COMMUNITY HEALTH/COMMUNICABLE DISEASE NURSING INSTRUCTIONS: Select the correct answer for each of the following questions.

Mark ONLY ONE ANSWER for each item by marking the box corresponding to the letter of your choice on the answer sheet provided. STRICTLY NO ERASURES ALLOWED. 1. This refers to group of people who share common characteristics, or developmental stage, common exposure to environmental factors thus has common health problems: A. Family B. Groups C. Sentinel D. Aggregate 2. Public Health is the science and art of preventing disease, prolonging life, promoting health and efficiency through: A. health education C. organized community effort B. communicable disease control D. development of social machinery 3. The above definition of health comes was popularized by: A. Pender B. WHO Expert Committee in Nursing C. Orem Dunn D.

4. It is the process whereby existing and potential health conditions or problems of the family are determined: A. primary health care C. second level assessment B. first level assessment D. potential problem assessment 5. Defines the nature or types of nursing problems that the family encounters in performing health tasks with respect to a given health condition or problem: A. primary health care C. second level assessment B. first level assessment D. potential problem assessment 6. In family nursing assessment which of the following level of assessment ends with the definition of family nursing problems? A. first B. second C. third D. fourth 7. Situations or condition which interferes with the promotion and or maintenance of health and recovery from illness or injury is: A. health problem C. typology B. nursing problem D. wellness condition 8. Mental retardation in Filipino children is a result of deficiency in: A. Vitamin A B. Vitamin B C. Iodine D. Iron 9. Which of the following refers to family nursing problem? A. family size beyond what family resources can provide B. inherent personality characteristics C. poor environmental sanitation

D. inability to provide home environment conducive to health maintenance 10. Given the following cues identify the health problem or family nursing problem: Dorina three years old, looks pale and emaciated with a weight of 11 kg. How will you classify the illness of Dorina? A. health threat C. family nursing problem B. health deficit D. foreseeable crisis A. health threat conditions that promote disease or injury and prevent people from realizng their potential. An example is when the population is inadequately immunized against preventable diseases. B. health deficit occurs when there is a gap between actual and achievable health status. Example is history of repeated infections, miscarriage are noted, no regular check-up. D. Foreseeable crisis includes stressful occurrences such as death or illness of a family member 11. The mother of Dorina verbalized Dorina is really small in built since she was a baby. She is not fond of eating to The mother is exhibiting: A. full knowledge of the disease C. miscommunication B. lack of knowledge D. salience 12. Which of the following is given more weight? A. health threat B. health deficit C. stress points foreseeable crisis D.

13. Why is it so? A. because of culture linked variables B. due to the urgency of the need C. because of the sense of clinical urgency D. because of the premium given to the effort of the family 14. Possible pre eclampsia is considered: A. wellness threat B. health threat C. health deficit foreseeable crisis 15. Improper waste disposal can be classified as: A. wellness threat B. health threat C. health deficit foreseeable crisis D.

D.

16. This compares the number of economically dependent with the economically productive group in the population: A. Age and sex composition C. sex ratio B. crowding index D. Dependency ratio

17. Age and sex composition of the population can be described using: A. pie chart C. population pyramid B. demographic data D. population density 18. It is a tool in estimating the extent or magnitude of health needs and problems of the community: A. Age sex composition C. Vital statistics B. Urban-rural distribution D. Epidemiology 19. It is the process whereby the community members develop the capability to assess their health needs and problems, p, implement action to solve the problems: A. family health nursing C. community organizing B. community health nursing D. community profiling 20. Consist of the identified potential leaders who will be tasked in laying down the foundation of a strong people organization: A. organizational phase C. core group formation B. leadership formation D. spotting leaders 21. It is a relationship among organizations that consists of exchanging information about each others goals and objectives, services or facilities: A. networking B. collaboration C. coordination D. cooperation 22. It is a relationship where organizations modify their activities in order to provide better service to the target beneficiary: A. networking B. collaboration C. coordination D. cooperation 23. It is the level of organizational relationship where organizations help each other enhance their capacities in performing their tasks as well as in the provision of services: A. networking B. collaboration C. coordination D. cooperation 24. A child is admitted in the barangay health station with maculopapular petechial rash in the distal portion of the extremities, the skin appears purple with balanced areas of various sizes. The nurse will suspect: A. measles B. chickenpox C. German measles D. dengue fever A. measles rubeola (koplik spots white speck at buccal mucosa surrounded by red halos) B. Chickenpox varicella ( Dewdrops on rose petal -- trunk-facescalp) C. German measles rubella ( forscheimer spots pink rashes in faceneck- trunk- leg) D. dengue fever a tourniquet test or rumple leads test is (+) when 20 or more petechial per 2.5

