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PNLE: Community Health Nursing Exam 5 (PM)
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Question 1
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 1 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 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 a physician who may give them rubella immunoglobulin.
B
Avoid crowded places, such as markets and moviehouses.
C
Advice them on the signs of German measles.
D
Consult at the health center where rubella vaccine may be given.
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
Among the following diseases, which is airborne?
A
Measles
B
Diphtheria
C
Acute poliomyelitis
D
Viral conjunctivitis
Question 3 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 4
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 are able to bring about a cure of the disease condition.
B
They prolong the life of the client with AIDS.
C
They reduce the risk of opportunistic infections
D
They shorten the period of communicability of the disease.
Question 4 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 5
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
Tetanus
B
Hepatitis A
C
Hepatitis B
D
Leptospirosis
Question 5 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 6
Among children aged 2 months to 3 years, the most prevalent form of meningitis is caused by which microorganism?
A
Steptococcus pneumoniae
B
Neisseria meningitidis
C
Morbillivirus
D
Hemophilus influenzae
Question 6 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 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
10
B
3
C
5
D
8
Question 7 Explanation:
Adequate blood supply to the area allows the return of the color of the nailbed within 3 seconds.
Question 8
In the Philippines, which condition is the most frequent cause of death associated with schistosomiasis?
A
Liver cirrhosis
B
Liver cancer
C
Bladder cancer
D
Intestinal perforation
Question 8 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 9
Which is the BEST control measure for AIDS?
A
Being faithful to a single sexual partner
B
Making sure that one’s sexual partner does not have signs of AIDS
C
Avoiding sexual contact with commercial sex workers
D
Using a condom during each sexual contact
Question 9 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 10
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 10 Explanation:
Waterworks systems, such as MWSS, are classified as level III.
Question 11
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
Respiratory candidiasis
C
Infectious mononucleosis
D
Pneumocystis carinii pneumonia
Question 11 Explanation:
Cytomegalovirus disease is an acute viral disease characterized by fever, sore throat and lymphadenopathy.
Question 12
You will conduct outreach immunization in a barangay with a population of about 1500. Estimate the number of infants in the barangay.
A
60
B
50
C
55
D
45
Question 12 Explanation:
To estimate the number of infants, multiply total population by 3%.
Question 13
The pathognomonic sign of measles is Koplik’s spot. You may see Koplik’s spot by inspecting the _____.
A
Nasal mucosa
B
Buccal mucosa
C
Skin on the abdomen
D
Skin on the antecubital surface
Question 13 Explanation:
Koplik’s spot may be seen on the mucosa of the mouth or the throat.
Question 14
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
Destruction of breeding places of the mosquito vector
D
Use of chemically treated mosquito nets
Question 14 Explanation:
Anopheles mosquitoes breed in slow-moving, clear water, such as mountain streams.
Question 15
Which biological used in Expanded Program on Immunization (EPI) should NOT be stored in the freezer?
A
DPT
B
MMR
C
Oral polio vaccine
D
Measles vaccine
Question 15 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 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
III
C
IV
D
II
Question 16 Explanation:
A communal faucet or water standpost is classified as Level II.
Question 17
You are the PHN in the city health center. A client underwent screening for AIDS using ELISA. His result was positive. What is the best course of action that you may take?
A
Get a thorough history of the client, focusing on the practice of high risk behaviors.
B
Refer the client to the physician since he is the best person to reveal the result to the client.
C
Ask the client to be accompanied by a significant person before revealing the result.
D
Refer the client for a supplementary test, such as Western blot, since the ELISA result may be false.
Question 17 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 18
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 18 Explanation:
Chicken pox is usually more severe in adults than in children. Complications, such as pneumonia, are higher in incidence in adults.
Question 19
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
Dysentery
C
Cholera
D
Giardiasis
Question 19 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 20
Complications to infectious parotitis (mumps) may be serious in which type of clients?
A
Young infants
B
Elderly clients
C
Pregnant women
D
Young adult males
Question 20 Explanation:
Epididymitis and orchitis are possible complications of mumps. In post-adolescent males, bilateral inflammation of the testes and epididymis may cause sterility.
