Chamomile
Uses: Chamomile is often used in the form of a tea as a sedative.
Reactions: Allergic reactions can occur, particularly in persons allergic to ragweed. Reported reactions include abdominal cramps, tongue thickness, tightness in the throat, swelling of the lips, throat and eyes, itching all over the body, hives, and blockage of the breathing passages. Close monitoring is recommended for patients who are taking medications to prevent blood clotting (anticoagulants) such as warfarin.
Echinacea
Uses: Largely because white blood cells in the laboratory can be stimulated to eat particles, Echinacea has been touted to be able to boost the body's ability to fight off infection.
Reactions: The most common side effect is an unpleasant taste. Echinacea can cause liver toxicity. It should be avoided in combination with other medications that can affect the liver (such as ketaconazole, leflunomide (Arava), methotrexate (Rheumatrex), isoniazide (Nizoral).
St. John's Wort
Uses: St. John's Wort is popularly used as an herbal treatment for depression, anxiety, and sleep disorders. It is technically known as Hypericum perforatum. Chemically, it is composed of at least 10 different substances that may produce its effects. The ratios of these different substances varies from plant to plant (and manufacturer). Studies of its effectiveness by the National Institutes of Health are in progress.
Reactions: The most common side effect has been sun sensitivity which causes burning of the skin. It is recommended that fair- skinned persons be particularly careful while in the sun. St. John's wort may also leave nerve changes in sunburned areas. This herb should be avoided in combination with other medications that can affect sun sensitivity (such as tetracycline/Achromycin, sulfa- containing medications, piroxicam (Feldend). St. John's wort can also cause headaches, dizziness, sweating, and agitation when used in combination with serotonin reuptake inhibitor medications such as fluoxetine (Prozac) and paroxetine (Paxil).
Garlic
Uses: Garlic has been used to lower blood pressure and cholesterol (Dr. Lucinda Miller notes that there is "...still insufficient evidence to recommend its routine use in clinical practice.")
Reactions: Allergic reactions, skin inflammation, and stomach upset have been reported. Bad breath is a notorious accompaniment. Studies in rats have shown decreases in male rats' ability to make sperm cells. Garlic may decrease normal blood clotting and should be used with caution in patients taking medications to prevent blood clotting (anticoagulants) such as warfarin /Coumadin.
Feverfew
Uses: Most commonly used for migraine headaches.
Reactions: Feverfew can cause allergic reactions, especially in persons who are allergic to chamomile, ragweed, or yarrow. Nonsteroidal anti-inflammatory drugs (NSAIDs such as ibuprofen (Advil), naproxen (Aleve) or Motrin) can reduce the effect of feverfew. A condition called "postfeverfew syndrome" features symptoms including headaches, nervousness, stiffness, joint pain, tiredness, and nervousness. Feverfew can impair the action of the normal blood clotting element (platelets). It should be avoided in patients taking medications to prevent blood clotting (anticoagulants) such as warfarin (Coumadin).
Ginko Biloba
Uses: This herb is very popular as a treatment for dementia (a progressive brain dysfunction) and to improve thinking.
Reactions: Mild stomach upset and headache have been reported. Ginko seems to have blood thinning properties. Therefore, it is not recommended to be taken with aspirin, nonsteroidal anti-inflammatory drugs (Advil), naproxen (Aleve) or Motrin), or medications to prevent blood clotting (anticoagulants) such as warfarin (Coumadin). Ginko should be avoided in patients with epilepsy taking seizure medicines, such as phenytoin (Dilantin), carbamazepine (Tegretol), and phenobarbital.
Ginseng
Uses: Ginseng has been used to stimulate the adrenal gland, and thereby increase energy. It also may have some beneficial effect on reducing blood sugar .in patients with diabetes mellitus. (Dr. Miller emphasized that there is substantial variation in the chemical components of substances branded as "Ginseng.")
Reactions: Ginseng can cause elevation in blood pressure, headache, vomiting, insomnia, and nose bleeding. Ginseng can also cause falsely abnormal blood tests for digoxin level. It is unclear whether ginseng may affect female hormones. Its use in pregnancy is not recommended. Ginseng may affect the action of the normal blood clotting element (platelets). It should be avoided in patients taking aspirin, nonsteroidal antiinflammatory drugs (such as ibuprofen (Advil), naproxen (Aleve) or Motrin), or medications to prevent blood clotting (anticoagulants) such as warfarin (Coumadin). Ginseng may also cause headaches, tremors, nervousness, and sleeplessness. It should be avoided in persons with manic disorder and psychosis.
Ginger
Uses: Ginger has been used as a treatment for nausea and bowel spasms.
Reactions: Ginger may lead to blood thinning. It is not recommended to be taken with medications that prevent blood clotting (anticoagulants) such as warfarin (Coumadin).
Saw Palmetto
Uses: Saw palmetto has been most commonly used for enlargement of the prostate gland. (Dr. Miller emphasized that studies verifying this assertion are necessary.) Saw palmetto has also been touted as a diuretic and urinary antiseptic to prevent bladder infections.
Reactions: This herb may affect the action of the sex hormone testosterone, thereby reducing sexual drive or performance. Dr. Miller states that "While no drug-herb interactions have been documented to date, it would be prudent to avoid concomitant use with other hormonal therapies (e.g., estrogen replacement therapy and oral contraceptives...")
This listing represents only a small portion of herbal treatments. Nevertheless, the popularity of herbal therapies is unquestionable. Doctors routinely confront the unknown with their patients who are using herbs. Doctors simply do not have any way of helping you to decide whether these herbs are helpful or harmful for you, or whether they are interacting with your current medications. There are no data.
Black Cohosh
Claims, Benefits: A natural way to treat menopausal symptoms.
Bottom Line: Little is known about its benefits and its risks. If you try it, tell your physician, since it might interact with other medications you are taking.
