1.
In the Philippines, which condition is the most frequent cause of death associated with schistosomiasis?
Correct Answer
B. Liver cirrhosis
Explanation
The etiologic agent of schistosomiasis in the Philippines is Schistosoma japonicum, which affects the small intestine and the liver. Liver damage is a consequence of fibrotic reactions to schistosoma eggs in the liver.
2.
What is the most effective way of controlling schistosomiasis in an endemic area?
Correct Answer
C. Proper use of sanitary toilets
Explanation
The ova of the parasite get out of the human body together with feces. Cutting the cycle at this stage is the most effective way of preventing the spread of the disease to susceptible hosts.
3.
When residents obtain water from an artesian well in the neighborhood, the level of this approved type of water facility is
Correct Answer
B. II
Explanation
A communal faucet or water standpost is classified as Level II.
4.
For prevention of hepatitis A, you decided to conduct health education activities. Which of the following is IRRELEVANT?
Correct Answer
A. Use of sterile syringes and needles
Explanation
Hepatitis A is transmitted through the fecal oral route. Hepatitis B is transmitted through infected body secretions like blood and semen.
5.
Which biological used in Expanded Program on Immunization (EPI) should NOT be stored in the freezer?
Correct Answer
A. DPT
Explanation
DPT is sensitive to freezing. The appropriate storage temperature of DPT is 2 to 8° C only. OPV and measles vaccine are highly sensitive to heat and require freezing. MMR is not an immunization in the Expanded Program on Immunization.
6.
You will conduct outreach immunization in a barangay with a population of about 1500. Estimate the number of infants in the barangay.
Correct Answer
A. 45
Explanation
To estimate the number of infants, multiply total population by 3%.
7.
In Integrated Management of Childhood Illness, severe conditions generally require urgent referral to a hospital. Which of the following severe conditions DOES NOT always require urgent referral to a hospital?
Correct Answer
B. Severe dehydration
Explanation
The order of priority in the management of severe dehydration is as follows: intravenous fluid therapy, referral to a facility where IV fluids can be initiated within 30 minutes, Oresol/nasogastric tube, Oresol/orem. When the foregoing measures are not possible or effective, tehn urgent referral to the hospital is done.
8.
A client was diagnosed as having Dengue fever. You will say that there is slow capillary refill when the color of the nailbed that you pressed does not return within how many seconds?
Correct Answer
A. 3
Explanation
Adequate blood supply to the area allows the return of the color of the nailbed within 3 seconds.
9.
A 3-year old child was brought by his mother to the health center because of fever of 4-day duration. The child had a positive tourniquet test result. In the absence of other signs, which is the most appropriate measure that the pHN may carry out to prevent Dengue shock syndrome?
Correct Answer
B. Instruct the mother to give the child Oresol.
Explanation
Since the child does not manifest any other danger sign, maintenance of fluid balance and replacement of fluid loss may be done by giving the client Oresol.
10.
The pathognomonic sign of measles is Koplik’s spot. You may see Koplik’s spot by inspecting the _____.
Correct Answer
B. Buccal mucosa
Explanation
Koplik’s spot may be seen on the mucosa of the mouth or the throat.
11.
Among the following diseases, which is airborne?
Correct Answer
D. Measles
Explanation
Viral conjunctivitis is transmitted by direct or indirect contact with discharges from infected eyes. Acute poliomyelitis is spread through the fecal-oral route and contact with throat secretions, whereas diphtheria is through direct and indirect contact with respiratory secretions.
12.
Among children aged 2 months to 3 years, the most prevalent form of meningitis is caused by which microorganism?
Correct Answer
A. HemopHilus influenzae
Explanation
Hemophilus meningitis is unusual over the age of 5 years. In developing countries, the peak incidence is in children less than 6 months of age. Morbillivirus is the etiology of measles. Streptococcus pneumoniae and Neisseria meningitidis may cause meningitis, but age distribution is not specific in young children.
13.
Human beings are the major reservoir of malaria. Which of the following strategies in malaria control is based on this fact?
Correct Answer
D. ZoopropHylaxis
Explanation
Zooprophylaxis is done by putting animals like cattle or dogs close to windows or doorways just before nightfall. The Anopheles mosquito takes his blood meal from the animal and goes back to its breeding place, thereby preventing infection of humans.
14.
The use of larvivorous fish in malaria control is the basis for which strategy of malaria control?
Correct Answer
A. Stream seeding
Explanation
Stream seeding is done by putting tilapia fry in streams or other bodies of water identified as breeding places of the Anopheles mosquito
15.
Mosquito-borne diseases are prevented mostly with the use of mosquito control measures. Which of the following is NOT appropriate for malaria control?
