Community Health Nursing Past Paper PDF

444 COMMUNITY HEALTH NURSING Part 1 disease causation C. Immunize nearby communities with Measles SITUATION : Epidemiology and Vital statistics is a very D. Educate the community in f...

444 COMMUNITY HEALTH NURSING Part 1 disease causation C. Immunize nearby communities with Measles SITUATION : Epidemiology and Vital statistics is a very D. Educate the community in future prevention of similar important tool that a nurse could use in controlling the outbreaks spread of disease in the community and at the same time, surveying the impact of the disease on the 6. The main concern of a public health nurse is the population and prevent it’s future occurrence. prevention of disease, prolonging of life and promoting physical health and efficiency through which of the 1. It is concerned with the study of factors that influence following? the occurrence and distribution of diseases, defects, disability or death which occurs in groups or aggregation A. Use of epidemiological tools and vital health statistics of individuals. B. Determine the spread and occurrence of the disease C. Political empowerment and Socio Economic A. Epidemiology Assistance B. Demographics D. Organized Community Efforts C. Vital Statistics D. Health Statistics 7. In order to control a disease effectively, which of the following must first be known? 2. Which of the following is the backbone in disease prevention? 1. The conditions surrounding its occurrence 2. Factors that do not favor its development A. Epidemiology 3. The condition that do not surround its occurrence B. Demographics 4. Factors that favors its development C. Vital Statistics D. Health Statistics A. 1 and 3 B. 1 and 4 3. Which of the following type of research could show C. 2 and 3 how community expectations can result in the actual D. 2 and 4 provision of services? 8. All of the following are uses of epidemiology except: A. Basic Research B. Operational Research A. To study the history of health population and the rise C. Action Research and fall of disease D. Applied Research B. To diagnose the health of the community and the condition of the people 4. An outbreak of measles has been reported in C. To provide summary data on health service delivery Community A. As a nurse, which of the following is your D. To identify groups needing special attention first action for an Epidemiological investigation? 9. Before reporting the fact of presence of an epidemic, A. Classify if the outbreak of measles is epidemic or just which of the following is of most importance to sporadic determine? B. Report the incidence into the RHU C. Determine the first day when the outbreak occurred A. Are the facts complete? D. Identify if it is the disease which it is reported to be B. Is the disease real? C. Is the disease tangible? 5. After the epidemiological investigation produced final D. Is it epidemic or endemic? conclusions, which of the following is your initial step in your operational procedure during disease outbreak? 10. An unknown epidemic has just been reported in Barangay Dekbudekbu. People said that affected person A. Coordinate personnel from Municipal to the National demonstrates hemorrhagic type of fever. You are level designated now to plan for epidemiological B. Collect pertinent laboratory specimen to confirm investigation. Arrange the sequence of events in 444  445 accordance with the correct outline plan for epidemiological investigation. 13. All of the following are function of Nurse Budek in epidemiology except 1. Report the presence of dengue 2. Summarize data and conclude the final picture of A. Laboratory Diagnosis epidemic B. Surveillance of disease occurrence 3. Relate the occurrence to the population group, C. Follow up cases and contacts facilities, food supply and carriers D. Refer cases to hospitals if necessary 4. Determine if the disease is factual or real E. Isolate cases of communicable disease 5. Determine any unusual prevalence of the disease and its nature; is it epidemic, sporadic, endemic or 14. All of the following are performed in team pandemic? organization except 6. Determine onset and the geographical limitation of the disease. A. Orientation and demonstration of methodology to be employed A. 4,1,3,5,2,6 B. Area assignments of team members B. 4,1,5,6,3,2 C. Check team’s equipments and paraphernalia C. 5,4,6,2,1,3 D. Active case finding and Surveillance D. 5,4,6,1,2,3 E. 1,2,3,4,5,6 15. Which of the following is the final output of data reporting in epidemiological operational procedure? 11. In the occurrence of SARS and other pandemics, which of the following is the most vital role of a nurse in A. Recommendation epidemiology? B. Evaluation C. Final Report A. Health promotion D. Preliminary report B. Disease prevention C. Surveillance 16. The office in charge with registering vital facts in the D. Casefinding Philippines is none other than the 12. Measles outbreak has been reported in Barangay A. PCSO Bahay Toro, After conducting an epidemiological B PAGCOR investigation you have confirmed that the outbreak is C. DOH factual. You are tasked to lead a team of medical D. NSO workers for operational procedure in disease outbreak. Arrange the correct sequence of events that you must 17. The following are possible sources of Data except: do to effectively contain the disease A. Experience 1. Create a final report and recommendation B. Census 2. Perform nasopharyngeal swabbing to infected C. Surveys individuals D. Research 3. Perform mass measles immunization to vulnerable groups 18. This refers to systematic study of vital events such as 4. Perform an environmental sanitation survey on the births, illnesses, marriages, divorces and deaths immediate environment 5. Organize your team and Coordinate the personnels A. Epidemiology 6. Educate the community on disease transmission B. Demographics C. Vital Statistics A. 1,2,3,4,5,6 D. Health Statistics B. 6,5,4,3,2,1 C. 5,6,4,2,3,1 19. In case of clerical errors in your birth certificate, D. 5,2,3,4,6,1 Where should you go to have it corrected? 445  446 A. 651 A. NSO B. 541 B. Court of Appeals C. 996 C. Municipal Trial Court D. 825 D. Local Civil Registrar 25. These rates are referred to the total living 20. Acasia just gave birth to Lestat, A healthy baby boy. population, It must be presumed that the total Who are going to report the birth of Baby Lestat? population was exposed to the risk of occurrence of the event. A. Nurse B. Midwife A. Rate C. OB Gyne B. Ratio D. Birth Attendant C. Crude/General Rates D. Specific Rate 21. In reporting the birth of Baby Lestat, where will he be registered? 26. These are used to describe the relationship between two numerical quantities or measures of events without A. At the Local Civil Registrar taking particular considerations to the time or place. B. In the National Statistics Office C. In the City Health Department A. Rate D. In the Field Health Services and Information System B. Ratios Main Office C. Crude/General Rate D. Specific Rate 22. Deejay, The birth attendant noticed that Lestat has low set of ears, Micrognathia, Microcephaly and a typical 27. This is the most sensitive index in determining the cat like cry. What should Deejay do? general health condition of a community since it reflects the changes in the environment and medical conditions A. Bring Lestat immediately to the nearest hospital of a community B. Ask his assistant to call the nearby pediatrician C. Bring Lestat to the nearest pediatric clinic A. Crude death rate D. Call a Taxi and together with Acasia, Bring Lestat to B. Infant mortality rate the nearest hospital C. Maternal mortality rate D. Fetal death rate 23. Deejay would suspect which disorder? 28. According to the WHO, which of the following is the A. Trisomy 21 most frequent cause of death in children underfive B. Turners Syndrome worldwide in the 2003 WHO Survey? C. Cri Du Chat D. Klinefelters Syndrome A. Neonatal B. Pneumonia 24. Deejay could expect which of the following C. Diarrhea congenital anomaly that would accompany this D. HIV/AIDS disorder? 