Sunday, December 9, 2007
Herbal Meds
ANTIDOTES
ACETAMINOPHEN ACETYLCYSTEIN MUCOMIST
DIGOXIN DIGIBIND, DIDIFAB
HEPARIN PROTAMINE SULFATE
COUMADIN, WARFARIN VITAMIN K, FRESH FROZEN PLASMA
LOVENOX VITAMIN K
LITHIUM DIAMOX
BENZODIAZEPINE FLUMAZENIL
ATROPINE SULFATE MESTINON
CURARE EDROPHONIUM TENSILON
MORPHINE NALOXONE HCL (NARCAN)
DEMEROL NALOXONE HCL (NARCAN)
METHOTREXATE LEUCOVORINE
NEOSTIGMINE PRALIDOXINE CHLORIDE (PAM)
PENICILLIN EPINEPHRINE
THROMBOLYTIC AMINO CAPROIC ACID
METHYLERGONOVINE MAGNESSIUM SULFATE
OXYTOCIN MAGNESSIUM SULFATE
MAGNESSIUM SULFATE CALCIUM GLUCONATE
YUTOPAR INDERAL
LEAD EDETATE DISODIUM (EDTA)
LEAD DIMERCAPROL (BAL)
LEAD SUCCIMER (CHEMET)
IRON DESFERAL
COPPER PENICILLAMINE
ETHYLENE POISONING FOMEPIZOL (ANTIZOL)
CYANIDE POISONING METHYLENE BLUE
MORPHINE DEMEROL
MI OK OK
SICKLE CELL OK NOT OK
CHOLECYSTITIS NOT OK OK
PANCREATITIS NOT OK OK
MNEMONICS
MNEMONICS CORNER 05
Acid-base—"ROME" (Respiratory Opposite, Metabolic Equal)
Acidosis
» Respiratory (opposite): pH Pco2
» Metabolic(equal): pH HCO3
Alkalosis
» Respiratory (opposite): pH Pco2
» Metabolic(equal): pH HCO3
Alcohol withdrawal: clinical features—"HITS"
Hallucinations (visual, tactile)
Increased vital signs and insomnia
Tremens delirium tremens (potentially lethal)
Shakes/ Sweats/ Seizures/ Stomach pains (nausea, vomiting)
Angina: precipitating factors—"4E's"
Eating
Emotion
Exertion (Exercise)
Extreme Temperatures (Hot or Cold weather)
Anorexia nervosa: clinical features—"ANOREXIC"
Adolescent women/ Amenorrhea
NGT alimentation (most severe cases)
Obsession with losing weight/ becoming fat though underweight
Refusal to eat (5% die)
Electrolyte abnormalities (e.g., K+, cardiac arrhythmia)
X - ercise
Intelligence often above average/ Induced vomiting
Cathartic use (and diuretic abuse)
Appendicitis: assessment—"PAINS"
Pain (RLQ)
Anorexia
Increased temperature, WBC (15,000–20,000)
Nausea
Signs (McBurney's, Psoas)
Neurovascular Occlusion: symptoms— "6 P's"
Pain
Pale
Pulseless
Paresthesia
Poikilothermic
Paralysis
Blood glucose (rhyme)
Symptom Implication
Cold and clammy . . . give hard candy
Hot and dry . . . glucose is high
Blood vessels in umbilical cord—"AVA" (2 arteries and 1 vein)
Artery
Vein
Artery
Cholecystitis: risk factors—"5F's"
Female
Fat
Forty
Fertile
Fair
Cleft lip: nursing care plan (postoperative)—"CLEFT LIP"
Crying, minimize
Logan bow
Elbow restraints
Feed with Brecht feeder
Teach feeding techniques; two months of age (average age at repair)
Liquid (sterile water), rinse after feeding
Impaired feeding (no sucking)
Position—never on abdomen
Cognitive disorders: assessment of difficulties—"JOCAM"
Judgment
Orientation
Confabulation
Affect
Memory
Coma: causes—"A-E-I-O-U TIPS"
Alcohol, acidosis (hyperglycemic coma)
Epilepsy (also electrolyte abnormality, endocrine problem)
Insulin (hypoglycemic shock)
Overdose (or poisoning)
Uremia and other renal problems
Trauma; temperature abnormalities (hypothermia, heat stroke)
Infection (e.g., meningitis)
Psychogenic ("hysterical coma")
Stroke or space-occupying lesions in the cranium
Complication of severe preeclampsia—"HELLP" syndrome
Hemolysis
Elevated Liver enzymes
Low Platelet count
Cushing's syndrome: symptoms—"3S's"
Sugar (hyperglycemia)
Salt (hypernatremia)
Sex (excess androgens)
Diabetes: signs and symptoms—"3P's,"
Polydipsia (very thirsty)
Polyphagia (very hungry)
Polyuria (urinary frequency)
Diet: low cholesterol—avoid the "3C's"
Cake
Cookies
Cream (dairy, e.g., milk, ice cream)
Dystocia: etiology—"3P's"
Power
Passageway
Passenger
Dystocia: general aspects (maternal)—"3P's"
Psych
Placenta
Position
Episiotomy assessment—"REEDA"
Redness
Edema
Ecchymosis
Discharge
Approximation of skin
Eye medications
Mydriatic = dilated pupils
Miotic = tiny (constricted) pupils
Hypertension: complications—"4 C's"
CAD (coronary artery disease)
CHF (congestive heart failure)
CRF (chronic renal failure)
CVA (cardiovascular accident; now called brain attack or stroke)
Hypertension: nursing care plan— "I-TIRED"
Intake and output (urine)
Take blood pressure
Ischemia attack, transient (watch for TIAs)
Respiration, pulse
Electrolytes
Daily weight
Hypoglycemia: signs and symptoms—"DIRE"
Diaphoresis
Increased pulse
Restless
Extra hungry
Infections during pregnancy—"TORCH"
Toxoplasmosis
Other (hepatitis B, syphilis, group B beta strep)
Rubella
Cytomegalovirus
Herpes simplex virus
IUD: potential problems with use—"PAINS"
Period (menstrual: late, spotting, bleeding)
Abdominal pain, dyspareunia
Infection (abnormal vaginal discharge)
Not feeling well, fever or chills
String missing
Manipulation: nursing plan—promote the "3C's"
Cooperation
Compromise
Collaboration
Medication administration—"six rights"
RIGHT medication
RIGHT dosage
RIGHT route
RIGHT time
RIGHT client
RIGHT technique
Melanoma characteristics—"ABCD"
Asymmetry
Border
Color
Diameter
Mental retardation: nursing care plan—"3R's"
Regularity (provide routine and structure)
Reward (positive reinforcement)
Redundancy (repeat)
Myocardial infarction: treatment—"MONA"
Monitor/ Morphine
Oxygen
Nitroglycerin
Aspirin
Newborn assessment components—"APGAR"
Appearance
Pulse
Grimace
Activity
Respiratory effort
Obstetric (maternity) history—"GTPAL"
Gravida
Term
Preterm
Abortions (SAB, TAB)
Living children
Oral contraceptives: signs of potential problems—"ACHES"
Abdominal pain (possible liver or gallbladder problem)
Chest pain or shortness of breath (possible pulmonary embolus)
Headache (possible hypertension, brain attack)
Eye problems (possible hypertension or vascular accident)
Severe leg pain (possible thromboembolic process)
Pain: assessment—"PQRST"
What Provokes the pain?
What is the Quality of the pain?
Does the pain Radiate?
What is the Severity of the pain?
What is the Timing of the pain?
