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PNLE: Community Health Nursing Exam 5 (PM)
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Question 1
Human beings are the major reservoir of malaria. Which of the following strategies in malaria control is based on this fact?
A
Stream clearing
B
Stream seeding
C
Zooprophylaxis
D
Destruction of breeding places
Question 1 Explanation:
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.
Question 2
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
Consult at the health center where rubella vaccine may be given.
B
Consult a physician who may give them rubella immunoglobulin.
C
Avoid crowded places, such as markets and moviehouses.
D
Advice them on the signs of German measles.
Question 2 Explanation:
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.
Question 3
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
8
B
10
C
5
D
3
Question 3 Explanation:
Adequate blood supply to the area allows the return of the color of the nailbed within 3 seconds.
Question 4
Among the following diseases, which is airborne?
A
Diphtheria
B
Measles
C
Acute poliomyelitis
D
Viral conjunctivitis
Question 4 Explanation:
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.
Question 5
You will conduct outreach immunization in a barangay with a population of about 1500. Estimate the number of infants in the barangay.
A
50
B
60
C
55
D
45
Question 5 Explanation:
To estimate the number of infants, multiply total population by 3%.
Question 6
In a mothers’ class, you discussed childhood diseases such as chicken pox. Which of the following statements about chicken pox is correct?
A
To prevent an outbreak in the community, quarantine may be imposed by health authorities.
B
The older one gets, the more susceptible he becomes to the complications of chicken pox.
C
A single attack of chicken pox will prevent future episodes, including conditions such as shingles.
D
Chicken pox vaccine is best given when there is an impending outbreak in the community.
Question 6 Explanation:
Chicken pox is usually more severe in adults than in children. Complications, such as pneumonia, are higher in incidence in adults.
Question 7
The use of larvivorous fish in malaria control is the basis for which strategy of malaria control?
A
Stream seeding
B
Zooprophylaxis
C
Destruction of breeding places
D
Stream clearing
Question 7 Explanation:
Stream seeding is done by putting tilapia fry in streams or other bodies of water identified as breeding places of the Anopheles mosquito
Question 8
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 reduce the risk of opportunistic infections
B
They prolong the life of the client with AIDS.
C
They are able to bring about a cure of the disease condition.
D
They shorten the period of communicability of the disease.
Question 8 Explanation:
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.
Question 9
The most frequent causes of death among clients with AIDS are opportunistic diseases. Which of the following opportunistic infections is characterized by tonsillopharyngitis?
A
Infectious mononucleosis
B
Cytomegalovirus disease
C
Pneumocystis carinii pneumonia
D
Respiratory candidiasis
Question 9 Explanation:
Cytomegalovirus disease is an acute viral disease characterized by fever, sore throat and lymphadenopathy.
Question 10
The pathognomonic sign of measles is Koplik’s spot. You may see Koplik’s spot by inspecting the _____.
A
Buccal mucosa
B
Skin on the abdomen
C
Nasal mucosa
D
Skin on the antecubital surface
Question 10 Explanation:
Koplik’s spot may be seen on the mucosa of the mouth or the throat.
Question 11
MWSS provides water to Manila and other cities in Metro Manila. This is an example of which level of water facility?
A
II
B
I
C
III
D
IV
Question 11 Explanation:
Waterworks systems, such as MWSS, are classified as level III.
Question 12
Which is the BEST control measure for AIDS?
A
Making sure that one’s sexual partner does not have signs of AIDS
B
Being faithful to a single sexual partner
C
Avoiding sexual contact with commercial sex workers
D
Using a condom during each sexual contact
Question 12 Explanation:
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.
Question 13
In the Philippines, which specie of schistosoma is endemic in certain regions?
A
S. japonicum
B
S. haematobium
C
S. mansoni
D
S. malayensis
Question 13 Explanation:
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.
Question 14
Complications to infectious parotitis (mumps) may be serious in which type of clients?
A
Elderly clients
B
Young adult males
C
Pregnant women
D
Young infants
Question 14 Explanation:
Epididymitis and orchitis are possible complications of mumps. In post-adolescent males, bilateral inflammation of the testes and epididymis may cause sterility.
Question 15
A 32-year old client came for consultation at the health center with the chief complaint of fever for a week. Accompanying symptoms were muscle pains and body malaise. A week after the start of fever, the client noted yellowish discoloration of his sclera. History showed that he waded in flood waters about 2 weeks before the onset of symptoms. Based on his history, which disease condition will you suspect?
