ANSWER KEY CRITICAL REVIEW I – Community Community Health Nursing NURSI NG PRA CTICE II - CHN CHN and CARE of the MOTHER and CHILD General Instructions 1. This test booklet contains 100 test questions. 2. Read INSTRUCTIONS TO EXAMINEES printed on your answer sheet. 3. Shade only one (1) box for each question on your answer sheets. Two or more boxes shaded will invalidate your answer. 4. AVOID ERASURES
INSTRUCTIONS: 1. Detach one (1) answer sheet from the bottom of your Examinee ID/ Answer Sheet Set. 2. Write the subject title “Nursing Practice I” on the box provided. 3. Shade Set Box “A” on your answer sheet if your test booklet is Set A; Set box “B” if your test booklet is Set B. Multiple Choice Situational Situation 1: 1 : One health program of the DOH that is being implemented is environmental sanitation. 1. If you were a farmer’s daughter, what specific program would you advocate so that your production is high? A. Rodents and insect control C. Water Supply B. Institutional sanitation D. Occupational Health Work 2. As a nurse, how would you promote food sanitation? A. Correct food to eat C. Wash fruits before eating B. Utilize the media D. Handwashing before eating 3. Garbage disposal is a problem everywhere. What are examples of non-biodegradable wastes? A. Food refuse C. Cans B. Newspaper D. Plastic wrappers and bottles 4. What would be your health teaching in the mothers’ class in relation to waste disposal? A. Burn newspaper C. Separate biodegradable from nonbiodegradable B. Throw away garbage in a pit D. Build compost pit 5. Which of the following is the most important instruction to families whose toilets are pit latrines? A. Use newspaper to wipe their anus B. Proper handwashing C. Cover latrines against flies D. Burn the newspaper used in cleaning their anus Situation 2: The grandmother of a 3-year old kid asks you to give immunization on another day because they are going on a vacation.
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6. What would you do in the above-mentioned situation? A. Explain that Wednesday is the immunization day. B. Refuse to give immunization C. Just give without question D. Tell her to bring the card to the center where they are having a vacation 7. Men wearing police uniform requested you to keep a package of prohibited drug in your cabinet. You know that it is metamphetamine hydrochloride or shabu. What would be your answer to them? A. ‘Sige na nga sir.’ B. ‘Sorry sir. But I cannot give in to what you want.’ C. ‘Sir, I’ll tell the mayor.’’ D. ‘Please do not involve me, sir.’ 8. What would you do if you know of the existing group which keep drugs in your area of duty? A. Inform the proper authorities C. Keep quiet about it. B. Call the narcotics command D. Tell you supervisor. 9. You are aware of a health provider using drugs too. What would you do? A. Keep quiet. C. Tell him that you know about it. B. Inform the authorities. D. Report him to your supervisor. 10. There was a quarrel outside your RHU. The men were drunk. What would you do? A. Call the doctor C. Call the barangay officer B. Let someone call for help D. Shout at them Situation 3: Environmental protection is a global concern 11. To which program should a CHN participate actively to support global action for the environment? A. Toxic chemical waste management C. Zero hospital waste management B. Anti-smoke belching D. Zero solid waste campaign 12. Under the environmental health services, which of the following should the nurse participate in? A. water-borne diseases C. environment-friendly initiatives B. gastrointestinal diseases D. diarrhea and vector-borne 13. How could research data be utilized in the prevention of diseases? A. in recording epidemics and in communicable disease control B. in prescribing medications for communicable diseases C. in monitoring effects of primary health care D. in reporting case findings 14. Which step in the research process uses surveys and interviews to obtain data A. statistical data C. review of related literature B. statement of the problem D. data collection 15. As a PHN, what is your primary function or responsibility? A. reporting of cases C. community diagnosis B. assisting the doctor D. health teaching
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Situation 4: The Department of Health prepared the National Health Plan and its blue print to define the country’s health problems, thrusts and strategies 16. Which A. B. C. D.
