PNLE: Community Health Nursing Exam 3

1. Estimate the number of pregnant women who will be given tetanus toxoid during an immunization outreach activity in a barangay with a population of about 1,500.

1. 265
2. 300
3. 375
4. 400

2. To describe the sex composition of the population, which demographic tool may be used?

1. Sex ratio
2. Sex proportion
3. Population pyramid
4. Any of these may be used.

3. Which of the following is a natality rate?

1. Crude birth rate
2. Neonatal mortality rate
3. Infant mortality rate
4. General fertility rate

4. You are computing the crude death rate of your municipality, with a total population of about 18,000, for last year. There were 94 deaths. Among those who died, 20 died because of diseases of the heart and 32 were aged 50 years or older. What is the crude death rate?

1. 4.2/1,000
2. 5.2/1,000
3. 6.3/1,000
4. 7.3/1,000

5. Knowing that malnutrition is a frequent community health problem, you decided to conduct nutritional assessment. What population is particularly susceptible to protein energy malnutrition (PEM)?

1. Pregnant women and the elderly
2. Under-5 year old children
3. 1-4 year old children
4. School age children

6. Which statistic can give the most accurate reflection of the health status of a community?

1. 1-4 year old age-specific mortality rate
2. Infant mortality rate
3. Swaroop’s index
4. Crude death rate

7. In the past year, Barangay A had an average population of 1655. 46 babies were born in that year, 2 of whom died less than 4 weeks after they were born. There were 4 recorded stillbirths. What is the neonatal mortality rate?

1. 27.8/1,000
2. 43.5/1,000
3. 86.9/1,000
4. 130.4/1,000

8. Which statistic best reflects the nutritional status of a population?

1. 1-4 year old age-specific mortality rate
2. Proportionate mortality rate
3. Infant mortality rate
4. Swaroop’s index

9. What numerator is used in computing general fertility rate?

1. Estimated midyear population
2. Number of registered live births
3. Number of pregnancies in the year
4. Number of females of reproductive age

10. You will gather data for nutritional assessment of a purok. You will gather information only from families with members who belong to the target population for PEM. What method of data gathering is best for this purpose?

1. Census
2. Survey
3. Record review
4. Review of civil registry

11. In the conduct of a census, the method of population assignment based on the actual physical location of the people is termed

1. De jure
2. De locus
3. De facto
4. De novo

12. The Field Health Services and Information System (FHSIS) is the recording and reporting system in public health care in the Philippines. The Monthly Field Health Service Activity Report is a form used in which of the components of the FHSIS?

1. Tally report
2. Output report
3. Target/client list
4. Individual health record

13. To monitor clients registered in long-term regimens, such as the Multi-Drug Therapy, which component will be most useful?

1. Tally report
2. Output report
3. Target/client list
4. Individual health record

14. Civil registries are important sources of data. Which law requires registration of births within 30 days from the occurrence of the birth?

1. P.D. 651
2. Act 3573
3. R.A. 3753
4. R.A. 3375

15. Which of the following professionals can sign the birth certificate?

1. Public health nurse
2. Rural health midwife
3. Municipal health officer
4. Any of these health professionals

16. Which criterion in priority setting of health problems is used only in community health care?

1. Modifiability of the problem
2. Nature of the problem presented
3. Magnitude of the health problem
4. Preventive potential of the health problem

17. The Sentrong Sigla Movement has been launched to improve health service delivery. Which of the following is/are true of this movement?

1. This is a project spearheaded by local government units.
2. It is a basis for increasing funding from local government units.
3. It encourages health centers to focus on disease prevention and control.
4. Its main strategy is certification of health centers able to comply with standards.

18. Which of the following women should be considered as special targets for family planning?

1. Those who have two children or more
2. Those with medical conditions such as anemia
3. Those younger than 20 years and older than 35 years
4. Those who just had a delivery within the past 15 months

19. Freedom of choice is one of the policies of the Family Planning Program of the Philippines. Which of the following illustrates this principle?