Pain: management—"ABCs"
Ask about the pain
Believe when clients say they have pain
Choices—let clients know their choices
Deliver what you can, when you said you would
Empower/Enable clients' control over pain
Postoperative complications: order—"4W's"
Wind (pulmonary)
Wound
Water (urinary tract infection)
Walk (thrombophlebitis)
Preterm infant: anticipated problems—"TRIES"
Temperature regulation (poor)
Resistance to infections (poor)
Immature liver
Elimination problems (necrotizing enterocolitis [NEC])
Sensory-perceptual functions (retinopathy of prematurity [ROP])
Psychotropic medications: common antidepressives (tricyclics)—"VENT"
Vivactil
Elavil
Norpramin
Tofranil
Schizophrenia: primary symptoms—"4A's"
Affect
Ambivalence
Associative looseness
Autism
Sprain: nursing care plan—"RICE"
Rest
Ice
Compression
Elevation
Stool assessment—"ACCT"
Amount
Color
Consistency
Timing
Tracheoesophageal fistula: assessment—"3Cs"
Coughing
Choking
Cyanosis
Traction: nursing care plan—"TRACTION"
Trapeze bar overhead to raise and lower upper body
Requires free-hanging weights; body alignment
Analgesia for pain, prn
Circulation (check color and pulse)
Temperature (check extremity)
Infection prevention
Output (monitor)
Nutrition (alteration related to immobility)
Transient ischemic attacks: assessment—"3Ts"
Temporary unilateral visual impairment
Transient paralysis (one-sided)
Tinnitus = vertigo
Trauma care: complications—"TRAUMA"
Thromboembolism; Tissue perfusion, altered
Respiration, altered
Anxiety related to pain and prognosis
Urinary elimination, altered
Mobility impaired
Alterations in sensory-perceptual functions and skin integrity (infections)
Wernicke-Korsakoff syndrome (alcohol-associated neurological disorder)—"COAT RACK"
Wernicke's encephalopathy (acute phase)
clinical features:
Confusion
Ophthalmoplegia
Ataxia
Thiamine is an important aspect of Tx
Korsakoff's psychosis (chronic phase)
characteristic findings:
Retrograde amnesia (recall of some old memories)
Anterograde amnesia (ability to form new memories)
Confabulation
Korsakoff's psychosis
MNEMONICS CORNER 04
SIGNS OF CANCER
Change in bowel /bladder habits
A sore that doesn’t heal
Unusual bleeding/ Discharge
Thickening of lump – breast or elsewhere
Indigestion/ Dysphagia
Obvious change in wart/ mole
Nagging cough/ hoarseness
Unexplained anemia
Sudden weight loss
FOCUS OF PATIENT CARE IN CLIENTS WITH CANCER
Chemotherapy
Assess body image disturbance (related to alopecia)
Nutritional needs when N/V present
Comfort from pain
Effective response to Tx? (Evaluate)
Rest (for patient and family)
MNEMONICS CORNER 03
Basic MI management - "BOOMAR"
Bed rest
Oxygen
Opiate
Monitoring
Anticoagulation
Reduce clot size
To Remember Immunoglobulins - "GAMED"
IgG
IgA
IgM
IgE
IgD
Location of the heart valve from right to left - "A Permanently Temperamental Man"
Aortic
Pulmonary
Tricuspid
Mitral
"Cut C4, breathe no more"
The 3rd, 4th and 5th cervical spinal nerves innervate the diaphragm.
Types of Joint movements - "FEEDPIPE CARDSHARP"
Flexion
Extension
Eversion
Dorsiflexion
Pronation
Inversion
Plantarflexion
Elevation
Circumduction
Abduction
Rotation
Depression
Supination
Hyperextension
Adduction
Retraction
Protraction
Cranial Nerves - "Oh Ohh Ohhh To Try And Fit A Gold Velvet So Heavenly"
Olfactory CN I
Optic CN II
Occulomotor CN III
Trochlear CN IV
Trigeminal CN V
Abducens CN VI
Facial CN VII
Auditory CN VIII
Glasopharyngeal CN IX
Vagus CN X
Spinal/Accessory CN XI
Hypoglossal CN XII
"Point and Shoot!"
For remembering that Parasympathetics are involved with erection and Sympathetics with ejaculation.
Layers of the scalp - "SCALP"
Skin
Connective tissue
Aponeurosis
Loose areolar tissue
Pericranium
Carpal bones of the hand (lateral to medial) - "She Looks Too Proud, Try To Chase Her"
Proximal row:
Scaphoid
Lunate
Triquetrum
Pisiform
Distal row:
Trapezium
Trapezoid
Capitate
Hamate
Viruses causing diarrhea - "ACNE CAR"
Adeno virus
Corana virus
Norwak virus
Entero virus
Calci virus
Astro virus
Rota virus
The Krebs cycle - "Can I Actually See Some Filipina Mothers"
Citrate
Isocitrate
alpha Ketoglutarate
Succinyl CoA
Succinate
Fumarate
Malate
Oxaloacetate
Stages of mitosis/meiosis including interphase as a phase - "In Philippines, Men Are Talented"
Interphase
Prophase
Metaphase
Anaphase
Telophase
Order of prevalence of White Blood Cells, most prevalent to least - "Never Let Monkeys Eat Bananas"
Neutrophils
Lymphocytes
Monocytes
Eosinophils
Basophils
10 essential amino acids - "PVT. TIM HALL"
Phenylalanine
Valine
Tryptophan
Threonine
Isoleucine
Metheonine
Histidine(semi-essential)
Arginine(semi-essential)
Leucine
Lysine
Uses of Chloroquine (other than malaria) - "RED LIP"
Rheumatoid arthritis
Extra intestinal amoebiasis
Discoid lupus erythematosus
Lepra reaction
Infectious mononucleosis
Photogenic reactions
Bronchodilators - "TO A SIS"
Terbutaline
Orciprenaline
Adrenaline
Salbutamol
Isoprenaline
Salmeterol
Signs of cor pulmonale - "Please Read His Text"
Peripheral edema
Raised JVP
Hepatomegaly
Tricuspid incompetence
Portal hypertension features - "ABCDE"
Ascites
Bleeding (hematemesis, piles)
Caput medusae
Diminished liver
Enlarged spleen
Key questions needed in an emergency history taking situation - "AMPLE"
Allergies
Medication
Past medical history
Last meal
Events and environment related to injury
Malignancies that metastisize to bone - "Laging Panalo Kung Taga Bulacan"
Lung
Prostat
Kidney
Thyroid
Breast
Six "S" in Scarlet Fever
Streptococci causal organism
Sorethroat
Swollen tonsils
Strawberry tongue
Sandpaper rash
miliarySudamina vesicles over hands, feet, abdomen
Signs of anti-cholinergic crisis - "SLUD"
Salivation
Lacrimation
Urination
Defecation
Causes of huge spleen - "3M's"
Myelofibrosis
Malaria
Myelogenous leukemia
Cardinal Symptoms of Parkinson's Disease - "TRAP"
Tremor
Rigidity
Akinesia and bradykinesia
