determine the sex composition of a population. A
population pyramid is used to present the composition of a
population by age and sex.
3. Answer: (A) Crude birth rate. Natality means birth. A natality rate is a
birth rate.
4. Answer: (B) 5.2/1,000. To compute crude death rate divide total
number of deaths (94) by total population (18,000) and multiply by
1,000.
5. Answer: (C) 1-4 year old children. Preschoolers are the most
susceptible to PEM because they have generally been weaned. Also,
this is the population who, unable to feed themselves, are often the
victims of poor intrafamilial food distribution.
6. Answer: (C) Swaroop’s index. Swaroop’s index is the proportion of
deaths aged 50 years and above. The higher the Swaroop’s index of
a population, the greater the proportion of the deaths who were able
to reach the age of at least 50 years, i.e., more people grew old before
they died.
7. Answer: (B) 43.5/1,000. To compute for neonatal mortality rate,
divide the number of babies who died before reaching the age of 28
days by the total number of live births, then multiply by 1,000.
8. Answer: (A) 1-4 year old age-specific mortality rate. Since
preschoolers are the most susceptible to the effects of malnutrition,
a population with poor nutritional status will most likely have a high
1-4 year old age-specific mortality rate, also known as child mortality
rate.
9. Answer: (B) Number of registered live births. To compute for general
or total fertility rate, divide the number of registered live births by the
number of females of reproductive age (15-45 years), then multiply
N

by 1,000.
ex

10. Answer: (B) Survey. A survey, also called sample survey, is data
tg

gathering about a sample of the population.

11. Answer: (C) De facto. The other method of population assignment,
en

de jure, is based on the usual place of residence of the people.

12. Answer: (A) Tally report. A tally report is prepared monthly or
N

quarterly by the RHU personnel and transmitted to the Provincial

ur

Health Office.
se

13. Answer: (C) Target/client list. The MDT Client List is a record of
clients enrolled in MDT and other relevant data, such as dates when
clients collected their monthly supply of drugs.
14. Answer: (A) P.D. 651. P.D. 651 amended R.A. 3753, requiring the
registry of births within 30 days from their occurrence.
15. Answer: (D) Any of these health professionals. D. R.A. 3753 states
that any birth attendant may sign the certificate of live birth.
16. Answer: (C) Magnitude of the health problem. Magnitude of the
problem refers to the percentage of the population affected by a
health problem. The other choices are criteria considered in both
family and community health care.
17. Answer: (D) Its main strategy is certification of health centers able
to comply with standards. Sentrong Sigla Movement is a joint project
of the DOH and local government units. Its main strategy is
 certification of health centers that are able to comply with standards
set by the DOH.
18. Answer: (D) Those who just had a delivery within the past 15
months. The ideal birth spacing is at least two years. 15 months plus
9 months of pregnancy = 2 years.
19. Answer: (C) Adequate information for couples regarding the
different methods. To enable the couple to choose freely among
different methods of family planning, they must be given full
information regarding the different methods that are available to
them, considering the availability of quality services that can support
their choice.
20. Answer: (B) Retinol 200,000 IU. Retinol 200,000 IU is a form of
megadose Vitamin A. This may have a teratogenic effect.
21. Answer: (A) Her OB score is G5P3. Only women with less than 5
pregnancies are qualified for a home delivery. It is also advisable for
a primigravida to have delivery at a childbirth facility.
N

22. Answer: (C) Folic acid. It is estimated that the incidence of neural
ex

tube defects can be reduced drastically if pregnant women have an

tg

adequate intake of folic acid.

23. Answer: (D) Note the interval, duration and intensity of labor
en

contractions.. Assessment of the woman should be done first to

determine whether she is having true labor and, if so, what stage of
N

labor she is in.

ur

24. Answer: (D) Explain to her that putting the baby to breast will lessen
blood loss after delivery. Suckling of the nipple stimulates the release
se

of oxytocin by the posterior pituitary gland, which causes uterine

contraction. Lactation begins 1 to 3 days after delivery. Nipple
stretching exercises are done when the nipples are flat or inverted.
Frequent washing dries up the nipples, making them prone to the
formation of fissures.
25. Answer: (B) To stimulate milk production by the mammary
acini. Suckling of the nipple stimulates prolactin reflex (the release of
prolactin by the anterior pituitary gland), which initiates lactation.
26. Answer: (B) The mother does not feel nipple pain.. When the baby
has properly latched on to the breast, he takes deep, slow sucks; his
mouth is wide open; and much of the areola is inside his mouth. And,
you’re right! The mother does not feel nipple pain.
27. Answer: (B) 6 months. After 6 months, the baby’s nutrient needs,
especially the baby’s iron requirement, can no longer be provided by
mother’s milk alone.
28. Answer: (C) Retinol 200,000 I.U., 1 capsule. A capsule of Retinol
200,000 IU is given within 1 month after delivery. Potassium iodate is
given during pregnancy; malunggay capsule is not routinely
administered after delivery; and ferrous sulfate is taken for two
months after delivery.
29. Answer: (C) Measles vaccine. Among the biologicals used in the
Expanded Program on Immunization, measles vaccine and OPV are
highly sensitive to heat, requiring storage in the freezer.
30. Answer: (B) 4. While the unused portion of other biologicals in EPI
may be given until the end of the day, only BCG is discarded 4 hours
after reconstitution. This is why BCG immunization is scheduled only
in the morning.
N
ex
tg
en
N
ur
se
Community Health Nursing Exam 4
1. In immunizing school entrants with BCG, you are not obliged to secure
parental consent. This is because of which legal document?

A. P.D. 996
B. R.A. 7846
C. Presidential Proclamation No. 6
D. Presidential Proclamation No. 46
2. Which immunization produces a permanent scar?

A. DPT
B. BCG
N

C. Measles vaccination
ex

D. Hepatitis B vaccination
3. A 4-week old baby was brought to the health center for his first immunization.
tg

Which can be given to him?

en

A. DPT1
B. OPV1
N

C. Infant BCG
ur

D. Hepatitis B vaccine 1
se

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

A. Seizures a day after DPT 1.

B. Fever for 3 days after DPT 1.
C. Abscess formation after DPT 1.
D. Local tenderness for 3 days after DPT 1.
5. A 2-month old infant was brought to the health center for immunization.
During assessment, the infant’s temperature registered at 38.1°C. Which is the
best course of action that you will take?

A. Go on with the infant’s immunizations.

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

A. 1 year
B. 3 years
C. 10 years
D. Lifetime
7. A 4-month old infant was brought to the health center because of cough. Her
respiratory rate is 42/minute. Using the Integrated Management of Child Illness
(IMCI) guidelines of assessment, her breathing is considered

A. Fast
B. Slow
C. Normal
D. Insignificant
8. Which of the following signs will indicate that a young child is suffering from
N

severe pneumonia?
ex

A. Dyspnea
tg

B. Wheezing
en

C. Fast breathing
D. Chest indrawing
N

9. Using IMCI guidelines, you classify a child as having severe pneumonia. What
ur

is the best management for the child?

se

A. Prescribe an antibiotic.
B. Refer him urgently to the hospital.
C. Instruct the mother to increase fluid intake.
D. Instruct the mother to continue breastfeeding.
10. A 5-month old infant was brought by his mother to the health center
because of diarrhea occurring 4 to 5 times a day. His skin goes back slowly
after a skin pinch and his eyes are sunken. Using the IMCI guidelines, you will
classify this infant in which category?

A. No signs of dehydration
B. Some dehydration
C. Severe dehydration
D. The data is insufficient.
11. Based on assessment, you classified a 3-month old infant with the chief
complaint of diarrhea in the category of SOME DEHYDRATION. Based on IMCI
management guidelines, which of the following will you do?

A. Bring the infant to the nearest facility where IV fluids can be given.
B. Supervise the mother in giving 200 to 400 ml. of Oresol in 4 hours.
C. Give the infant’s mother instructions on home management.
D. Keep the infant in your health center for close observation.
12. A mother is using Oresol in the management of diarrhea of her 3-year old
child. She asked you what to do if her child vomits. You will tell her to

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

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

13. A 1 ½ year old child was classified as having 3rd degree protein energy
ex

malnutrition, kwashiorkor. Which of the following signs will be most apparent

in this child?
tg
en

A. Voracious appetite
B. Wasting
N

C. Apathy
ur

D. Edema
14. Assessment of a 2-year old child revealed “baggy pants”. Using the IMCI
se

guidelines, how will you manage this child?

A. Refer the child urgently to a hospital for confinement.

B. Coordinate with the social worker to enroll the child in a feeding
program.
C. Make a teaching plan for the mother, focusing on menu planning for
her child.
D. Assess and treat the child for health problems like infections and
intestinal parasitism.
15. During the physical examination of a young child, what is the earliest sign
of xerophthalmia that you may observe?

A. Keratomalacia
B. Corneal opacity
C. Night blindness
 D. Conjunctival xerosis
16. To prevent xerophthalmia, young children are given Retinol capsule every 6
months. What is the dose given to preschoolers?

A. 10,000 IU
B. 20,000 IU
C. 100,000 IU
D. 200,000 IU
17. The major sign of iron deficiency anemia is pallor. What part is best
examined for pallor?

A. Palms
B. Nailbeds
C. Around the lips
D. Lower conjunctival sac
18. Food fortification is one of the strategies to prevent micronutrient
N

deficiency conditions. R.A. 8976 mandates fortification of certain food items.

ex

Which of the following is among these food items?

tg

A. Sugar
en

B. Bread
C. Margarine
N

D. Filled milk
ur

19. What is the best course of action when there is a measles epidemic in a
nearby municipality?
se

A. Give measles vaccine to babies aged 6 to 8 months.

B. Give babies aged 6 to 11 months one dose of 100,000 I.U. of Retinol
C. Instruct mothers to keep their babies at home to prevent disease
transmission.
D. Instruct mothers to feed their babies adequately to enhance their
babies’ resistance.
20. A mother brought her daughter, 4 years old, to the RHU because of cough
and colds. Following the IMCI assessment guide, which of the following is a
danger sign that indicates the need for urgent referral to a hospital?

A. Inability to drink
B. High grade fever
C. Signs of severe dehydration
D. Cough for more than 30 days
21. Management of a child with measles includes the administration of which
of the following?

A. Gentian violet on mouth lesions

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

A. Do a tourniquet test.
B. Ask where the family resides.
C. Get a specimen for blood smear.
D. Ask if the fever is present everyday.
23. The following are strategies implemented by the Department of Health to
N

prevent mosquito-borne diseases. Which of these is most effective in the

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control of Dengue fever?