1. Information dissemination about the need for family planning
2. Support of research and development in family planning methods
3. Adequate information for couples regarding the different methods
4. Encouragement of couples to take family planning as a joint responsibility

20. A woman, 6 months pregnant, came to the center for consultation. Which of the following substances is contraindicated?

1. Tetanus toxoid
2. Retinol 200,000 IU
3. Ferrous sulfate 200 mg
4. Potassium iodate 200 mg. capsule

21. During prenatal consultation, a client asked you if she can have her delivery at home. After history taking and physical examination, you advised her against a home delivery. Which of the following findings disqualifies her for a home delivery?

1. Her OB score is G5P3.
2. She has some palmar pallor.
3. Her blood pressure is 130/80.
4. Her baby is in cephalic presentation.

22. Inadequate intake by the pregnant woman of which vitamin may cause neural tube defects?

1. Niacin
2. Riboflavin
3. Folic acid
4. Thiamine

23. You are in a client’s home to attend to a delivery. Which of the following will you do first?

1. Set up the sterile area.
2. Put on a clean gown or apron.
3. Cleanse the client’s vulva with soap and water.
4. Note the interval, duration and intensity of labor contractions.

24. In preparing a primigravida for breastfeeding, which of the following will you do?

1. Tell her that lactation begins within a day after delivery.
2. Teach her nipple stretching exercises if her nipples are everted.
3. Instruct her to wash her nipples before and after each breastfeeding.
4. Explain to her that putting the baby to breast will lessen blood loss after delivery.

25. A primigravida is instructed to offer her breast to the baby for the first time within 30 minutes after delivery. What is the purpose of offering the breast this early?

1. To initiate the occurrence of milk letdown
2. To stimulate milk production by the mammary acini
3. To make sure that the baby is able to get the colostrum
4. To allow the woman to practice breastfeeding in the presence of the health worker

26. In a mothers’ class, you discuss proper breastfeeding technique. Which is of these is a sign that the baby has “latched on” to the breast properly?

1. The baby takes shallow, rapid sucks.
2. The mother does not feel nipple pain.
3. The baby’s mouth is only partly open.
4. Only the mother’s nipple is inside the baby’s mouth.

27. You explain to a breastfeeding mother that breast milk is sufficient for all of the baby’s nutrient needs only up to ____.

1. 3 months
2. 6 months
3. 1 year
4. 2 years

28. What is given to a woman within a month after the delivery of a baby?

1. Malunggay capsule
2. Ferrous sulfate 100 mg. OD
3. Retinol 200,000 I.U., 1 capsule
4. Potassium iodate 200 mg, 1 capsule