cm square or 1 inch square are observed 25. Which of the following condition will manifest bulls neck? A. diphtheria B. pertussis C. TB in children mumps 26. This condition affects the peyers patches of the small intestine: A. diphtheria B. dengue C. liver ulcer typhoid fever D.

D.

27. The most serious type of leprosy and very infectious is the: (CHN book pp.216) A. tuberculoid B. lepromatous C. indeterminate D borderline 28. A baby came in the clinic with the following signs and symptoms: Stiff jaw, with tonic rigid muscular contraction, spasm and convulsion. The nurse will suspect a case of: A. diphtheria B. rabies C leptospirosis D. tetanus 29. In EPI immunization, the immunity is called: A. active acquired B. passive acquired natural passive C. active artificial D.

NOTE: NATURAL ACTIVE IMMUNITY antibodies are formed in the presence of active infection in the body. It is life long. E.g. recovery from mumps, chickenpox measles and others ARTIFICIAL ACTIVE IMMUNITY antigen (vaccine or toxoids) are administered to stimulate Antibody production. Requires boosters dose after many years. e.g. Tetanus toxoids, OPV INACTIVATED KILLED PATHOGEN ATTENUATED WEAKENED PATHOGENS EXTRACTS PARTS OF PATHOGENS or sub-units TOXOIDS given for prevention (bacteria has not yet invaded the body) ANTITOXIN given to counteract bacteria that has already invaded the body NATURAL PASSIVE IMMUNITY - antibodies are transferred from the mother to her newborn through the placenta or in the colostrums . Immunity may be from 6 months to 1 year.

ARTIFICIAL PASSIVE IMMUNITY - (antibody) from animal or another human and injected to a person. Immunity lasts only for 2 3 weeks. e.g. tetanus immunoglobulin (antiserum, antitoxin, gamma globulin) 30. Which of the following are contraindicated for submitting the child for immunization? A. scar in the extremities B. recurrent convulsions C. fever D. recurrent convulsions 31. The leading cause of morbidity is: A. diarrhea B. Influenza hypertension C. pneumonia D.

32. Classify the childs dehydration: Restless, irritable, sunken eyes, drinks eagerly, thirsty Skin pinch goes back slowly: A. severe dehydration difficult to awake, not able to drink, sunken eyes, skin pinch goes back slowly B. some dehydration C. no dehydration D. undetermined 33. The Food fortification law is covered by RA: A. 8967 B. 8878 C. 8172 34. While the ASIN Law is: A. 8967 B. 8878 C. 8172 D. 8976 D. 8976 D. iron

35. The Food fortification law covers the fortification of rice with: A. iodine B. sugar C. oil

36. A child came in the BHS with foamy, soapy white patches seen in the white part of the eyes: A. xerophthalmia B. conjunctival C. corneal scar D. Bitots spot 37. This disease was first reported in China in 2002 with asymptomatic mild respiratory illness and reported to be caused by a novel corona virus: A. Kawasaki disease B. Mud cow disease C. SARS D. ARI 38. This disease is characterized by a pinkish rash on the soft palate know as Forchheimers spot refers to: A. measles koplik spots B rubella C. roseola D. robeola 39. A confirmatory test for typhoid fever can be done by:

A. ELISA - AIDS D. Typhidot

B. Widal

C. Rectal swab

40. The drug of choice in the treatment of typhoid fever is: A. Ampicillin B. Ciprofloxazole C. Co-trimoxazole Chloramphenicol

D.