Correct Answer
C. Destruction of breeding places of the mosquito vector
Explanation
Anopheles mosquitoes breed in slow-moving, clear water, such as mountain streams.
16.
A 4-year old client was brought to the health center with the chief complaint of severe diarrhea and the passage of “rice water” stools. The client is most probably suffering from which condition?
Correct Answer
B. Cholera
Explanation
Passage of profuse watery stools is the major symptom of cholera. Both amebic and bacillary dysentery are characterized by the presence of blood and/or mucus in the stools. Giardiasis is characterized by fat malabsorption and, therefore, steatorrhea.
17.
In the Philippines, which specie of schistosoma is endemic in certain regions?
Correct Answer
B. S. japonicum
Explanation
S. mansoni is found mostly in Africa and South America; S. haematobium in Africa and the Middle East; and S. malayensis only in peninsular Malaysia.
18.
A 32-year old client came for consultation at the health center with the chief complaint of fever for a week. Accompanying symptoms were muscle pains and body malaise. A week after the start of fever, the client noted yellowish discoloration of his sclera. History showed that he waded in flood waters about 2 weeks before the onset of symptoms. Based on his history, which disease condition will you suspect?
Correct Answer
D. Leptospirosis
Explanation
Leptospirosis is transmitted through contact with the skin or mucous membrane with water or moist soil contaminated with urine of infected animals, like rats.
19.
MWSS provides water to Manila and other cities in Metro Manila. This is an example of which level of water facility?
Correct Answer
C. III
Explanation
Waterworks systems, such as MWSS, are classified as level III.
20.
You are the pHN in the city health center. A client underwent screening for AIDS using ELISA. His result was positive. What is the best course of action that you may take?
Correct Answer
D. Refer the client for a supplementary test, such as Western blot, since the ELISA result may be false.
Explanation
A client having a reactive ELISA result must undergo a more specific test, such as Western blot. A negative supplementary test result means that the ELISA result was false and that, most probably, the client is not infected.
21.
Which is the BEST control measure for AIDS?
Correct Answer
A. Being faithful to a single sexual partner
Explanation
Sexual fidelity rules out the possibility of getting the disease by sexual contact with another infected person. Transmission occurs mostly through sexual intercourse and exposure to blood or tissues.
22.
The most frequent causes of death among clients with AIDS are opportunistic diseases. Which of the following opportunistic infections is characterized by tonsillopharyngitis?
Correct Answer
B. Infectious mononucleosis
Explanation
Cytomegalovirus disease is an acute viral disease characterized by fever, sore throat and lymphadenopathy.
23.
To determine possible sources of sexually transmitted infections, which is the BEST method that may be undertaken by the public health nurse?
Correct Answer
A. Contact tracing
Explanation
Contact tracing is the most practical and reliable method of finding possible sources of person-to-person transmitted infections, such as sexually transmitted diseases.
24.
Antiretroviral agents, such as AZT, are used in the management of AIDS. Which of the following is NOT an action expected of these drugs.
Correct Answer
D. They are able to bring about a cure of the disease condition.
Explanation
There is no known treatment for AIDS. Antiretroviral agents reduce the risk of opportunistic infections and prolong life, but does not cure the underlying immunodeficiency.
25.
A barangay had an outbreak of German measles. To prevent congenital rubella, what is the BEST advice that you can give to women in the first trimester of pregnancy in the barangay?
Correct Answer
D. Consult a pHysician who may give them rubella immunoglobulin.
Explanation
Rubella vaccine is made up of attenuated German measles viruses. This is contraindicated in pregnancy. Immune globulin, a specific prophylactic against German measles, may be given to pregnant women.
26.
You were invited to be the resource person in a training class for food handlers. Which of the following would you emphasize regarding prevention of staphylococcal food poisoning?
Correct Answer
D. Proper handwashing during food preparation is the best way of preventing the condition.
Explanation
Symptoms of this food poisoning are due to staphylococcal enterotoxin, not the microorganisms themselves. Contamination is by food handling by persons with staphylococcal skin or eye infections.
27.
In a mothers’ class, you discussed childhood diseases such as chicken pox. Which of the following statements about chicken pox is correct?
Correct Answer
A. The older one gets, the more susceptible he becomes to the complications of chicken pox.
Explanation
Chicken pox is usually more severe in adults than in children. Complications, such as pneumonia, are higher in incidence in adults.
28.
Complications to infectious parotitis (mumps) may be serious in which type of clients?
Correct Answer
C. Young adult males
Explanation
Epididymitis and orchitis are possible complications of mumps. In post-adolescent males, bilateral inflammation of the testes and epididymis may cause sterility.