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A. Stream seeding with larva-eating fish

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B. Destroying breeding places of mosquitoes

C. Chemoprophylaxis of non-immune persons going to endemic areas
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D. Teaching people in endemic areas to use chemically treated

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mosquito nets
24. Secondary prevention for malaria includes
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A. Planting of neem or eucalyptus trees

B. Residual spraying of insecticides at night
C. Determining whether a place is endemic or not
D. Growing larva-eating fish in mosquito breeding places
25. Scotch tape swab is done to check for which intestinal parasite?

A. Ascaris
B. Pinworm
C. Hookworm
D. Schistosoma
26. Which of the following signs indicates the need for sputum examination for
AFB?

A. Hematemesis
 B. Fever for 1 week
C. Cough for 3 weeks
D. Chest pain for 1 week
27. Which clients are considered targets for DOTS Category I?

A. Sputum negative cavitary cases

B. Clients returning after a default
C. Relapses and failures of previous PTB treatment regimens
D. Clients diagnosed for the first time through a positive sputum exam
28. To improve compliance to treatment, what innovation is being implemented
in DOTS?

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

B. Having the health worker or a responsible family member monitor
drug intake
C. Having the patient come to the health center every month to get his
N

medications
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D. Having a target list to check on whether the patient has collected his
monthly supply of drugs
tg

29. Diagnosis of leprosy is highly dependent on recognition of symptoms.

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Which of the following is an early sign of leprosy?

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A. Macular lesions
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B. Inability to close eyelids

C. Thickened painful nerves
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D. Sinking of the nosebridge

30. Which of the following clients should be classified as a case of
multibacillary leprosy?

A. 3 skin lesions, negative slit skin smear

B. 3 skin lesions, positive slit skin smear
C. 5 skin lesions, negative slit skin smear
D. 5 skin lesions, positive slit skin smear
Answers and Rationales
1. Answer: (A) P.D. 996. Presidential Decree 996, enacted in 1976,
made immunization in the EPI compulsory for children under 8 years
of age. Hepatitis B vaccination was made compulsory for the same
age group by R.A. 7846.
2. Answer: (B) BCG. BCG causes the formation of a superficial abscess,
which begins 2 weeks after immunization. The abscess heals without
treatment, with the formation of a permanent scar.
3. Answer: (C) Infant BCG. Infant BCG may be given at birth. All the
other immunizations mentioned can be given at 6 weeks of age.
4. Answer: (A) Seizures a day after DPT 1. Seizures within 3 days after
administration of DPT is an indication of hypersensitivity to pertussis
vaccine, a component of DPT. This is considered a specific
contraindication to subsequent doses of DPT.
5. Answer: (A) Go on with the infant’s immunizations. In the EPI, fever up
to 38.5°C is not a contraindication to immunization. Mild acute
respiratory tract infection, simple diarrhea and malnutrition are not
contraindications either.
6. Answer: (A) 1 year. The baby will have passive natural immunity by
placental transfer of antibodies. The mother will have active artificial
immunity lasting for about 10 years. 5 doses will give the mother
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lifetime protection.
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7. Answer: (C) Normal. In IMCI, a respiratory rate of 50/minute or more

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is fast breathing for an infant aged 2 to 12 months.

8. Answer: (D) Chest indrawing. In IMCI, chest indrawing is used as the
en

positive sign of dyspnea, indicating severe pneumonia.

9. Answer: (B) Refer him urgently to the hospital. Severe pneumonia
N

requires urgent referral to a hospital. Answers A, C and D are done for

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a client classified as having pneumonia.

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10. Answer: (B) Some dehydration. Using the assessment guidelines

of IMCI, a child (2 months to 5 years old) with diarrhea is classified
as having SOME DEHYDRATION if he shows 2 or more of the
following signs: restless or irritable, sunken eyes, the skin goes back
slow after a skin pinch.
11. Answer: (B) Supervise the mother in giving 200 to 400 ml. of Oresol
in 4 hours. In the IMCI management guidelines, SOME DEHYDRATION
is treated with the administration of Oresol within a period of 4 hours.
The amount of Oresol is best computed on the basis of the child’s
weight (75 ml/kg body weight). If the weight is unknown, the amount
of Oresol is based on the child’s age.
12. Answer: (D) Let the child rest for 10 minutes then continue giving
Oresol more slowly. If the child vomits persistently, that is, he vomits
everything that he takes in, he has to be referred urgently to a hospital.
Otherwise, vomiting is managed by letting the child rest for 10
 minutes and then continuing with Oresol administration. Teach the
mother to give Oresol more slowly.
13. Answer: (D) Edema. Edema, a major sign of kwashiorkor, is
caused by decreased colloidal osmotic pressure of the blood brought
about by hypoalbuminemia. Decreased blood albumin level is due a
protein-deficient diet.
14. Answer: (A) Refer the child urgently to a hospital for
confinement. “Baggy pants” is a sign of severe marasmus. The best
management is urgent referral to a hospital.
15. Answer: (D) Conjunctival xerosis. The earliest sign of Vitamin A
deficiency (xerophthalmia) is night blindness. However, this is a
functional change, which is not observable during physical
examination.The earliest visible lesion is conjunctival xerosis or
dullness of the conjunctiva due to inadequate tear production.
16. Answer: (D) 200,000 IU. Preschoolers are given Retinol 200,000 IU
every 6 months. 100,000 IU is given once to infants aged 6 to 12
N

months. The dose for pregnant women is 10,000 IU.

ex

17. Answer: (A) Palms. The anatomic characteristics of the palms

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allow a reliable and convenient basis for examination for pallor.

18. Answer: (A) Sugar. R.A. 8976 mandates fortification of rice, wheat
en

flour, sugar and cooking oil with Vitamin A, iron and/or iodine.
19. Answer: (A) Give measles vaccine to babies aged 6 to 8
N

months. Ordinarily, measles vaccine is given at 9 months of age.

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During an impending epidemic, however, one dose may be given to

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babies aged 6 to 8 months. The mother is instructed that the baby

needs another dose when the baby is 9 months old.
20. Answer: (A) Inability to drink. A sick child aged 2 months to 5
years must be referred urgently to a hospital if he/she has one or
more of the following signs: not able to feed or drink, vomits
everything, convulsions, abnormally sleepy or difficult to awaken.
21. Answer: (D) Retinol capsule regardless of when the last dose was
given. An infant 6 to 12 months classified as a case of measles is
given Retinol 100,000 IU; a child is given 200,000 IU regardless of
when the last dose was given.
22. Answer: (B) Ask where the family resides. Because malaria is
endemic, the first question to determine malaria risk is where the
client’s family resides. If the area of residence is not a known
endemic area, ask if the child had traveled within the past 6 months,
where he/she was brought and whether he/she stayed overnight in
that area.
23. Answer: (B) Destroying breeding places of mosquitoes. Aedes
aegypti, the vector of Dengue fever, breeds in stagnant, clear water.
Its feeding time is usually during the daytime. It has a cyclical pattern
of occurrence, unlike malaria which is endemic in certain parts of the
country.
24. Answer: (C) Determining whether a place is endemic or not. This is
diagnostic and therefore secondary level prevention. The other
choices are for primary prevention.
25. Answer: (B) Pinworm. Pinworm ova are deposited around the anal
orifice.
26. Answer: (C) Cough for 3 weeks. A client is considered a PTB
suspect when he has cough for 2 weeks or more, plus one or more of
the following signs: fever for 1 month or more; chest pain lasting for
2 weeks or more not attributed to other conditions; progressive,
unexplained weight loss; night sweats; and hemoptysis.
27. Answer: (D) Clients diagnosed for the first time through a positive
N

sputum exam. Category I is for new clients diagnosed by sputum

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examination and clients diagnosed to have a serious form of

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extrapulmonary tuberculosis, such as TB osteomyelitis.

28. Answer: (B) Having the health worker or a responsible family
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member monitor drug intake. Directly Observed Treatment Short

Course is so-called because a treatment partner, preferably a health
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worker accessible to the client, monitors the client’s compliance to

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the treatment.
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29. Answer: (C) Thickened painful nerves. The lesion of leprosy is not
macular. It is characterized by a change in skin color (either reddish
or whitish) and loss of sensation, sweating and hair growth over the
lesion. Inability to close the eyelids (lagophthalmos) and sinking of
the nosebridge are late symptoms.
30. Answer: (D) 5 skin lesions, positive slit skin smear. A multibacillary
leprosy case is one who has a positive slit skin smear and at least 5
skin lesions.
Community Health Nursing Exam 5
1. In the Philippines, which condition is the most frequent cause of death
associated with schistosomiasis?

A. Liver cancer
B. Liver cirrhosis
C. Bladder cancer
D. Intestinal perforation
2. What is the most effective way of controlling schistosomiasis in an endemic
area?

A. Use of molluscicides
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B. Building of foot bridges

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C. Proper use of sanitary toilets

D. Use of protective footwear, such as rubber boots
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3. When residents obtain water from an artesian well in the neighborhood, the
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level of this approved type of water facility is

A. I
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B. II
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C. III
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D. IV
4. For prevention of hepatitis A, you decided to conduct health education
activities. Which of the following is IRRELEVANT?

A. Use of sterile syringes and needles

B. Safe food preparation and food handling by vendors
C. Proper disposal of human excreta and personal hygiene
D. Immediate reporting of water pipe leaks and illegal water
connections
5. Which biological used in Expanded Program on Immunization (EPI) should
NOT be stored in the freezer?

A. DPT
B. Oral polio vaccine
C. Measles vaccine
 D. MMR
6. You will conduct outreach immunization in a barangay with a population of
about 1500. Estimate the number of infants in the barangay.

A. 45
B. 50
C. 55
D. 60
7. In Integrated Management of Childhood Illness, severe conditions generally
require urgent referral to a hospital. Which of the following severe conditions
DOES NOT always require urgent referral to a hospital?

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

8. A client was diagnosed as having Dengue fever. You will say that there is
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slow capillary refill when the color of the nailbed that you pressed does not
return within how many seconds?
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A. 3
B. 5
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C. 8
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D. 10
9. A 3-year old child was brought by his mother to the health center because of
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fever of 4-day duration. The child had a positive tourniquet test result. In the
absence of other signs, which is the most appropriate measure that the PHN
may carry out to prevent Dengue shock syndrome?

A. Insert an NGT and give fluids per NGT.

B. Instruct the mother to give the child Oresol.
C. Start the patient on intravenous fluids STAT.
D. Refer the client to the physician for appropriate management.
10. The pathognomonic sign of measles is Koplik’s spot. You may see Koplik’s
spot by inspecting the _____.