41.This disease condition in children is characterized by the presence of maculopapular rash on either cheeks, bridge of the nose, along the hairline at the temple or the earlobe: A measles B. mumps C. rubella D. herpes zoster (rubeola virus) (german measle) (chickenpox) 42. The maintenance of correct temperature of vaccine starts from: A. DOH B. Regional Health Office C. RHU D. manufacturer site 43. Diseases that occurs occasionally is referred to as: A. endemic B. sporadic C. epidemic pandemic D.

A. endemic continuous occurrence(e.g. schistosomiasis in leyte and samar, filariasis in Sorsogon) B. sporadic Intermittent or occasionally (e.g. rabies) C. epidemic large number or sudden increase D. pandemic world-wide (e.g. SARS) 44. Which of the following belongs to an approved level I toilet facility? A. pour flush level I B. water sealed with septic tank level II C. water sealed, septic tank, treatment plant level III D. water sealed with sewerage facilities, septic tank level III 45. A method of waste disposal that calls for recycling of waste into fertilizer is: A. Burning C. decomposting B. Burying D. recycling 46. Rodents & vermins control is best achieved by the use of: A. traps C. natural predators B. spraying of chemicals D. eradication of garbage and refuse 47. Water supply sanitation is crucial in environmental sanitation. Which of the following source of water supply is less subject to contamination or surface run off? A. surface water C. underground water B. Rain water D. public water supply 48. The best way to treat water at home is the use of: A. chlorine C. boiling B. potassium permanganate D. sedimentation

49. Type of epidemic where direct or indirect transmission of an infectious agents from infected individual to susceptible hosts, is referred to as: A. common source epidemic C. cyclic variation B. propagated epidemic D. secular variation 50. Living bodies that harbor, sustain and maintain the growth and multiplication of infectious agent: A. reservoir C. fomites inanimate objects of materials B. vehicle means to transport D. antibodies 51. Most fear of patients with AIDS is related to: A. Treatment C. Self-image B. Disfigurement D. Prognosis

52. The collapse of the immune response defenses in AIDS patient stems from which defect? A. Insufficient amounts of immunoglobulins (IgG) B. Overproduction of immature B lymphocytes C. Reduction in the numbers of T cells and change in function of CD4+antigen D. Decreased in the amount of tissue macrophages and infiltrates 53. Which type of infection control does an externally ill hospitalized patient with AIDS require? A. Respiratory isolation C. Contact isolation B. Blood and body fluids D. reverse isolation 54. A specific virus, which recently has been given a new name, causes Human Immune deficiency Syndrome (AIDS). Causative virus is: A. Arbovirus C. Adenovirus B. Rhinovirus D. Retrovirus Situation: Erik was then tested for Treponema Pallidum and HIV to make sure he was not harboring those microorganisms as well. 55. Before patient diagnosed with Syphilis leaves the clinic, treatment is initiated. Which of the following actions is essential for the nurse to take? A. Ask client to identify his/her sexual contacts/partners B. Advise client to avoid sexual activity for two months C. Arrange for the client to have hearing and vision tests D. Have the client return to the clinic weekly for blood test 56. Primary Health services around the world is using this to detect and cure TB patients: A. National TB program B. Direct observe treatment short course (DOTS) C. Center for CD D. International TB control organization 57. Which of the following is not a sign of leprosy?

A. Madarosis- late stage(superficial) bleeding first stage

C. Nasal obstruction or

(Internal) B. Change in skin color- first stage (superficial) D. Ulcers that do not heat first stage(superficial) NOTE: SIGN OBJECTIVE (YOU CAN OBSERVE) SYMPTOMS SUBJECTIVE (PATIENT) 58. Leprosy can be transmitted through: A. Blood C. Semen B. Sex contact D. Prolonged skin-to-skin contact 59. Best method of prevention of TB and Leprosy especially among children is: A. Taking INH for prophylaxis C. Good nutrition B. Healthy environment D. BCG immunization 60. Which among there is the host of Schistosomiasis Japonicum? A. Mosquitoes C. Snails B. Rats D. Dogs 61. The Drug of Choice for Schistosomiasis: A. Metrofronate B. Praziquantel C. Heterzan D. Quinidine Sulfate