A
Hepatitis B
B
Hepatitis A
C
Tetanus
D
Leptospirosis
Question 15 Explanation:
Leptospirosis is transmitted through contact with the skin or mucous membrane with water or moist soil contaminated with urine of infected animals, like rats.
Question 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
Cholera
B
Giardiasis
C
Amebiasis
D
Dysentery
Question 16 Explanation:
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.
Question 17
Among children aged 2 months to 3 years, the most prevalent form of meningitis is caused by which microorganism?
A
Steptococcus pneumoniae
B
Hemophilus influenzae
C
Neisseria meningitidis
D
Morbillivirus
Question 17 Explanation:
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.
Question 18
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
Proper handwashing during food preparation is the best way of preventing the condition.
B
All cooking and eating utensils must be thoroughly washed.
C
Food must be cooked properly to destroy staphylococcal microorganisms.
D
Food handlers and food servers must have a negative stool examination result.
Question 18 Explanation:
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.
Question 19
A 3-year old child was brought by his mother to the health center because of fever of 4-day duration. The child had a positive tourniquet test result. In the absence of other signs, which is the most appropriate measure that the PHN may carry out to prevent Dengue shock syndrome?
A
Refer the client to the physician for appropriate management.
B
Instruct the mother to give the child Oresol.
C
Insert an NGT and give fluids per NGT.
D
Start the patient on intravenous fluids STAT.
Question 19 Explanation:
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.
Question 20
For prevention of hepatitis A, you decided to conduct health education activities. Which of the following is IRRELEVANT?
A
Safe food preparation and food handling by vendors
B
Use of sterile syringes and needles
C
Proper disposal of human excreta and personal hygiene
D
Immediate reporting of water pipe leaks and illegal water connections
Question 20 Explanation:
Hepatitis A is transmitted through the fecal oral route. Hepatitis B is transmitted through infected body secretions like blood and semen.
Question 21
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
Destruction of breeding places of the mosquito vector
C
Seeding of breeding places with larva-eating fish
D
Use of mosquito-repelling soaps, such as those with basil or citronella
Question 21 Explanation:
Anopheles mosquitoes breed in slow-moving, clear water, such as mountain streams.
Question 22
Which biological used in Expanded Program on Immunization (EPI) should NOT be stored in the freezer?
A
Measles vaccine
B
MMR
C
Oral polio vaccine
D
DPT
Question 22 Explanation:
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.
Question 23
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
Ask the client to be accompanied by a significant person before revealing the result.
B
Refer the client to the physician since he is the best person to reveal the result to the client.
C
Refer the client for a supplementary test, such as Western blot, since the ELISA result may be false.
D
Get a thorough history of the client, focusing on the practice of high risk behaviors.
Question 23 Explanation:
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.
Question 24
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 pneumonia
C
Severe febrile disease
D
Severe dehydration
Question 24 Explanation:
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.
Question 25
When residents obtain water from an artesian well in the neighborhood, the level of this approved type of water facility is
A
III
B
I
C
IV
D
II
Question 25 Explanation:
A communal faucet or water standpost is classified as Level II.
Question 26
In the Philippines, which condition is the most frequent cause of death associated with schistosomiasis?
A
Bladder cancer
B
Liver cancer
C
Intestinal perforation
D
Liver cirrhosis
Question 26 Explanation:
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.
Question 27
What is the most effective way of controlling schistosomiasis in an endemic area?
A
Use of molluscicides
B
Proper use of sanitary toilets
C
Use of protective footwear, such as rubber boots
D
Building of foot bridges
Question 27 Explanation:
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.
Question 28
To determine possible sources of sexually transmitted infections, which is the BEST method that may be undertaken by the public health nurse?
A
Mass screening tests
B
Interview of suspects
C
Community survey
D
Contact tracing
Question 28 Explanation:
Contact tracing is the most practical and reliable method of finding possible sources of person-to-person transmitted infections, such as sexually transmitted diseases.
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PNLE: Community Health Nursing Exam 5 (EM)
Choose the letter of the correct answer. You got 28 minutes to finish the exam .Good luck!
Start
Congratulations - you have completed PNLE: Community Health Nursing Exam 5 (EM).
You scored %%SCORE%% out of %%TOTAL%%.
Your performance has been rated as %%RATING%%
Your answers are highlighted below.
Question 1
Among children aged 2 months to 3 years, the most prevalent form of meningitis is caused by which microorganism?
A
Neisseria meningitidis
B
Hemophilus influenzae
C
Steptococcus pneumoniae
D
Morbillivirus
Question 1 Explanation:
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.
Question 2
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 antecubital surface
D
Skin on the abdomen
Question 2 Explanation:
Koplik’s spot may be seen on the mucosa of the mouth or the throat.
