COMMUNITY HEALTH NURSING EXAMINATION PART I

Answer Key:
COMMUNITY HEALTH NURSINGEXAMINATION PART I Outline :
I. Epidemiology
II. II. Vital Statistics
III. III. FHSISIV. COPAR
IV. V. Health Education
SITUATION : Epidemiology and Vital statistics is a very important tool that a nurse could use in controlling the spread of
disease in the community and at the same time, surveying the impact of the disease on the population and prevent it’s future
occurrence.

1. It is concerned with the study of factors that influence the occurrence and distribution of diseases, defects, disability or
death which occurs in groups or aggregation of individuals.
A. Epidemiology B. Demographics C. Vital Statistics D. Health Statistics

2. Which of the following is the backbone in disease prevention?

A. Epidemiology B. Demographics C. Vital Statistics D. Health Statistics

3. Which of the following type of research could show how community expectations canresult in the actual provision of
services?
A. Basic Research B. Operational Research C. Action Research D. Applied Research

4. An outbreak of measles has been reported in Community. As a nurse, which of the following is your first action for
an Epidemiological investigation?
A. Classify if the outbreak of measles is epidemic or just sporadic B. Report the incidence into the RHU
C. Determine the first day when the outbreak occurred D. Identify if it is the disease which it is reported to be

5. After the epidemiological investigation produced final conclusions, which of the followingis your initial step in your
operational procedure during disease outbreak?
A. Coordinate personnel from Municipal to the National level B. Collect pertinent laboratory specimen to confirm disease
causation C. Immunize nearby communities with Measles D. Educate the community in future prevention of similar
outbreaks

6. The main concern of a public health nurse is the prevention of disease, prolonging of lifeand promoting physical health
and efficiency through which of the following?
A. Use of epidemiological tools and vital health statistics B. Determine the spread and occurrence of the disease
C. Political empowerment and Socio Economic Assistance D. Organized Community Efforts

7. In order to control a disease effectively, which of the following must first be known?
1. The conditions surrounding its occurrence 2. Factors that do not favor its development
3. The condition that do not surround its occurrence 4. Factors that favors its development
A. 1 and 3
B. 1 and 4
C. 2 and 3
D. 2 and 4

8. All of the following are uses of epidemiology except:

A. To study the history of health population and the rise and fall of disease B. To diagnose the health of the community and
the condition of the people
C. To provide summary data on health service delivery D. To identify groups needing special
attention

9. Before reporting the fact of presence of an epidemic, which of the following is of mostimportance to determine?
A. Are the facts complete? B. Is the disease real?
C. Is the disease tangible? D. Is it epidemic or endemic?

10. An unknown epidemic has just been reported in Barangay Dekbudekbu. People said that affected person demonstrates
hemorrhagic type of fever. You are designated now to plan for epidemiological investigation. Arrange the sequence of
events in accordance with the correct outline plan for epidemiological investigation.1. Report the presence of dengue2.
Summarize data and conclude the final picture of epidemic3. Relate the occurrence to the population group, facilities,
food supply and carriers4. Determine if the disease is factual or real 5. Determine any unusual prevalence of the
disease and its nature; is it epidemic, sporadic, endemic or pandemic? 6. Determine onset and the geographical
limitation of the disease.
A. 4,1,3,5,2,6
B. 4,1,5,6,3,2
C. 5,4,6,2,1,3
D. 5,4,6,1,2,3E. 1,2,3,4,5,6
11. In the occurrence of SARS and other pandemics, which of the following is the most vital role of a nurse in epidemiology?
A. Health promotion
B. Disease prevention
C. Surveillance
D. Casefinding

12. Measles outbreak has been reported in Barangay Bahay Toro, After conducting an
epidemiological investigation you have confirmed that the outbreak is factual. You are
tasked to lead a team of medical workers for operational procedure in disease outbreak. Arrange the correct sequence of
events that you must do to effectively contain the disease 1. Create a final report and recommendation 2. Perform
nasopharyngeal swabbing to infected individuals 3. Perform mass measles immunization to vulnerable groups 4. Perform an
environmental sanitation survey on the immediate environment 5. Organize your team and Coordinate the personnels
6. Educate the community on disease transmission
A. 1,2,3,4,5,6 B. 6,5,4,3,2,1 C. 5,6,4,2,3,1 D. 5,2,3,4,6,1

13. All of the following are function of Nurse Budek in epidemiology except
A. Laboratory Diagnosis B. Surveillance of disease occurrence C. Follow up cases and contacts
D. Refer cases to hospitals if necessary E. Isolate cases of communicable disease