29. In the Philippines, what is the most common cause of A. AVSD death of infants according to the latest survey? B. PDA C. TOF A. Pneumonia D. TOGV B. Diarrhea C. Other perinatal condition 26. Which presidential decree orders reporting of births D. Respiratory condition of fetus and newborn within 30 days after its occurrence? 30. The major cause of mortality from 1999 up to 2002 446  447 in the Philippines are 4. Death from CVD : 3,029 5. Deaths under 1 year of age : 23 A. Diseases of the heart 6. Fetal deaths : 8 B. Diseases of the vascular system 7. Deaths under 28 days : 8 C. Pneumonias 8. Death due to rabies : 45 D. Tuberculosis 9. Registered cases of rabies : 45 10. People with pneumonia : 79 31. Alicia, a 9 year old child asked you “ What is the 11. People exposed with pneumonia : 2,593 common cause of death in my age group here in the 12. Total number of deaths from all causes : 10,998 Philippines? “ The nurse is correct if he will answer The following questions refer to these data A. Pneumonia is the top leading cause of death in children age 5 to 9 35. What is the crude birth rate of Barangay PinoyBSN? B. Malignant neoplasm if common in your age group C. Probability wise, You might die due to accidents A. 90/100,000 D. Diseases of the respiratory system is the most B. 9/100 common cause of death in children C. 90/1000 D. 9/1000 32. In children 1 to 4 years old, which is the most common cause of death? 36. What is the cause specific death rate from cardiovascular diseases? A. Diarrhea B. Accidents A. 27/100 C. Pneumonia B. 1191/100,000 D. Diseases of the heart C. 27/100,000 D. 1.1/1000 33. Working in the community as a PHN for almost 10 years, Aida knew the fluctuation in vital statistics. She 37. What is the Maternal Mortality rate of this knew that the most common cause of morbidity among barangay? the Filipinos is A. 6.55/1000 A. Diseases of the heart B. 5.89/1000 B. Diarrhea C. 1.36/1000 C. Pneumonia D. 3.67/1000 D. Vascular system diseases 38. What is the fetal death rate? 34. Nurse Aida also knew that most maternal deaths are caused by A. 3.49/1000 B. 10.04/1000 A. Hemorrhage C. 3.14/1000 B. Other Complications related to pregnancy occurring D. 3.14/100,000 in the course of labor, delivery and puerperium C. Hypertension complicating pregnancy, childbirth and 39. What is the attack rate of pneumonia? puerperium D. Abortion A. 3.04/1000 B. 7.18/1000 SITUATION : Barangay PinoyBSN has the following data C. 32.82/100 in year 2006 D. 3.04/100 1. July 1 population : 254,316 40. Determine the Case fatality ratio of rabies in this 2. Livebirths : 2,289 Barangay 3. Deaths from maternal cause : 15 447  448 A. 1/100 B. 100% 47. Which of the following is a POINT SOURCE epidemic? C. 1% D. 100/1000 A. Dengue H.F B. Malaria 41. The following are all functions of the nurse in vital C. Contaminated Water Source statistics, which of the following is not? D. Tuberculosis A. Consolidate Data 48. All but one is a characteristic of a point source B. Collects Data epidemic, which one is not? C. Analyze Data D. Tabulate Data A. The spread of the disease is caused by a common vehicle 42. The following are Notifiable diseases that needs to B. The disease is usually caused by contaminated food have a tally sheet in data reporting, Which one is not? C. There is a gradual increase of cases D. Epidemic is usually sudden A. Hypertension B. Bronchiolitis 49. The only Microorganism monitored in cases of C. Chemical Poisoning contaminated water is D. Accidents A. Vibrio Cholera 43. Which of the following requires reporting within 24 B. Escherichia Coli hours? C. Entamoeba Histolytica D. Coliform Test A. Neonatal tetanus B. Measles 50. Dengue increase in number during June, July and C. Hypertension August. This pattern is called D. Tetanus A. Epidemic 44. Which Act declared that all communicable disease be B. Endemic reported to the nearest health station? C. Cyclical D. Secular A. 1082 B. 1891 SITUATION : Field health services and information C. 3573 system provides summary data on health service D. 6675 delivery and selected program from the barangay level up to the national level. As a nurse, you should know the 45. In the RHU Team, Which professional is directly process on how these information became processed responsible in caring a sick person who is homebound? and consolidated. A. Midwife 51. All of the following are objectives of FHSIS Except B. Nurse C. BHW A. To complete the clinical picture of chronic disease D. Physician and describe their natural history B. To provide standardized, facility level data base which 46. During epidemics, which of the following can be accessed for more in depth studies epidemiological function will you have to perform first? C. To minimize recording and reporting burden allowing more time for patient care and promotive activities A. Teaching the community on disease prevention D. To ensure that data reported are useful and accurate B. Assessment on suspected cases and are disseminated in a timely and easy to use fashion C. Monitor the condition of people affected D. Determining the source and nature of the epidemic 52. What is the fundamental block or foundation of the 448  449 field health service information system? A. Leprosy cases B. TB cases A. Family treatment record C. Prenatal care B. Target Client list D. Diarrhea cases C. Reporting forms D. Output record 59. This is the only mechanism through which data are routinely transmitted from once facility to another 53. What is the primary advantage of having a target client list? A. Family treatment record B. Target Client list A. Nurses need not to go back to FTR to monitor C. Reporting forms treatment and services to beneficiaries thus saving time D. Output record and effort B. Help monitor service rendered to clients in general 60. FHSIS/Q-3 Or the report for environmental health C. Facilitate monitoring and supervision of services activities is prepared how frequently? D. Facilitates easier reporting A. Daily 54. Which of the following is used to monitor particular B. Weekly groups that are qualified as eligible to a certain program C. Quarterly of the DOH? D. Yearly A. Family treatment record 61. Nurse Budek is preparing the reporting form for B. Target Client list weekly notifiable diseases. He knew that he will code the C. Reporting forms report form as D. Output record A. FHSIS/E-1 55. In using the tally sheet, what is the recommended B. FHSIS/E-2 frequency in tallying activities and services? C. FHSIS/E-3 D. FHSIS/M-1 A. Daily B. Weekly 62. In preparing the maternal death report, which of the C. Monthly following correctly codes this occurrence? D. Quarterly A. FHSIS/E-1 56. When is the counting of the tally sheet done? B. FHSIS/E-2 C. FHSIS/E-3 A. At the end of the day D. FHSIS/M-1 B. At the end of the week C. At the end of the month 63. Where should Nurse Budek bring the reporting forms D. At the end of the year if he is in the BHU Facility? 57. Target client list will be transmitted to the next A. Rural health office facility in the form of B. FHSIS Main office C. Provincial health office A. Family treatment record D. Regional health office B. Target Client list C. Reporting forms 64. After bringing the reporting forms in the right facility D. Output record for processing, Nurse Budek knew that the output reports are solely produced by what office? 58. All but one of the following are eligible target client list A. Rural health office B. FHSIS Main office 449  450 C. Provincial health office D. Regional health office 70. Data submitted to the PHO is processed using what type of technology? 