Question 3
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 handlers and food servers must have a negative stool examination result.
C
Food must be cooked properly to destroy staphylococcal microorganisms.
D
Proper handwashing during food preparation is the best way of preventing the condition.
Question 3 Explanation:
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.
Question 4
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
Refer the client to the physician since he is the best person to reveal the result to the client.
B
Ask the client to be accompanied by a significant person before revealing the result.
C
Get a thorough history of the client, focusing on the practice of high risk behaviors.
D
Refer the client for a supplementary test, such as Western blot, since the ELISA result may be false.
Question 4 Explanation:
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.
Question 5
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
Severe pneumonia
B
Severe febrile disease
C
Severe dehydration
D
Mastoiditis
Question 5 Explanation:
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.
Question 6
You will conduct outreach immunization in a barangay with a population of about 1500. Estimate the number of infants in the barangay.
A
50
B
45
C
55
D
60
Question 6 Explanation:
To estimate the number of infants, multiply total population by 3%.
Question 7
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
5
B
8
C
3
D
10
Question 7 Explanation:
Adequate blood supply to the area allows the return of the color of the nailbed within 3 seconds.
Question 8
Which is the BEST control measure for AIDS?
A
Avoiding sexual contact with commercial sex workers
B
Being faithful to a single sexual partner
C
Making sure that one’s sexual partner does not have signs of AIDS
D
Using a condom during each sexual contact
Question 8 Explanation:
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.
Question 9
Human beings are the major reservoir of malaria. Which of the following strategies in malaria control is based on this fact?
A
Stream clearing
B
Stream seeding
C
Zooprophylaxis
D
Destruction of breeding places
Question 9 Explanation:
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.
Question 10
Mosquito-borne diseases are prevented mostly with the use of mosquito control measures. Which of the following is NOT appropriate for malaria control?
A
Seeding of breeding places with larva-eating fish
B
Use of mosquito-repelling soaps, such as those with basil or citronella
C
Use of chemically treated mosquito nets
D
Destruction of breeding places of the mosquito vector
Question 10 Explanation:
Anopheles mosquitoes breed in slow-moving, clear water, such as mountain streams.
Question 11
A 32-year old client came for consultation at the health center with the chief complaint of fever for a week. Accompanying symptoms were muscle pains and body malaise. A week after the start of fever, the client noted yellowish discoloration of his sclera. History showed that he waded in flood waters about 2 weeks before the onset of symptoms. Based on his history, which disease condition will you suspect?
A
Hepatitis A
B
Leptospirosis
C
Hepatitis B
D
Tetanus
Question 11 Explanation:
Leptospirosis is transmitted through contact with the skin or mucous membrane with water or moist soil contaminated with urine of infected animals, like rats.
Question 12
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
Amebiasis
B
Cholera
C
Giardiasis
D
Dysentery
Question 12 Explanation:
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.
Question 13
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
Consult at the health center where rubella vaccine may be given.
B
Avoid crowded places, such as markets and moviehouses.
C
Consult a physician who may give them rubella immunoglobulin.
D
Advice them on the signs of German measles.
Question 13 Explanation:
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.
Question 14
In a mothers’ class, you discussed childhood diseases such as chicken pox. Which of the following statements about chicken pox is correct?
A
The older one gets, the more susceptible he becomes to the complications of chicken pox.
B
To prevent an outbreak in the community, quarantine may be imposed by health authorities.
C
Chicken pox vaccine is best given when there is an impending outbreak in the community.
D
A single attack of chicken pox will prevent future episodes, including conditions such as shingles.
Question 14 Explanation:
Chicken pox is usually more severe in adults than in children. Complications, such as pneumonia, are higher in incidence in adults.
Question 15
MWSS provides water to Manila and other cities in Metro Manila. This is an example of which level of water facility?
A
III
B
IV
C
II
D
I
Question 15 Explanation:
Waterworks systems, such as MWSS, are classified as level III.
Question 16
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
IV
D
III
Question 16 Explanation:
A communal faucet or water standpost is classified as Level II.
Question 17
To determine possible sources of sexually transmitted infections, which is the BEST method that may be undertaken by the public health nurse?
A
Interview of suspects
B
Mass screening tests
C
Contact tracing
D
Community survey
Question 17 Explanation:
Contact tracing is the most practical and reliable method of finding possible sources of person-to-person transmitted infections, such as sexually transmitted diseases.
Question 18
Complications to infectious parotitis (mumps) may be serious in which type of clients?