DOH project aims to eradicate polio as expressed in one DOH slogan below? Health in the hands of the people Eradicate polio for 9 million kids Ceasefire for children:Support Immunization Day Shoot vaccines, not bullets
17. Sarah Jane is a victim of AIDS. Which program of the DOH was established to check the prevalence rate of AIDS? A. AIDS surveillance program C. National AIDS prevention and control program B. Philippine National AIDS control D. AIDS awareness activities 18. An advocacy and action strategy to fight cancer and cardiovascular disease affected by smoking is reflected in one of the following campaigns: A. Smoking is dangerous to your health C. This is a Smoke-free building B. Tobacco and Smoke-Free Environment D. Smoke moderately 19. Hospitals as centers of wellness began in 1993 which institutionalized promotive and preventive aspects of care. What is the best feature of the mother and baby-friendly hospital? A. Well-baby clinic C. Free immunization B. Free maternal services D. breastfeeding is enforced 20. Health for More in ’94 included Oplan Alis Disease. As a nurse, which one below would you promote as a non-pharmacological strategy to have a healthy heart? A. Taking prescribed drugs C. Research on heart disease B. Consulting a physician D. Client education on healthy lifestyle Situation 5: Based on the safe motherhood survey, maternal morbidity ratio is 209/100,000 livebirths and perinatal mortality rate is also high 21. Based on DOH findings, maternal tragedies occur due to delayed referrals. Which one below contributes to delayed referrals? A. transportation and communication C. late detection of complications B. untrained manpower D. lack of blood supplies 22. Target population for total care during pregnancy, delivery and postpartum belongs to this age group A. 15-40 B. 15-44 C. 16-45 D.18-35 23. Maternal mortality is the number of maternal deaths per 1,000 livebirths in a specific year. Which one below is the t he correct formula? A. Livebirths + number of fetal deaths X 1,000 Number of deaths due to maternal causes B.
Livebirths - number of fetal deaths
X 1,000
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Number of deaths due to maternal causes
C.
Number of deaths due to maternal causes
X 1,000
Livebirths + number number of fetal deaths D.
Number of deaths due to maternal causes
X 1,000
Livebirths in the same year 24. Neonatal mortality is the number of deaths of babies born alive before they reach 28 days for every 1,000 livebirths in a specific year. Which formula is correct? A. Deaths under 28 days X 1,000 Livebirths in the same year B.
Deaths under 28 days
X 100,000
Livebirths in the same year C.
Deaths under 28 days
X 100
Livebirths in the same year D.
Livebirths in the same year
X 1,000
Deaths under 28 days 25. Infant mortality is deaths under 1 year of age per 1,000 live births in a specific year. Which formula is correct? A. Deaths under 1 year of age X 1,000 Livebirths in the same year B.
Deaths below 1 year of age
X 10,000
Livebirths in the same year C.
Deaths below 1 year of age
X 100,000
Livebirths in the same year D.
Livebirths in the same year
X 1,000
Deaths under under 1 year of age Situation 6: Maternal and child health service is one vital program in the DOH. Maternal mortality rate is high due to hemorrhage, infection and hypertension complications. 26. Mrs. Santos came to the RHU to consult with MHO but she was attending a seminar. What would you do first if she tells you that she is bleeding? A. Check vital sign
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B. Give a transfusion at once C. Tell her to go the city D. Accompany her to the provincial hospital 27. Camille is 21 years old, 3 months pregnant and asks you about the prenatal services. What would you tell her? A. “Are you going to practice family planning?” B. Do you have an Obstetrician? C. Let me tell you the importance of prenatal check-up D. “ Why did you come only today? 28. Home delivery for a normal pregnant woman is being encouraged by primary care providers. If there is no licensed health professional in the RHU, who will attend to the delivery of the woman? A. Komadrona C. Trained hilot B. New RN D. Licensed midwife 29. Postpartum complications must be avoided through appropriate prenatal counseling. After home delivery, when will you do the first home visit to check for bleeding and infection? A. 24 hours C. 1 week B. 2 weeks D. 40 hours 30. To promote appropriate health practice of pregnant women, you as a PHN must focus on: A. Public education program B. Accurate record and report C. Linkage with PNA and IMAP D. Prompt referral system 31. Which of the following identifies increased risk for AIDS? A. Sentinel site nationwide C. AIDS surveillance B. AIDS prevention D. AIDS protection 32. Which program advocates the right to protection and human dignity? A. AIDS national council C. Sentinel site B. AIDS prevention D. HIV/AIDS patients 33. Which A. B. C. D.
