1. Answer: A Rationale: The context of Community Health Nursing is based on the nurse's evaluation about the existing health problems and needs of the people. One of the principles of CHN states that Community Health Nursing is based on the recognized needs of individuals, families, communities and groups.
2. Answer: B Rationale: The primary goal of Community Health Nursing is to help communities and families to cope with the discontinuities of health and threats in such a way as to maximize their potential for high level wellness, as well as to promote reciprocally supportive relationship between people and their physical and social environment.
3. Answer: D Rationale: Community Development is defined as an organized effort of people to improve the conditions of the community life and the capacity of the people for participation, self-direction and integrated efforts in community affairs in which development is accomplished by the people. Everyone has something to contribute to the life of the community. It is not solely for women (option A) and not a short term process (option C).
4. Answer: A Rationale: If people are not attending to the services offered by the health staff, the team must reassess the needs of the people. This is base on the principle that Community Health Nursing is based on the recognized needs of individuals, families, communities and groups.
5. Answer: C Rationale: If a particular health service fails, it is important to reassess the felt needs of the people not their demands (option A).
6. Answer: C Rationale: The modern concept of health refers to the optimum level of functioning (OLOF) or the maximum level of wellness of individual, families and communities.
7. Answer: C Rationale: Environmental influences is the factor in the ecosystem that is involved in the menace of pollution, which has been growing over the years and has greatly affected the health of the people. The disease today are largely man-made. Examples of these are communicable diseases due to poor sanitation, poor garbage collection ,smoking, air pollution and utilization of chemicals such as pesticides
8. Answer: B Rationale: Health Care Delivery System is the factor in the ecosystem affecting the individuals health that is involved in the provision of essential health services whether community-based, accessible, sustainable and affordable. Although promotive and preventive health measures are emphasized in community health, the availability and accessibility of curative and rehabilitative services also affect people's health.
9. Answer: D Rationale: Behavioral influences refers to the factor in the ecosystem affecting the individuals health through certain habits that a person has. These may be in the form of smoking, intake of alcoholic drinks, substance abuse or lack of exercise. The people's lifestyle, health care and child rearing practices are shaped, to a large extent, by their culture and ethnic heritage. Option D is not a behavioral influence, it is an environmental influence.
10. Answer: A Rationale: In the Health Care Delivery System, ideally, rehabilitation services begin upon admission of the client in the health care system.
11. Answer: D Rationale: The Filipino people are characterized by the following descriptions: (option A) The ten leading causes of Mortality are due non-communicable diseases with diseases of the heart and vascular systems as the two most common causes of death; (option B) The projected life expectancy at birth year for 2000-2005 is 64.10 years for males and 70.10 years for females; and (option C) The productive age group belongs to 15 to 59 years old. Option D is incorrect because Pneumonia is the leading cause of death among newborns and children aged below 5 years old (37.76/100,000) followed only by accidents at the rate of 17.63/100,000, while Accidents are identified as the top cause of mortality among older children aged 5 to 9 years old followed by pneumonia and malignant neoplasm.
12. Answer: B Rationale: The leading cause of morbidity among the elderly population is infectious in nature, such as influenza (making option A incorrect), pneumonia and tuberculosis. Option C is incorrect because errors of refraction is the leading cause of visual impairment and of bilateral or monocular low vision while Cataract is leading cause of bilateral (62%) and monocular blindness. Option D is incorrect because Anxiety disorders (10.5%) is the leading cause of mental illness among adult Filipinos.
13. Answer: B Rationale: The 2003 fertility rate in the country remains at 3.5 children per woman, much higher than the desired fertility rate of 2.5 children per woman. However, option B is an incorrect statement because Women aged 15-24 years are the age group with the highest, not lowest, unmet need for family planning services at 26%. Option A is a correct statement because according the 2000 Philippine health Statistics, 25% of all maternal deaths are due to hypertension, 20.3% to postpartum hemorrhage and 9% to pregnancy with abortive outcomes. Option C is correct because there are lesser adult women who die due to accidents and injuries compared to adult males (86.85%). option D is a correct statement because among adolescent aged 19, there are about 12% of the young people who are already sexually active and by age 24, 45% of women are already mothers.