Postural Instability
Days of appearance of rashesVaricella(chickenpox) - "Very Sick Patients Must Take Double Exercise"
1st dayScarlet fever
2nd dayPox(smallpox)
3rd dayMumps
4th dayTyphus
5th dayDengue
6th dayEnteric fever(typhoid)
MNEMONICS CORNER 02
SHOCK – HYPOTACHYTACHY
HYPOTENSION
TACHYPNEA
TACHYCARDIA
INCREASE ICP – HYPERBRADYBRADY
CUSHINGS TRIAD
HYPERTENSION (WIDE PULSE PRESSURE)
BRADYCARDIA
BRADYPNEA
HYPOGLYCEMIA
TREMORS, TACHYCARDIA
IRRITABILITY
RESTLESSNESS
EXTREME
DIAPHORESIS
EARLY SIGNS OF HYPOXIA
RESTLESSNESS
AGITATION
TACHYCARDIA
LATE SIGNS OF HYPOXIA
BRADYCARDIA
EXTREME RESTLESSNESS
DYSPNEA
CYANOSIS
CONGESTIVE HEART FAILURE
DIGOXIN
MORPHINE
AMINOPHYLLINE
DOPAMINE
DIURETICS
O2
GASSES – MONITOR (ABG)
MG SO4 TOXICITY
BP DECREASE
URINE OUTPUT DECREASE
RESPIRATORY RATE DECREASE
PATELLAR REFLEX ABSENT
SICKLE CELL DISEASE
HYDRATION
OXYGENATION
PAIN
INFECTION
AVOID HIGH PLACES
PREGNANCY INDUCED HYPERTENSION
HEMOLYSIS
ELEVATED LIVER ENZYMES
LOW
PLATELETS
GI SYMPTOMS AND TOXICITY TO DIGOXIN
VOMITTING
ANOREXIA
NAUSEA
DIARRHEA
ABDOMINAL PAIN
FRACTURE
PRESSURE
REST
ICE
COMPRESSION
ELEVATION
TETRALOGY OF FALLOT
DISPLACED AORTA
RIGHT VENTRICULAR HYPERTROPHY
OPENING INTO THE SEPTUM (VSD)
PULMONARY STENOSIS
HYPOKALEMIA
SKELETAL MUSCLE WEAKNESS
U-WAVE ON ECG
CONSTIPATION
TOXICITY TO DIGOXIN
IRREGULAR WEAK PULSE
OTOSTASIS
NUMBNESS PARESTHESIA
PAIN ASSESSMENT
PROVOCATION
QUALITY
RADIATION, RELIEF
SEVERITY
TIME
NEUROVASCULAR CHECK
PAIN
PULSELESSNESS
PARESTHESIA
PARALYSIS
PALLOR
VIRCHOW’S TRIAD IN DVT
VENUS STASIS
DAMAGE TO VESSELS
HYPERCOAGUABILITY
ABDOMINAL AORTIC ANEURISM (4A)
ASSYMPTOMATIC
ABDOMINAL MASS
ABDOMINAL PULSE
ACHES LOW BACK
ANTI TB DRUGS AND SIDE EFFECTS
RIFAMPICIN – RED-ORANGE URINE
ISONIAZID – PERIPHERAL NEURITIS
PYRAZINAMIDE – INCREASE URIC ACID
ETHAMBUTOL – EYE PROBLEMS
STREPTOMYCIN – OTOTOXIC
MNEMONICS CORNER 01
USE STRAW BECAUSE THESE DRUGS STAIN THE TEETH
L - LUGOL'S SOLUTION
I - IRON
N - NITROFURANTOIN
T - TETRACYCLINE
LR6 - LATERAL RECTUS : CN6
SO4 - SUPERIOR OBLIQUE : CN4
ALL3 - ALL THE REST : CN3
RADIATION TX VIA:
MUSTARD
ESTROGEN
NITROGEN
STEROIDS
ANTIBIOTICS
PTB drug categories
CATEGORY 1
NEW PTB Pts with sputum (+)
Seriously ill pts with severe forms of:
Smear (-) PTB with extensive parenchymal involvement
Extra pulmonary TB
INTENSIVE PHASE
2 months
Rifampicin
INH
Pyrazinamide
Ethambutol
MAINTENANCE PHASE
4 months
Rifampicin
INH
CATEGORY 2
Relapse
Failures
Others
INTENSIVE PHASE
2 months
Rifampicin
INH
Pyrazinamide
Ethambutol
Streptomycin
1 month
Rifampicin
INH
Pyrazinamide
Ethambutol
MAINTENANCE PHASE
5 months
Rifampicin
INH
Ethambutol
CATEGORY 3
NEW PTB Pts with sputum smear (-) 3x & CXR result of TB minimal
Failures
INTENSIVE PHASE
2 months
Rifampicin
INH
Pyrazinamide
MAINTENANCE PHASE
2 months
Rifampicin
INH
Community Health Nursing Exam
A. To support and supplement the efforts of the medical profession in the promotion of health and prevention of
B. To enhance the capacity of individuals, families and communities to cope with their health needs
C. To increase the productivity of the people by providing them with services that will increase their level of health
D. To contribute to national development through promotion of family welfare, focusing particularly on mothers and children
2. CHN is a community-based practice. Which best explains this statement?
A. The service is provided in the natural environment of people
B. The nurse has to conduct community diagnosis to determine nursing needs and problems
C. The service are based on the available resources within the community
D. Priority setting is based on the magnitude of the health problems identified
3. Population- focused nursing practice requires which of the following processes?
A. Community organizing .
B. Nursing, process
C. Community diagnosis
D. Epidemiologic process
4. RA 1054 is also known as the Occupational Health Act. Aside from the number of employees, what other factor must be considered in determining the occupational health privileges to which the workers will be entitled?
A. Type of occupation,: agriculture, commercial, industrial
B. Location of the workplace in relation to health facilities
C. Classification of the business enterprise based on net profit
D. Sex and age composition of employees
5. A business firm must employ an occupational health nurse when it has at least how many employees.
A. 21
B. 101
C. 201
D. 301
6. When the occupational health nurse employs ergonomic principles, she is performing which of her roles?
A. Health care provider
B. Health educator
C. Health care coordinator
D. Environment manager
7. A garment factory does not have an occupational nurse. Who shall provide the occupational health needs of the factory workers?
A. Occupational health nurse at the Provincial Health Office
B. Physician employed by the factory
C. Public Health nurse of the RHU of their municipality
D. Rural Sanitary inspector of the RHU in their municipality
8. "Public health services are given free of charge". Is this statement true or false?
A. The statement is true; it is the responsibility of government to provide haste services
B. The statement is false; people pay indirectly for public health services
C. The statement may be true or false; depending on the Specific service required
D. The statement may be true or false; depending on policies of the government concerned.
9. According to C.E. Winslow, which of the following is the goal of Public Health?
A. For people to attain their birthrights and longevity
B. For promotion of health and prevention and diseases
C. For people to have access to basic health services
D. For people to be organized in their health efforts
10. We say that a Filipino has attained longevity when he is able to reach the average life span of Filipinos. What other statistic may be used to determine attainment of longevity?