A
Elderly clients
B
Young infants
C
Pregnant women
D
Young adult males
Question 18 Explanation:
Epididymitis and orchitis are possible complications of mumps. In post-adolescent males, bilateral inflammation of the testes and epididymis may cause sterility.
Question 19
Which biological used in Expanded Program on Immunization (EPI) should NOT be stored in the freezer?
A
Oral polio vaccine
B
DPT
C
MMR
D
Measles vaccine
Question 19 Explanation:
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.
Question 20
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 shorten the period of communicability of the disease.
B
They prolong the life of the client with AIDS.
C
They reduce the risk of opportunistic infections
D
They are able to bring about a cure of the disease condition.
Question 20 Explanation:
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.
Question 21
A 3-year old child was brought by his mother to the health center because of fever of 4-day duration. The child had a positive tourniquet test result. In the absence of other signs, which is the most appropriate measure that the PHN may carry out to prevent Dengue shock syndrome?
A
Start the patient on intravenous fluids STAT.
B
Insert an NGT and give fluids per NGT.
C
Refer the client to the physician for appropriate management.
D
Instruct the mother to give the child Oresol.
Question 21 Explanation:
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.
Question 22
In the Philippines, which specie of schistosoma is endemic in certain regions?
A
S. mansoni
B
S. haematobium
C
S. malayensis
D
S. japonicum
Question 22 Explanation:
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.
Question 23
Among the following diseases, which is airborne?
A
Measles
B
Diphtheria
C
Viral conjunctivitis
D
Acute poliomyelitis
Question 23 Explanation:
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.
Question 24
What is the most effective way of controlling schistosomiasis in an endemic area?
A
Use of molluscicides
B
Building of foot bridges
C
Use of protective footwear, such as rubber boots
D
Proper use of sanitary toilets
Question 24 Explanation:
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.
Question 25
In the Philippines, which condition is the most frequent cause of death associated with schistosomiasis?
A
Liver cirrhosis
B
Bladder cancer
C
Intestinal perforation
D
Liver cancer
Question 25 Explanation:
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.
Question 26
For prevention of hepatitis A, you decided to conduct health education activities. Which of the following is IRRELEVANT?
A
Safe food preparation and food handling by vendors
B
Proper disposal of human excreta and personal hygiene
C
Use of sterile syringes and needles
D
Immediate reporting of water pipe leaks and illegal water connections
Question 26 Explanation:
Hepatitis A is transmitted through the fecal oral route. Hepatitis B is transmitted through infected body secretions like blood and semen.
Question 27
The most frequent causes of death among clients with AIDS are opportunistic diseases. Which of the following opportunistic infections is characterized by tonsillopharyngitis?
A
Cytomegalovirus disease
B
Pneumocystis carinii pneumonia
C
Infectious mononucleosis
D
Respiratory candidiasis
Question 27 Explanation:
Cytomegalovirus disease is an acute viral disease characterized by fever, sore throat and lymphadenopathy.
Question 28
The use of larvivorous fish in malaria control is the basis for which strategy of malaria control?
A
Destruction of breeding places
B
Zooprophylaxis
C
Stream seeding
D
Stream clearing
Question 28 Explanation:
Stream seeding is done by putting tilapia fry in streams or other bodies of water identified as breeding places of the Anopheles mosquito
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1. In the Philippines, which condition is the most frequent cause of death associated with schistosomiasis?
Liver cancer
Liver cirrhosis
Bladder cancer
Intestinal perforation
2. What is the most effective way of controlling schistosomiasis in an endemic area?
Use of molluscicides
Building of foot bridges
Proper use of sanitary toilets
Use of protective footwear, such as rubber boots
3. When residents obtain water from an artesian well in the neighborhood, the level of this approved type of water facility is
I
II
III
IV
4. For prevention of hepatitis A, you decided to conduct health education activities. Which of the following is IRRELEVANT?
Use of sterile syringes and needles
Safe food preparation and food handling by vendors
Proper disposal of human excreta and personal hygiene
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?
DPT
Oral polio vaccine
Measles vaccine
MMR
6. You will conduct outreach immunization in a barangay with a population of about 1500. Estimate the number of infants in the barangay.
45
50
55
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?
Mastoiditis
Severe dehydration
Severe pneumonia
Severe febrile disease
8. A client was diagnosed as having Dengue fever. You will say that there is slow capillary refill when the color of the nailbed that you pressed does not return within how many seconds?
3
5
8
10
9. A 3-year old child was brought by his mother to the health center because of fever of 4-day duration. The child had a positive tourniquet test result. In the absence of other signs, which is the most appropriate measure that the PHN may carry out to prevent Dengue shock syndrome?