Situation: In Primary Health Care system of our health centers, Tuberculosis is one of their priority diseases for control, if not eradicated. 62. Category 3 treatment regimen for TB is prescribed to: (CHN pp. 205) A. New PTB patients who sputum culture is positive category I B. Previously treated patients who are on relapse- category II C. New PTB patients whose sputum is serum-negative for 3x and chest xray category III D. Previously treated patient who are failures in taking medications category II 63. What PTB drug is not given to children under 6 who are too young to report visual disturbances? A. INH C. Ethambutol CHN book pp.209 B. Rifampicin D. PZA 64. Category 1 treatment regimen for TB is prescribed and this is given: (CNH book pp. 209) A. 2 months intensive phase, 4 months maintenance phase - category I B. 3 months intensive phase, 5 months maintenance phase category 2 C. 2 months intensive phase, 2 months maintenance phase category 3

D. 3 months intensive phase, 6 months maintenance phase total duration of treatment (9 months) 65. The usual treatment for Tuberculosis includes the use of isoniazid (INH) and which of the following therapies? A. Theophylline inhaler C. Three of her antibacterial agents B. IM penicillin D. Aerosol treatment with Pentamidine Situation: Nurse in San Agustin Hospital, Isolation Ward is giving extra information to affiliates, emphasizing on observation and assessment. 66. The nurse assesses a 16-year-old client diagnosed with Bacterial Meningitis. Which of the following signs and symptoms of meningeal irritation does the nurse likely to observe? A. Generalized seizures and spasm C. Nuchal rigidity and photophobia B. Positive Babinskis reflex D. Tripod and photophobia 67. Nurse is performing a respiratory assessment on a client with Pneumonia. She asks the client to say ninety-nine several times. Through her stethoscope she hears the words clearly over his left lower lobe. What term should the nurse use to document this finding? A. Echo C. Bronchophony B. Bronchosymmetry D. Pulmono echo 68. A parent asks the nurse about head lice (pediculosis capitis) infestation during the visit to the clinic. Which of the following symptoms would the nurse tell the parent as the most common in a child infected with head lice? A. Itching of the scalp - subjective C. Serous weeping on the scalp surface B. Scaling of the scalp D. Pinpoint hemorrhagis spots on the scalp NOTE: C, B, D are signs or objectives Sign objective subjective symptoms -

69. After teaching the parent about the cause of ringworm of the scalp (linea capitis), which of the following, if stated, indicates successful teaching? A. Overexposure to the sun C. Fungal infection of the scalp B. Infestation with a mile D. An allergic reaction NOTE: ringworm is a fungal infection 70. A mother has heard that several children have been diagnosed with Mononucleosis. She asks the nurse what precautions should be taken to prevent this from occurring in her child. Which of the following would the nurse advice the mother? A. Take no particular precautionary B. Sterilized the eating utensils C. Wash the childs linens separately in hot, soapy water D. Wear masks when providing direct personal care

71. A parent asks why it is recommended that second dose of the measles, mumps, rubella (MMR) vaccine be given by 12 years of age. The nurse responds based on which of the following as the most important reason: A. The risks of a fetus are high if a girl receiving the vaccine becomes pregnant B. The chance of contacting the disease is much lower after puberty than before it C. The dangers associated with the strong reaction to the vaccine are increased after puberty D. The changes that occur in the immunologic system may affect the rhythm of the menstrual cycle 72. During the acute stage of Meningitis, client is restless and irritable. Which of the following would be most appropriate to institute? A. Limiting conversation with client C. Allowing client to do own activity B. Keeping sound to a minimum D. Perform/administer treatment quickly NOTE: MENINGITIS has intolerance to light and sound 73. Which of the following assessments would be most important for the nurse to make initially on a client with complaints of sore throat, muscle tenderness, arms feeling weak and generally not feeling well? A. Difficulty in swallowing C. Exposure to illnesses B. Diet make for the last 24 hours D. Difficulty in urinating 74. Which of the following actions would be the priority when caring for a child client admitted with the diagnosis of Guillain Barre Syndrome? A. Assessing the childs ability to follow simple commands - assess, plan, intervention, evaluation B. Evaluating the childs bilateral muscle strength C. Making a game of range-of-motion exercises D. Providing the child with diversional activity 75. The nurse asks the child with Guillain Barre Syndrome to cough and also assess the childs speech for the decreased volume and clarity. The underlying rationale for these assessments is to determine which of the following? A. Inflammation of the larynx C. Involvement of facial and cranial nerves CN V &CN9 B. Increased intracranial pressure D. regression to an earlier developmental phase 76. Assessment reveals absent of gag and cough reflexes. Which of the following nursing diagnoses would receive the highest priority during acute phase? A. Risk of infection due to altered immune system B. Ineffective breathing pattern related to neuromuscular impairment C. Impaired swallowing related to neuromuscular impairment D. Total urinary incontinence related to fluid losses Situation: Glenmar was on his way home when he decided to pass by his friend Arnolds house. Along the way a dog attacked him. He had several bite wounds and scratches. He was brought to the