A. Age-specific mortality rate
B. Proportionate mortality rate
C. Swaroop's index
D. Case fatality rate
11. Which of the following is the most prominent feature of public health nursing?
A. It involves providing home care to sick people who are not confined in the hospital
B. Services are provided free of charge to people within the catchment area
C. The public health nurse functions as part of a team providing a public health nursing service
D. Public health nursing focuses on preventive, not curative services
12. According to Margaret Shetland, the philosophy of public health nursing is based on which of the following?
A. Health and longevity as birthrights
B. The mandate of the state to protect the birthrights of its citizens
C. Public health nursing as a specialized field of nursing
D. The worth and dignity of man
13. Which of the following is the mission of the Department of Health?
A. Health for all Filipinos
B. Ensure the accessibility and quality of health
C. Improve the general health status of the population
D. Health in the hands of the Filipino people by the year 2020
14. Region IV Hospital is classified as what level of facility?
A. Primary
B. Secondary
C. Intermediate
D. Tertiary
15. What is true of primary facilities?
A. They are usually government-run
B. Their services are provided on an out-patient basis
C. They are training facilities for health professionals
D. A community hospital is an example of this level of health facilities
16. Which is an example of the school nurse's health care provider function?
A. Requesting for BCG from the RHU for school entrance immunization
B. Conducting random classroom inspection during measles epidemic
C. Taking remedial action on an accident hazard in the school playground
D. Observing places in the school where pupils spend their free times
17. When the nurse determines whether resources were maximized in implementing Ligtas Tigdas, she is evaluating:
A. Effectiveness
B. Efficiency
C. Adequacy
D. Appropriateness
18. You are a new B.S.N. graduate. You want to become a Public Health Nurse. Where will you apply?
A. Department of Health
B. Provincial Health Office
C. Regional Health Office
D. Rural Health Unit
19. RA 7160 mandates devolution of basic services from the national government to local government units. Which of the following is the major goal of devolution?
A. To strengthen local government units
B. To allow greater autonomy to local government units.
C. To empower the people and promote their self-reliance
D. To make basic services more accessible to the people
20. Who is the Chairman of the Municipal Health Board?
A. Mayor
B. Municipal Health Officer
C. Public Health Nurse
D. Any qualified physician
21. Which level of health facility is the usual point of entry of a client into the health care delivery system?
A. Primary
B. Secondary
C. Intermediate
D. Tertiary
22. The public health nurse is the supervisor of rural health midwives. Which of the following is a supervisory function of the pubic health nurse?
A. Referring cases or patients to the midwife
B. Providing technical guidance to the midwife
C. Proving nursing care to cases referred by the midwife
D. Formulating and implementing training programs for midwives
23. One of the participants in a hilot training class asked you to whom she should refer a patient in labor who develops a complication. You will answer, to the;
A. Public health nurse
B. Rural health midwife
C. Municipal health officer
D. Any of these health professionals
24. You are the public health nurse in a municipality with a total population of about 20,000. There are3 health midwives among the RHU personnel. How many more midwife items will the RHU need?
A. 1
B. 2
C. 3
D. 4
25. If the RHU needs additional midwife items, you will submit the request for additional midwife items for approval to the:
A. Rural Health Unit
B. District Health Office
C. Provincial Health Office
D. Municipal Health Board
26. As an epidemiologist, the nurse is responsible for reporting cases or notifiable diseases. What law mandates reporting cases of notifiable diseases?
A. Act 3573
B. RA.3753
C. RA 1054
D. RA 1082
27. According to Freeman and Heinrich, community health nursing is a developmental service. Which of the following best illustrates this statement?
A. The community health nurse continuously develops himself personally and professionally
B. Health education and community organizing are necessary in providing community health services
C. Community health nursing in intended primarily for health promotion and prevention and treatment of disease.
D. The goal of community health nursing is to provide nursing services to people in their own place of .residence
28. Which disease was declared through Presidential Proclamation No. 4 as a target for, eradication in the
A. Pioliomyelitis
B. Measles
C. Rabies
D. Neonatal Tetanus
29. The public health nurse is responsible for presenting the municipal health statistics using graphs and tables. To compare the frequency of the leading causes of mortality in the municipality, which graph will you prepare?
A. Line
B. Bar
C. Pie
D. Scatter diagram
30. Which step in community organizing involves training of potential leaders in the community?
A. Integration
B. Community organization
C. Community study
D. Core group formation
31. In which step are plans formulated for solving community problems?
A. Mobilization
B. Community organization
C. Follow-up/extension
D. Core group formation
32. The public health nurse takes an active role in community participation. What is the primary goal of community organizing?
A. To educate the people regarding community health problems
B. To mobilize the people to resolve community health problems
C. To maximize the community's resources in dealing with health problems
33. An indicator of success in community organizing is when people are able to:
A. Participate in community activities for the solution of a community problem
B. Implement activities for the solution of the community problem
C. Plan activities for the solution of the community problem
D. Identify the health problem as a common concern
34. Tertiary prevention is needed in which stage of the natural history of disease?
A. Pre-pathogenesis
B. Pathogenesis
C. Predromal
D. Terminal
35. Isolation of a child with measles belongs to what level of prevention?
A. Primary
B. Secondary
C. Intermediate
D. Tertiary
36. On the other hand, Operation Timbang is_____ prevention?
A. Primary
B. Secondary
C. Intermediate
D. Tertiary
37. Which type of family-nurse contact will provide you with the best opportunity to observe family dynamics?
A. Clinic consultation
B. Group conferences
C. Home visit
D. Written communication
38. The typology of family nursing problems is used in the statement of nursing diagnosis in the care of families. The youngest child of the delos Reyes family has been diagnosed as mentally retarded. This is classified as:
A. Health threat
B. Health deficit
C. Foreseeable crisis
D. Stress point
39. The delos Reyes coupled have 6-year old child entering school for the first time. The delos Reyes family has a:
A. Health threat
B. Health deficit
C. Foreseeable crisis
D. Stress point
40. Which of the following is an advantage of a home visit?
A. It allows the nurse to provide nursing care to a greater number of people
B. It provides an opportunity to do first hand appraisal of the home situation
C. It allows sharing of experience among people with similar health problems
D. It develops the family's initiative in providing for health needs of its members
41. Which is CONTRARY to the principles in planning a home visit?
A. A home visit should have a purpose of objective
B. The plan should revolve around the family health .needs
C. A home visit should be conducted in the manner prescribed by RHU
D. Planning of continuing care should involve a responsible-family member
42. The PHN bag is an important tool in providing nursing care during a home visit. The most important principle in bag technique states that it;
A. Should save time and effort
B. Should minimize if not totally prevent the spread of infection
C. Should not overshadow concern for the patient and his family
D. May be done in variety of ways depending on the home situation, etc.
43. To maintain the cleanliness of the bag and its contents, which of the following must the nurse do?
A. Wash his/her hands before and after providing nursing care to the family members
B. In the care of family member's, as much as possible, use only articles taken from the bag
C. Put on an apron to protect her uniform and fold it with the right side out before putting it back into the bag.
D. At the end of the visit, fold the lining on which the bag was placed, ensuring that the contaminated side is on the outside.
44. The public health conducts a study on the factors contributing to the high morality rate due to heart diseases in the municipality where she works. Which branch of epidemiology does the nurse practice in this situation?