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

A. Viral conjunctivitis
B. Acute poliomyelitis
C. Diphtheria
D. Measles
12. Among children aged 2 months to 3 years, the most prevalent form of
meningitis is caused by which microorganism?

A. Hemophilus influenzae
B. Morbillivirus
C. Steptococcus pneumoniae
D. Neisseria meningitidis
13. Human beings are the major reservoir of malaria. Which of the following
strategies in malaria control is based on this fact?
N

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

14. The use of larvivorous fish in malaria control is the basis for which strategy
of malaria control?
N
ur

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

D. Zooprophylaxis
15. Mosquito-borne diseases are prevented mostly with the use of mosquito
control measures. Which of the following is NOT appropriate for malaria
control?

A. Use of chemically treated mosquito nets

B. Seeding of breeding places with larva-eating fish
C. Destruction of breeding places of the mosquito vector
D. Use of mosquito-repelling soaps, such as those with basil or
citronella
16. A 4-year old client was brought to the health center with the chief complaint
of severe diarrhea and the passage of “rice water” stools. The client is most
probably suffering from which condition?
 A. Giardiasis
B. Cholera
C. Amebiasis
D. Dysentery
17. In the Philippines, which specie of schistosoma is endemic in certain
regions?

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

condition will you suspect?

ex

A. Hepatitis A
tg

B. Hepatitis B
en

C. Tetanus
D. Leptospirosis
N

19. MWSS provides water to Manila and other cities in Metro Manila. This is an
ur

example of which level of water facility?

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A. I
B. II
C. III
D. IV
20. You are the PHN in the city health center. A client underwent screening for
AIDS using ELISA. His result was positive. What is the best course of action that
you may take?

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

risk behaviors.
B. Ask the client to be accompanied by a significant person before
revealing the result.
C. Refer the client to the physician since he is the best person to reveal
the result to the client.
 D. Refer the client for a supplementary test, such as Western blot, since
the ELISA result may be false.
21. Which is the BEST control measure for AIDS?

A. Being faithful to a single sexual partner

B. Using a condom during each sexual contact
C. Avoiding sexual contact with commercial sex workers
D. Making sure that one’s sexual partner does not have signs of AIDS
22. The most frequent causes of death among clients with AIDS are
opportunistic diseases. Which of the following opportunistic infections is
characterized by tonsillopharyngitis?

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

23. To determine possible sources of sexually transmitted infections, which is

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the BEST method that may be undertaken by the public health nurse?
tg

A. Contact tracing
en

B. Community survey
C. Mass screening tests
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D. Interview of suspects
ur

24. Antiretroviral agents, such as AZT, are used in the management of AIDS.
Which of the following is NOT an action expected of these drugs.
se

A. They prolong the life of the client with AIDS.

B. They reduce the risk of opportunistic infections
C. They shorten the period of communicability of the disease.
D. They are able to bring about a cure of the disease condition.
25. A barangay had an outbreak of German measles. To prevent congenital
rubella, what is the BEST advice that you can give to women in the first trimester
of pregnancy in the barangay?

A. Advice them on the signs of German measles.

B. Avoid crowded places, such as markets and moviehouses.
C. Consult at the health center where rubella vaccine may be given.
D. Consult a physician who may give them rubella immunoglobulin.
26. You were invited to be the resource person in a training class for food
handlers. Which of the following would you emphasize regarding prevention of
staphylococcal food poisoning?

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

B. Food must be cooked properly to destroy staphylococcal
microorganisms.
C. Food handlers and food servers must have a negative stool
examination result.
D. Proper handwashing during food preparation is the best way of
preventing the condition.
27. In a mothers’ class, you discussed childhood diseases such as chicken pox.
Which of the following statements about chicken pox is correct?

A. The older one gets, the more susceptible he becomes to the

complications of chicken pox.
N

B. A single attack of chicken pox will prevent future episodes, including

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conditions such as shingles.

C. To prevent an outbreak in the community, quarantine may be
tg

imposed by health authorities.

en

D. Chicken pox vaccine is best given when there is an impending

outbreak in the community.
N

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

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of clients?
se

A. Pregnant women
B. Elderly clients
C. Young adult males
D. Young infants
Answers and Rationales
1. Answer: (B) Liver cirrhosis. The etiologic agent of schistosomiasis in
the Philippines is Schistosoma japonicum, which affects the small
intestine and the liver. Liver damage is a consequence of fibrotic
reactions to schistosoma eggs in the liver.
2. Answer: (C) Proper use of sanitary toilets. The ova of the parasite get
out of the human body together with feces. Cutting the cycle at this
stage is the most effective way of preventing the spread of the
disease to susceptible hosts.
3. Answer: (B) II. A communal faucet or water standpost is classified
as Level II.
4. Answer: (A) Use of sterile syringes and needles. Hepatitis A is
transmitted through the fecal oral route. Hepatitis B is transmitted
through infected body secretions like blood and semen.
5. Answer: (A) DPT. DPT is sensitive to freezing. The appropriate
storage temperature of DPT is 2 to 8° C only. OPV and measles
vaccine are highly sensitive to heat and require freezing. MMR is not
an immunization in the Expanded Program on Immunization.
6. Answer: (A) 45. To estimate the number of infants, multiply total
population by 3%.
7. Answer: (B) Severe dehydration. The order of priority in the
management of severe dehydration is as follows: intravenous fluid
therapy, referral to a facility where IV fluids can be initiated within 30
minutes, Oresol/nasogastric tube, Oresol/orem. When the foregoing
measures are not possible or effective, tehn urgent referral to the
N

hospital is done.
ex

8. Answer: (A) 3. Adequate blood supply to the area allows the return
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of the color of the nailbed within 3 seconds.

9. Answer: (B) Instruct the mother to give the child Oresol. Since the
en

child does not manifest any other danger sign, maintenance of fluid
balance and replacement of fluid loss may be done by giving the
N

client Oresol.
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10. Answer: (B) Buccal mucosa. Koplik’s spot may be seen on the
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mucosa of the mouth or the throat.

11. Answer: (D) Measles. Viral conjunctivitis is transmitted by direct or
indirect contact with discharges from infected eyes. Acute
poliomyelitis is spread through the fecal-oral route and contact with
throat secretions, whereas diphtheria is through direct and indirect
contact with respiratory secretions.
12. Answer: (A) Hemophilus influenzae. Hemophilus meningitis is
unusual over the age of 5 years. In developing countries, the peak
incidence is in children less than 6 months of age. Morbillivirus is the
etiology of measles. Streptococcus pneumoniae and Neisseria
meningitidis may cause meningitis, but age distribution is not
specific in young children.
13. Answer: (D) Zooprophylaxis. Zooprophylaxis is done by putting
animals like cattle or dogs close to windows or doorways just before
nightfall. The Anopheles mosquito takes his blood meal from the
 animal and goes back to its breeding place, thereby preventing
infection of humans.
14. Answer: (A) Stream seeding. Stream seeding is done by putting
tilapia fry in streams or other bodies of water identified as breeding
places of the Anopheles mosquito
15. Answer: (C) Destruction of breeding places of the mosquito
vector. Anopheles mosquitoes breed in slow-moving, clear water,
such as mountain streams.
16. Answer: (B) Cholera. Passage of profuse watery stools is the
major symptom of cholera. Both amebic and bacillary dysentery are
characterized by the presence of blood and/or mucus in the stools.
Giardiasis is characterized by fat malabsorption and, therefore,
steatorrhea.
17. Answer: (B) S. japonicum. S. mansoni is found mostly in Africa and
South America; S. haematobium in Africa and the Middle East; and S.
malayensis only in peninsular Malaysia.
N

18. Answer: (D) Leptospirosis. Leptospirosis is transmitted through

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contact with the skin or mucous membrane with water or moist soil
tg

contaminated with urine of infected animals, like rats.

19. Answer: (C) III. Waterworks systems, such as MWSS, are
en

classified as level III.

20. Answer: (D) Refer the client for a supplementary test, such as
N

Western blot, since the ELISA result may be false. A client having a
ur

reactive ELISA result must undergo a more specific test, such as

Western blot. A negative supplementary test result means that the
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ELISA result was false and that, most probably, the client is not
infected.
21. Answer: (A) Being faithful to a single sexual partner. Sexual fidelity
rules out the possibility of getting the disease by sexual contact with
another infected person. Transmission occurs mostly through sexual
intercourse and exposure to blood or tissues.
22. Answer: (B) Infectious mononucleosis. Cytomegalovirus disease is
an acute viral disease characterized by fever, sore throat and
lymphadenopathy.
23. Answer: (A) Contact tracing. Contact tracing is the most practical
and reliable method of finding possible sources of person-to-person
transmitted infections, such as sexually transmitted diseases.
24. Answer: (D) They are able to bring about a cure of the disease
condition. There is no known treatment for AIDS. Antiretroviral agents
 reduce the risk of opportunistic infections and prolong life, but does
not cure the underlying immunodeficiency.
25. Answer: (D) Consult a physician who may give them rubella
immunoglobulin. Rubella vaccine is made up of attenuated German
measles viruses. This is contraindicated in pregnancy. Immune
globulin, a specific prophylactic against German measles, may be
given to pregnant women.
26. Answer: (D) Proper handwashing during food preparation is the
best way of preventing the condition. Symptoms of this food poisoning
are due to staphylococcal enterotoxin, not the microorganisms
themselves. Contamination is by food handling by persons with
staphylococcal skin or eye infections.
27. Answer: (A) The older one gets, the more susceptible he becomes to
the complications of chicken pox. Chicken pox is usually more severe
in adults than in children. Complications, such as pneumonia, are
higher in incidence in adults.
N

28. Answer: (C) Young adult males. Epididymitis and orchitis are
ex

possible complications of mumps. In post-adolescent males,

bilateral inflammation of the testes and epididymis may cause
tg

sterility.
en
N
ur
se
PNLE II for Community Health
Nursing and Care of the Mother and
Child

1. May arrives at the health care clinic and tells the nurse that her last menstrual
period was 9 weeks ago. She also tells the nurse that a home pregnancy test
was positive but she began to have mild cramps and is now having moderate
vaginal bleeding. During the physical examination of the client, the nurse notes
that May has a dilated cervix. The nurse determines that May is experiencing
N

which type of abortion?

