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?
A. The service is provided in the natural environment
of people
B. The nurse has to conduct community diagnosis to
determine nursing needs and problems
C. The service are based on the available resources
within the community
D. Priority setting is based on the magnitude of the
health problems identified
3. Population- focused nursing practice requires
which of the following processes?
A. Community organizing .
B. Nursing, process
C. Community diagnosis
D. Epidemiologic process
4. 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

B. Physician employed by the factory

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. Swaroops index
D. Case fatality rate
11. Which of the following is the most prominent
feature of public health nursing?
A. It involves providing home care to sick people who
are not confined in the hospital
B. Services are provided free of charge to people
within the catchment area
C. The public health nurse functions as part of a team
providing a public health nursing service
D. Public health nursing focuses on preventive, not
curative services

5. A business firm must employ an occupational

health nurse when it has at least how many
employees.

12. According to Margaret Shetland, the philosophy

of public health nursing is based on which of the
following?

A. 21
B. 101
C. 201
D. 301

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

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. Environment manager
7. A garment factory does not have an occupational
nurse. Who shall provide the occupational health
needs of the factory workers?
A. Occupational health nurse at the Provincial Health
Office

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
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 nurses health
care provider function?
A. Requesting for BCG from the RHU for school
entrance immunization
B. Conducting random classroom inspection during
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 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 selfreliance
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 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?
A. 1
B. 2
C. 3
D. 4
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 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?
A. Pioliomyelitis
B. Measles
C. Rabies
D. Neonatal Tetanus

29. The public health nurse is responsible for

presenting the municipal health statistics using
graphs and tables. To compare the frequency of the
leading causes of mortality in the municipality, which
graph will you prepare?
A. Line
B. Bar
C. Pie
D. Scatter diagram
30. Which step in community organizing involves
training of potential leaders in the community?
A. Integration
B. Community organization
C. Community study
D. Core group formation
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
C. To maximize the communitys resources in dealing
with health problems
33. An indicator of success in community organizing
is when people are able to:
A. Participate in community activities for the solution
of a community problem
B. Implement activities for the solution of the
community problem
C. Plan activities for the solution of the community
problem
D. Identify the health problem as a common concern
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
B. Group conferences
C. Home visit
D. Written communication
38. The typology of family nursing problems is used
in the statement of nursing diagnosis in the care of
families. The youngest child of the delos Reyes family
has been diagnosed as mentally retarded. This is
classified as:
A. Health threat
B. Health deficit
C. Foreseeable crisis
D. Stress point
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 familys 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
C. A home visit should be conducted in the manner
prescribed by RHU
D. Planning of continuing care should involve a
responsible-family member
42. The PHN bag is an important tool in providing
nursing care during a home visit. The most important
principle in bag technique states that it;
A. Should save time and effort
B. Should minimize if not totally prevent the spread
of infection
C. Should not overshadow concern for the patient
and his family
D. May be done in variety of ways depending on the
home situation, etc.
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 members, as much as
possible, use only articles taken from the bag

C. Put on an apron to protect her uniform and fold it

with the right side out before putting it back into the
bag.
D. At the end of the visit, fold the lining on which the
bag was placed, ensuring that the contaminated side
is on the outside.

D. Appraisal of facts

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. Epidemic occurrence
B. Cyclical variation
C. Sporadic occurrence
D. Secular occurrence

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
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
46. Which of the following is an epidemiologic
function of the nurse during an epidemic?
A Conducting assessment of suspected cases to
detect the communicable diseases
B. Monitoring the condition of the cases affected by
the communicable disease
C. Participating in the investigation to determine the
source of epidemic
D. Teaching the community on preventive measures
against the disease
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

50. 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;

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. 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
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
B. Letter of Instruction No 949
C. Presidential Decree No. 147
D. Presidential Decree 996
59. Which of the following demonstrates intersectoral linkages?
A. Two-way referral system
B. Team approach
C. Endorsement done by a midwife to another
midwife
D. Cooperation between 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.