program broadens the context on women’s health and safe motherhood? Family planning program of the Philippines DOH family planning services Family Planning Organization of the Philippines None of these
34. Which innovative scheme provides health manpower in doctorless and nurseless municipalities? A. Human resources manpower of DOH C. Human resources for health manpower B. Health manpower resources program D. Health resources program 35. Which of these promote backyard propagation and herbal medication production? A. Indigenous healing B. Herbal and Philippine traditional medicines
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C. Anthropology and traditional medicines D. Herbal collection of scientific benefits Situation 7: The Expanded Program of Immunization (EPI) was started in July 1976 by the virtue of PD 996, a compulsory immunization of children below 8 years old. 36. This EPI is based on 3 principles. Which one is pro-people? A. Mass approach rather than individual C. A basic health services B. Based on epidemiological situation D. Case finding and treatment on site 37. Which one is the primary component of EPI? A. Surveillance and research B. Information campaign
C. Target setting D. Logistic management
38. The general objective of EPI is to reduce the morbidity and mortality rates among children. BCG is given at birth followed by 1 dose. When is the 2 nd dose given? A. Every months for 2 months C. One and half months after B. Two months after first dose D. Pre-school booster 39. Measles vaccine is given subcutaneous in a dose of 0.5ml. At what age is this done? A. one year C. six months B. one and half year D. nine months 40. Which collaborating agency in the world helps eradicate polio in children? A. UNICEF C. WHO B. Rotary International D. Canadian International Development Agency Situation 8: Water quality and monitoring for surveillance is the responsibility for each municipality through the RHU. Planning must be assisted by the environmental health services. 41. The nurse should know that the examination of drinking water by the government and non-government municipality is through the RHU. Planning must be assisted by: A. City health C. Municipality B. Department of health D. Sanitary engineer/inspector 42. Disinfections of water supply is required in a newly constructed well, repaired water pipes, and contaminated container, EXCEPT: A. River C. Open well B. Surface water D. Unimproved spring 43. Approved types of toilet facilities may or may not need water depending on receiving space. What type of toilet is without need for water? A. Aqua privies C. Water sealed B. Flush toilet D. Pit privies 44. Hospital waste management program is a requirement before construction of newly facilities. The hospital personnel are required to train in waste management to prevent which of the following? A. Transmission infection C. Nosocomial infection B. Cross infection D. Communicable disease
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45. Nursing responsibilities and activities toward environment and population is beyond measure. The nurse is in the best position to conduct health education through which of the following? A. Role modeling approach B. Development and distribution of IEC materials C. Use of communication media D. Development of designs or program Situation 9: Care of the elderly as included in the WHO’s Health for all in the Philippines, the elderly is properly cared for at home. 46. Which of the following needs, according to Maslow, apply to old people? A. Belongingness C. Emotional B. Economic D. Spiritual 47. Respiratory disease affects the elderly. Which nursing function would best assist your grandparents? A. Function specific to diseases C. Referral to specialist B. Home management D. Guidance counseling 48. Humanitarian issue affect the care of the elderly. Filipino values is changing. Which one would you maintain in the care of elderly? A. Labor and management C. Educational and recreational B. Income of elderly D. Security and protection 49. What would be the thrust of the program that you would make for the elderly? A. Invoke elderly in a volunteer work C. Information on physical & social process B. Children to be responsible for parents D. Build homes for elderly 50. In our country senior citizens are given the privilege when they purchase their medicines. How much is the discount? A. 25% C. 15% B. 10% D. 20% Situation 10: Mrs. Florida Rasol, 35 years old and G4P4, expressed her desire to undergo bilateral tubal ligation (BTL). Her youngest child is one year old. 51. In counseling Mrs. Rasol and her husband about BTL which of the following should be the main focus of the nurse? A. If the couple has any doubts, offer another contraceptive B. Assist the couple to make a sound, well informed decision to undergo the procedure C. Motivate the couple to make a sound, well informed the decision to undergo the procedure D. Review the family and personal circumstances that could their affect their decision 52. After sterilization, which of the following choices should be avoided by Mrs. Rasol? A. Lift her youngest child B. Resume sexual relationship with husband C. Shower anytime, but keep the incision site dry for 7 days D. Take medication as ordered