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A. Inevitable
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B. Incomplete
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C. Threatened
D. Septic
N

2. Nurse Reese is reviewing the record of a pregnant client for her first prenatal
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visit. Which of the following data, if noted on the client’s record, would alert the
nurse that the client is at risk for a spontaneous abortion?
se

A. Age 36 years
B. History of syphilis
C. History of genital herpes
D. History of diabetes mellitus
3. Nurse Hazel is preparing to care for a client who is newly admitted to the
hospital with a possible diagnosis of ectopic pregnancy. Nurse Hazel develops
a plan of care for the client and determines that which of the following nursing
actions is the priority?
A. Monitoring weight
B. Assessing for edema
C. Monitoring apical pulse
D. Monitoring temperature
4. Nurse Oliver is teaching a diabetic pregnant client about nutrition and insulin
needs during pregnancy. The nurse determines that the client understands
dietary and insulin needs if the client states that the second half of pregnancy
require:
A. Decreased caloric intake
B. Increased caloric intake
C. Decreased Insulin
D. Increase Insulin
5. Nurse Michelle is assessing a 24 year old client with a diagnosis of
hydatidiform mole. She is aware that one of the following is unassociated with
this condition?
A. Excessive fetal activity.
B. Larger than normal uterus for gestational age.
C. Vaginal bleeding
N

D. Elevated levels of human chorionic gonadotropin.

ex

6. A pregnant client is receiving magnesium sulfate for severe pregnancy

induced hypertension (PIH). The clinical findings that would warrant use of the
tg

antidote , calcium gluconate is:

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A. Urinary output 90 cc in 2 hours.

B. Absent patellar reflexes.
N

C. Rapid respiratory rate above 40/min.

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D. Rapid rise in blood pressure.

se

7. During vaginal examination of Janah who is in labor, the presenting part is at

station plus two. Nurse, correctly interprets it as:
A. Presenting part is 2 cm above the plane of the ischial spines.
B. Biparietal diameter is at the level of the ischial spines.
C. Presenting part in 2 cm below the plane of the ischial spines.
D. Biparietal diameter is 2 cm above the ischial spines.
8. A pregnant client is receiving oxytocin (Pitocin) for induction of labor. A
condition that warrant the nurse in-charge to discontinue I.V. infusion of Pitocin
is:
A. Contractions every 1 ½ minutes lasting 70-80 seconds.
B. Maternal temperature 101.2
C. Early decelerations in the fetal heart rate.
D. Fetal heart rate baseline 140-160 bpm.
9. Calcium gluconate is being administered to a client with pregnancy induced
hypertension (PIH). A nursing action that must be initiated as the plan of care
throughout injection of the drug is:
A. Ventilator assistance
B. CVP readings
C. EKG tracings
D. Continuous CPR
10. A trial for vaginal delivery after an earlier caesareans, would likely to be
given to a gravida, who had:
A. First low transverse cesarean was for active herpes type 2 infections;
vaginal culture at 39 weeks pregnancy was positive.
B. First and second caesareans were for cephalopelvic disproportion.
C. First caesarean through a classic incision as a result of severe fetal
distress.
N

D. First low transverse caesarean was for breech position. Fetus in this
ex

pregnancy is in a vertex presentation.

11.Nurse Ryan is aware that the best initial approach when trying to take a
tg

crying toddler’s temperature is:

en

A. Talk to the mother first and then to the toddler.

B. Bring extra help so it can be done quickly.
N

C. Encourage the mother to hold the child.

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D. Ignore the crying and screaming.

se

12.Baby Tina a 3 month old infant just had a cleft lip and palate repair. What
should the nurse do to prevent trauma to operative site?
A. Avoid touching the suture line, even when cleaning.
B. Place the baby in prone position.
C. Give the baby a pacifier.
D. Place the infant’s arms in soft elbow restraints.
13. Which action should nurse Marian include in the care plan for a 2 month old
with heart failure?
A. Feed the infant when he cries.
B. Allow the infant to rest before feeding.
C. Bathe the infant and administer medications before feeding.
D. Weigh and bathe the infant before feeding.
14.Nurse Hazel is teaching a mother who plans to discontinue breast feeding
after 5 months. The nurse should advise her to include which foods in her
infant’s diet?
A. Skim milk and baby food.
B. Whole milk and baby food.
C. Iron-rich formula only.
D. Iron-rich formula and baby food.
15.Mommy Linda is playing with her infant, who is sitting securely alone on the
floor of the clinic. The mother hides a toy behind her back and the infant looks
for it. The nurse is aware that estimated age of the infant would be:
A. 6 months
B. 4 months
C. 8 months
D. 10 months
N

16.Which of the following is the most prominent feature of public health

ex

nursing?
tg

A. It involves providing home care to sick people who are not confined
in the hospital.
en

B. Services are provided free of charge to people within the catchments

area.
N

C. The public health nurse functions as part of a team providing a public

ur

health nursing services.

se

D. Public health nursing focuses on preventive, not curative, services.

17.When the nurse determines whether resources were maximized in
implementing Ligtas Tigdas, she is evaluating
A. Effectiveness
B. Efficiency
C. Adequacy
D. Appropriateness
18.Vangie is a new B.S.N. graduate. She wants to become a Public Health
Nurse. Where should she apply?
A. Department of Health
B. Provincial Health Office
C. Regional Health Office
D. Rural Health Unit
19.Tony is aware the Chairman of the Municipal Health Board is:
 A. Mayor
B. Municipal Health Officer
C. Public Health Nurse
D. Any qualified physician
20.Myra is the public health nurse in a municipality with a total population of
about 20,000. There are 3 rural health midwives among the RHU personnel.
How many more midwife items will the RHU need?
A. 1
B. 2
C. 3
D. The RHU does not need any more midwife item.
21.According to Freeman and Heinrich, community health nursing is a
developmental service. Which of the following best illustrates this statement?
A. The community health nurse continuously develops himself
N

personally and professionally.

ex

B. Health education and community organizing are necessary in

providing community health services.
tg

C. Community health nursing is intended primarily for health promotion

en

and prevention and treatment of disease.

D. The goal of community health nursing is to provide nursing services
to people in their own places of residence.
N

22.Nurse Tina is aware that the disease declared through Presidential

ur

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

se

A. Poliomyelitis
B. Measles
C. Rabies
D. Neonatal tetanus
23.May knows that the step in community organizing that involves training of
potential leaders in the community is:
A. Integration
B. Community organization
C. Community study
D. Core group formation
24.Beth a public health nurse takes an active role in community participation.
What is the primary goal of community organizing?
A. To educate the people regarding community health problems
 B. To mobilize the people to resolve community health problems
C. To maximize the community’s resources in dealing with health
problems.
D. To maximize the community’s resources in dealing with health
problems.
25.Tertiary prevention is needed in which stage of the natural history of
disease?
A. Pre-pathogenesis
B. Pathogenesis
C. Prodromal
D. Terminal
26.The nurse is caring for a primigravid client in the labor and delivery area.
Which condition would place the client at risk for disseminated intravascular
coagulation (DIC)?
N

A. Intrauterine fetal death.

ex

B. Placenta accreta.
C. Dysfunctional labor.
tg

D. Premature rupture of the membranes.

en

27.A fullterm client is in labor. Nurse Betty is aware that the fetal heart rate
would be:
N

A. 80 to 100 beats/minute
ur

B. 100 to 120 beats/minute

se

C. 120 to 160 beats/minute

D. 160 to 180 beats/minute
28.The skin in the diaper area of a 7 month old infant is excoriated and red.
Nurse Hazel should instruct the mother to:
A. Change the diaper more often.
B. Apply talc powder with diaper changes.
C. Wash the area vigorously with each diaper change.
D. Decrease the infant’s fluid intake to decrease saturating diapers.
29.Nurse Carla knows that the common cardiac anomalies in children with
Down Syndrome (tri-somy 21) is:
A. Atrial septal defect
B. Pulmonic stenosis
C. Ventricular septal defect
D. Endocardial cushion defect
30.Malou was diagnosed with severe preeclampsia is now receiving I.V.
magnesium sulfate. The adverse effects associated with magnesium sulfate
is:
A. Anemia
B. Decreased urine output
C. Hyperreflexia
D. Increased respiratory rate
31.A 23 year old client is having her menstrual period every 2 weeks that last
for 1 week. This type of menstrual pattern is bets defined by:
A. Menorrhagia
B. Metrorrhagia
C. Dyspareunia
D. Amenorrhea
32. Jannah is admitted to the labor and delivery unit. The critical laboratory
N

result for this client would be:

ex

A. Oxygen saturation
tg

B. Iron binding capacity

C. Blood typing
en

D. Serum Calcium
33.Nurse Gina is aware that the most common condition found during the
N

second-trimester of pregnancy is:

ur

A. Metabolic alkalosis
se

B. Respiratory acidosis
C. Mastitis
D. Physiologic anemia
34.Nurse Lynette is working in the triage area of an emergency department. She
sees that several pediatric clients arrive simultaneously. The client who needs
to be treated first is:
A. A crying 5 year old child with a laceration on his scalp.
B. A 4 year old child with a barking coughs and flushed appearance.
C. A 3 year old child with Down syndrome who is pale and asleep in his
mother’s arms.
D. A 2 year old infant with stridorous breath sounds, sitting up in
his mother’s arms and drooling.
35.Maureen in her third trimester arrives at the emergency room with painless
vaginal bleeding. Which of the following conditions is suspected?
 A. Placenta previa
B. Abruptio placentae
C. Premature labor
D. Sexually transmitted disease
36.A young child named Richard is suspected of having pinworms. The
community nurse collects a stool specimen to confirm the diagnosis. The nurse
should schedule the collection of this specimen for:
A. Just before bedtime
B. After the child has been bathe
C. Any time during the day
D. Early in the morning
37.In doing a child’s admission assessment, Nurse Betty should be alert to note
which signs or symptoms of chronic lead poisoning?
A. Irritability and seizures
N

B. Dehydration and diarrhea

ex

C. Bradycardia and hypotension

D. Petechiae and hematuria
tg

38.To evaluate a woman’s understanding about the use of diaphragm for family
en

planning, Nurse Trish asks her to explain how she will use the appliance. Which
response indicates a need for further health teaching?
N