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nearby hospital. The nurse washed his wound with soap and water and the doctor treated his wounds and ordered the following: tetanus antitoxins (initially) after (-) skin test and rabies antitoxins after (-) skin test. Penicillin IV after (-) skin test, analgesics as well as cleansing and dressing of wounds. Glenmar started sobbing and shaking. The doctor identifies it as fear and anxiety. 77. Glenmar in danger of suffering: A. Rabies and Tetanus B. Rabies and Encephalitis Poliomyelitis C. Tetanus and Poliomyelitis D. Meningitis and

78. Viral disease of warm-blooded animals, identified causative agent is: A. Myxovirus measles, mumps, flu C. Cytomegatovirus herpes virus B. Rabovirus/ribonucleic acid virus D. Ptcona virus 79. Virus inoculates on the site of the wound but toxins are released and replicates in the muscles. The normal pathway of the toxins: A. Spreads through the nerve, to CNS and replicates in the brain then back to the tissues and end organ B. Absorbs through the cells, spreads through lymphatics, to CNS then manifests specific signs and symptoms C. Spreads through blood stream then to CNS, and back to tissues and absorbed through GIT D. Spreads through the nerves to CNS and brain and causes paralysis of the nerves 80. Which of the following clinical manifestation does the nurse expects that Glenmar will exhibit? A. Prodromal signs with photophobia and agitation B. Prodromal signs with frequency of urination and profuse sweating C. Prodromal signs and bilateral paralysis D. Prodromal signs and with probable hydrophobia and aero phobia 81. Which of the following is not a special consideration in the care of Glenmar? A. Prevention of complication B. Providing patient proper treatment and management C. Community cares, studying and eradicating the cause D. Disposing of the animal immediately to prevent from biting another person 82. Rabies can be prevented. Patients should do: A. Immediate washing and care of the wound and treatment after a dog bite B. Observation of the dog for 10m days before treatment can be given C. Killing of the dog, as it is a nuisance to society D. Maintaining good body resistance 83. A client was brought in for admission manifesting severe agitation and rigidity of muscle. Nurse best initial care would be:

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A. B. C. D.

Check ABC and do the emergency care Protect patient from further trauma Protect patient from further by putting him in a dark quiet room Keep patient calm and protected and initially give prescribed medications