14. Answer: C Rationale: The most widely used summary measure of the burden of diseases which combines the number of years of healthy life lost to premature death with time spent in less than full health is known as the Disability Adjusted Life Year or DALY.
15. Answer: C Rationale: The life expectancy of Filipinos in 2002 has gone up to 69.6 years.
16. Answer: C Rationale: The proper sequence of doing the clinic visit are as follows: Registration or admission; Waiting time; Triaging; Clinical Evaluation; Laboratory and other diagnostic examinations; Referral system; Prescription and Dispensing; and Health Education.
17. Answer: A Rationale: Pre-clinic lecture is usually done during pre-consultation conference that is conducted prior to the admission of patients, which is one way of providing health education.
18. Answer: A Rationale: In triaging, a public health nurse manage a program-based case. Certain programs of the DOH like the IMCI utilize an acceptable decision to which the nurse has to follow in the management of a simple case. All non-program based cases are refer to the physician (option B). All emergency cases are provided with first aid treatment and refer the case to the next level of care (option C and D).
19. Answer: C Rationale: The Physician-in-Charge is the leader in planning the clinical activities.
20. Answer: C Rationale: Health Education is the appropriate response by the nurse to the situation. Option A is incorrect because the nurse breach the right of confidentiality. Option B and D because nurses should never confront a fellow health care team in front of a patient and should never practice avoidance.
21. Answer: C Rationale: Home visit is a professional contact made by the nurse and an extension of the services of the health center. When preparing for a home visit, it should have a purpose or objective. Home visit should always be recorded or documented (making option C incorrect).
22. Answer: B Rationale: The steps in home visits are as follows: Greet the client or household member and introduce yourself; Explain the purpose of the home visit; Inquire about health and welfare of the client and other family members. Ask about any health and health-related problems; Place bag in a convenient place before doing bag technique; Wash hands and wear apron and put out needed articles and/or medicines, dressings from bag; Perform physical assessment and nursing care needed. Give the necessary heath teaching and advice based on client's need and condition; Wash hands and close bag; Record findings and nursing care given; make appointment either for a clinic or home visit. (Public Health Nursing in the Philippines)
23. Answer: A Rationale: In the Preparatory phase, the nurse reviews the records of the family in the clinic.
24. Answer: D Rationale: In performing home visit, it is necessary to prepare a plan of visit to meet the needs of the client and achieve the best results of desired outcomes.
25. Answer: D Rationale: The following are principles of home visits: A home visit must have a purpose or objective (option B); Planning for a home visit should make use of all available information about the patient and his family through family records and from other agencies that may have rendered services to the family (option C); In planning for a visit, the nurse should consider and give priority to the essential needs of the individual and his family; Planning and delivery of care should involve the individual and family; and the plan should be flexible and practical (option A).
26. Answer: D Rationale: The rationale when performing the bag technique is that it should render effective nursing care to clients or other family members.
27. Answer: C Rationale: When wiping the thermometer after use, clean the thermometer in a downward spiral motion from the stem to the bulb, holding it over the waste paper bag using the following technique: 1st - 3 cotton balls moistened with soap. Discard. 2Nd - 3 cotton balls moistened with water. 3Rd - 1 cotton ball moistened with alcohol, then wrap around the bulb of the thermometer and lay it inside the kidney basin.
28. Answer: C Rationale: A yellow result of a Benedict's test indicates a ++ result. Blue indicates (-) (option A). Green indicates + (option B). Blue-green indicates traces of glucose in the urine. Orange indicates +++ (option D). Brick red indicates ++++.
29. Answer: A Rationale: If the result of a Heat and Acetic acid test is clear, there is no albumin in the urine. If it is cloudy, the nurse should repeat the procedure. If on the second test, the result is still cloudy then it is interpreted as positive protein leak or positive proteinuria.
30. Answer: B Rationale: Tourniquet test or Rumpel-Lead's test is used as screening for dengue. An imaginary one square inch just below the BP cuff or in the antecubital fossa is made to check for the presence of petechial rashes. If it manifested 20 or more petechial rashes, it indicates a positive dengue result. If it is less than 20 it means that the test is negative.
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