Community Health Nursing Answers III

60. Answer: A

Rationale: Hospital waste management program is an important requirement for registration and renewal of licenses of newly constructed and existing hospitals.

61. Answer: A Rationale: Ulasimang bato or Pansit-pansitan (Peperonia pellucida) is the herbal plant used for the treatment of rheumatism and gout as it lowers uric acid level.

62. Answer: C Rationale: Based on the principle that life is the result of Qi or life energy, Acupressure is the alternative medicine practice that maintains health, treats diseases, and alleviates pain by massaging certain points on the body surface. Tai Chi (option A) is also known as the Chinese shadow boxing. Cupping (option B) uses suctions. Acupuncture (option D) uses needles.

63. Answer: A Rationale: Auriculotherapy is also known as ear acupuncture. Homeopathy (option B) uses diluted remedy. Moxibustion (option C) uses heat on acupuncture site. QiGong (option D) uses gentle movement, deep breathing and meditation. QiGong is the activation (Gong) of life energy (Qi).

64. Answer: C Rationale: Yoga, which is good for spiritual cleansing and rebirth, is an alternative health care that is used for the development of fitness wave. It promotes strength, flexibility and endurance.

65. Answer: B Rationale: Republic Act 8423 or the Traditional and Alternative Medicine Act paved way for the creation of the Philippine Institute of Traditional and Alternative Health Care. Option A is the Anti-child Abuse Law (R.A. 7610). Option C is the Devolution Law (R.A. 7160). Option D requires that couples intending to get married must first undergo a family planning an responsible parenthood instruction prior to the issuance of a marriage license.

66. Answer: A Rationale: The following are qualified for home delivery: full term; less than 5 pregnancies; cephalic presentation; without existing diseases such as diabetes, bronchial asthma, heart disease, hypertension, goiter, tuberculosis and sever anemia; no history of complications like hemorrhage during previous deliveries; no history of difficulty delivery and prolonged labor; no previous caesarian section; imminent deliveries; no premature rupture of membranes (bag of water); adequate pelvis (gynecoid); and abdominal enlargement is appropriate for age of gestation.

67. Answer: D Rationale: The 3 pointers during home deliveries are Clean hands , Clean surface and Clean cord.

68. Answer: C Rationale: When breastfeeding it is important to teach mothers that the size of their breasts doesn't affect lactation. Option A is incorrect because exercise doesn't increase the size of the breasts. Option B is incorrect because breastfeeding is encouraged and recommended for the first six months of an infant's life. Option D is incorrect because will not increase in size when the baby breastfeed on it.

69. Answer: A Rationale: Republic Act 9288 or the Newborn Screening Act is the law that provides mandate for newborn screening. Option B is the national Hepatitis B Immunization Act (R.A. 7846). Option C is the Rooming in and Breastfeeding Act (R.A. 7600). Option D is the Clean Air Act (R.A. 8749).

70. Answer: A Rationale: Municipal Form 102 or the Birth Certificate is the record that should be submitted to the local civil registrar's office within 30 days after the mother's delivery. This is according to the Birth Registration Law or Presidential Decree 651. FHSIS/E-3 (option B) refers to the Perinatal death report. FHSIS/E-2 (option C) refers to the maternal death report. Community tax Certificate (option D) is the cedula.

71. Answer: D Rationale: The Department of Health launched in July 1976 the Expanded Program on Immunization (EPI) in cooperation with the World Health Organization (WHO) and the UNICEF. There are laws that pertain to the practice of EPI in the Philippines. Presidential Decree 996 (option A) is Compulsory Immunization Act, providing for compulsory basic immunization for infants and children below 8 years of age. Presidential Proclamation 773 is the declaration of April 17 and May 15 and every third Wednesday of April and May from 1996 to 2000 as “Knock Out Polio Days.” Presidential Proclamation 1066 is the Tetanus elimination campaign, declaring a national neonatal tetanus elimination campaign starting 1997. Republic Act 3573 (option D) is not connected with EPI because it is the Communicable Disease Act.

72. Answer: D Rationale: The EPI is one of the programs being delivered by Community Health Nurses. One of its principles that is considered as pro-people is the principle that states “The whole community rather than just the individual is to be protected, thus mass approach is utilized.”

73. Answer: D Rationale: Among the vaccines, OPV and AMV (vowels) are the most sensitive to heat. They are to be kept on the freezer with a storage temperature of -15 to -25°C. Those vaccines least sensitive to heat such as DPT, Hepa B, BCG and TT (consonants) are stored in the body of the refrigerator with a storage temperature of 2 to 8°C.

74. Answer: C Rationale: A child is said to be “Fully Immunized Child” when a child receives 1 BCG, 3 OPV, 3 DPT, 3 Hepa B and 1 Measles Vaccine before a child's first birthday.

75. Answer: A Rationale: In Immunization, no extra doses must be given to a child who missed any dose of vaccine making option A incorrect. Options B, C and D are correct statements.