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. Swaroops index
D. Crude death rate
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 recorded stillbirths. What is the
neonatal mortality rate?
A. 27.8/1000
B. 43.5/1000
C. 86.9/1000
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. Swaroops index
69. What numerator is used in computing general
fertility rate?

A. 265
B. 300
C. 375
D. 400

A. Estimated midyear population

B. Number of registered live births
C. Number of pregnancies in the year
D. Number of females of reproductive age

62. To describe the sex composition of the

population, which demographic tool may be used?

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. Sex ratio
B. Sex proportion
C. Population pyramid
D. Any of these maybe used
63. Which of the following is a natality rate?
A. Crude birth rate
B. Neonatal mortality rate
C. Infant mortality rate
D. General fertility rate
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

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 actual physical
location of the people is termed;
A. De jure
B. De locus
C. De facto
D. De novo
72. 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

80. A woman, 6 months pregnant, came to the center

for consultation. Which of the following substances is
contraindicated?

73. To monitor clients registered in long-term

regimens, such as the Multi-Drug Therapy, which
component will be most useful?

A. Tetanus toxoid
B. Retinol 200,000 IU
C. Ferrous sulfate 200mg
D. Potassium iodate 200 mg, capsule

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
B. Rural health midwife
C. Municipal health officer
D. Any of these health professionals
76. 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
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
C. Adequate information for couples regarding the
different methods
D. Encouragement of couples to take family planning
as a joint responsibility

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 clients home to attend to a delivery.
Which of the following will you do first?
A. Set up a sterile area
B. Put on a clean gown and apron
C. Cleanse the clients vulva with soap and water
D. Note the interval, duration and intensity of labor
and contractions
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
B. Teach her nipple stretching exercises if her nipples
are everted
C. Instruct her to wash her nipples before and after
each breastfeeding
D. Explain to her that putting the baby to breast will
lessen blood loss after delivery
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 mothers 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 babys mouth is only partly open
D. Only the mothers nipple is inside the babys
mouth

87. You explain to a breastfeeding mother that

breastmilk is sufficient for all of the babys nutrient
needs only up to:
A. 3 months
B. 6 months
C. 1 year
D. 2 years
88. What is given to a woman within a month after
the delivery of a baby?
A. Malunggay capsule
B. Ferrous sutfate l00mg O.D.
C. Retinol 200.000 IU 1 capsule
D. Potassium Iodate 200 mg, 1 capsule
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
C. Measles vaccination
D. Hepatitis B vaccination
93. A 4 week old baby was brought to the health
center for his first immunization. Which can be given
to him?
A. DPT1
B. OPV1
C. Infant BCG
D. Hepatitis B Vaccin
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
infants 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 infants 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
B. 3 years
C. 10 years
D. Lifetime
97. A 4-month old infant was brought to the health
center of cough. Her respiratory rate is 42/minute.
Using the IMCI guidelines of assessment, her
breathing is considered;
A. Fast
B. Slow
C. Normal
D. Insignificant
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
B. Some dehydration
C. Severe dehydration
D. The data is insufficient
101. Based on the assessment, you classified a 3month old infant with the chief complaint of diarrhea
in the category of SOME DEHYDRATION. Based on the
IMCI management guidelines, which of the following
will you do?
A. Bring the infant to the nearest facility where IV
fluids can be given
B. Supervise the mother in giving 200 to 400 ml of
Oresol in 4 hours
C. Give the infants 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?
A. Refer the child urgently to a hospital for
confinement
B. Coordinate with the social worker to enroll the
child in a feeding program
C. Make a teaching plan for the mother, focusing on
the menu planning for her child
D. Assess and treat the child for health problems like
infections and intestinal parasitism
105. During the physical examination of a young
child, what is the earliest sign of xerophthalmia that
may observe?
A. Keratomalacia
B. Corneal opacity
C. Night blindness
D. Conjunctival xerosis
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

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
C. Get a specimen for blood smear
D. Ask if the fever is present everyday
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?
A. Stream seeding with larva-eating fish
B. Destroying breeding places of mosquitoes
C. Chemoprophylaxis of non-immune persons going
to endemic areas
D. Teaching people in endemic areas to use
chemically treated mosquito nets
114. Secondary prevention for malaria includes?