A. “I should check the diaphragm carefully for holes every time I use it”
ur

B. “I may need a different size of diaphragm if I gain or lose weight more

se

than 20 pounds”
C. “The diaphragm must be left in place for atleast 6 hours after
intercourse”
D. “I really need to use the diaphragm and jelly most during the middle
of my menstrual cycle”.
39.Hypoxia is a common complication of laryngotracheobronchitis. Nurse
Oliver should frequently assess a child with laryngotracheobronchitis for:
A. Drooling
B. Muffled voice
C. Restlessness
D. Low-grade fever
40.How should Nurse Michelle guide a child who is blind to walk to the
playroom?
 A. Without touching the child, talk continuously as the child walks down
the hall.
B. Walk one step ahead, with the child’s hand on the nurse’s elbow.
C. Walk slightly behind, gently guiding the child forward.
D. Walk next to the child, holding the child’s hand.
41.When assessing a newborn diagnosed with ductus arteriosus, Nurse Olivia
should expect that the child most likely would have an:
A. Loud, machinery-like murmur.
B. Bluish color to the lips.
C. Decreased BP reading in the upper extremities
D. Increased BP reading in the upper extremities.
42.The reason nurse May keeps the neonate in a neutral thermal environment
is that when a newborn becomes too cool, the neonate requires:
A. Less oxygen, and the newborn’s metabolic rate increases.
N

B. More oxygen, and the newborn’s metabolic rate decreases.

ex

C. More oxygen, and the newborn’s metabolic rate increases.

D. Less oxygen, and the newborn’s metabolic rate decreases.
tg

43.Before adding potassium to an infant’s I.V. line, Nurse Ron must be sure to
en

assess whether this infant has:

A. Stable blood pressure
N

B. Patant fontanelles
ur

C. Moro’s reflex
D. Voided
se

44.Nurse Carla should know that the most common causative factor of
dermatitis in infants and younger children is:
A. Baby oil
B. Baby lotion
C. Laundry detergent
D. Powder with cornstarch
45.During tube feeding, how far above an infant’s stomach should the nurse
hold the syringe with formula?
A. 6 inches
B. 12 inches
C. 18 inches
D. 24 inches
46. In a mothers’ class, Nurse Lhynnete discussed childhood diseases such as
chicken pox. Which of the following statements about chicken pox is correct?
A. The older one gets, the more susceptible he becomes to the
complications of chicken pox.
B. A single attack of chicken pox will prevent future episodes, including
conditions such as shingles.
C. To prevent an outbreak in the community, quarantine may be
imposed by health authorities.
D. Chicken pox vaccine is best given when there is an impending
outbreak in the community.
47.Barangay Pinoy 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 Pinoy?
A. Advice them on the signs of German measles.
N

B. Avoid crowded places, such as markets and movie houses.

ex

C. Consult at the health center where rubella vaccine may be given.

D. Consult a physician who may give them rubella immunoglobulin.
tg

48.Myrna a public health nurse knows that to determine possible sources of

en

sexually transmitted infections, the BEST method that may be undertaken is:
A. Contact tracing
N

B. Community survey
ur

C. Mass screening tests

se

D. Interview of suspects
49.A 33-year old female client came for consultation at the health center with
the chief complaint of fever for a week. Accompanying symptoms were muscle
pains and body malaise. A week after the start of fever, the client noted
yellowish discoloration of his sclera. History showed that he waded in flood
waters about 2 weeks before the onset of symptoms. Based on her history,
which disease condition will you suspect?
A. Hepatitis A
B. Hepatitis B
C. Tetanus
D. Leptospirosis
50.Mickey a 3-year old client was brought to the health center with the chief
complaint of severe diarrhea and the passage of “rice water” stools. The client
is most probably suffering from which condition?
 A. Giardiasis
B. Cholera
C. Amebiasis
D. Dysentery
51.The most prevalent form of meningitis among children aged 2 months to 3
years is caused by which microorganism?
A. Hemophilus influenzae
B. Morbillivirus
C. Steptococcus pneumoniae
D. Neisseria meningitidis
52.The student nurse is aware that the pathognomonic sign of measles is
Koplik’s spot and you may see Koplik’s spot by inspecting the:
A. Nasal mucosa
B. Buccal mucosa
N

C. Skin on the abdomen

ex

D. Skin on neck
53.Angel was diagnosed as having Dengue fever. You will say that there is slow
tg

capillary refill when the color of the nailbed that you pressed does not return
en

within how many seconds?

A. 3 seconds
N

B. 6 seconds
ur

C. 9 seconds
se

D. 10 seconds
54.In Integrated Management of Childhood Illness, the nurse is aware that the
severe conditions generally require urgent referral to a hospital. Which of the
following severe conditions DOES NOT always require urgent referral to a
hospital?
A. Mastoiditis
B. Severe dehydration
C. Severe pneumonia
D. Severe febrile disease
55.Myrna a public health nurse will conduct outreach immunization in a
barangay Masay with a population of about 1500. The estimated number of
infants in the barangay would be:
A. 45 infants
B. 50 infants
 C. 55 infants
D. 65 infants
56.The community nurse is aware that the biological used in Expanded
Program on Immunization (EPI) should NOT be stored in the freezer?
A. DPT
B. Oral polio vaccine
C. Measles vaccine
D. MMR
57.It is the most effective way of controlling schistosomiasis in an endemic
area?
A. Use of molluscicides
B. Building of foot bridges
C. Proper use of sanitary toilets
D. Use of protective footwear, such as rubber boots
N

58.Several clients is newly admitted and diagnosed with leprosy. Which of the
ex

following clients should be classified as a case of multibacillary leprosy?

tg

A. 3 skin lesions, negative slit skin smear

B. 3 skin lesions, positive slit skin smear
en

C. 5 skin lesions, negative slit skin smear

D. 5 skin lesions, positive slit skin smear
N

59.Nurses are aware that diagnosis of leprosy is highly dependent on

ur

recognition of symptoms. Which of the following is an early sign of leprosy?

se

A. Macular lesions
B. Inability to close eyelids
C. Thickened painful nerves
D. Sinking of the nosebridge
60.Marie brought her 10 month old infant for consultation because of fever,
started 4 days prior to consultation. In determining malaria risk, what will you
do?
A. Perform a tourniquet test.
B. Ask where the family resides.
C. Get a specimen for blood smear.
D. Ask if the fever is present everyday.
61.Susie brought her 4 years old daughter to the RHU because of cough and
colds. Following the IMCI assessment guide, which of the following is a danger
sign that indicates the need for urgent referral to a hospital?
 A. Inability to drink
B. High grade fever
C. Signs of severe dehydration
D. Cough for more than 30 days
62.Jimmy a 2-year old child revealed “baggy pants”. As a nurse, using the IMCI
guidelines, how will you manage Jimmy?
A. Refer the child urgently to a hospital for confinement.
B. Coordinate with the social worker to enroll the child in a feeding
program.
C. Make a teaching plan for the mother, focusing on menu planning for
her child.
D. Assess and treat the child for health problems like infections and
intestinal parasitism.
63.Gina is using Oresol in the management of diarrhea of her 3-year old child.
She asked you what to do if her child vomits. As a nurse you will tell her to:
N
ex

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

B. Bring the child to the health center for intravenous fluid therapy.
tg

C. Bring the child to the health center for assessment by the physician.
en

D. Let the child rest for 10 minutes then continue giving Oresol more
slowly.
64.Nikki a 5-month old infant was brought by his mother to the health center
N

because of diarrhea for 4 to 5 times a day. Her skin goes back slowly after a
ur

skin pinch and her eyes are sunken. Using the IMCI guidelines, you will classify
se

this infant in which category?

A. No signs of dehydration
B. Some dehydration
C. Severe dehydration
D. The data is insufficient.
65.Chris a 4-month old infant was brought by her mother to the health center
because of cough. His respiratory rate is 42/minute. Using the Integrated
Management of Child Illness (IMCI) guidelines of assessment, his breathing is
considered as:
A. Fast
B. Slow
C. Normal
D. Insignificant
66.Maylene had just received her 4th dose of tetanus toxoid. She is aware that
her baby will have protection against tetanus for
A. 1 year
B. 3 years
C. 5 years
D. Lifetime
67.Nurse Ron is aware that unused BCG should be discarded after how many
hours of reconstitution?
A. 2 hours
B. 4 hours
C. 8 hours
D. At the end of the day
68.The nurse explains to a breastfeeding mother that breast milk is sufficient
for all of the baby’s nutrient needs only up to:
N

A. 5 months
ex

B. 6 months
tg

C. 1 year
D. 2 years
en

69.Nurse Ron is aware that the gestational age of a conceptus that is

considered viable (able to live outside the womb) is:
N
ur

A. 8 weeks
B. 12 weeks
se

C. 24 weeks
D. 32 weeks
70.When teaching parents of a neonate the proper position for the neonate’s
sleep, the nurse Patricia stresses the importance of placing the neonate on his
back to reduce the risk of which of the following?
A. Aspiration
B. Sudden infant death syndrome (SIDS)
C. Suffocation
D. Gastroesophageal reflux (GER)
71.Which finding might be seen in baby James a neonate suspected of having
an infection?
A. Flushed cheeks
B. Increased temperature
C. Decreased temperature
 D. Increased activity level
72.Baby Jenny who is small-for-gestation is at increased risk during the
transitional period for which complication?
A. Anemia probably due to chronic fetal hyposia
B. Hyperthermia due to decreased glycogen stores
C. Hyperglycemia due to decreased glycogen stores
D. Polycythemia probably due to chronic fetal hypoxia
73.Marjorie has just given birth at 42 weeks’ gestation. When the nurse
assessing the neonate, which physical finding is expected?
A. A sleepy, lethargic baby
B. Lanugo covering the body
C. Desquamation of the epidermis
D. Vernix caseosa covering the body
74.After reviewing the Myrna’s maternal history of magnesium sulfate during
N

labor, which condition would nurse Richard anticipate as a potential problem in

ex

the neonate?
tg

A. Hypoglycemia
B. Jitteriness
en

C. Respiratory depression
D. Tachycardia
N

75.Which symptom would indicate the Baby Alexandra was adapting

ur

appropriately to extra-uterine life without difficulty?

se

A. Nasal flaring
B. Light audible grunting
C. Respiratory rate 40 to 60 breaths/minute
D. Respiratory rate 60 to 80 breaths/minute
76. When teaching umbilical cord care for Jennifer a new mother, the nurse
Jenny would include which information?
A. Apply peroxide to the cord with each diaper change
B. Cover the cord with petroleum jelly after bathing
C. Keep the cord dry and open to air
D. Wash the cord with soap and water each day during a tub bath.
77.Nurse John is performing an assessment on a neonate. Which of the
following findings is considered common in the healthy neonate?
A. Simian crease
B. Conjunctival hemorrhage
 C. Cystic hygroma
D. Bulging fontanelle
78.Dr. Esteves decides to artificially rupture the membranes of a mother who is
on labor. Following this procedure, the nurse Hazel checks the fetal heart tones
for which the following reasons?
A. To determine fetal well-being.
B. To assess for prolapsed cord
C. To assess fetal position
D. To prepare for an imminent delivery.
79.Which of the following would be least likely to indicate anticipated bonding
behaviors by new parents?
A. The parents’ willingness to touch and hold the new born.
B. The parent’s expression of interest about the size of the new born.
C. The parents’ indication that they want to see the newborn.
N