76. Answer: B Rationale: The principal focus of CARI program of the DOH is to teach mothers and community health workers how to detect and where to refer.

77. Answer: B Rationale: Doing careful focused assessment is the most important responsibility of a nurse in the prevention of unnecessary deaths from pneumonia and other severe diseases. This is because a thorough assessment supported with laboratory results is necessary for the classification, confirmation and the treatment of the disease.

78. Answer: D Rationale: The principal focus of CARI program of the DOH is to teach mothers and community health workers how to detect and where to refer.

79. Answer: A Rationale: Difficulty to awaken or sleeping abnormality is one of the danger signs. It should be classified in the pink row and referral to the nearest hospital is an essential intervention.

80. Answer: D Rationale: Before classifying the child as Pneumonia, the child is assess further by giving a trial of rapid-acting inhaled bronchodilator. This is to rule out Asthma, since children with asthma also exhibits fast breathing. If the symptom still persists then by now the child can be classified as having pneumonia. The patient in the situation is manifesting fast breathing because base on her age, which is 18 months, it is considered fast breathing when her respiratory rate exceeds 40 breaths/minute (1-5 years old).

81. Answer: B Rationale: The child is classified under Some dehydration because he manifested more than 2 symptoms in the yellow row. They are as follows: irritable, sunken eyes, drinks eagerly and skin pinch goes back slowly.

82. Answer: B Rationale: Since the child is classified under the yellow row, the appropriate intervention is following Plan B, which is the administration of ORS (oral rehydration solution). Plan A (option A) is used for children classified under the green row that requires only home management. Plan C (option C) is the administration of IVF that is used for children classified under the pink row. There is no Plan D.

83. Answer: C Rationale: When giving ORS to a child, the nurse first check if the weight is available before considering the age. By simply multiplying the child's weight with 75 (15 kg x 75 = 1125 ml), you can determine the amount of ORS to be given. Option D is correct if the weight is not mentioned or unavailable (2-5 years old = 900-1400 ml).

84. Answer: B Rationale: If a child vomits while receiving ORS, the appropriate action of the nurse is to wait for 10 minutes, then continue giving the ORS but more slowly.

85. Answer: B Rationale: If the child has one sign each both in the pink and yellow rows, the child is classified under the yellow row (Some dehydration).

86. Answer: A Rationale: A child who has just traveled to a malaria-risk area and exhibiting fever with stiff neck should be classified under the pink row (Very Severe Febrile Disease/Malaria).

87. Answer: B Rationale: A child with a positive blood smear with no runny nose is classified under the yellow row. The following are specific treatments to be given: Treat the child with an oral antimalarial drug (option A); Give one dose of paracetamol (option C); and Advise to follow up in 2 days if fever persists (option D).

88. Answer: B Rationale: Tetracycline eye ointment is given to patients with pus draining from their eyes. Gentian violet (option A) is for mouth ulcers.

89. Answer: D Rationale: A child who lived in a dengue risk area, develops fever and experienced bleeding episodes from the nose and was tested positive in tourniquet test should be classified under the pink row.

90. Answer: A Rationale: A child manifesting visible severe wasting or severe palmar pallor should be classified under the pink row (Severe malnutrition/anemia).

91. Answer: B Rationale: When assessing children for ear infection, the nurse should determine first presence of ear pain and swelling behind the ears, look for ear discharges, and ask the duration if it is acute or chronic. Asking for the presence of fever (option B) is inappropriate.

92. Answer: C Rationale: Ear infection that has been present for less than 14 days are considered acute while those exceeding 14 days are classified as chronic.

93. Answer: C Rationale: In chronic ear infection, the nurse should counsel the mother to bring back her child to the center after 5 days.

94. Answer: A Rationale: The appropriate intervention for a child classified under the pink row is the urgent referral of the child to the nearest hospital.

95. Answer: D Rationale: In performing IMCI, the nurse should follow the correct sequence of assessment. They are as follows: IMCI ARI, IMCI CDD, IMCI Fever, IMCI Ear problem, Malnutrition, Immunization and other local bacterial infection.

96. answer: A Rationale: According to the new IMCI chart, Amoxicillin is the appropriate oral antibiotic for a child with pneumonia, acute ear infection, very severe disease, and mastoiditis.

97. Answer: B Rationale: According to the new IMCI chart, Ciprofloxacin is the first line drug for treating dysentery.

98. Answer: D Rationale: According to the new IMCI chart, Artemeter-Lumefantrine is considered as the first line antimalarial drug.

99. Answer: D Rationale: A child should be given albendazole as a single advised dose in the center if: Hookworm/whipworm infection is a problem among children in the area; the child is 2 years of age or older; and the child did not have a dose of the drug in the previous 6 months.

100. Answer: A Rationale: To treat oral thrush, the mother should do the following interventions: Wash hands; Wash mouth with clean soft cloth wrapped around the finger and wet with salt water; and Paint the mouth with half-strength gentian violet.