65. Mang Raul entered the health center complaining of fatigue and frequent syncope. You assessed Mang Raul A. Internet and found out that he is severely malnourished and B. Microcomputer anemic. What record should you get first to document C. Supercomputer these findings? D. Server Interlink Connections A. Family treatment record SITUATION : Community organizing is a process by which B. Target Client list people, health services and agencies of the community C. Reporting forms are brought together to act and solve their own D. Output record problems. 66. The information about Mang Raul’s address, full 71. Mang Ambo approaches you for counseling. You are name, age, symptoms and diagnosis is recorded in an effective counselor if you A. Family treatment record A. Give good advice to Mang Ambo B. Target Client list B. Identify Mang Ambo’s problems C. Reporting forms C. Convince Mang Ambo to follow your advice D. Output record D. Help Mang Ambo identify his problems 67. Another entry is to be made for Mang Raul because 72. As a newly appointed PHN instructed to organize he is in the target client’s list, In what TCL should Mang Barangay Baritan, Which of the following is your initial Raul’s entry be documented? step in organizing the community for initial action? A. TCL Eligible Population A. Study the Barangay Health statistics and records B. TCL Family Planning B. Make a courtesy call to the Barangay Captain C. TCL Nutrition C. Meet with the Barangay Captain to make plans D. TCL Pre Natal D. Make a courtesy call to the Municipal Mayor 68. The nurse uses the FHSIS Record system incorrectly 73. Preparatory phase is the first phase in organizing the when she found out that community. Which of the following is the initial step in the preparatory phase? A. She go to the individual or FTR for entry confirmation in the Tally/Report Summary A. Area selection B. She refer to other sources for completing monthly B. Community profiling and quarterly reports C. Entry in the community C. She records diarrhea in the Tally sheet/Report form D. Integration with the people with a code FHSIS/M-1 D. She records a Child who have frequent diarrhea in TCL 74. the most important factor in determining the proper : Under Five area for community organizing is that this area should 69. The BHS Is the lowest level of reporting unit in FHSIS. A. Be already adopted by another organization A BHS can be considered a reporting unit if all of the B. Be able to finance the projects following are met except C. Have problems and needs assistance D. Have people with expertise to be developed as A. It renders service to 3 barangays leaders B. There is a midwife the regularly renders service to the area 75. Which of the following dwelling place should the C. The BHS Have no mother BHS Nurse choose when integrating with the people? D. It should be a satellite BHS 450  451 A. A simple house in the border of Barangay Baritan and Nurse must first San Pablo B. A simple house with fencing and gate located in the A. Make a lesson plan center of Barangay Baritan B. Set learning goals and objective C. A modest dwelling place where people will not C. Assess their learning needs hesitate to enter D. Review materials needed for training D. A modest dwelling place where people will not hesitate to enter located in the center of the 81. Nurse Budek wrote a letter to PCSO asking them for community assistance in their feeding programs for the community’s nutrition and health projects. PCSO then approved the 76. In choosing a leader in the community during the request and gave Budek 50,000 Pesos and a truckload of Organizational phase, Which among these people will rice, fruits and vegetables. Which phase of COPAR did you choose? Budek utilized? A. Miguel Zobel, 50 years old, Rich and Famous A. Preparatory B. Rustom, 27 years old, Actor B. Organizational C. Mang Ambo, 70, Willing to work for the desired C. Education and Training change D. Intersectoral Collaboration D. Ricky, 30 years old, Influential and Willing to work E. Phase out for the desired change 82. Ideally, How many years should the Nurse stay in the 77. Which type of leadership style should the leaders of community before he can phase out and be assured of a the community practice? Self Reliant community? A. Autocratic A. 5 years B. Democratic B. 10 years C. Laissez Faire C. 1 year D. Consultative D. 6 months 78. Setting up Committee on Education and Training is in 83. Major discussion in community organization are what phase of COPAR? made by A. Preparatory A. The nurse B. Organizational B. The leaders of each committee C. Education and Training C. The entire group D. Intersectoral Collaboration D. Collaborating Agencies E. Phase out 84. The nurse should know that Organizational plan best 79. Community diagnosis is done to come up with a succeeds when profile of local health situation that will serve as basis of health programs and services. This is done in what phase 1. People sees its values of COPAR? 2. People think its antagonistic professionally 3. It is incompatible with their personal beliefs A. Preparatory 4. It is compatible with their personal beliefs B. Organizational C. Education and Training A. 1 and 3 D. Intersectoral Collaboration B. 2 and 4 E. Phase out C. 1 and 2 D. 1 and 4 80. The people named the community health workers based on the collective decision in accordance with the 85. Nurse Budek made a proposal that people should set criteria. Before they can be trained by the Nurse, The turn their backyard into small farming lots to plant 451  452 vegetables and fruits. He specified that the objective is community health problems and needs. to save money in buying vegetables and fruits that tend to have a fluctuating and cyclical price. Which step in A. Residing in the area of assignment Community organizing process did he utilized? B. Listing down the name of person to contact for courtesy call A. Fact finding C. Gathering initial information about the community B. Determination of needs D. Preparing Agenda for the first meeting C. Program formation D. Education and Interpretation SITUATION : Health education is the process whereby knowledge, attitude and practice of people are changed 86. One of the critical steps in COPAR is becoming one to improve individual, family and community health. with the people and understanding their culture and lifestyle. Which critical step in COPAR will the Nurse try 91. Which of the following is the correct sequence in to immerse himself in the community? health education? A. Integration 1. Information B. Social Mobilization 2. Communication C. Ground Work 3. Education D. Mobilization A. 1,2,3 87. The Actual exercise of people power occurs during B. 3,2,1 when? C. 1,3,2 D. 3,1,2 A. Integration B. Social Mobilization 92. The health status of the people is greatly affected C. Ground Work and determined by which of the following? D. Mobilization A. Behavioral factors 88. Which steps in COPAR trains indigenous and informal B. Socioeconomic factors leaders? C. Political factors D. Psychological factors A. Ground Work B. Mobilization 93. Nurse Budek is conducting a health teaching to C. Core Group formation Agnesia, 50 year old breast cancer survivor needing D. Integration rehabilitative measures. He knows that health education is effective when 89. As a PHN, One of your role is to organize the community. Nurse Budek knows that the purposes of A. Agnesia recites the procedure and instructions community organizing are perfectly B. Agnesia’s behavior and outlook in life was changed 1. Move the community to act on their own problems positively 2. Make people aware of their own problems C. Agnesia gave feedback to Budek saying that she 3. Enable the nurse to solve the community problems understood the instruction 4. Offer people means of solving their own problems D. Agnesia requested a written instruction from Budek A. 1,2,3 94. Which of the following is true about health B. 1,2,3,4 education? C. 1,2 D. 1,2,4 A. It helps people attain their health through the nurse’s sole efforts 90. This is considered the first act of integrating with the B. It should not be flexible people. This gives an in depth participation in C. It is a fast and mushroom