A. Descriptive
B. Analytical
C. Therapeutic
D. Evaluation
45. Which of the following is a function of epidemiology?
A. Identifying the disease condition based on manifestations presented by a client
B. Determining factors that contributed to the occurrence of pneumonia in a 3 year old
C. Determining the efficacy of the antibiotic used in the treatment of the 3 year old client with pneumonia
D. Evaluating the effectiveness of the implementation of the Integrated Management of Childhood Illness
46. Which of the following is an epidemiologic function of the nurse during an epidemic?
A Conducting assessment of suspected cases to detect the communicable diseases
B. Monitoring the condition of the cases affected by the communicable disease
C. Participating in the investigation to determine the source of epidemic
D. Teaching the community on preventive measures against the disease
47. The primary purpose of conducting an epidemiologic investigation is to;
A. Delineate the etiology of the epidemic
B. Encourage cooperation and support of the community
C. Identify groups who are at risk of contracting the disease
D. Identify geographical location of cases of the disease in the community
48. Which is a characteristic of person-to-person propagated epidemic?
A. There are more cases of the disease than expected
B. The disease must necessarily be transmitted through a vector
C. The spread of the disease can be attributed to a common vehicle
D. There is gradual build up of cases before we epidemic becomes easily noticeable
49. In the investigation of an epidemic, you compare the present frequency of the disease with the usual frequency at this time of the year in this community. This is done during which stage of the investigation?
A. Establishing the epidemic
B. Testing the hypothesis
C. Formulation of the hypothesis
D. Appraisal of facts
50. The number of cases of Dengue fever usually increases towards the end of the rainy season. This pattern of occurrence of Dengue fever is best described as;
A. Epidemic occurrence
B. Cyclical variation
C. Sporadic occurrence
D. Secular occurrence
51. In the year 1980, the World Health Organization declared the
A. Pneumonic plaque
B. Poliomyelitis
C. Small pox
D. Anthrax
52. In the census of the
A. 99.06:100
B. 100.94:100
C. 50.23%
D. 49.76%
53. Primary health care is a total approach to community development. Which of the following is an indicator of success in the use of the primary health care approach?
A. Health services are provided free of charge to individuals and families
B. Local officials are empowered as the major decision makers in matters of health
C. Health workers are able too provide care based on identified health needs of the people
D. Health programs are sustained according to the level of development of the community
54. Sputum examination is the major screening tool for pulmonary tuberculosis. Clients would sometimes get false negative results in this exam. This means that the test is not perfect in terms of which characteristic of a diagnostic examination?
A. Effectiveness
B. Efficacy
C. Specificity
D. Sensitivity
55. Use of appropriate technology requires knowledge of indigenous technology. Which medical herb is given for fever, headache and cough?
A. Sambong
B. Tsaang gubat
C. Akapulko
D. Lagundi
56. What law created the Philippine
A. RA 8483
B. RA4823
C. RA 2483
D. RA 3482
57. In traditional Chinese medicine, the yielding, negative and feminine force is termed:
A. Yin
B. Yang
C. Qi
D. Chai
58. What is the legal basis of Primary Health Care approach in the
A. Alma Ata Declaration of PHC
B. Letter of Instruction No 949
C. Presidential Decree No. 147
D. Presidential Decree 996
59. Which of the following demonstrates inter-sectoral linkages?
A. Two-way referral system
B. Team approach
C. Endorsement done by a midwife to another midwife
D. Cooperation between PHN and public school teacher
60. The municipality assigned to you has a population of about 20/000. Estimate the number of 1-4 year old children who be given Retinol capsule 200.000 every 6 months.
A. 1,500
B. 1,800
C. 2,000
D. 2,300
61. 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.
A. 265
B. 300
C. 375
D. 400
62. To describe the sex composition of the population, which demographic tool may be used?
A. Sex ratio
B. Sex proportion
C. Population pyramid
D. Any of these maybe used
63. Which of the following is a natality rate?
A. Crude birth rate
B. Neonatal mortality rate
C. Infant mortality rate
D. General fertility rate
64. You are computing the crude rate of your municipality, with a total population o 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?
A. 4.1/1000
B. 5.2/1000
C. 6.3/1000
D. 7.3/1000
65. 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)?
A. Pregnant women and the elderly
B. Under 5 year old children
C. 1-4 year old children
D. School age children
66. Which statistic can give the most accurate reflection of the health status of a community?
A. 1-4 year old age-specific mortality rate
B. Infant mortality rate
C. Swaroop's index
D. Crude death rate
67. 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. They were 4 recorded stillbirths. What is the neonatal mortality rate?
A. 27.8/1000
B. 43.5/1000
C. 86.9/1000
D. 130.4/1000
68. Which statistic best reflects the nutritional status of a population?
A. 1-4 year old age-specific mortality rate
B. Proportionate mortality rate
C. Infant mortality rate
D. Swaroop's index
69. What numerator is used in computing general fertility rate?
A. Estimated midyear population
B. Number of registered live births
C. Number of pregnancies in the year
D. Number of females of reproductive age
70. 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 delta gathering is best for this purpose?
A. Census
B. Survey
C. Record Review
D. Review of civil registry
71. In the conduct of a census, the method of population assignment based on the actual physical location of the people is termed;
A. De jure
B. De locus
C. De facto
D. De novo
72. The Field Health Services and information System (FHSIS) is the recording and reporting system in public health) care in the
A. Tally report
B. Output report
C. Target/client list
D. Individual health record
73. To monitor clients registered in long-term regimens, such as the Multi-Drug Therapy, which component will be most useful?
A. Tally report
B. Output report
C. Target/client list
D. Individual health record
74. Civil registries are important sources of data. Which law requires registration of births within 30 days from the occurrence of the birth?
A. PD 651
B. Act 3573
C. RA 3753
D. RA 3375
75. Which of the following professionals can sign the birth certificate?
A. Public health nurse
B. Rural health midwife
C. Municipal health officer
D. Any of these health professionals
76. Which criterion in priority setting of health problems is used only in community health care?
A. Modifiability of the problem
B. Nature of the problem presented
C. Magnitude of the health problem
D. Preventive potential of the health problem
77. The Sentrong Sigla Movement has been launched to improve health service delivery. Which of the following is/are true of this movement?
A. This is a project spearheaded by local government units
B. It is a basis for increasing funding from local government units
C. It encourages health centers to focus on disease prevention and control
D. Its main strategy is certification of health centers able to comply with standards
78. Which of the following women should be considered as special targets for family planning?
A. Those who have two children or more
B. Those with medical conditions such as anemia
C. Those younger than 20 years and older than 35 years
D. Those who just had a delivery within the past 15 months
79. Freedom of choice in one of the policies of the Family Planning Program of the
A. Information dissemination about the need for family planning
B. Support of research and development in family planning methods
C. Adequate information for couples regarding the different methods
D. Encouragement of couples to take family planning as a joint responsibility
80. A woman, 6 months pregnant, came to the center for consultation. Which of the following substances is contraindicated?
A. Tetanus toxoid
B. Retinol 200,000 IU
C. Ferrous sulfate 200mg
D. Potassium iodate 200 mg, capsule
81. 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?