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
B. Bread
C. Margarine
D. Filled milk
109. What is the best course of action when there is
a measles epidemic in a nearby municipality?
A. Give measles vaccine to babies aged 6 to 3
months
B. Give babies aged 6 to 11 months one dose of
100,000 IU of Retinol

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?

A. Sputum negative cavitary cases

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

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

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

126. You will conduct outreach immunization in a

barangay with a population of about 1500. Estimate
the number of infants in the barangay.

119. Diagnosis of leprosy is highly dependent on

recognition of symptoms. Which of the following is an
early sign of leprosy?

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. 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
C. Bladder cancer
D. Intestinal perforation
122. What is the most effective way of controlling
schistosomiasis in an endemic area?
A. Use of molluscicides
B. Building of foot bridges
C. Proper use of sanitary toilets
D. Use of protective footwear, such as rubber boots
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

A. 45
B. 50
C. 55
D. 60

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
D. Refer the client to the physician for appropriate
management
130. The pathognomonic sign of measles is Kopliks
spot. You may see Kopliks spot by inspecting the:
A. Nasal Mucosa
B. Buccal mucosa
C. Skin on the abdomen
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?
A. Stream seeding
B. Stream clearing
C. Destruction of breeding places
D. Zooprophylaxis .
135. 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

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

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?

143. To determine the possible sources of sexually

transmitted infections, which is the BEST method
that may be undertaken by the public health nurse?

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

A. Contact tracing
B. Community survey
C. Mass screening tests
D. Interview suspects

137. In the Philippines, which specie of schistosoma

is endemic in certain regions?

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. 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?
A. Hepatitis A
B. Hepatitis B
C. Tetanus
D. Leptospirosis
139. MWSS provides water to Manila and other cities
in Metro Manila. This is an example of which level of
water facility?
A. I
B. II
C. III
D. IV

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

1. Answer: (B) To enhance the capacity of individuals,

families and communities to cope with their health
needs.
To contribute to national development through
promotion of family welfare, focusing particularly on
mothers and children.
2. Answer: (B) The nurse has to conduct community
diagnosis to determine nursing needs and problems.
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 workers 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) Swaroops index
Swaroops 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 Shetlands
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 outpatient 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 (LGUs). 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 LGUs.
20. Answer: (A) Mayor
The local executive serves as the chairman of the
Municipal Health Board.
21. Answer: (A) Primary
The entry of a person into the health care delivery
system is usually through a consultation in outpatient services.
22. Answer: (B) Providing technical guidance to the
midwife
The nurse provides technical guidance to the midwife
in the care of clients, particularly in the
implementation of management guidelines, as in
Integrated Management of Childhood Illness.
23. Answer: (C) Municipal Health Officer
A public health nurse and rural health midwife can
provide care during normal childbirth. A physician
should attend to a woman with a complication during
labor.
24. Answer: (A) 1
Each rural health midwife is given a population
assignment of about 5,000.
25. Answer: (D) Municipal Health Board
As mandated by R.A. 7160, basic health services
have been devolved from the national government to
local government units.
26. Answer: (A) Act 3573
Act 3573, the Law on Reporting of Communicable
Diseases, enacted in 1929, mandated the reporting
of diseases listed in the law to the nearest health
station.
27. Answer: (B) Health education and community
organizing are necessary in providing community
health services.
The community health nurse develops the health
capability of people through health education and
community organizing activities.
28. Answer: (B) Measles
Presidential Proclamation No. 4 is on the Ligtas
Tigdas Program.