like process 452  453 D. It is a slow and continuous process D. Muscle Built 95. Which of the following factors least influence the 100. Appearance and disposition of clients are best learning readiness of an adult learner? observed initially during which of the following situation? A. The individuals stage of development B. Ability to concentrate on information to be learned A. Taking V/S C. The individual’s psychosocial adaptation to his illness B. Interview D. The internal impulses that drive the person to take C. Implementation of the initial care action D. Actual Physical examination 96. Which of the following is the most important condition for diabetic patients to learn how to control their diet? A. Use of pamphlets and other materials during instructions B. Motivation to be symptom free C. Ability of the patient to understand teaching instruction D. Language used by the nurse 97. An important skill that a primigravida has to acquire is the ability to bathe her newborn baby and clean her breast if she decides to breastfeed her baby, Which of the following learning domain will you classify the above goals? A. Psychomotor B. Cognitive C. Affective D. Attitudinal 98. When you prepare your teaching plan for a group of hypertensive patients, you first formulate your learning objectives. Which of the following steps in the nursing process corresponds to the writing of the learning objectives? A. Planning B. Implementing C. Evaluation C. Assessment 99. Rose, 50 years old and newly diagnosed diabetic patient must learn how to inject insulin. Which of the following physical attribute is not in anyway related to her ability to administer insulin? A. Strength B. Coordination C. Dexterity 453  454 COMMUNITY HEALTH NURSING Part 2 4. R.A. 1054 is also known as the Occupational Health 1. Which is the primary goal of community health Act. Aside from number of employees, what other factor nursing? must be considered in determining the occupational A. To support and supplement the efforts of the medical health privileges to which the workers will be entitled? profession in the promotion of health and prevention of A. Type of occupation: agricultural, commercial, illness industrial B. To enhance the capacity of individuals, families and B. Location of the workplace in relation to health communities to cope with their health needs facilities C. To increase the productivity of the people by C. Classification of the business enterprise based on net providing them with services that will increase their level profit of health D. Sex and age composition of employees D. To contribute to national development through promotion of family welfare, focusing particularly on Answer: (B) Location of the workplace in relation to mothers and children. health facilities Based on R.A. 1054, an occupational nurse must be Answer: (B) To enhance the capacity of individuals, employed when there are 30 to 100 employees and the families and communities to cope with their health workplace is more than 1 km. away from the nearest needs health center. To contribute to national development through promotion of family welfare, focusing particularly on 5. A business firm must employ an occupational health mothers and children. nurse when it has at least how many employees? A. 21 2. CHN is a community-based practice. Which best B. 101 explains this statement? C. 201 A. The service is provided in the natural environment of D. 301 people. B. The nurse has to conduct community diagnosis to Answer: (B) 101 determine nursing needs and problems. Again, this is based on R.A. 1054. C. The services are based on the available resources within the community. 6. When the occupational health nurse employs D. Priority setting is based on the magnitude of the ergonomic principles, she is performing which of her health problems identified. roles? A. Health care provider Answer: A. The service is provided in the natural B. Health educator environment of people. C. Health care coordinator Community-based practice means providing care to D. Environmental manager people in their own natural environments: the home, school and workplace, for example. Answer: (D) Environmental manager Ergonomics is improving efficiency of workers by 3. Population-focused nursing practice requires which of improving the worker’s environment through the following processes? appropriately designed furniture, for example. A. Community organizing B. Nursing process 7. A garment factory does not have an occupational C. Community diagnosis nurse. Who shall provide the occupational health needs D. Epidemiologic process of the factory workers? A. Occupational health nurse at the Provincial Health Answer: (C) Community diagnosis Office Population-focused nursing care means providing care B. Physician employed by the factory based on the greater need of the majority of the C. Public health nurse of the RHU of their municipality population. The greater need is identified through D. Rural sanitary inspector of the RHU of their community diagnosis. municipality 454  455 A. It involves providing home care to sick people who are Answer: (C) Public health nurse of the RHU of their not confined in the hospital. municipality B. Services are provided free of charge to people within You’re right! This question is based on R.A.1054. the catchment area. C. The public health nurse functions as part of a team 8. “Public health services are given free of charge.” Is this providing a public health nursing services. statement true or false? D. Public health nursing focuses on preventive, not A. The statement is true; it is the responsibility of curative, services. government to provide basic services. B. The statement is false; people pay indirectly for public Answer: (D) Public health nursing focuses on health services. preventive, not curative, services. C. The statement may be true or false, depending on the The catchment area in PHN consists of a residential specific service required. community, many of whom are well individuals who D. The statement may be true or false, depending on have greater need for preventive rather than curative policies of the government concerned. services. Answer: (B) The statement is false; people pay 12. According to Margaret Shetland, the philosophy of indirectly for public health services. public health nursing is based on which of the following? Community health services, including public health A. Health and longevity as birthrights services, are pre-paid services, though taxation, for B. The mandate of the state to protect the birthrights of example. its citizens C. Public health nursing as a specialized field of nursing 9. According to C.E.Winslow, which of the following is D. The worth and dignity of man the goal of Public Health? A. For people to attain their birthrights of health and Answer: (D) The worth and dignity of man longevity This is a direct quote from Dr. Margaret Shetland’s B. For promotion of health and prevention of disease statements on Public Health Nursing. C. For people to have access to basic health services D. For people to be organized in their health efforts 13. Which of the following is the mission of the Department of Health? Answer: (A) For people to attain their birthrights of A. Health for all Filipinos health and longevity B. Ensure the accessibility and quality of health care According to Winslow, all public health efforts are for C. Improve the general health status of the population people to realize their birthrights of health and D. Health in the hands of the Filipino people by the year longevity. 