Question 21
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
Destruction of breeding places
C
Zooprophylaxis
D
Stream seeding
Question 21 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 22
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 febrile disease
C
Severe dehydration
D
Severe pneumonia
Question 22 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 23
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
Food handlers and food servers must have a negative stool examination result.
B
All cooking and eating utensils must be thoroughly washed.
C
Proper handwashing during food preparation is the best way of preventing the condition.
D
Food must be cooked properly to destroy staphylococcal microorganisms.
Question 23 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 24
In the Philippines, which specie of schistosoma is endemic in certain regions?
A
S. japonicum
B
S. malayensis
C
S. mansoni
D
S. haematobium
Question 24 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 25
What is the most effective way of controlling schistosomiasis in an endemic area?
A
Building of foot bridges
B
Use of protective footwear, such as rubber boots
C
Proper use of sanitary toilets
D
Use of molluscicides
Question 25 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 26
To determine possible sources of sexually transmitted infections, which is the BEST method that may be undertaken by the public health nurse?
A
Community survey
B
Interview of suspects
C
Mass screening tests
D
Contact tracing
Question 26 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 27
The use of larvivorous fish in malaria control is the basis for which strategy of malaria control?
A
Destruction of breeding places
B
Stream clearing
C
Zooprophylaxis
D
Stream seeding
Question 27 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 28
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
Immediate reporting of water pipe leaks and illegal water connections
C
Proper disposal of human excreta and personal hygiene
D
Safe food preparation and food handling by vendors
Question 28 Explanation:
Hepatitis A is transmitted through the fecal oral route. Hepatitis B is transmitted through infected body secretions like blood and semen.
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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
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
Refer the client to the physician for appropriate management.
C
Insert an NGT and give fluids per NGT.
D
Instruct the mother to give the child Oresol.
Question 1 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 2
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
Giardiasis
C
Cholera
D
Dysentery
Question 2 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 3
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 3 Explanation:
Waterworks systems, such as MWSS, are classified as level III.
Question 4
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 a physician who may give them rubella immunoglobulin.
B
Avoid crowded places, such as markets and moviehouses.
C
Consult at the health center where rubella vaccine may be given.
D
Advice them on the signs of German measles.
Question 4 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 5
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 reduce the risk of opportunistic infections
C
They prolong the life of the client with AIDS.
D
They are able to bring about a cure of the disease condition.
Question 5 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 6
In the Philippines, which condition is the most frequent cause of death associated with schistosomiasis?
A
Liver cancer
B
Bladder cancer
C
Intestinal perforation
D
Liver cirrhosis
Question 6 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 7
You were invited to be the resource person in a training class for food handlers. Which of the following would you emphasize regarding prevention of staphylococcal food poisoning?
A
All cooking and eating utensils must be thoroughly washed.
B
Food must be cooked properly to destroy staphylococcal microorganisms.
C
Food handlers and food servers must have a negative stool examination result.
D
Proper handwashing during food preparation is the best way of preventing the condition.
Question 7 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 8
The use of larvivorous fish in malaria control is the basis for which strategy of malaria control?
A
Stream clearing
B
Stream seeding
C
Zooprophylaxis
D
Destruction of breeding places
Question 8 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 9
When residents obtain water from an artesian well in the neighborhood, the level of this approved type of water facility is
A
IV
B
III
C
II
D
I
Question 9 Explanation:
A communal faucet or water standpost is classified as Level II.
Question 10
Among children aged 2 months to 3 years, the most prevalent form of meningitis is caused by which microorganism?
A
Morbillivirus
B
Neisseria meningitidis
C
Hemophilus influenzae
D
Steptococcus pneumoniae
Question 10 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 11
In the Philippines, which specie of schistosoma is endemic in certain regions?
A
S. malayensis
B
S. haematobium
C
S. mansoni
D
S. japonicum
Question 11 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 12
You are the PHN in the city health center. A client underwent screening for AIDS using ELISA. His result was positive. What is the best course of action that you may take?
A
Get a thorough history of the client, focusing on the practice of high risk behaviors.