14. All of the following are performed in team organization except

A. Orientation and demonstration of methodology to be employed B. Area assignments of team members
C. Check team’s equipments and paraphernalia D. Active case finding and Surveillance

15. Which of the following is the final output of data reporting in epidemiological operationalprocedure?
A. Recommendation B. Evaluation C. Final Report D. Preliminary report

16. The office in charge with registering vital facts in the Philippines is none other than the
A. PCSO B. PAGCOR C. DOH
D. NSO
17. The following are possible sources of Data except:
A. Experience
B. CensusC. SurveysD. Research18. This refers to systematic study of vital events such as births, illnesses, marriages,divorces and
deathsA. EpidemiologyB. Demographics
C. Vital Statistics
D. Health Statistics19. In case of clerical errors in your birth certificate, Where should you go to have itcorrected?A. NSOB. Court
of AppealsC. Municipal Trial Court
D. Local Civil Registrar
20. Acasia just gave birth to Lestat, A healthy baby boy. Who are going to report the birth of Baby Lestat?A. NurseB. MidwifeC.
OB Gyne
D. Birth Attendant
21. In reporting the birth of Baby Lestat, where will he be registered?
A. At the Local Civil Registrar
B. In the National Statistics OfficeC. In the City Health DepartmentD. In the Field Health Services and Information System Main
Office22. Deejay, The birth attendant noticed that Lestat has low set of ears, Micrognathia,Microcephaly and a typical cat like
cry. What should Deejay do?A. Bring Lestat immediately to the nearest hospitalB. Ask his assistant to call the nearby
pediatricianC. Bring Lestat to the nearest pediatric clinic
D. Call a Taxi and together with Acasia, Bring Lestat to the nearest hospital
23. Deejay would suspect which disorder?

A. PCSOB PAGCORC. DOH

D. NSO
17. The following are possible sources of Data except:
A. Experience
B. CensusC. SurveysD. Research18. This refers to systematic study of vital events such as births, illnesses, marriages,divorces and
deathsA. EpidemiologyB. Demographics
C. Vital Statistics
D. Health Statistics19. In case of clerical errors in your birth certificate, Where should you go to have itcorrected?A. NSOB. Court
of AppealsC. Municipal Trial Court
D. Local Civil Registrar
20. Acasia just gave birth to Lestat, A healthy baby boy. Who are going to report the birth of Baby Lestat?A. NurseB. MidwifeC.
OB Gyne
D. Birth Attendant
21. In reporting the birth of Baby Lestat, where will he be registered?
A. At the Local Civil Registrar
B. In the National Statistics OfficeC. In the City Health DepartmentD. In the Field Health Services and Information System Main
Office22. Deejay, The birth attendant noticed that Lestat has low set of ears, Micrognathia,Microcephaly and a typical cat like
cry. What should Deejay do?A. Bring Lestat immediately to the nearest hospitalB. Ask his assistant to call the nearby
pediatricianC. Bring Lestat to the nearest pediatric clinic
D. Call a Taxi and together with Acasia, Bring Lestat to the nearest hospital
23. Deejay would suspect which disorder?
A. Trisomy 21B. Turners Syndrome
C. Cri Du Chat
D. Klinefelters Syndrome24. Deejay could expect which of the following congenital anomaly that would accompanythis disorder?
A. AVSD
B. PDAC. TOFD. TOGV26. Which presidential decree orders reporting of births within 30 days after its occurrence?
A. 651
B. 541C. 996D. 82525. These rates are referred to the total living population, It must be presumed that thetotal population was
exposed to the risk of occurrence of the event.A. RateB. Ratio
C. Crude/General Rates
D. Specific Rate26. These are used to describe the relationship between two numerical quantities ormeasures of events without
taking particular considerations to the time or place.A. Rate
B. Ratios
C. Crude/General RateD. Specific Rate
27. This is the most sensitive index in determining the general health condition of acommunity since it reflects the changes in
the environment and medical conditions of acommunityA. Crude death rate
B. Infant mortality rate
C. Maternal mortality rateD. Fetal death rate
28. According to the WHO, which of the following is the most frequent cause of death inchildren underfive worldwide in the
2003 WHO Survey?
A. Neonatal
B. PneumoniaC. DiarrheaD. HIV/AIDS