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53. Which of the following is NOT TRUE about the BTL? A. very effective and safe C. Does not interfere with sexual activities B. Irreversible D. Allows immediate sterility 54. Mrs. Rasol asks, “Will it be possible for me to get pregnant after the procedure? The best response of the nurse will be: A. “What made you ask?” B. “There are some report of the women getting pregnant, but this is comparatively rare.” C. “Absolutely not, this is a permanent sterility.” D. “The doctor here are all specialists. I wouldn’t worry if I were you.” 55. Other methods of contraception are explored. Mrs. Rasol expressed her-non preference for vasectomy. Which of the following are the main reasons why this method is not a popular choice among men? A. Diminishes macho image B. Sterility is not immediate C. Restoration of fertility does not always succeed D. Very costly Situation 11: Aling Dolor, a retired school teacher and a sari-sari store owner, came to t he health center complaining of easy fatigability. She is very much worried about her health although according to her, work in the store is very light. 56. Based on the above situation, which of the following statements best exemplifies health promotion priority goal for Aling Dolor? A. Have regular physical examination B. Encourage her to have a bed rest C. Allay or reduce her stress D. Plan a therapeutic diet for her 57. In doing risk appraisal for Aling Dolor, which of the following behaviors of the nurse is most appropriate A. show a helping attitude by supervising her ADL B. show an attitude of concern considering her individuality as a person C. develop client trust in you by explaining in technical terms her condition D. perform physical assessment including technical gynecological history 58. The objective of a risk appraisal for Aling Dolor is to assess the: A. Undesirable health practice C. Health habit and practice B. Danger sign and disease D. Health threats in the community Situation 12: As a community health nurse, your clients are usually diverse. It is important that you should be aware of the needs of these clients according to their developmental stages 59. Princess, 22 years old has just been accepted in an ambulatory health care clinic. She approached you to report an outbreak of influenza in their neighborhood and has shared with you how she anxiously awaits her first job. The major developmental focus of Princess and her age group is: A. rebelling against parental control in matter of dating and going out with friends
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B. deciding what worth can be shared by the next generation C. finding oneself and developing initial commitments D. resolving how one will confront death 60. In one of your clinics, you met Mrs. Baby a 42-year old woman, who began to feel anxious about her life. Her husband has been very busy having been promoted as CEO of their company. Her oldest child is already working and two younger ones are in school. She daydreams about having another baby. You would consider her situation as: A. Expected midlife disillusionment B. Healthy life expectation C. Serious developmental abnormality D. Out of control midlife crisis 61. Mr. Melanio, 50 years old, is known to be obsessed with his graying and balding hair. He makes frequent negative references to his body and energy level and at one time he told to his wife to leave him for a younger man. His behavior probably indicates: A. Mental and / or neurotic disorder C. Desire to separate from the wife B. Loss of sexuality D. Awareness of aging and mortality 62. Aling Melody, 75 years old, is very active in church activities. She is in good physical health but was brought to your clinic clinic by her eldest daughter. Her daughter is disturbed because Aling Melody always talks about “when she dies”. She has given away some of her possessions to friends and other close relatives. She a lso told her family about a bout wanting to be cremated when the “time” comes. She say she is fine and just wants to be realistic and ready. Your nursing interventions would most likely be: A. Explain that her behavior is developmentally normal B. Obtain a prescription for anti depressant C. Refer her to the hospital for further observation D. Just ignore the complaints of the eldest daughter 63. Mr. Valeros, 70 years old came to the clinic complaining about muscle weakness, fatigue and shortness of breath with his regular walking exercise in the morning. Upon examination, his BP is 136/86 and pulse rate is 70/min. He said that after the short rest, he feels fine again. He is not taking any medication. Your analysis with his assessment would most likely be that he: A. Probably experiences signs of normal aging B. Needs to take preventive “anti hypertensive” medication C. Has cardiac pathology and needs to be seen by the doctors D. None of the above Situation 13: Flor, age 40 seeks consultation for difficulty of sleeping and poor appetite for one month after their house was destroyed by lahar. 