A. Her
B. She has some palmar pallor
C. Her blood pressure is 130/80
D. Her baby is in cephalic presentation
82. Inadequate intake by the pregnant woman of which vitamin may cause neural tube defects?
A. Niacin
B. Riboflavin
C. Folic Acid
D. Thiamine
83. You are in a client's home to attend to a delivery. Which of the following will you do first?
A. Set up a sterile area
B. Put on a clean gown and apron
C. Cleanse the client's vulva with soap and water
D. Note the interval, duration and intensity of labor and contractions
84. In preparing a primigravida for breastfeeding, which of the following will you do?
A. Tell her that lactation begins within a day after delivery
B. Teach her nipple stretching exercises if her nipples are everted
C. Instruct her to wash her nipples before and after each breastfeeding
D. Explain to her that putting the baby to breast will lessen blood loss after delivery
85. 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?
A. To initiate the occurrence of milk letdown
B. To stimulate milk production by the mammary acini
C. To make sure that the baby is able to get the colustrum
D. To allow the woman to practice breastfeeding in the presence of the health worker
86. In a mother's class, you discuss proper breastfeeding technique. Which of these is a sign that the baby has "lactated on" the breast property?
A. The baby takes shallow, rapid sucks
B. The mother does not feel nipple pain
C. The baby's mouth is only partly open
D. Only the mother's nipple is inside the baby's mouth
87. You explain to a breastfeeding mother that breastmilk is sufficient for all of the baby's nutrient needs only up to:
A. 3 months
B. 6 months
C. 1 year
D. 2 years
88. What is given to a woman within a month after the delivery of a baby?
A. Malunggay capsule
B. Ferrous sutfate l00mg O.D.
C. Retinol 200.000 IU 1 capsule
D. Potassium Iodate 200 mg, 1 capsule
89. Which biological used in EPI is stored in the freezer?
A. DPT
B. Tetanus toxoid
C. Measles vaccine
D. Hepatitis B vaccine
90. Unused BCG should be discarded how many hours after reconstitution?
A. 2
B. 4
C. 6
D. At the end of the day
91. In immunity school entrants with BCG, you not obliged to secure parental consent. This is because of which legal document?
A. PD 996
B. RA 7864
C. Presidential Proclamation No. 6
D. Presidential Proclamation No. 46
92. Which immunization produces a permanent scar?
A. DPT
B. BCG
C. Measles vaccination
D. Hepatitis B vaccination
93. A 4 week old baby was brought to the health center for his first immunization. Which can be given to him?
A. DPT1
B. OPV1
C. Infant BCG
D. Hepatitis B Vaccin
94. You will not give DPT 2 if the mother says that the infant had?
A. Seizures a day after DPT1
B. Fever for 3 days after DPT1
C. Abscess formation after DPT1
D. Local tenderness for 3 days after DPT1
95. A 2-month old infant was brought to the health center for immunization. During assessment, the infant's temperature registered at 38.1 C. Which is the best course of action that you will take?
A. Go on with the infants immunization
B. Give paracetamol and wait for his fever to subside
C. Refer the infant to the physician for further assessment
D. Advise the infant's mother to bring him back for immunization when he is well
96. A pregnant woman had just received her 4th dose of tetanus toxoid. Subsequently, her baby will have protection against tetanus for how long?
A. 1 year
B. 3 years
C. 10 years
D. Lifetime
97. A 4-month old infant was brought to the health center of cough. Her respiratory rate is 42/minute. Using the IMCI guidelines of assessment, her breathing is considered;
A. Fast
B. Slow
C. Normal
D. Insignificant
98. Which of the following signs will indicate that a young child is suffering from severe pneumonia?
A. Dyspnea
B. Wheezing
C. Fast breathing
D. Chest indrawing
99. Using IMCI guidelines, you classify a child as having severe pneumonia. What is the best management for the child?
A. Prescribe antibiotic
B. Refer him urgently to the hospital
C. Instruct the mother to increase fluid intake
D. Instruct the mother to continue breastfeeding
100. A 5-month old infant was brought by his mother to the health center because of diarrhea occurring 4 to 5 times a day. His skin goes back slowly after a skin pinch and his eyes are sunken. Using the IMCI guidelines, you will classify this infant in which category?
A. No signs of dehydration
B. Some dehydration
C. Severe dehydration
D. The data is insufficient
101. Based on the assessment, you classified a 3-month old infant with the chief complaint of diarrhea in the category of SOME DEHYDRATION. Based on the IMCI management guidelines, which of the following will you do?
A. Bring the infant to the nearest facility where IV fluids can be given
B. Supervise the mother in giving 200 to 400ml of Oresol in 4 hours
C. Give the infant's mother instructions on home management
D. Keep the infant in your health center for close observation
102. A mother is using Oresol' in the management of diarrhea of her 3-year old child. She asked you what to do if her child vomits. You will tell her to:
A. Bring the child to the nearest hospital for further assessment
B. Bring the child to the health center for IV therapy
C. Bring the child to the health center for assessment by the physician
D. Let the child rest for 10 minutes then continue giving Oresol more slowly
103. A 1 1/2 year old child was classified as having 3rd degree of protein energy malnutrition, kwashjorkor. Which of the following signs will be most apparent in this child?
A. Voracious appetite
B. Wasting
C. Apathy
D. Edema
104. Assessment of a 2-year old child revealed "baggy pants". Using the IMCI guidelines, how will you manage this child?
A. Refer the child urgently to a hospital for confinement
B. Coordinate with the social worker to enroll the child in a feeding program
C. Make a teaching plan for the mother, focusing on the menu planning for her child
D. Assess and treat the child for health problems like infections and intestinal parasitism
105. During the physical examination of a young child, what is the earliest sign of xerophthalmia that may observe?
A. Keratomalacia
B. Corneal opacity
C. Night blindness
D. Conjunctival xerosis
106. To prevent xerophthalmia, young children are given Retinol capsule every 6 months. What is the dose given to preschoolers?
A. 10, 000 IU
B. 20, 000 IU
C. 100, 000 IU
D. 200, 000 IU
107. The major sign of iron deficiency anemia is pallor. What part is best examined for pallor?
A. Palms
B. Nailbeds
C. Around the lips
D. Lower conjunctival sac
108. Food fortification is one of the strategies to prevent micronutrient deficiency conditions. RA 8976 mandates fortification of certain food items. Which of the following is among these food items?
A. Sugar
B. Bread
C. Margarine
D. Filled milk
109. What is the best course of action when there is a measles epidemic in a nearby municipality?
A. Give measles vaccine to babies aged 6 to 3 months
B. Give babies aged 6 to 11 months one dose of 100,000 IU of Retinol
C. Instruct mother to keep their babies at home to prevent disease transmission
D. Instruct mothers to feed their babies adequately to enhance their babies resistance
110. A mother brought her daughter, 4 years old, to the RHU because of cough and colds. Following the IMCI assessment guide, which of the following is a danger sign that indicates the need for urgent referral to a hospital?
A. Inability to drink
B. High grade fever
C. Signs of severe dehydration
D. Cough for more than 30 days
111. Management of a child with measles includes the administration of which of the following?
A. Gentian violet on mouth lesions
B. Antibiotic to prevent pneumonia
C. Tetracycline eye ointment for corneal opacity
D. Retinol capsule regardless of when the last dose was given
112. A mother brought her 10 month old infant for consultation because of fever which started 4 days prior to consultation. To determine malaria risk, what will you do?