29. In the Philippines, what is the most common cause of death of infants according to thelatest survey?A. PneumoniaB.
Diarrhea
C. Other perinatal condition
D. Respiratory condition of fetus and newborn30. The major cause of mortality from 1999 up to 2002 in the Philippines are
A. Diseases of the heart
B. Diseases of the vascular systemC. PneumoniasD. Tuberculosis31. Alicia, a 9 year old child asked you “ What is the common
cause of death in my agegroup here in the Philippines? “ The nurse is correct if he will answerA. Pneumonia is the top leading
cause of death in children age 5 to 9B. Malignant neoplasm if common in your age group
C. Probability wise, You might die due to accidents
D. Diseases of the respiratory system is the most common cause of death in children
32. In children 1 to 4 years old, which is the most common cause of death?A. DiarrheaB. Accidents
C. Pneumonia
D. Diseases of the heart33. Working in the community as a PHN for almost 10 years, Aida knew the fluctuation invital statistics.
She knew that the most common cause of morbidity among the Filipinos isA. Diseases of the heartB. Diarrhea
C. Pneumonia
D. Vascular system diseases
34. Nurse Aida also knew that most maternal deaths are caused by
A. Hemorrhage
B. Other Complications related to pregnancy occurring in the course of labor,delivery and puerperium
C. Hypertension complicating pregnancy, childbirth and puerperiumD. AbortionSITUATION : Barangay PinoyBSN has the
following data in year 20061. July 1 population : 254,3162. Livebirths : 2,2893. Deaths from maternal cause : 154. Death from
CVD : 3,029

41. The following are all functions of the nurse in vital statistics, which of the following isnot?
A. Consolidate Data
B. Collects DataC. Analyze DataD. Tabulate Data42. The following are Notifiable diseases that needs to have a tally sheet in
data reporting,Which one is not?A. HypertensionB. BronchiolitisC. Chemical Poisoning
D. Accidents
43. Which of the following requires reporting within 24 hours?A. Neonatal tetanus
B. Measles
C. HypertensionD. Tetanus44. Which Act declared that all communicable disease be reported to the nearest healthstation?A.
1082B. 1891
C. 3573
D. 667545. In the RHU Team, Which professional is directly responsible in caring a sick person whois homebound?
A. Midwife
B. NurseC. BHWD. Physician46. During epidemics, which of the following epidemiological function will you have toperform
first?A. Teaching the community on disease preventionB. Assessment on suspected casesC. Monitor the condition of people
affected
D. Determining the source and nature of the epidemic
47. Which of the following is a POINT SOURCE epidemic?A. Dengue H.FB. Malaria
C. Contaminated Water Source
D. Tuberculosis

48. All but one is a characteristic of a point source epidemic, which one is not?A. The spread of the disease is caused by
a common vehicleB. The disease is usually caused by contaminated food
C. There is a gradual increase of cases
D. Epidemic is usually sudden49. The only Microorganism monitored in cases of contaminated water isA. Vibrio Cholera
B. Escherichia Coli
C. Entamoeba HistolyticaD. Coliform Test50. Dengue increase in number during June, July and August. This pattern is calledA.
EpidemicB. Endemic
C. Cyclical
D. SecularSITUATION : Field health services and information system provides summary data on healthservice delivery and
selected program from the barangay level up to the national level. As anurse, you should know the process on how these
information became processed andconsolidated.51. All of the following are objectives of FHSIS Except
A. To complete the clinical picture of chronic disease and describe their naturalhistory
B. To provide standardized, facility level data base which can be accessed for more in depthstudiesC. To minimize recording and
reporting burden allowing more time for patient care andpromotive activitiesD. To ensure that data reported are useful and
accurate and are disseminated in a timelyand easy to use fashion52. What is the fundamental block or foundation of the field
health service informationsystem?
A. Family treatment record
B. Target Client listC. Reporting formsD. Output record
53. What is the primary advantage of having a target client list?
A. Nurses need not to go back to FTR to monitor treatment and services tobeneficiaries thus saving time and effort
B. Help monitor service rendered to clients in generalC. Facilitate monitoring and supervision of servicesD. Facilitates easier
reporting

54. Which of the following is used to monitor particular groups that are qualified as eligibleto a certain program of the DOH?A.
Family treatment record
B. Target Client list
C. Reporting formsD. Output record55. In using the tally sheet, what is the recommended frequency in tallying activities
andservices?
A. Daily
B. WeeklyC. MonthlyD. Quarterly56. When is the counting of the tally sheet done?A. At the end of the dayB. At the end of the
week
C. At the end of the month
D. At the end of the year57. Target client list will be transmitted to the next facility in the form of A. Family treatment recordB.
Target Client list
C. Reporting forms
D. Output record58. All but one of the following are eligible target client listA. Leprosy casesB. TB casesC. Prenatal care
D. Diarrhea cases
59. This is the only mechanism through which data are routinely transmitted from oncefacility to anotherA. Family treatment
recordB. Target Client list
C. Reporting forms
D. Output record60. FHSIS/Q-3 Or the report for environmental health activities is prepared how frequently?A. DailyB. Weekly
C. Quarterly
D. Yearly