2020 10. We say that a Filipino has attained longevity when he Answer: (B) Ensure the accessibility and quality of is able to reach the average lifespan of Filipinos. What health care other statistic may be used to determine attainment of (none) longevity? A. Age-specific mortality rate 14. Region IV Hospital is classified as what level of B. Proportionate mortality rate facility? C. Swaroop’s index A. Primary D. Case fatality rate B. Secondary C. Intermediate Answer: (C) Swaroop’s index D. Tertiary Swaroop’s index is the percentage of the deaths aged 50 years or older. Its inverse represents the percentage of Answer: (D) Tertiary untimely deaths (those who died younger than 50 years). Regional hospitals are tertiary facilities because they serve as training hospitals for the region. 11. Which of the following is the most prominent feature of public health nursing? 455  456 15. Which is true of primary facilities? A. They are usually government-run. 19. R.A. 7160 mandates devolution of basic services from B. Their services are provided on an out-patient basis. the national government to local government units. C. They are training facilities for health professionals. Which of the following is the major goal of devolution? D. A community hospital is an example of this level of A. To strengthen local government units health facilities. B. To allow greater autonomy to local government units C. To empower the people and promote their self- Answer: (B) Their services are provided on an out- reliance patient basis. D. To make basic services more accessible to the people Primary facilities government and non-government facilities that provide basic out-patient services. Answer: (C) To empower the people and promote their self-reliance 16. Which is an example of the school nurse’s health People empowerment is the basic motivation behind care provider functions? devolution of basic services to LGU’s. A. Requesting for BCG from the RHU for school entrant immunization 20. Who is the Chairman of the Municipal Health Board? B. Conducting random classroom inspection during a A. Mayor measles epidemic B. Municipal Health Officer C. Taking remedial action on an accident hazard in the C. Public Health Nurse school playground D. Any qualified physician D. Observing places in the school where pupils spend their free time Answer: (A) Mayor The local executive serves as the chairman of the Answer: (B) Conducting random classroom inspection Municipal Health Board. during a measles epidemic Random classroom inspection is assessment of 21. Which level of health facility is the usual point of pupils/students and teachers for signs of a health entry of a client into the health care delivery system? problem prevalent in the community. A. Primary B. Secondary 17. When the nurse determines whether resources were C. Intermediate maximized in implementing Ligtas Tigdas, she is D. Tertiary evaluating A. Effectiveness Answer: (A) Primary B. Efficiency The entry of a person into the health care delivery C. Adequacy system is usually through a consultation in out-patient D. Appropriateness services. Answer: (B) Efficiency 22. The public health nurse is the supervisor of rural Efficiency is determining whether the goals were health midwives. Which of the following is a supervisory attained at the least possible cost. function of the public health nurse? A. Referring cases or patients to the midwife 18. You are a new B.S.N. graduate. You want to become B. Providing technical guidance to the midwife a Public Health Nurse. Where will you apply? C. Providing nursing care to cases referred by the A. Department of Health midwife B. Provincial Health Office D. Formulating and implementing training programs for C. Regional Health Office midwives D. Rural Health Unit Answer: (B) Providing technical guidance to the Answer: (D) Rural Health Unit midwife R.A. 7160 devolved basic health services to local The nurse provides technical guidance to the midwife in government units (LGU’s ). The public health nurse is an the care of clients, particularly in the implementation of employee of the LGU. 456  457 management guidelines, as in Integrated Management Diseases, enacted in 1929, mandated the reporting of of Childhood Illness. diseases listed in the law to the nearest health station. 23. One of the participants in a hilot training class asked 27. According to Freeman and Heinrich, community you to whom she should refer a patient in labor who health nursing is a developmental service. Which of the develops a complication. You will answer, to the following best illustrates this statement? A. Public Health Nurse A. The community health nurse continuously develops B. Rural Health Midwife himself personally and professionally. C. Municipal Health Officer B. Health education and community organizing are D. Any of these health professionals necessary in providing community health services. C. Community health nursing is intended primarily for Answer: (C) Municipal Health Officer health promotion and prevention and treatment of A public health nurse and rural health midwife can disease. provide care during normal childbirth. A physician should D. The goal of community health nursing is to provide attend to a woman with a complication during labor. nursing services to people in their own places of residence. 24. You are the public health nurse in a municipality with a total population of about 20,000. There are 3 rural Answer: (B) Health education and community health midwives among the RHU personnel. How many organizing are necessary in providing community health more midwife items will the RHU need? services. A. 1 The community health nurse develops the health B. 2 capability of people through health education and C. 3 community organizing activities. D. The RHU does not need any more midwife item. 28. Which disease was declared through Presidential Answer: (A) 1 Proclamation No. 4 as a target for eradication in the Each rural health midwife is given a population Philippines? assignment of about 5,000. A. Poliomyelitis B. Measles 25. If the RHU needs additional midwife items, you will C. Rabies submit the request for additional midwife items for D. Neonatal tetanus approval to the A. Rural Health Unit Answer: (B) Measles B. District Health Office Presidential Proclamation No. 4 is on the Ligtas Tigdas C. Provincial Health Office Program. D. Municipal Health Board 29. The public health nurse is responsible for presenting Answer: (D) Municipal Health Board the municipal health statistics using graphs and tables. As mandated by R.A. 7160, basic health services have To compare the frequency of the leading causes of been devolved from the national government to local mortality in the municipality, which graph will you government units. prepare? A. Line 26. As an epidemiologist, the nurse is responsible for B. Bar reporting cases of notifiable diseases. What law C. Pie mandates reporting of cases of notifiable diseases? D. Scatter diagram A. Act 3573 B. R.A. 3753 Answer: (B) Bar C. R.A. 1054 A bar graph is used to present comparison of values, a D. R.A. 1082 line graph for trends over time or age, a pie graph for population composition or distribution, and a scatter Answer: (A) Act 3573 diagram for correlation of two variables. Act 3573, the Law on Reporting of Communicable 457  458 30. Which step in community organizing involves training problem of potential leaders in the community? D. Identify the health problem as a common concern A. Integration B. Community organization Answer: (A) Participate in community activities for the C. Community study solution of a community problem D. Core group formation Participation in community activities in resolving a community problem may be in any of the processes Answer: (D) Core group formation mentioned in the other choices. In core group formation, the nurse is able to transfer the technology of community organizing to the potential or 34. Tertiary prevention is needed in which stage of the informal community leaders through a training program. natural history of disease? A. Pre-pathogenesis 31. In which step are plans formulated for solving B. Pathogenesis community problems? C. Prodromal A. Mobilization D. Terminal B. Community organization C. Follow-up/extension Answer: (D) Terminal D. Core group formation Tertiary prevention involves