B
Ask the client to be accompanied by a significant person before revealing the result.
C
Refer the client for a supplementary test, such as Western blot, since the ELISA result may be false.
D
Refer the client to the physician since he is the best person to reveal the result to the client.
Question 12 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 13
Among the following diseases, which is airborne?
A
Measles
B
Diphtheria
C
Acute poliomyelitis
D
Viral conjunctivitis
Question 13 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 14
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
Using a condom during each sexual contact
D
Making sure that one’s sexual partner does not have signs of AIDS
Question 14 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 15
Mosquito-borne diseases are prevented mostly with the use of mosquito control measures. Which of the following is NOT appropriate for malaria control?
A
Seeding of breeding places with larva-eating fish
B
Destruction of breeding places of the mosquito vector
C
Use of mosquito-repelling soaps, such as those with basil or citronella
D
Use of chemically treated mosquito nets
Question 15 Explanation:
Anopheles mosquitoes breed in slow-moving, clear water, such as mountain streams.
Question 16
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
Tetanus
B
Hepatitis B
C
Leptospirosis
D
Hepatitis A
Question 16 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 17
The pathognomonic sign of measles is Koplik’s spot. You may see Koplik’s spot by inspecting the _____.
A
Buccal mucosa
B
Nasal mucosa
C
Skin on the antecubital surface
D
Skin on the abdomen
Question 17 Explanation:
Koplik’s spot may be seen on the mucosa of the mouth or the throat.
Question 18
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 18 Explanation:
Hepatitis A is transmitted through the fecal oral route. Hepatitis B is transmitted through infected body secretions like blood and semen.
Question 19
Human beings are the major reservoir of malaria. Which of the following strategies in malaria control is based on this fact?
A
Destruction of breeding places
B
Stream seeding
C
Stream clearing
D
Zooprophylaxis
Question 19 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 20
Which biological used in Expanded Program on Immunization (EPI) should NOT be stored in the freezer?
A
MMR
B
DPT
C
Oral polio vaccine
D
Measles vaccine
Question 20 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 21
In a mothers’ class, you discussed childhood diseases such as chicken pox. Which of the following statements about chicken pox is correct?
A
A single attack of chicken pox will prevent future episodes, including conditions such as shingles.
B
Chicken pox vaccine is best given when there is an impending outbreak in the community.
C
The older one gets, the more susceptible he becomes to the complications of chicken pox.
D
To prevent an outbreak in the community, quarantine may be imposed by health authorities.
Question 21 Explanation:
Chicken pox is usually more severe in adults than in children. Complications, such as pneumonia, are higher in incidence in adults.
Question 22
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 22 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 23
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
Respiratory candidiasis
C
Pneumocystis carinii pneumonia
D
Infectious mononucleosis
Question 23 Explanation:
Cytomegalovirus disease is an acute viral disease characterized by fever, sore throat and lymphadenopathy.
Question 24
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
8
C
10
D
5
Question 24 Explanation:
Adequate blood supply to the area allows the return of the color of the nailbed within 3 seconds.
Question 25
To determine possible sources of sexually transmitted infections, which is the BEST method that may be undertaken by the public health nurse?
A
Contact tracing
B
Community survey
C
Mass screening tests
D
Interview of suspects
Question 25 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 26
Complications to infectious parotitis (mumps) may be serious in which type of clients?
A
Pregnant women
B
Young adult males
C
Young infants
D
Elderly clients
Question 26 Explanation:
Epididymitis and orchitis are possible complications of mumps. In post-adolescent males, bilateral inflammation of the testes and epididymis may cause sterility.
Question 27
You will conduct outreach immunization in a barangay with a population of about 1500. Estimate the number of infants in the barangay.
A
60
B
45
C
50
D
55
Question 27 Explanation:
To estimate the number of infants, multiply total population by 3%.
Question 28
What is the most effective way of controlling schistosomiasis in an endemic area?
A
Building of foot bridges
B
Use of molluscicides
C
Proper use of sanitary toilets
D
Use of protective footwear, such as rubber boots
Question 28 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.
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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.