61. Nurse Budek is preparing the reporting form for weekly notifiable diseases. He knewthat he will code the report form asA.
FHSIS/E-1B. FHSIS/E-2C. FHSIS/E-3
D. FHSIS/M-1
62. In preparing the maternal death report, which of the following correctly codes thisoccurrence?A. FHSIS/E-1
B. FHSIS/E-2
C. FHSIS/E-3D. FHSIS/M-163. Where should Nurse Budek bring the reporting forms if he is in the BHU Facility?A. Rural health
officeB. FHSIS Main office
C. Provincial health office
D. Regional health office64. After bringing the reporting forms in the right facility for processing, Nurse Budek knewthat the
output reports are solely produced by what office?A. Rural health officeB. FHSIS Main office
C. Provincial health office
D. Regional health office65. Mang Raul entered the health center complaining of fatigue and frequent syncope. Youassessed
Mang Raul and found out that he is severely malnourished and anemic. Whatrecord should you get first to document these
findings?
A. Family treatment record
B. Target Client listC. Reporting formsD. Output record66. The information about Mang Raul’s address, full name, age,
symptoms and diagnosis isrecorded in
A. Family treatment record
B. Target Client listC. Reporting formsD. Output record
67. Another entry is to be made for Mang Raul because he is in the target client’s list, Inwhat TCL should Mang Raul’s entry be
documented?A. TCL Eligible PopulationB. TCL Family Planning

SUPPLEMENTAL REVIEWKEY POINTS IN COMMUNITY HEALTH NURSING(

Prepared by Rhenier S. Ilado RN)
Some test taking techniques:
A-ssimilate essential principles in the care of patients in thecommunity
These principles may include:
1. have a purpose or objective when conducting home visit
2. plan ahead
3. priority should be given to the recognized needs of the family
4. there is no definite rule as to the frequency of a home visit
5. frequency of home visit should take into account, the physical,psychological and educational needs of the individual and
family
6. the initial step in conducting a home visit is to GREET the client andintroduce yourself
7. soiled articles with discharge should be boiled in water 30 minutes beforelaundering
B- ag Technique
- steps which are carried out by the nurse to facilitate theperformance of nursing procedures with ease and deafness
Remember the
:
B
ag and its contents must be protected from any possible contamination
A
lways wash your hands to prevent the spread of infection
G
ather all necessary articles and supplies to answer emergency needs
Note:
blood pressure apparatus and stethoscope are carriedseparately Consider the following principles: 1. prevention of
contamination Note: place waste paper bag outside the work areas 2. protection of the caregiver Note: clean and alcoholize all
articles after use 3. make articles readily accessible Note: place the articles in one corner of the work area 4. make follow-up
care Note: set the date and time for the next visit

C- ommunity Based Rehabilitation Program

•
the goal of this program is the improvement of quality of life andproductivity of disabled persons
•
R.A 7277, Magna Carta for Disabled Persons, serves as the legal basis ofthe program
•
The components of the program include: social preparations, servicespreparation, training, information, education and commun
ication andmonitoring, supervision and evaluation
•
The VISION of the Department of Health is:
health for all Filipinos
•
The MISSION of the Department of Health is:
Ensure accessibility ofhealth care to improve the quality of life of all Filipinos especially thepoor
•
The basic principles to achieve improvement in health
include:E – nsure universal access to basic health servicesE – pidemiological shift from infectious to degenerative disease mustbe
managedE – nhance the performance of health sectorE – nsure the priotization of health and nutrition of vulnerable groups
•
The primary strategies to achieve health goals
include:S – upport for frontline health workers and to local systemdevelopmentA – ssurance of health careI – ncreasing
investment for primary health careD – evelopment of national standard and objectives for health
•
Primary health Care (PHC)
,
according to the World Health organization is an essential health care made universally accessible to individuals and families in
the community by means acceptable to them through their full participation and at a cost that the community and country can
afford at every stage of development
•
The goal of PHC is
health for all Filipinos and Health in the hands ofthe people by the year 2020
•
Letter of instruction (LOI) 949 (October 19, 1979) is the legal basis ofPHC
•
The first international conference on primary health care was held inAlma, Ata, USSR on September 6-12, 1978 sponsored by the
WHO andUNICEF
•
The framework for meeting the goal of primary health care isorganizational strategy, it calls for among communities, private an
dgovernment agencies with the end view of health development
•
The
four cornerstone/pillars in primary health care
includes:1. active community participation2. intra and inter sectoral linkages3. use of appropriate technology4. support
mechanism made available
•
The
expanded program on immunization
aims to reduce the morbidityand mortality among infants and children caused by the six childhoodimmunizable diseases. It was
launched in July 1976.