D. The parents’ interactions with each other.

ex

80.Following a precipitous delivery, examination of the client’s vagina reveals

tg

a fourth-degree laceration. Which of the following would be contraindicated

when caring for this client?
en

A. Applying cold to limit edema during the first 12 to 24 hours.

N

B. Instructing the client to use two or more peripads to cushion the area.
ur

C. Instructing the client on the use of sitz baths if ordered.

D. Instructing the client about the importance of perineal (kegel)
se

exercises.
81. A pregnant woman accompanied by her husband, seeks admission to the
labor and delivery area. She states that she’s in labor and says she attended the
facility clinic for prenatal care. Which question should the nurse Oliver ask her
first?
A. “Do you have any chronic illnesses?”
B. “Do you have any allergies?”
C. “What is your expected due date?”
D. “Who will be with you during labor?”
82.A neonate begins to gag and turns a dusky color. What should the nurse do
first?
A. Calm the neonate.
B. Notify the physician.
 C. Provide oxygen via face mask as ordered
D. Aspirate the neonate’s nose and mouth with a bulb syringe.
83. When a client states that her “water broke,” which of the following actions
would be inappropriate for the nurse to do?
A. Observing the pooling of straw-colored fluid.
B. Checking vaginal discharge with nitrazine paper.
C. Conducting a bedside ultrasound for an amniotic fluid index.
D. Observing for flakes of vernix in the vaginal discharge.
84. A baby girl is born 8 weeks premature. At birth, she has no spontaneous
respirations but is successfully resuscitated. Within several hours she develops
respiratory grunting, cyanosis, tachypnea, nasal flaring, and retractions. She’s
diagnosed with respiratory distress syndrome, intubated, and placed on a
ventilator. Which nursing action should be included in the baby’s plan of care
to prevent retinopathy of prematurity?
N

A. Cover his eyes while receiving oxygen.

ex

B. Keep her body temperature low.

C. Monitor partial pressure of oxygen (Pao2) levels.
tg

D. Humidify the oxygen.

en

85. Which of the following is normal newborn calorie intake?

A. 110 to 130 calories per kg.
N

B. 30 to 40 calories per lb of body weight.

ur

C. At least 2 ml per feeding

se

D. 90 to 100 calories per kg

86. Nurse John is knowledgeable that usually individual twins will grow
appropriately and at the same rate as singletons until how many weeks?
A. 16 to 18 weeks
B. 18 to 22 weeks
C. 30 to 32 weeks
D. 38 to 40 weeks
87. Which of the following classifications applies to monozygotic twins for
whom the cleavage of the fertilized ovum occurs more than 13 days after
fertilization?
A. conjoined twins
B. diamniotic dichorionic twins
C. diamniotic monochorionic twin
D. monoamniotic monochorionic twins
88. Tyra experienced painless vaginal bleeding has just been diagnosed as
having a placenta previa. Which of the following procedures is usually
performed to diagnose placenta previa?
A. Amniocentesis
B. Digital or speculum examination
C. External fetal monitoring
D. Ultrasound
89. Nurse Arnold knows that the following changes in respiratory functioning
during pregnancy is considered normal:
A. Increased tidal volume
B. Increased expiratory volume
C. Decreased inspiratory capacity
D. Decreased oxygen consumption
90. Emily has gestational diabetes and it is usually managed by which of the
N

following therapy?
ex

A. Diet
tg

B. Long-acting insulin
C. Oral hypoglycemic
en

D. Oral hypoglycemic drug and insulin

91. Magnesium sulfate is given to Jemma with preeclampsia to prevent which
N

of the following condition?

ur

A. Hemorrhage
se

B. Hypertension
C. Hypomagnesemia
D. Seizure
92. Cammile with sickle cell anemia has an increased risk for having a sickle
cell crisis during pregnancy. Aggressive management of a sickle cell crisis
includes which of the following measures?
A. Antihypertensive agents
B. Diuretic agents
C. I.V. fluids
D. Acetaminophen (Tylenol) for pain
93. Which of the following drugs is the antidote for magnesium toxicity?
A. Calcium gluconate (Kalcinate)
B. Hydralazine (Apresoline)
C. Naloxone (Narcan)
 D. Rho (D) immune globulin (RhoGAM)
94. Marlyn is screened for tuberculosis during her first prenatal visit. An
intradermal injection of purified protein derivative (PPD) of the tuberculin bacilli
is given. She is considered to have a positive test for which of the following
results?
A. An indurated wheal under 10 mm in diameter appears in 6 to 12
hours.
B. An indurated wheal over 10 mm in diameter appears in 48 to 72
hours.
C. A flat circumcised area under 10 mm in diameter appears in 6 to 12
hours.
D. A flat circumcised area over 10 mm in diameter appears in 48 to 72
hours.
95. Dianne, 24 year-old is 27 weeks’ pregnant arrives at her physician’s office
with complaints of fever, nausea, vomiting, malaise, unilateral flank pain, and
N

costovertebral angle tenderness. Which of the following diagnoses is most

ex

likely?
tg

A. Asymptomatic bacteriuria
en

B. Bacterial vaginosis
C. Pyelonephritis
N

D. Urinary tract infection (UTI)

ur

96. Rh isoimmunization in a pregnant client develops during which of the

following conditions?
se

A. Rh-positive maternal blood crosses into fetal blood, stimulating

fetal antibodies.
B. Rh-positive fetal blood crosses into maternal blood,
stimulating maternal antibodies.
C. Rh-negative fetal blood crosses into maternal blood,
stimulating maternal antibodies.
D. Rh-negative maternal blood crosses into fetal blood, stimulating
fetal antibodies.
97. To promote comfort during labor, the nurse John advises a client to assume
certain positions and avoid others. Which position may cause maternal
hypotension and fetal hypoxia?
A. Lateral position
B. Squatting position
 C. Supine position
D. Standing position
98. Celeste who used heroin during her pregnancy delivers a neonate. When
assessing the neonate, the nurse Lhynnette expects to find:
A. Lethargy 2 days after birth.
B. Irritability and poor sucking.
C. A flattened nose, small eyes, and thin lips.
D. Congenital defects such as limb anomalies.
99. The uterus returns to the pelvic cavity in which of the following time frames?
A. 7th to 9th day postpartum.
B. 2 weeks postpartum.
C. End of 6th week postpartum.
D. When the lochia changes to alba.
100. Maureen, a primigravida client, age 20, has just completed a difficult,
N

forceps-assisted delivery of twins. Her labor was unusually long and required
ex

oxytocin (Pitocin) augmentation. The nurse who’s caring for her should stay
alert for:
tg

A. Uterine inversion
en

B. Uterine atony
C. Uterine involution
N

D. Uterine discomfort
ur

Answers and Rationales

se

1. Answer: (A) Inevitable. An inevitable abortion is termination of

pregnancy that cannot be prevented. Moderate to severe bleeding
with mild cramping and cervical dilation would be noted in this type
of abortion.
2. Answer: (B) History of syphilis. Maternal infections such as syphilis,
toxoplasmosis, and rubella are causes of spontaneous abortion.
3. Answer: (C) Monitoring apical pulse. Nursing care for the client with a
possible ectopic pregnancy is focused on preventing or identifying
hypovolemic shock and controlling pain. An elevated pulse rate is an
indicator of shock.
4. Answer: (B) Increased caloric intake. Glucose crosses the placenta,
but insulin does not. High fetal demands for glucose, combined with
the insulin resistance caused by hormonal changes in the last half of
pregnancy can result in elevation of maternal blood glucose levels.
 This increases the mother’s demand for insulin and is referred to as
the diabetogenic effect of pregnancy.
5. Answer: (A) Excessive fetal activity. The most common signs and
symptoms of hydatidiform mole includes elevated levels of human
chorionic gonadotropin, vaginal bleeding, larger than normal uterus
for gestational age, failure to detect fetal heart activity even with
sensitive instruments, excessive nausea and vomiting, and early
development of pregnancy-induced hypertension. Fetal activity
would not be noted.
6. Answer: (B) Absent patellar reflexes. Absence of patellar reflexes is
an indicator of hypermagnesemia, which requires administration of
calcium gluconate.
7. Answer: (C) Presenting part in 2 cm below the plane of the ischial
spines. Fetus at station plus two indicates that the presenting part is
2 cm below the plane of the ischial spines.
8. Answer: (A) Contractions every 1 ½ minutes lasting 70-80
N

seconds. Contractions every 1 ½ minutes lasting 70-80 seconds,

ex

is indicative of hyperstimulation of the uterus, which could result in

tg

injury to the mother and the fetus if Pitocin is not discontinued.

9. Answer: (C) EKG tracings. A potential side effect of calcium
en

gluconate administration is cardiac arrest. Continuous monitoring of

cardiac activity (EKG) throught administration of calcium gluconate
N

is an essential part of care.

ur

10. Answer: (D) First low transverse caesarean was for breech position.
Fetus in this pregnancy is in a vertex presentation. This type of client
se

has no obstetrical indication for a caesarean section as she did with

her first caesarean delivery.
11. Answer: (A) Talk to the mother first and then to the toddler. When
dealing with a crying toddler, the best approach is to talk to the
mother and ignore the toddler first. This approach helps the toddler
get used to the nurse before she attempts any procedures. It also
gives the toddler an opportunity to see that the mother trusts the
nurse.
12. Answer: (D) Place the infant’s arms in soft elbow restraints. Soft
restraints from the upper arm to the wrist prevent the infant from
touching her lip but allow him to hold a favorite item such as a
blanket. Because they could damage the operative site, such as
objects as pacifiers, suction catheters, and small spoons shouldn’t
be placed in a baby’s mouth after cleft repair. A baby in a prone
position may rub her face on the sheets and traumatize the operative
 site. The suture line should be cleaned gently to prevent infection,
which could interfere with healing and damage the cosmetic
appearance of the repair.
13. Answer: (B) Allow the infant to rest before feeding. Because
feeding requires so much energy, an infant with heart failure should
rest before feeding.
14. Answer: (C) Iron-rich formula only. The infants at age 5 months
should receive iron-rich formula and that they shouldn’t receive solid
food, even baby food until age 6 months.
15. Answer: (D) 10 months. A 10 month old infant can sit alone and
understands object permanence, so he would look for the hidden toy.
At age 4 to 6 months, infants can’t sit securely alone. At age 8
months, infants can sit securely alone but cannot understand the
permanence of objects.
16. Answer: (D) Public health nursing focuses on preventive, not
curative, services. The catchments area in PHN consists of a
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residential community, many of whom are well individuals who have

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greater need for preventive rather than curative services.