A. Do a tourniquet test
B. Ask where the family resides
C. Get a specimen for blood smear
D. Ask if the fever is present everyday
113. The following are strategies implemented by the DOH to prevent mosquito-borne diseases. Which of these is most effective in the control of Dengue fever?
A. Stream seeding with larva-eating fish
B. Destroying breeding places of mosquitoes
C. Chemoprophylaxis of non-immune persons going to endemic areas
D. Teaching people in endemic areas to use chemically treated mosquito nets
114. Secondary prevention for malaria includes?
A. Planting of neem or eucalyptus trees
B. Residual spraying of insecticides at night
C. Determining whether a place is endemic or not
D. Growing larva-eating fish in mosquito breeding places
115. Scotch tape swab is done to check for which intestinal parasite?
A. Ascaris
B. Pinworm
C. Hookworm
D. Schistosoma
116. Which of the following signs indicates the need for sputum examination for AFB?
A. Hematemesis
B. Fever for 1 week
C. Cough for 3 weeks
D. Chest pain for 1 week
117. Which clients are considered targets for DOTS category?
A. Sputum negative cavitary cases
B. Clients returning after default
C. Relapses and failures of previous PTB treatment regimens
D. Clients diagnosed for the first time through a positive sputum exam
118. To improve compliance to treatment, what innovation is being implemented in DOTS?
A. Having the health worker follow up the client at home
B. Having the health worker or a responsible family member monitor drug intake
C. Having the patient come to the health center every month to get his medications
D. Having a target list to check on whether the patient has collected his monthly supply of drugs
119. Diagnosis of leprosy is highly dependent on recognition of symptoms. Which of the following is an early sign of leprosy?
A. Macular lesions
B. Inability to close eyelids
C. Thickened painful nerves
D. Sinking of the nose bridge
120. Which of the following clients should be classified as a case of mutibacillary leprosy?
A. 3 skin lesions, negative slit skin smear
B. 3 skin lesions, positive slit skin smear
C. 5 skin lesions, negative slit skin smear
D. 5 skin lesions, positive slit skin smear
121. In the
A. Liver cancer
B. Liver cirrhosis
C. Bladder cancer
D. Intestinal perforation
122. What is the most effective way of controlling schistosomiasis in an endemic area?
A. Use of molluscicides
B. Building of foot bridges
C. Proper use of sanitary toilets
D. Use of protective footwear, such as rubber boots
123. When residents obtain water from an artesian well in the neighborhood, the level of this approved type of water facility is:
A. I
B. II
C. III
D. IV
124. For prevention of Hepatitis A, you decided to conduct health education activities. Which of the following is Irrelevant?
A. Use of sterile syringes and needles
B. Safe food preparation and food handling by vendors
C. Proper disposal of human excreta and personal hygiene
D. Immediate reporting of water pipe leaks and illegal water connections
125. Which biological used in EPI should not be stored in the freezer?
A. DPT
B. OPV
C. Measles vaccine
D. MMR
126. You will conduct outreach immunization in a barangay with a population of about 1500. Estimate the number of infants in the barangay.
A. 45
B. 50
C. 55
D. 60
127. In IMCI, severe conditions generally require urgent referral to a hospital. Which of the following severe conditions Does not always require urgent referral to hospital?
A. Mastoiditis
B. Severe dehydration
C. Severe pneumonia
D. Severe febrile disease.
128. 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?
A. 3
B. 5
C. 8
D. 10
129. 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 of the most appropriate measure that the PHN may carry out to prevent Dengue shock syndrome?
A. Insert an NGT and give fluids per NGT
B. Instruct the mother to give the child Oresol
C. Start the patient on IV Stat
D. Refer the client to the physician for appropriate management
130. The pathognomonic sign of measles is Koplik’s spot. You may see Koplik’s spot by inspecting the:
A. Nasal Mucosa
B. Buccal mucosa
C. Skin on the abdomen
D. Skin on the antecubital surface
131. Among the following diseases, which is airborne?
A. Viral conjunctivitis
B. Acute poliomyelitis
C. Diptheria
D. Measles
132. Among children aged 2 months to 3 years, the most prevalent form of meningitis is caused by which microorganism?
A. Hemophilus Influenzae
B. Morbillivirus
C. Streptococcus Pneumoniae
D. Neisseria meningitides
133. Human beings are the major reservoir of malaria. Which of the following strategies in malaria control is based on this fact?
A. Stream seeding
B. Stream clearing
C. Destruction of breeding places
D. Zooprophylaxis
134. The use of larvivorous fish in malaria control is the basis for which strategy of malaria control?
A. Stream seeding
B. Stream clearing
C. Destruction of breeding places
D. Zooprophylaxis .
135. Mosquito-borne diseases are prevented mostly with the use of mosquito control measures. Which of the following is NOT appropriate for malaria control?
A. Use of chemically treated mosquito nets
B. Seeding of breeding places with larva-eating fish
C. Destruction of breeding places of the mosquito vector
D. Use of mosquito-repelling soaps, such as those with basil or citronella
136. A 4-year old client was brought to the health center with chief complaint of severe diarrhea and the passage of “rice water”. The client is most probably suffering from which condition?
A. Giardiasis
B. Cholera
C. Amebiasis
D. Dysentery
137. In the
A. S. mansoni
B. S. japonicum
C. S. malayensis
D. S. haematobium
138. 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 this history/ which disease condition will you suspect?
A. Hepatitis A
B. Hepatitis B
C. Tetanus
D. Leptospirosis
139. MWSS provides water to
A. I
B. II
C. III
D. IV
140. 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?
A. Get a thorough history of the client, focusing on the practice of high risk behavior
B. Ask the client to be accompanied by a significant person before revealing the result.
C. Refer the client to the physician since he is the best person to reveal the result to the client
D. Refer the client for a supplementary test, such as Western blot, since the ELISA result maybe false
141. Which is the BEST control measure for AIDS?
A. Being faithful to a single sexual partner
B. Using a condom during each sexual contact
C. Avoiding sexual contact with commercial sex workers
D. Making sure that one's sexual partner does not have signs of AIDS
142. The most frequent causes of death among clients with AIDS are opportunistic diseases. Which of the following opportunistic infections is characterized by tonsilllopharyngitis?
A. Respiratory candidiasis
B. Infectious mononucleosis
C. Cytomegalovirus disease
D. Pneumocystis carinii pneumonia
143. To determine the possible sources of sexually transmitted infections, which is the BEST method that may be undertaken by the public health nurse?
A. Contact tracing
B. Community survey
C. Mass screening tests
D. Interview suspects
144. Antiretroviral agents, such as AZT are used in the management of AIDS. Which of the following is not an action expected of these drugs?
A. They prolong the life of the client with AIDS
B. They reduce the risk of opportunistic infections
C. They shorten the period of communicability of the disease
D. They are able to bring about a cure of the disease condition
145. 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?
a. Advice them on the sign of German Measles
b. Avoid crowded places, such as markets and moviehouses
c. Consult at the health center where rubella vaccine may be given
d. Consult a physician who may give them rubella immunoglobulin