29. Answer: (B) Bar

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

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 familys needs and
the resources available to the nurse and the family.

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.

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.

31. 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.

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
familys resources, which is encouraged in CHN.
Choices C and D goes against the principle of asepsis
of confining the contaminated surface of objects.

32. Answer: (D) To maximize the communitys

resources in dealing with health problems
Community organizing is a developmental service,
with the goal of developing the peoples 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 familys natural environment, which
is the home.
38. Answer: (B) Health deficit
Failure of a family member to develop according to
what is expected, as in mental retardation, is a
health deficit.
39. Answer: (C) Foreseeable crisis
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.
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.

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
Epidemiology is the study of patterns of occurrence
and distribution of disease in the community, as well
as the factors that affect disease patterns. The
purpose of an epidemiologic investigation is to
identify the source of an epidemic, i.e., what brought
about the epidemic.
47. Answer: (A) Delineate the etiology of the
epidemic
Delineating the etiology of an epidemic is identifying
its source.
48. 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.
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
Sambong is used as a diuretic. Tsaang gubat is used
to relieve diarrhea. Akapulko is used for its antifungal
property.
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
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 December 9, 1997.
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
To compute crude death rate divide total number of
deaths (94) by total population (18,000) and multiply
by 1,000.
65. 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.

66. Answer: (C) Swaroops index

Swaroops index is the proportion of deaths aged 50
years and above. The higher the Swaroops 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 Provincial
Health Office.
73. 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.
74. Answer: (A) P.D. 651
P.D. 651 amended R.A. 3753, requiring the registry of
births within 30 days from their occurrence.
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
It is estimated that the incidence of neural tube
defects can be reduced drastically if pregnant women
have an adequate intake of folic acid.
83. Answer: (D) Note the interval, duration and
intensity of labor contractions.
Assessment of the woman should be done first to
determine whether she is having true labor and, if so,
what stage of labor she is in.
84. Answer: (D) Explain to her that putting the baby
to breast will lessen blood loss after delivery.
Suckling of the nipple stimulates the release of
oxytocin by the posterior pituitary gland, which
causes uterine contraction. Lactation begins 1 to 3
days after delivery. Nipple stretching exercises are
done when the nipples are flat or inverted. Frequent
washing dries up the nipples, making them prone to
the formation of fissures.
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,
youre right! The mother does not feel nipple pain.
87. Answer: (B) 6 months
After 6 months, the babys nutrient needs, especially
the babys iron requirement, can no longer be
provided by mothers 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 is

discarded 4 hours after reconstitution. This is why

BCG immunization is scheduled only in the morning.
91. 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.
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 infants
immunizations.
In the EPI, fever up to 38.5C 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.
99. Answer: (B) Refer him urgently to the hospital.
Severe pneumonia requires urgent referral to a
hospital. Answers A, C and D are done for a client
classified as having pneumonia.
100. 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.
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 childs
weight (75 ml/kg body weight). If the weight is
unknown, the amount of Oresol is based on the
childs 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.
107. Answer: (A) Palms
The anatomic characteristics of the palms allow a
reliable and convenient basis for examination for
pallor.
108. Answer: (A) Sugar
R.A. 8976 mandates fortification of rice, wheat flour,
sugar and cooking oil with Vitamin A, iron and/or
iodine.
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 clients 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.
115. Answer: (B) Pinworm
Pinworm ova are deposited around the anal orifice.
116. 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.
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 socalled because a treatment partner, preferably a
health worker accessible to the client, monitors the
clients 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.
124. 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.

125. 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.
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
Kopliks 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. Streptococcus pneumoniae
and Neisseria meningitidis may cause meningitis, but
age distribution is not specific in young children.
133. 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.
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, the client is
not infected.
141. 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.
142. Answer: (B) Infectious mononucleosis
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-toperson 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.