84. Nurse is aware that the toxin was released absorbed and spreads to the CNS, thus aside from the manifested ophisthotonous, rigidity of the back and abdominal muscles, this one may be manifested too: A. Spasm of the maxillary muscles and the cheeks B. Bleeding of the GIT C. Spasm of the eye muscles D. Pain of the toes and fingers 85. Which of the following is not included in the plan of care to patient with tetanus? A. Maintain adequate airway and ventilation to prevent pneumonia and atelectasis B. Monitor ECG frequently for arrhythmia C. Because any minimal external stimulation provokes spasm, keep patients room dark, cool and quiet D. Because any minimal external stimulation provokes spasm, wound should be checked only when necessary 86. What is the most obvious and earliest clinical manifestation that the nurse finds on physical assessment of client with Meningococcemia? A. Ophisthotonous and rigidity of muscles B. Respiratory infection symptoms and petechial hemorrhages (rash) C. Headache and high fever D. Hematuria and delirium 87. To prevent the spread of Meningococcemia: A. Impose respiratory isolation B. Follow strictly universal precaution and limit exposure to areas of concentration C. When a doubt of exposure, take prophylactic medications as prescribed by the doctor. Avoid being a carrier D. All of the above 88. The stool culture of a child with profuse diarrhea reveals salmonella bacilli. After teaching the mother of the course of salmonella infection, which of the following statement of the mother indicates effective teaching: A. Some people become carriers and stay infectious for a long time B. After the acute stage passes, the organism is usually not present in the stool C. Although the organism may be alive indefinitely, in time it will be no danger to anyone D. If my child continue to have the organism in the stool, an antitoxin can help destroy the organism 89. When assessing the child diagnosed with diarrhea due to salmonella infection, for which of the following possible sources would the nurse be alert during history taking? A. Non-refrigerated custard C. Undercooked eggs B. A pet canary D. Unwashed fruit

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90. Typhoid Fever is caused by salmonella typhosa; the disease is transmitted through: A. Air and water C. Droplet infection B. Infected water, food and milk D. Bite by a mosquito carrier 91. A mother of a child who was just admitted for severe diarrhea due to E. Coli causing gastroenteritis says that she cannot stay with the child because she has to take care of the other children at home and she has to do some works to earn. Which of the responses by the nurse would be most appropriate? A. You really should not leave right now, your child is very sick B. I understand, but feel free to visit or call anytime to see how your child is doing C. It is really isnt necessary to stay with your child, well take good care of him D. Can you find someone to stay with your other children? Your child needs you here 92. After 2 days of treatment in the hospital the child is started on a soft diet after being in clear liquids following the attack of severe diarrhea. When helping the mother in choosing foods for the child, which of the following food is most appropriate? A. Muffins and Eggs C. Bananas and rice cereals B. Bran cereal and wheat bread D. Pancakes and sausage 93. The nurse is planning a staff development program for healthcare staff on how to care for clients with hepatitis A. Which of the following precautions would indicates as essential when caring for these clients? A. Gowning when entering clients room C. Assigning the client to a private room B. Wearing a mask when providing care D. Wearing gloves when giving direct care 94. When developing a plan of care for the client with viral hepatitis, nurse should incorporate nursing orders that reflect the primary treatment. Emphasis will be on ensuring that client receives which of the following: A. Adequate bed rest due to fatigue C. regular antibiotic therapy B. Generous fluid intake D. Daily intravenous electrolyte therapy 95. Which of the following test result would the nurse use to assess the liver function of a client with viral hepatitis? A. Glucose tolerance - DM C. Serum tramsaminase B. Creatinine clearance - kidney D. Serum electrolyte diarrhea 96. Which of the following diets would likely be prescribed for a client with viral hepatitis? (fatigue) A. High fat, low protein C. High carbohydrate, high calorie for energy B. High protein, low carbohydrate D. Low sodium, low fat

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97. The nurse develops a teaching plan on how to prevent the transmission of hepatitis A, which of the following discharge instructions is most appropriate? A. Spray the house to eliminate infected insects B. Tell the other family members to try to stay away from the client C. Tell family members to wash their hands frequently hepa A is fecal -oral D. Disinfect all clothing and eating utensils 98. The nurse is preparing a community education program for hepatitis B infection, which of the following will be appropriate to incorporate into the teaching plan? A. Hepatitis B is relatively uncommon among college students B. Frequent ingestion of alcohol can predispose an individual to development of hepatitis B C. Good personal hygiene habits are most effective in preventing the spread of hepatitis B D. The use of condom is advised for sexual intercourse 99. Diphtheria is an acute and highly contagious disease with fixation symptoms: A. Intimate contact and/ or airborne respiratory droplets from carriers B. Direct contact with direct patients C. Hand to hand contact D. Indirect contact through secretions/equipments 100. A most common cause of sudden death of patients with diphtheria is: A. Thrombocytopenia C. Ventricular fibrillation B. Motor paralysis - difficulty in breathing & swallowing D. Neural Paralysis

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