64. One of the basic goal for crisis intervention is: A. Assist the person to attain higher level of functioning B. Help the person return to the normal level of functioning C. Assist the person person explore available and appropriate resources in the community D. Assist the person person identify the nature and extent of her problem 65. After a thorough assessment, the nurse identifies this relevant nursing diagnosis: A. Sensory perceptual disturbance C. Impaired adjustment B. Impaired physical mobility D. Ineffective individual coping
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66. The initial task in crisis intervention is to assess: A. The client support system B. The type of crisis crisis the client is experiencing
C. The individual and the problem D. The plan for coping with with crisis crisis
67. One important factor to consider in assessing Flor’s ability to handle a crisis is: A. Person’s coping skills C. Her family background B. Age and level of maturity D. Her intelligence Situation 14: Currently, a lot of developments are happening in health care institutions. Surfacing new health care agencies that are managed by nurses are slowly evolving amidst the rising health care cost. 68. The following are major health problem in the current health care system that have most affected the national health policy: I. older adult population ll. access to health care service lll. Quality of health services lV. Medical cost control V. Nursing specialization A. ll, lll, lV and V C. l, ll, lll, lV B. l, lll, lV and V D. l, ll, lll, V 69. The unit in training hospitals which includes physicians’ offices, clinics, emergency care centers as well as wellness center is called: A. Community extension services B. Emergency room department C. Hospital care services D. Out patient department 70. The following are major factors most significantly influencing the health care delivery system over the last decade: 1 legal, ethical and bioethical issues 2 new knowledge knowledge and technology technology in the management of disease 3 political and economic condition 4 society and consumer movement A. 1, 3, 4, 5 B. 2, 3, 4, 5 C. 1, 2, 3, 4 D. 1, 2, 3, 5 71. The Philippine Health Insurance Corporation is a: A. Private insurance program to reduce client’s medical cost B. Fixed payment to hospital based on cost incurred by each client C. Fixed payment to hospital based on diagnostic categories D. Government health insurance program to reduce client’s medical cost 72. Which of the following factors affecting health care cost is LEAST apparent in the Philippines? A. Increase poverty resulting in least preventive care B. Increase in numbers of clients with AIDS and AIDS related illness C. Growing specialization in medical practice D. Emergent modern technology
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Situation 15: Iodine deficiency affects more females than males in the reproductive years. 73. What would you include in your health teaching on iodine deficiency? A. eat seafoods and vegetables B. eat beans C. eat meat and vegetables D. eat sweet potatoes 74. The nurse recognizes that one of the major effects of iodine deficiency is mental retardation. How would the nurse assess mental retardation? A. ask questions B. let child tell a story C. ask mother if she has history of abortion D. ask parents what they eat 75. Place where populations are affected a ffected by iodine deficiency are those where products are goitrogenics. What are these foods? A. pili nuts B. saur kraut and mandarins C. monggo sprouts D. cassava and cauliflower 76. Which A. B. C. D.
food prevents goiter? broccoli sea foods green fruits and vegetables cauliflower
77. Prevention of thyroidism should be included in health teaching. What should be your topic? A. foods to eat B. operable goiters C. cooking lessons D. types of goiter Situation 16: Reproductive Health is the exercise of reproductive rights with responsibility. One of the goals of the program is to prevent illness/ injuries related to sexuality and reproduction. 78. The following are goals of RH, EXCEPT: A. every pregnancy should be intended B. every birth should be healthy C. all married couple should use artificial contraceptive D. achieve a desired family size 79. In the A. B. C. D.
international framework of RH, the focus is on: past 40 years age group women’s health displaced people with RH problem barren people
80. Which of the following is not an element of the RH? A. prevention and management of abortion complications
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B. violence against women C. self- employment D. men’s reproductivehealth 81. In the A. B. C. D.