29. Which biological used in Expanded Program on Immunization (EPI) is stored in the freezer?

1. DPT
2. Tetanus toxoid
3. Measles vaccine
4. Hepatitis B vaccine

30. Unused BCG should be discarded how many hours after reconstitution?

1. 2
2. 4
3. 6
4. At the end of the day

Answers and Rationales

1. Answer: (A) 265. To estimate the number of pregnant women, multiply the total population by 3.5%.
2. Answer: (D) Any of these may be used. Sex ratio and sex proportion are used to determine the sex composition of a population. A population pyramid is used to present the composition of a population by age and sex.
3. Answer: (A) Crude birth rate. Natality means birth. A natality rate is a birth rate.
4. Answer: (B) 5.2/1,000. To compute crude death rate divide total number of deaths (94) by total population (18,000) and multiply by 1,000.
5. Answer: (C) 1-4 year old children. Preschoolers are the most susceptible to PEM because they have generally been weaned. Also, this is the population who, unable to feed themselves, are often the victims of poor intrafamilial food distribution.
6. Answer: (C) Swaroop’s index. Swaroop’s index is the proportion of deaths aged 50 years and above. The higher the Swaroop’s index of a population, the greater the proportion of the deaths who were able to reach the age of at least 50 years, i.e., more people grew old before they died.
7. Answer: (B) 43.5/1,000. To compute for neonatal mortality rate, divide the number of babies who died before reaching the age of 28 days by the total number of live births, then multiply by 1,000.
8. Answer: (A) 1-4 year old age-specific mortality rate. Since preschoolers are the most susceptible to the effects of malnutrition, a population with poor nutritional status will most likely have a high 1-4 year old age-specific mortality rate, also known as child mortality rate.
9. Answer: (B) Number of registered live births. To compute for general or total fertility rate, divide the number of registered live births by the number of females of reproductive age (15-45 years), then multiply by 1,000.
10. Answer: (B) Survey. A survey, also called sample survey, is data gathering about a sample of the population.
11. Answer: (C) De facto. The other method of population assignment, de jure, is based on the usual place of residence of the people.
12. Answer: (A) Tally report. A tally report is prepared monthly or quarterly by the RHU personnel and transmitted to the Provincial Health Office.
13. Answer: (C) Target/client list. The MDT Client List is a record of clients enrolled in MDT and other relevant data, such as dates when clients collected their monthly supply of drugs.
14. Answer: (A) P.D. 651. P.D. 651 amended R.A. 3753, requiring the registry of births within 30 days from their occurrence.
15. Answer: (D) Any of these health professionals. D. R.A. 3753 states that any birth attendant may sign the certificate of live birth.
16. Answer: (C) Magnitude of the health problem. Magnitude of the problem refers to the percentage of the population affected by a health problem. The other choices are criteria considered in both family and community health care.
17. Answer: (D) Its main strategy is certification of health centers able to comply with standards. Sentrong Sigla Movement is a joint project of the DOH and local government units. Its main strategy is certification of health centers that are able to comply with standards set by the DOH.
18. Answer: (D) Those who just had a delivery within the past 15 months. The ideal birth spacing is at least two years. 15 months plus 9 months of pregnancy = 2 years.
19. Answer: (C) Adequate information for couples regarding the different methods. To enable the couple to choose freely among different methods of family planning, they must be given full information regarding the different methods that are available to them, considering the availability of quality services that can support their choice.
20. Answer: (B) Retinol 200,000 IU. Retinol 200,000 IU is a form of megadose Vitamin A. This may have a teratogenic effect.
21. Answer: (A) Her OB score is G5P3. Only women with less than 5 pregnancies are qualified for a home delivery. It is also advisable for a primigravida to have delivery at a childbirth facility.
22. Answer: (C) Folic acid. It is estimated that the incidence of neural tube defects can be reduced drastically if pregnant women have an adequate intake of folic acid.
23. Answer: (D) Note the interval, duration and intensity of labor contractions.. Assessment of the woman should be done first to determine whether she is having true labor and, if so, what stage of labor she is in.
24. Answer: (D) Explain to her that putting the baby to breast will lessen blood loss after delivery. Suckling of the nipple stimulates the release of oxytocin by the posterior pituitary gland, which causes uterine contraction. Lactation begins 1 to 3 days after delivery. Nipple stretching exercises are done when the nipples are flat or inverted. Frequent washing dries up the nipples, making them prone to the formation of fissures.
25. Answer: (B) To stimulate milk production by the mammary acini. Suckling of the nipple stimulates prolactin reflex (the release of prolactin by the anterior pituitary gland), which initiates lactation.
26. Answer: (B) The mother does not feel nipple pain.. When the baby has properly latched on to the breast, he takes deep, slow sucks; his mouth is wide open; and much of the areola is inside his mouth. And, you’re right! The mother does not feel nipple pain.
27. Answer: (B) 6 months. After 6 months, the baby’s nutrient needs, especially the baby’s iron requirement, can no longer be provided by mother’s milk alone.
28. Answer: (C) Retinol 200,000 I.U., 1 capsule. A capsule of Retinol 200,000 IU is given within 1 month after delivery. Potassium iodate is given during pregnancy; malunggay capsule is not routinely administered after delivery; and ferrous sulfate is taken for two months after delivery.
29. Answer: (C) Measles vaccine. Among the biologicals used in the Expanded Program on Immunization, measles vaccine and OPV are highly sensitive to heat, requiring storage in the freezer.
30. Answer: (B) 4. While the unused portion of other biologicals in EPI may be given until the end of the day, only BCG is discarded 4 hours after reconstitution. This is why BCG immunization is scheduled only in the morning.