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17. Answer: (B) Efficiency. Efficiency is determining whether the goals

were attained at the least possible cost.
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18. Answer: (D) Rural Health Unit. R.A. 7160 devolved basic health
services to local government units (LGU’s ). The public health nurse
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is an employee of the LGU.

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19. Answer: (A) Mayor. The local executive serves as the chairman of
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the Municipal Health Board.

20. Answer: (A) 1. Each rural health midwife is given a population
assignment of about 5,000.
21. Answer: (B) Health education and community organizing are
necessary in providing community health services. The community
health nurse develops the health capability of people through health
education and community organizing activities.
22. Answer: (B) Measles. Presidential Proclamation No. 4 is on the
Ligtas Tigdas Program.
23. Answer: (D) Core group formation. In core group formation, the
nurse is able to transfer the technology of community organizing to
the potential or informal community leaders through a training
program.
24. Answer: (D) To maximize the community’s resources in dealing with
health problems. Community organizing is a developmental service,
with the goal of developing the people’s self-reliance in dealing with
 community health problems. A, B and C are objectives of contributory
objectives to this goal.
25. Answer: (D) Terminal. Tertiary prevention involves rehabilitation,
prevention of permanent disability and disability limitation
appropriate for convalescents, the disabled, complicated cases and
the terminally ill (those in the terminal stage of a disease).
26. Answer: (A) Intrauterine fetal death. Intrauterine fetal death,
abruptio placentae, septic shock, and amniotic fluid embolism may
trigger normal clotting mechanisms; if clotting factors are depleted,
DIC may occur. Placenta accreta, dysfunctional labor, and premature
rupture of the membranes aren’t associated with DIC.
27. Answer: (C) 120 to 160 beats/minute. A rate of 120 to 160
beats/minute in the fetal heart appropriate for filling the heart with
blood and pumping it out to the system.
28. Answer: (A) Change the diaper more often. Decreasing the amount
of time the skin comes contact with wet soiled diapers will help heal
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the irritation.
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29. Answer: (D) Endocardial cushion defect. Endocardial cushion

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defects are seen most in children with Down syndrome, asplenia, or

polysplenia.
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30. Answer: (B) Decreased urine output. Decreased urine output may
occur in clients receiving I.V. magnesium and should be monitored
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closely to keep urine output at greater than 30 ml/hour, because

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magnesium is excreted through the kidneys and can easily

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accumulate to toxic levels.

31. Answer: (A) Menorrhagia. Menorrhagia is an excessive menstrual
period.
32. Answer: (C) Blood typing. Blood type would be a critical value to
have because the risk of blood loss is always a potential complication
during the labor and delivery process. Approximately 40% of a
woman’s cardiac output is delivered to the uterus, therefore, blood
loss can occur quite rapidly in the event of uncontrolled bleeding.
33. Answer: (D) Physiologic anemia. Hemoglobin values and
hematocrit decrease during pregnancy as the increase in plasma
volume exceeds the increase in red blood cell production.
34. Answer: (D) A 2 year old infant with stridorous breath sounds,
sitting up in his mother’s arms and drooling. The infant with the airway
emergency should be treated first, because of the risk of epiglottitis.
35. Answer: (A) Placenta previa. Placenta previa with painless vaginal
bleeding.
36. Answer: (D) Early in the morning. Based on the nurse’s knowledge
of microbiology, the specimen should be collected early in the
morning. The rationale for this timing is that, because the female
worm lays eggs at night around the perineal area, the first bowel
movement of the day will yield the best results. The specific type of
stool specimen used in the diagnosis of pinworms is called the tape
test.
37. Answer: (A) Irritability and seizures. Lead poisoning primarily
affects the CNS, causing increased intracranial pressure. This
condition results in irritability and changes in level of consciousness,
as well as seizure disorders, hyperactivity, and learning disabilities.
38. Answer: (D) “I really need to use the diaphragm and jelly most
during the middle of my menstrual cycle”. The woman must
understand that, although the “fertile” period is approximately mid-
cycle, hormonal variations do occur and can result in early or late
ovulation. To be effective, the diaphragm should be inserted before
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every intercourse.
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39. Answer: (C) Restlessness. In a child, restlessness is the earliest

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sign of hypoxia. Late signs of hypoxia in a child are associated with a

change in color, such as pallor or cyanosis.
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40. Answer: (B) Walk one step ahead, with the child’s hand on the
nurse’s elbow. This procedure is generally recommended to follow in
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guiding a person who is blind.

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41. Answer: (A) Loud, machinery-like murmur. A loud, machinery-like

murmur is a characteristic finding associated with patent ductus
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arteriosus.
42. Answer: (C) More oxygen, and the newborn’s metabolic rate
increases. When cold, the infant requires more oxygen and there is an
increase in metabolic rate. Non-shievering thermogenesis is a
complex process that increases the metabolic rate and rate of
oxygen consumption, therefore, the newborn increase heat
production.
43. Answer: (D) Voided. Before administering potassium I.V. to any
client, the nurse must first check that the client’s kidneys are
functioning and that the client is voiding. If the client is not voiding,
the nurse should withhold the potassium and notify the physician.
44. Answer: (C) Laundry detergent. Eczema or dermatitis is an allergic
skin reaction caused by an offending allergen. The topical allergen
that is the most common causative factor is laundry detergent.
45. Answer: (A) 6 inches. This distance allows for easy flow of the
formula by gravity, but the flow will be slow enough not to overload
the stomach too rapidly.
46. 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.
47. Answer: (D) Consult a physician who may give them rubella
immunoglobulin. Rubella vaccine is made up of attenuated German
measles viruses. This is contraindicated in pregnancy. Immune
globulin, a specific prophylactic against German measles, may be
given to pregnant women.
48. 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.
49. Answer: (D) Leptospirosis. Leptospirosis is transmitted through
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contact with the skin or mucous membrane with water or moist soil
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contaminated with urine of infected animals, like rats.

50. Answer: (B) Cholera. Passage of profuse watery stools is the
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major symptom of cholera. Both amebic and bacillary dysentery are

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characterized by the presence of blood and/or mucus in the stools.

Giardiasis is characterized by fat malabsorption and, therefore,
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steatorrhea.
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51. Answer: (A) Hemophilus influenzae. Hemophilus meningitis is

unusual over the age of 5 years. In developing countries, the peak
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incidence is in children less than 6 months of age. Morbillivirus is the

etiology of measles. Streptococcus pneumoniae and Neisseria
meningitidis may cause meningitis, but age distribution is not
specific in young children.
52. Answer: (B) Buccal mucosa. Koplik’s spot may be seen on the
mucosa of the mouth or the throat.
53. Answer: (A) 3 seconds. Adequate blood supply to the area allows
the return of the color of the nailbed within 3 seconds.
54. Answer: (B) Severe dehydration. The order of priority in the
management of severe dehydration is as follows: intravenous fluid
therapy, referral to a facility where IV fluids can be initiated within 30
minutes, Oresol or nasogastric tube. When the foregoing measures
are not possible or effective, then urgent referral to the hospital is
done.
55. Answer: (A) 45 infants. To estimate the number of infants, multiply
total population by 3%.
56. Answer: (A) DPT. DPT is sensitive to freezing. The appropriate
storage temperature of DPT is 2 to 8° C only. OPV and measles
vaccine are highly sensitive to heat and require freezing. MMR is not
an immunization in the Expanded Program on Immunization.
57. Answer: (C) Proper use of sanitary toilets. The ova of the parasite
get out of the human body together with feces. Cutting the cycle at
this stage is the most effective way of preventing the spread of the
disease to susceptible hosts.
58. 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.
59. 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
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lesion. Inability to close the eyelids (lagophthalmos) and sinking of

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the nosebridge are late symptoms.

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60. Answer: (B) Ask where the family resides. Because malaria is
endemic, the first question to determine malaria risk is where the
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client’s family resides. If the area of residence is not a known

endemic area, ask if the child had traveled within the past 6 months,
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where she was brought and whether she stayed overnight in that
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area.
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61. Answer: (A) Inability to drink. A sick child aged 2 months to 5

years must be referred urgently to a hospital if he/she has one or
more of the following signs: not able to feed or drink, vomits
everything, convulsions, abnormally sleepy or difficult to awaken.
62. Answer: (A) Refer the child urgently to a hospital for
confinement. “Baggy pants” is a sign of severe marasmus. The best
management is urgent referral to a hospital.
63. Answer: (D) Let the child rest for 10 minutes then continue giving
Oresol more slowly. If the child vomits persistently, that is, he vomits
everything that he takes in, he has to be referred urgently to a hospital.
Otherwise, vomiting is managed by letting the child rest for 10
minutes and then continuing with Oresol administration. Teach the
mother to give Oresol more slowly.
64. Answer: (B) Some dehydration. Using the assessment guidelines
of IMCI, a child (2 months to 5 years old) with diarrhea is classified
as having SOME DEHYDRATION if he shows 2 or more of the
 following signs: restless or irritable, sunken eyes, the skin goes back
slow after a skin pinch.
65. Answer: (C) Normal. In IMCI, a respiratory rate of 50/minute or
more is fast breathing for an infant aged 2 to 12 months.
66. Answer: (A) 1 year. The baby will have passive natural immunity by
placental transfer of antibodies. The mother will have active artificial
immunity lasting for about 10 years. 5 doses will give the mother
lifetime protection.
67. Answer: (B) 4 hours. While the unused portion of other biologicals
in EPI may be given until the end of the day, only BCG is discarded 4
hours after reconstitution. This is why BCG immunization is
scheduled only in the morning.
68. Answer: (B) 6 months. After 6 months, the baby’s nutrient needs,
especially the baby’s iron requirement, can no longer be provided by
mother’s milk alone.
69. Answer: (C) 24 weeks. At approximately 23 to 24 weeks’ gestation,
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the lungs are developed enough to sometimes maintain extrauterine

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life. The lungs are the most immature system during the gestation
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period. Medical care for premature labor begins much earlier

(aggressively at 21 weeks’ gestation)
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70. Answer: (B) Sudden infant death syndrome (SIDS). Supine

positioning is recommended to reduce the risk of SIDS in infancy. The
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risk of aspiration is slightly increased with the supine position.