rehabilitation, prevention of permanent disability and disability limitation appropriate Answer: (B) Community organization for convalescents, the disabled, complicated cases and Community organization is the step when community the terminally ill (those in the terminal stage of a assemblies take place. During the community assembly, disease) the people may opt to formalize the community organization and make plans for community action to 35. Isolation of a child with measles belongs to what resolve a community health problem. level of prevention? A. Primary 32. The public health nurse takes an active role in B. Secondary community participation. What is the primary goal of C. Intermediate community organizing? D. Tertiary A. To educate the people regarding community health problems Answer: (A) Primary B. To mobilize the people to resolve community health The purpose of isolating a client with a communicable problems disease is to protect those who are not sick (specific C. To maximize the community’s resources in dealing disease prevention). with health problems D. To maximize the community’s resources in dealing 36. On the other hand, Operation Timbang is _____ with health problems prevention. A. Primary Answer: (D) To maximize the community’s resources in B. Secondary dealing with health problems C. Intermediate Community organizing is a developmental service, with D. Tertiary the goal of developing the people’s self-reliance in dealing with community health problems. A, B and C are Answer: (B) Secondary objectives of contributory objectives to this goal. Operation Timbang is done to identify members of the susceptible population who are malnourished. Its 33. An indicator of success in community organizing is purpose is early diagnosis and, subsequently, prompt when people are able to treatment. A. Participate in community activities for the solution of a community problem 37. Which type of family-nurse contact will provide you B. Implement activities for the solution of the with the best opportunity to observe family dynamics? community problem A. Clinic consultation C. Plan activities for the solution of the community B. Group conference 458  459 C. Home visit 41. Which is CONTRARY to the principles in planning a D. Written communication home visit? A. A home visit should have a purpose or objective. Answer: (C) Home visit B. The plan should revolve around family health needs. Dynamics of family relationships can best be observed in C. A home visit should be conducted in the manner the family’s natural environment, which is the home. prescribed by the RHU. D. Planning of continuing care should involve a 38. The typology of family nursing problems is used in responsible family member. the statement of nursing diagnosis in the care of families. The youngest child of the de los Reyes family Answer: (C) A home visit should be conducted in the has been diagnosed as mentally retarded. This is manner prescribed by the RHU. classified as a The home visit plan should be flexible and practical, A. Health threat depending on factors, such as the family’s needs and the B. Health deficit resources available to the nurse and the family. C. Foreseeable crisis D. Stress point 42. The PHN bag is an important tool in providing nursing care during a home visit. The most important Answer: (B) Health deficit principle of bag technique states that it Failure of a family member to develop according to what A. Should save time and effort. is expected, as in mental retardation, is a health deficit. B. Should minimize if not totally prevent the spread of infection. 39. The de los Reyes couple have a 6-year old child C. Should not overshadow concern for the patient and entering school for the first time. The de los Reyes family his family. has a D. May be done in a variety of ways depending on the A. Health threat home situation, etc. B. Health deficit C. Foreseeable crisis Answer: (B) Should minimize if not totally prevent the D. Stress point spread of infection. Bag technique is performed before and after handling a Answer: (C) Foreseeable crisis client in the home to prevent transmission of infection Entry of the 6-year old into school is an anticipated to and from the client. period of unusual demand on the family. 43. To maintain the cleanliness of the bag and its 40. Which of the following is an advantage of a home contents, which of the following must the nurse do? visit? A. Wash his/her hands before and after providing A. It allows the nurse to provide nursing care to a greater nursing care to the family members. number of people. B. In the care of family members, as much as possible, B. It provides an opportunity to do first hand appraisal of use only articles taken from the bag. the home situation. C. Put on an apron to protect her uniform and fold it C. It allows sharing of experiences among people with with the right side out before putting it back into the similar health problems. bag. D. It develops the family’s initiative in providing for D. At the end of the visit, fold the lining on which the bag health needs of its members. was placed, ensuring that the contaminated side is on the outside. Answer: (B) It provides an opportunity to do first hand appraisal of the home situation. Answer: (A) Wash his/her hands before and after Choice A is not correct since a home visit requires that providing nursing care to the family members. the nurse spend so much time with the family. Choice C Choice B goes against the idea of utilizing the family’s is an advantage of a group conference, while choice D is resources, which is encouraged in CHN. Choices C and D true of a clinic consultation. goes against the principle of asepsis of confining the contaminated surface of objects. 459  460 44. The public health nurse conducts a study on the 47. The primary purpose of conducting an epidemiologic factors contributing to the high mortality rate due to investigation is to heart disease in the municipality where she works. A. Delineate the etiology of the epidemic Which branch of epidemiology does the nurse practice in B. Encourage cooperation and support of the community this situation? C. Identify groups who are at risk of contracting the A. Descriptive disease B. Analytical D. Identify geographical location of cases of the disease C. Therapeutic in the community D. Evaluation Answer: (A) Delineate the etiology of the epidemic Answer: (B) Analytical Delineating the etiology of an epidemic is identifying its Analytical epidemiology is the study of factors or source. determinants affecting the patterns of occurrence and distribution of disease in a community. 48. Which is a characteristic of person-to-person propagated epidemics? 45. Which of the following is a function of epidemiology? A. There are more cases of the disease than expected. A. Identifying the disease condition based on B. The disease must necessarily be transmitted through a manifestations presented by a client vector. B. Determining factors that contributed to the C. The spread of the disease can be attributed to a occurrence of pneumonia in a 3 year old common vehicle. C. Determining the efficacy of the antibiotic used in the D. There is a gradual build up of cases before the treatment of the 3 year old client with pneumonia epidemic becomes easily noticeable. D. Evaluating the effectiveness of the implementation of the Integrated Management of Childhood Illness Answer: (D) There is a gradual build up of cases before the epidemic becomes easily noticeable. Answer: (D) Evaluating the effectiveness of the A gradual or insidious onset of the epidemic is usually implementation of the Integrated Management of observable in person-to-person propagated epidemics. Childhood Illness Epidemiology is used in the assessment of a community 49. In the investigation of an epidemic, you compare the or evaluation of interventions in community health present frequency of the disease with the usual practice. frequency at this time of the year in this community. This is done during which stage of the investigation? 