Philippines, the focus of RH in terms of its elements is/are on: men and women men only women only gender discrimination
82. What factor generally affects reproductive results in the international framework? A. poverty B. underemployment C. environment D. gender discrimination Situation 17: For a developing country like the Philippines, sanitation is the most common problem. Along with the programs to promote sanitation, the DOH also promotes a program that helps control diarrheal disease. 83. Which of the following is the vital role of the nurse in the CDD program? A. maternal and child health B. sanitation and environment C. health education D. nutrition 84. What is the personal commitment of the nurse in the prevention of diarrheal disease program? A. setting good examples B. encouraging barangay officials C. motivating groups D. health education 85. It is utilized in the extensive case management of diarrhea to reduce mortality rate in children: A. oral rehydration solution B. oral rehydration therapy C. proper waste disposal D. improved weaning practices 86. What is the primary objective of the CDD advocated by the DOH? A. to reduce mortality from diarrhea B. environmental sanitation C. maternal and child health D. promote breastfeeding practices 87. What is the primary prevention for CDD advocated by DOH that is effective and affordable? A. fluid replacement B. breastfeeding C. oral rehydration therapy D. measles immunization
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Situation 18: Quality health services is the aim of the DOH. Numerous programs have been devised to promote such. 88. It is the certification program that develops and promotes standard for health facilities: A. sentrong sigla movement B. ‘sang milyong sepilyo C. reproductive health D. expanded program on immunization 89. Among the pillars of Sentrong Sigla Movement, except: A. quality assurance B. award C. international recognition D. health promotion 90. All A. B. C. D.
are the priorities of Sentrong Sigla Movement, except: EPI Disease surveillance Family planning Voluntary blood donation
91. All of the following are the standard requirements of Sentrong Sigla M ovement, except: A. infrastructure B. equipment C. pharmaceuticals D. herbal medicines 92. An A. B. C. D.
expected result of Sentrong Sigla Movement in every individual is to: adapt healthy lifestyles develop policies develop a system of surveillance advocacy law
Situation 19: One of the leading causes of morbidity and mortality is pulmonary infections. Acute respiratory infection (ARI) could be managed a t home, given the proper protocol. 93. Which of the following should a nurse include in the health teaching given top mothers to prevent ARI? A. wash hands after using toilet B. avoid smoking in the home C. avoid droplet infection D. consult the doctor regularly 94. In adults with pneumonia or ARI in the home, which drug must be available at the RHU based on standard case management? A. chloramphenicol B. oxygen tanks C. co- trimoxazole D. injectable gentamycin
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95. In far flung areas, who could dispose ARI standard orders in case of Pneumonia in children? A. sanitarian B. midwife C. nurse D. barangay health worker 96. During home visit, the nurse assessed the child with ARI. Which of the following signs indicate immediate medical intervention? A. inability to drink B. restlessness C. temperature of 37.70C D. poor appetite 97. Which of the following is not included in the prevention of acute respiratory infection? A. measles immunization B. avoid smoking C. breastfeeding D. good ventilation Situation 20: Being the public health nurse, you provide nursing care to the family. 98. The nurse performs the following to determine the family’s nursing problems/ needs: A. family health care plan formulation B. assessment C. goal setting D. evaluation 99. An A. B. C. D.
appropriate source of information about the family is/ are: interview results with the members of the family family folder actual observation of the family situation all these are sources of information
100.
The family presents several problems, which of the following criteria is considered in determining the priority health problem? A. involvement of members of the family in the problem B. cooperation and support of the family C. modifiability of the problem D. expected consequence of the problem
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