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Suffocation would be less likely with an infant supine than prone and
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the position for GER requires the head of the bed to be elevated.
71. Answer: (C) Decreased temperature. Temperature instability,
especially when it results in a low temperature in the neonate, may be
a sign of infection. The neonate’s color often changes with an
infection process but generally becomes ashen or mottled. The
neonate with an infection will usually show a decrease in activity level
or lethargy.
72. Answer: (D) Polycythemia probably due to chronic fetal
hypoxia. The small-for-gestation neonate is at risk for developing
polycythemia during the transitional period in an attempt to
decreasehypoxia. The neonates are also at increased risk for
developing hypoglycemia and hypothermia due to decreased
glycogen stores.
73. Answer: (C) Desquamation of the epidermis. Postdate fetuses lose
the vernix caseosa, and the epidermis may become desquamated.
 These neonates are usually very alert. Lanugo is missing in the
postdate neonate.
74. Answer: (C) Respiratory depression. Magnesium sulfate crosses
the placenta and adverse neonatal effects are respiratory depression,
hypotonia, and bradycardia. The serum blood sugar isn’t affected by
magnesium sulfate. The neonate would be floppy, not jittery.
75. Answer: (C) Respiratory rate 40 to 60 breaths/minute. A respiratory
rate 40 to 60 breaths/minute is normal for a neonate during the
transitional period. Nasal flaring, respiratory rate more than 60
breaths/minute, and audible grunting are signs of respiratory
distress.
76. Answer: (C) Keep the cord dry and open to air. Keeping the cord dry
and open to air helps reduce infection and hastens drying. Infants
aren’t given tub bath but are sponged off until the cord falls off.
Petroleum jelly prevents the cord from drying and encourages
infection. Peroxide could be painful and isn’t recommended.
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77. Answer: (B) Conjunctival hemorrhage. Conjunctival hemorrhages

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are commonly seen in neonates secondary to the cranial pressure

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applied during the birth process. Bulging fontanelles are a sign of

intracranial pressure. Simian creases are present in 40% of the
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neonates with trisomy 21. Cystic hygroma is a neck mass that can
affect the airway.
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78. Answer: (B) To assess for prolapsed cord. After a client has an
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amniotomy, the nurse should assure that the cord isn’t prolapsed and
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that the baby tolerated the procedure well. The most effective way to
do this is to check the fetal heart rate. Fetal well-being is assessed
via a nonstress test. Fetal position is determined by vaginal
examination. Artificial rupture of membranes doesn’t indicate an
imminent delivery.
79. Answer: (D) The parents’ interactions with each other. Parental
interaction will provide the nurse with a good assessment of the
stability of the family’s home life but it has no indication for parental
bonding. Willingness to touch and hold the newborn, expressing
interest about the newborn’s size, and indicating a desire to see the
newborn are behaviors indicating parental bonding.
80. Answer: (B) Instructing the client to use two or more peripads to
cushion the area. Using two or more peripads would do little to reduce
the pain or promote perineal healing. Cold applications, sitz baths,
and Kegel exercises are important measures when the client has a
fourth-degree laceration.
81. Answer: (C) “What is your expected due date?” When obtaining the
history of a client who may be in labor, the nurse’s highest priority is
to determine her current status, particularly her due date, gravidity,
and parity. Gravidity and parity affect the duration of labor and the
potential for labor complications. Later, the nurse should ask about
chronic illnesses, allergies, and support persons.
82. Answer: (D) Aspirate the neonate’s nose and mouth with a bulb
syringe. The nurse’s first action should be to clear the neonate’s
airway with a bulb syringe. After the airway is clear and the neonate’s
color improves, the nurse should comfort and calm the neonate. If the
problem recurs or the neonate’s color doesn’t improve readily, the
nurse should notify the physician. Administering oxygen when the
airway isn’t clear would be ineffective.
83. Answer: (C) Conducting a bedside ultrasound for an amniotic fluid
index. It isn’t within a nurse’s scope of practice to perform and
interpret a bedside ultrasound under these conditions and
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without specialized training. Observing for pooling of straw-colored

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fluid, checking vaginal discharge with nitrazine paper, and observing

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for flakes of vernix are appropriate assessments for determining

whether a client has ruptured membranes.
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84. Answer: (C) Monitor partial pressure of oxygen (Pao2)

levels. Monitoring PaO2 levels and reducing the oxygen concentration
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to keep PaO2 within normal limits reduces the risk of retinopathy of

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prematurity in a premature infant receiving oxygen. Covering the

infant’s eyes and humidifying the oxygen don’t reduce the risk of
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retinopathy of prematurity. Because cooling increases the risk of

acidosis, the infant should be kept warm so that his respiratory
distress isn’t aggravated.
85. Answer: (A) 110 to 130 calories per kg. Calories per kg is the
accepted way of determined appropriate nutritional intake for a
newborn. The recommended calorie requirement is 110 to 130
calories per kg of newborn body weight. This level will maintain a
consistent blood glucose level and provide enough calories for
continued growth and development.
86. Answer: (C) 30 to 32 weeks. Individual twins usually grow at the
same rate as singletons until 30 to 32 weeks’ gestation, then twins
don’t’ gain weight as rapidly as singletons of the same gestational
age. The placenta can no longer keep pace with the nutritional
requirements of both fetuses after 32 weeks, so there’s some growth
retardation in twins if they remain in utero at 38 to 40 weeks.
87. Answer: (A) conjoined twins. The type of placenta that develops in
monozygotic twins depends on the time at which cleavage of the
ovum occurs. Cleavage in conjoined twins occurs more than 13 days
after fertilization. Cleavage that occurs less than 3 day after
fertilization results in diamniotic dicchorionic twins. Cleavage that
occurs between days 3 and 8 results in diamniotic monochorionic
twins. Cleavage that occurs between days 8 to 13 result in
monoamniotic monochorionic twins.
88. Answer: (D) Ultrasound. Once the mother and the fetus are
stabilized, ultrasound evaluation of the placenta should be done to
determine the cause of the bleeding. Amniocentesis is
contraindicated in placenta previa. A digital or speculum examination
shouldn’t be done as this may lead to severe bleeding or hemorrhage.
External fetal monitoring won’t detect a placenta previa, although it
will detect fetal distress, which may result from blood loss or
placenta separation.
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89. Answer: (A) Increased tidal volume. A pregnant client breathes

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deeper, which increases the tidal volume of gas moved in and out of
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the respiratory tract with each breath. The expiratory volume and
residual volume decrease as the pregnancy progresses. The
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inspiratory capacity increases during pregnancy. The increased

oxygen consumption in the pregnant client is 15% to 20% greater than
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in the nonpregnant state.

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90. Answer: (A) Diet. Clients with gestational diabetes are usually
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managed by diet alone to control their glucose intolerance. Oral

hypoglycemic drugs are contraindicated in pregnancy. Long-acting
insulin usually isn’t needed for blood glucose control in the client with
gestational diabetes.
91. Answer: (D) Seizure. The anticonvulsant mechanism of
magnesium is believes to depress seizure foci in the brain and
peripheral neuromuscular blockade. Hypomagnesemia isn’t a
complication of preeclampsia. Antihypertensive drug other than
magnesium are preferred for sustained hypertension. Magnesium
doesn’t help prevent hemorrhage in preeclamptic clients.
92. Answer: (C) I.V. fluids. A sickle cell crisis during pregnancy is
usually managed by exchange transfusion oxygen, and L.V. Fluids.
The client usually needs a stronger analgesic than acetaminophen to
control the pain of a crisis. Antihypertensive drugs usually aren’t
necessary. Diuretic wouldn’t be used unless fluid overload resulted.
93. Answer: (A) Calcium gluconate (Kalcinate). Calcium gluconate is
the antidote for magnesium toxicity. Ten milliliters of 10% calcium
gluconate is given L.V. push over 3 to 5 minutes. Hydralazine is given
for sustained elevated blood pressure in preeclamptic clients. Rho (D)
immune globulin is given to women with Rh-negative blood to prevent
antibody formation from RH-positive conceptions. Naloxone is used
to correct narcotic toxicity.
94. Answer: (B) An indurated wheal over 10 mm in diameter appears in
48 to 72 hours. A positive PPD result would be an indurated wheal
over 10 mm in diameter that appears in 48 to 72 hours. The area must
be a raised wheal, not a flat circumcised area to be considered
positive.
95. Answer: (C) Pyelonephritis. The symptoms indicate acute
pyelonephritis, a serious condition in a pregnant client. UTI symptoms
include dysuria, urgency, frequency, and suprapubic tenderness.
Asymptomatic bacteriuria doesn’t cause symptoms. Bacterial
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vaginosis causes milky white vaginal discharge but no systemic

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symptoms.
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96. Answer: (B) Rh-positive fetal blood crosses into maternal blood,
stimulating maternal antibodies. Rh isoimmunization occurs when Rh-
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positive fetal blood cells cross into the maternal circulation and
stimulate maternal antibody production. In subsequent pregnancies
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with Rh-positive fetuses, maternal antibodies may cross back into the
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fetal circulation and destroy the fetal blood cells.

97. Answer: (C) Supine position. The supine position causes
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compression of the client’s aorta and inferior vena cava by the fetus.
This, in turn, inhibits maternal circulation, leading to maternal
hypotension and, ultimately, fetal hypoxia. The other positions
promote comfort and aid labor progress. For instance, the lateral, or
side-lying, position improves maternal and fetal circulation, enhances
comfort, increases maternal relaxation, reduces muscle tension, and
eliminates pressure points. The squatting position promotes comfort
by taking advantage of gravity. The standing position also takes
advantage of gravity and aligns the fetus with the pelvic angle.
98. Answer: (B) Irritability and poor sucking. Neonates of heroin-
addicted mothers are physically dependent on the drug and
experience withdrawal when the drug is no longer supplied. Signs of
heroin withdrawal include irritability, poor sucking, and restlessness.
Lethargy isn’t associated with neonatal heroin addiction. A flattened
nose, small eyes, and thin lips are seen in infants with fetal alcohol
 syndrome. Heroin use during pregnancy hasn’t been linked to specific
congenital anomalies.
99. Answer: (A) 7th to 9th day postpartum. The normal involutional
process returns the uterus to the pelvic cavity in 7 to 9 days. A
significant involutional complication is the failure of the uterus to
return to the pelvic cavity within the prescribed time period. This is
known as subinvolution.
100. Answer: (B) Uterine atony. Multiple fetuses, extended labor
stimulation with oxytocin, and traumatic delivery commonly are
associated with uterine atony, which may lead to postpartum
hemorrhage. Uterine inversion may precede or follow delivery and
commonly results from apparent excessive traction on the umbilical
cord and attempts to deliver the placenta manually. Uterine involution
and some uterine discomfort are normal after delivery.
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