46. Which of the following is an epidemiologic function A. Establishing the epidemic of the nurse during an epidemic? B. Testing the hypothesis A. Conducting assessment of suspected cases to detect C. Formulation of the hypothesis the communicable disease D. Appraisal of facts B. Monitoring the condition of the cases affected by the communicable disease Answer: (A) Establishing the epidemic C. Participating in the investigation to determine the Establishing the epidemic is determining whether there source of the epidemic is an epidemic or not. This is done by comparing the D. Teaching the community on preventive measures present number of cases with the usual number of cases against the disease of the disease at the same time of the year, as well as establishing the relatedness of the cases of the disease. Answer: (C) Participating in the investigation to determine the source of the epidemic 50. The number of cases of Dengue fever usually Epidemiology is the study of patterns of occurrence and increases towards the end of the rainy season. This distribution of disease in the community, as well as the pattern of occurrence of Dengue fever is best described factors that affect disease patterns. The purpose of an as epidemiologic investigation is to identify the source of A. Epidemic occurrence an epidemic, i.e., what brought about the epidemic. B. Cyclical variation C. Sporadic occurrence D. Secular variation 460  461 diagnostic examination? Answer: (B) Cyclical variation A. Effectiveness A cyclical variation is a periodic fluctuation in the B. Efficacy number of cases of a disease in the community. C. Specificity D. Sensitivity 51. In the year 1980, the World Health Organization declared the Philippines, together with some other Answer: (D) Sensitivity countries in the Western Pacific Region, “free” of which Sensitivity is the capacity of a diagnostic examination to disease? detect cases of the disease. If a test is 100% sensitive, all A. Pneumonic plague the cases tested will have a positive result, i.e., there will B. Poliomyelitis be no false negative results. C. Small pox D. Anthrax 55. Use of appropriate technology requires knowledge of indigenous technology. Which medicinal herb is given for Answer: (C) Small pox fever, headache and cough? The last documented case of Small pox was in 1977 at A. Sambong Somalia. B. Tsaang gubat C. Akapulko 52. In the census of the Philippines in 1995, there were D. Lagundi about 35,299,000 males and about 34,968,000 females. What is the sex ratio? Answer: (D) Lagundi A. 99.06:100 Sambong is used as a diuretic. Tsaang gubat is used to B. 100.94:100 relieve diarrhea. Akapulko is used for its antifungal C. 50.23% property. D. 49.76% 56. What law created the Philippine Institute of Answer: (B) 100.94:100 Traditional and Alternative Health Care? Sex ratio is the number of males for every 100 females in A. R.A. 8423 the population. B. R.A. 4823 C. R.A. 2483 53. Primary health care is a total approach to community D. R.A. 3482 development. Which of the following is an indicator of success in the use of the primary health care approach? Answer: (A) R.A. 8423 A. Health services are provided free of charge to (none) individuals and families. B. Local officials are empowered as the major decision 57. In traditional Chinese medicine, the yielding, makers in matters of health. negative and feminine force is termed C. Health workers are able to provide care based on A. Yin identified health needs of the people. B. Yang D. Health programs are sustained according to the level C. Qi of development of the community. D. Chai Answer: (D) Health programs are sustained according to Answer: (A) Yin the level of development of the community. Yang is the male dominating, positive and masculine Primary health care is essential health care that can be force. sustained in all stages of development of the community. 58. What is the legal basis for Primary Health Care approach in the Philippines? 54. Sputum examination is the major screening tool for A. Alma Ata Declaration on PHC pulmonary tuberculosis. Clients would sometimes get B. Letter of Instruction No. 949 false negative results in this exam. This means that the C. Presidential Decree No. 147 test is not perfect in terms of which characteristic of a D. Presidential Decree 996 461  462 C. Population pyramid Answer: (B) Letter of Instruction No. 949 D. Any of these may be used. Letter of Instruction 949 was issued by then President Ferdinand Marcos, directing the formerly called Ministry Answer: (D) Any of these may be used. of Health, now the Department of Health, to utilize Sex ratio and sex proportion are used to determine the Primary Health Care approach in planning and sex composition of a population. A population pyramid is implementing health programs. used to present the composition of a population by age and sex. 59. Which of the following demonstrates intersectoral linkages? 63. Which of the following is a natality rate? A. Two-way referral system A. Crude birth rate B. Team approach B. Neonatal mortality rate C. Endorsement done by a midwife to another midwife C. Infant mortality rate D. Cooperation between the PHN and public school D. General fertility rate teacher Answer: (A) Crude birth rate Answer: (D) Cooperation between the PHN and public Natality means birth. A natality rate is a birth rate. school teacher Intersectoral linkages refer to working relationships 64. You are computing the crude death rate of your between the health sector and other sectors involved in municipality, with a total population of about 18,000, for community development. last year. There were 94 deaths. Among those who died, 20 died because of diseases of the heart and 32 were 60. The municipality assigned to you has a population of aged 50 years or older. What is the crude death rate? about 20,000. Estimate the number of 1-4 year old A. 4.2/1,000 children who will be given Retinol capsule 200,000 I.U. B. 5.2/1,000 every 6 months. C. 6.3/1,000 A. 1,500 D. 7.3/1,000 B. 1,800 C. 2,000 Answer: (B) 5.2/1,000 D. 2,300 To compute crude death rate divide total number of deaths (94) by total population (18,000) and multiply by Answer: (D) 2,300 1,000. Based on the Philippine population composition, to estimate the number of 1-4 year old children, multiply 65. Knowing that malnutrition is a frequent community total population by 11.5%. health problem, you decided to conduct nutritional assessment. What population is particularly susceptible 61. Estimate the number of pregnant women who will be to protein energy malnutrition (PEM)? given tetanus toxoid during an immunization outreach A. Pregnant women and the elderly activity in a barangay with a population of about 1,500. B. Under-5 year old children A. 265 C. 1-4 year old children B. 300 D. School age children C. 375 D. 400 Answer: (C) 1-4 year old children Preschoolers are the most susceptible to PEM because Answer: (A) 265 they have generally been weaned. Also, this is the To estimate the number of pregnant women, multiply population who, unable to feed themselves, are often the total population by 3.5%. the victims of poor intrafamilial food distribution. 62. To describe the sex composition of the population, 66. Which statistic can give the most accurate reflection which demographic tool may be used? of the health status of a community? A. Sex ratio A. 1-4 year old age-specific mortality rate B. Sex proportion B. Infant mortality rate 462  463 C. Swaroop’s index 70. You will gather data for nutritional assessment of a D. Crude death rate purok. You will gather information only from families with members who belong to the target population for Answer: (C) Swaroop’s index PEM. What method of data gathering is best for this Swaroop’s index is the proportion of deaths aged 50 purpose? years and above. The higher the Swaroop’s index of a A. Census population, the greater the proportion of the deaths B. Survey who were able to reach the age of at least 50 years, i.e., C. Record review more people grew old before they died. D. Review of civil registry 67. In the past year, Barangay A had an average population of 1655. 