Insert an NGT and give fluids per NGT.
Instruct the mother to give the child Oresol.
Start the patient on intravenous fluids STAT.
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 _____.
Nasal mucosa
Buccal mucosa
Skin on the abdomen
Skin on the antecubital surface
11. Among the following diseases, which is airborne?
Viral conjunctivitis
Acute poliomyelitis
Diphtheria
Measles
12. Among children aged 2 months to 3 years, the most prevalent form of meningitis is caused by which microorganism?
Hemophilus influenzae
Morbillivirus
Steptococcus pneumoniae
Neisseria meningitidis
13. Human beings are the major reservoir of malaria. Which of the following strategies in malaria control is based on this fact?
Stream seeding
Stream clearing
Destruction of breeding places
Zooprophylaxis
14. The use of larvivorous fish in malaria control is the basis for which strategy of malaria control?
Stream seeding
Stream clearing
Destruction of breeding places
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?
Use of chemically treated mosquito nets
Seeding of breeding places with larva-eating fish
Destruction of breeding places of the mosquito vector
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?
Giardiasis
Cholera
Amebiasis
Dysentery
17. In the Philippines, which specie of schistosoma is endemic in certain regions?
S. mansoni
S. japonicum
S. malayensis
S. haematobium
18. A 32-year old client came for consultation at the health center with the chief complaint of fever for a week. Accompanying symptoms were muscle pains and body malaise. A week after the start of fever, the client noted yellowish discoloration of his sclera. History showed that he waded in flood waters about 2 weeks before the onset of symptoms. Based on his history, which disease condition will you suspect?
Hepatitis A
Hepatitis B
Tetanus
Leptospirosis
19. MWSS provides water to Manila and other cities in Metro Manila. This is an example of which level of water facility?
I
II
III
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?
Get a thorough history of the client, focusing on the practice of high risk behaviors.
Ask the client to be accompanied by a significant person before revealing the result.
Refer the client to the physician since he is the best person to reveal the result to the client.
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?
Being faithful to a single sexual partner
Using a condom during each sexual contact
Avoiding sexual contact with commercial sex workers
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?
Respiratory candidiasis
Infectious mononucleosis
Cytomegalovirus disease
Pneumocystis carinii pneumonia
23. To determine possible sources of sexually transmitted infections, which is the BEST method that may be undertaken by the public health nurse?
Contact tracing
Community survey
Mass screening tests
Interview of suspects
24. Antiretroviral agents, such as AZT, are used in the management of AIDS. Which of the following is NOT an action expected of these drugs.
They prolong the life of the client with AIDS.
They reduce the risk of opportunistic infections
They shorten the period of communicability of the disease.
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?
Advice them on the signs of German measles.
Avoid crowded places, such as markets and moviehouses.
Consult at the health center where rubella vaccine may be given.
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?
All cooking and eating utensils must be thoroughly washed.
Food must be cooked properly to destroy staphylococcal microorganisms.
Food handlers and food servers must have a negative stool examination result.
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?
The older one gets, the more susceptible he becomes to the complications of chicken pox.
A single attack of chicken pox will prevent future episodes, including conditions such as shingles.
To prevent an outbreak in the community, quarantine may be imposed by health authorities.
Chicken pox vaccine is best given when there is an impending outbreak in the community.
28. Complications to infectious parotitis (mumps) may be serious in which type of clients?
Pregnant women
Elderly clients
Young adult males
Young infants
Answers and Rationales
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.
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.
Answer: (B) II. A communal faucet or water standpost is classified as Level II.
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.
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.
Answer: (A) 45. To estimate the number of infants, multiply total population by 3%.
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.
Answer: (A) 3. Adequate blood supply to the area allows the return of the color of the nailbed within 3 seconds.
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.
Answer: (B) Buccal mucosa. Koplik’s spot may be seen on the mucosa of the mouth or the throat.
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.
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.
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.
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
Answer: (C) Destruction of breeding places of the mosquito vector. Anopheles mosquitoes breed in slow-moving, clear water, such as mountain streams.
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.
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.
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.
Answer: (C) III. Waterworks systems, such as MWSS, are classified as level III.
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.
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.
Answer: (B) Infectious mononucleosis. Cytomegalovirus disease is an acute viral disease characterized by fever, sore throat and lymphadenopathy.
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.
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.
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.
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.
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.
Answer: (C) Young adult males. Epididymitis and orchitis are possible complications of mumps. In post-adolescent males, bilateral inflammation of the testes and epididymis may cause sterility.