P.D. 996
(September 16, 1976) provides for compulsory basicimmunization for infants and children below 8 years of age. The EPIprogram
is based on epidemiological situations.
Presidential proclamation no. 147
(March 3, 1993) declares April 21and May 19, 1993 and every third Wednesday of January and Februarythereafter for two years
as National Immunization Days.
R.A. 7846
(December 30, 1994) requires compulsory immunizationagainst hepatitis B for infants and children below 8 years old
•
the ultimate goal of promotion of reproductive health is “
QUALITY OFLIFE”
. The focus of the Philippine framework of the program isReproductive Health status in terms of, its elements. The ten
elementsof Reproductive Health includes:1. maternal and child health and nutrition2. family planning3. prevention and
management of abortion complications4. prevention and treatment of reproductive tract infection (RTI’s)including STD’s, HIV
and AIDS5. education and counseling on sexuality and sexual
health6. breast and reproductive tract cancers and other gynecologicalconditions7. men’s reproductive health8. violence
against women9. prevention and treatment of infertility and sexual disorders10. adolescent reproductive
•
the goal of the 2000 Nutritional Guidance for Filipinos is theimprovement of nutritional status, productivity and quality of life of
thepopulation through adoption of desirable dietary practices and
healthylifestyle. An example is the exclusive breastfeeding of infants
frombirth to 4-6 months
and the use of iodized salt.
•
The use of fluoride in the prevention of tooth decay is carried out bymaking four application of fluoride about
a week apart among childrenwho are aged 3, 7, 10 and 13 because at these ages new teeth haveerupted
•
The goal for health care and services for older persons is to provide a
longer disability-free life
. This is carried out through a holistic careapproach
•
To reduce the blindness prevalence rate in the Philippines, the preventionof blindness program was conceived. It is subdivided
into four programsnamely, cataract program, primary eye care, vitamin A deficiency programand other eye care program
•
The goals of the mental health program include:
promotion of mentalhealth, decreased health-related effects of stressful lifestyle andreduction of prevalence
of mental ill health and disorders in thePhilippines
•
The
Sentrong sigla movement
aims to promote availability of qualityhealth services in health centers and hospitals and to make theseservices accessible to
every Filipino
•
“
Sang Milyong Sepilyo
” is a strategy for social mobilization of Dentalhealth program. It aims to emphasize the importance of oral health
inrelation to total body health to increase public awareness on theprevention of common dental diseases
D- OH PROGRAMSD -
ental health Program
O-
steoporosis prevention
H-
ealth education and Community Organization
P
-rimary Health Care
R
-eproductive health
O
-lder Persons health Services
G
-uidelines for Good Nutrition
R
-espiratory Infection control
A
-ccupressures
M
-aternal and Child care
S
-entrong Sigla Movement
E- pidemiology
•
Systematic and scientific study of the distribution patterns anddeterminants of health, disease and condition for the purpose ofp
romoting wellness and preventing disease conditions
•
Basic concepts that guide epidemiological study include: biostatistics,aggregate at risk, the natural life history of a disease,
levels ofprevention, host-agent-environment relationships, multiple causation,person-place-time-relationships
•
When monitoring incidence of infectious disease, the term used todistinguish relative frequency in time and space include the
following:
Sporadic
– presence of occasional cases of the disease
Endemic
– constant long-term presence of the disease
Epidemic
– presence of the disease at a much higher frequency over a shortperiod of time
Pandemic
– presence of a disease in many countries in a relatively shortperiod of time
•
Effective implementation of the epidemiological process requires amulti disciplinary approach
•
A community health nurse must apply the principles of epidemiology inorder to provide preventive services to the community
•
Community health nurses participate in may epidemiological activitieslike: case finding, health teaching, counseling and follow
up essentialto the prevention of diseases and other conditions

•
HEPA and DPT
– the best injection site is the outer part of thechild’s midthigh- ask the mother of the child to hold the child’s legs
•
MEASLES
–the best injection site is on the outer side of the upperarm
•
TETANUS TOXOID
–the best injection site for a woman is the outerside of the left upper arm

Vaccine Dose Timing of Vaccination

TT1 5-6 months of pregnancy
TT2 1 month/ 4 weeks after
TT1TT3 at least 6 months later
TT4 at least 1 year laterTT5at least 1 year lae