46 babies were born in that year, 2 Answer: (B) Survey of whom died less than 4 weeks after they were born. A survey, also called sample survey, is data gathering There were 4 recorded stillbirths. What is the neonatal about a sample of the population. mortality rate? A. 27.8/1,000 71. In the conduct of a census, the method of population B. 43.5/1,000 assignment based on the actual physical location of the C. 86.9/1,000 people is termed D. 130.4/1,000 A. De jure B. De locus Answer: (B) 43.5/1,000 C. De facto To compute for neonatal mortality rate, divide the D. De novo number of babies who died before reaching the age of 28 days by the total number of live births, then multiply Answer: (C) De facto by 1,000. The other method of population assignment, de jure, is based on the usual place of residence of the people. 68. Which statistic best reflects the nutritional status of a population? 72. The Field Health Services and Information System A. 1-4 year old age-specific mortality rate (FHSIS) is the recording and reporting system in public B. Proportionate mortality rate health care in the Philippines. The Monthly Field Health C. Infant mortality rate Service Activity Report is a form used in which of the D. Swaroop’s index components of the FHSIS? A. Tally report Answer: (A) 1-4 year old age-specific mortality rate B. Output report Since preschoolers are the most susceptible to the C. Target/client list effects of malnutrition, a population with poor D. Individual health record nutritional status will most likely have a high 1-4 year old age-specific mortality rate, also known as child mortality Answer: (A) Tally report rate. A tally report is prepared monthly or quarterly by the RHU personnel and transmitted to the Provincial Health 69. What numerator is used in computing general Office. fertility rate? A. Estimated midyear population 73. To monitor clients registered in long-term regimens, B. Number of registered live births such as the Multi-Drug Therapy, which component will C. Number of pregnancies in the year be most useful? D. Number of females of reproductive age A. Tally report B. Output report Answer: (B) Number of registered live births C. Target/client list To compute for general or total fertility rate, divide the D. Individual health record number of registered live births by the number of females of reproductive age (15-45 years), then multiply Answer: (C) Target/client list by 1,000. The MDT Client List is a record of clients enrolled in MDT 463  464 and other relevant data, such as dates when clients centers able to comply with standards. collected their monthly supply of drugs. Sentrong Sigla Movement is a joint project of the DOH and local government units. Its main strategy is 74. Civil registries are important sources of data. Which certification of health centers that are able to comply law requires registration of births within 30 days from with standards set by the DOH. the occurrence of the birth? A. P.D. 651 78. Which of the following women should be considered B. Act 3573 as special targets for family planning? C. R.A. 3753 A. Those who have two children or more D. R.A. 3375 B. Those with medical conditions such as anemia C. Those younger than 20 years and older than 35 years Answer: (A) P.D. 651 D. Those who just had a delivery within the past 15 P.D. 651 amended R.A. 3753, requiring the registry of months births within 30 days from their occurrence. Answer: (D) Those who just had a delivery within the 75. Which of the following professionals can sign the past 15 months birth certificate? The ideal birth spacing is at least two years. 15 months A. Public health nurse plus 9 months of pregnancy = 2 years. B. Rural health midwife C. Municipal health officer 79. Freedom of choice is one of the policies of the Family D. Any of these health professionals Planning Program of the Philippines. Which of the following illustrates this principle? Answer: (D) Any of these health professionals A. Information dissemination about the need for family D. R.A. 3753 states that any birth attendant may sign the planning certificate of live birth. B. Support of research and development in family planning methods 76. Which criterion in priority setting of health problems C. Adequate information for couples regarding the is used only in community health care? different methods A. Modifiability of the problem D. Encouragement of couples to take family planning as B. Nature of the problem presented a joint responsibility C. Magnitude of the health problem D. Preventive potential of the health problem Answer: (C) Adequate information for couples regarding the different methods Answer: (C) Magnitude of the health problem To enable the couple to choose freely among different Magnitude of the problem refers to the percentage of methods of family planning, they must be given full the population affected by a health problem. The other information regarding the different methods that are choices are criteria considered in both family and available to them, considering the availability of quality community health care. services that can support their choice. 77. The Sentrong Sigla Movement has been launched to 80. A woman, 6 months pregnant, came to the center for improve health service delivery. Which of the following consultation. Which of the following substances is is/are true of this movement? contraindicated? A. This is a project spearheaded by local government A. Tetanus toxoid units. B. Retinol 200,000 IU B. It is a basis for increasing funding from local C. Ferrous sulfate 200 mg government units. D. Potassium iodate 200 mg. capsule C. It encourages health centers to focus on disease prevention and control. Answer: (B) Retinol 200,000 IU D. Its main strategy is certification of health centers able Retinol 200,000 IU is a form of megadose Vitamin A. This to comply with standards. may have a teratogenic effect. Answer: (D) Its main strategy is certification of health 464  465 81. During prenatal consultation, a client asked you if Answer: (D) Explain to her that putting the baby to she can have her delivery at home. After history taking breast will lessen blood loss after delivery. and physical examination, you advised her against a Suckling of the nipple stimulates the release of oxytocin home delivery. Which of the following findings by the posterior pituitary gland, which causes uterine disqualifies her for a home delivery? contraction. Lactation begins 1 to 3 days after delivery. A. Her OB score is G5P3. Nipple stretching exercises are done when the nipples B. She has some palmar pallor. are flat or inverted. Frequent washing dries up the C. Her blood pressure is 130/80. nipples, making them prone to the formation of fissures. D. Her baby is in cephalic presentation. 85. A primigravida is instructed to offer her breast to the Answer: (A) Her OB score is G5P3. baby for the first time within 30 minutes after delivery. Only women with less than 5 pregnancies are qualified What is the purpose of offering the breast this early? for a home delivery. It is also advisable for a primigravida A. To initiate the occurrence of milk letdown to have delivery at a childbirth facility. B. To stimulate milk production by the mammary acini C. To make sure that the baby is able to get the 82. Inadequate intake by the pregnant woman of which colostrum vitamin may cause neural tube defects? D. To allow the woman to practice breastfeeding in the A. Niacin presence of the health worker B. Riboflavin C. Folic acid Answer: (B) To stimulate milk production by the D. Thiamine mammary acini Suckling of the nipple stimulates prolactin reflex (the Answer: (C) Folic acid release of prolactin by the anterior