Community Health Nursing and Care of the Mother and Child

I.
1. 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

2. 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

3. 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

4. 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

5. Scotch tape swab is done to check for which intestinal parasite?

A. Ascaris
B. Pinworm
C. Hookworm
D. Schistosoma

6. 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

7. 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

8. 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

9. 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

10. 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

11. In the Philippines, which condition is the most frequent cause of death associated by
schistosomiasis?
A. Liver cancer
B. Liver cirrhosis
C. Bladder cancer
D. Intestinal perforation

12. 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

13. 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

14. 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

15. Which biological used in EPI should not be stored in the freezer?
A. DPT
B. OPV
C. Measles vaccine
D. MMR

16. 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

17. 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

18. 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

19. 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

20. Freedom of choice in one of the policies of the Family Planning Program of the Philippines. Which of
the following illustrates this principle?
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

21. 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

22. 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 OB score is G5P3
B. She has some palmar pallor
C. Her blood pressure is 130/80
D. Her baby is in cephalic presentation

23. Inadequate intake by the pregnant woman of which vitamin may cause neural tube defects?
A. Niacin
B. Riboflavin
C. Folic Acid
D. Thiamine

24. 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

25. 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

26. 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

27. 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

28. 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

29. 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

30. Which biological used in EPI is stored in the freezer?

A. DPT
B. Tetanus toxoid
C. Measles vaccine
D. Hepatitis B vaccine

31. Unused BCG should be discarded how many hours after reconstitution?
A. 2
B. 4
C. 6
D. At the end of the day

32. 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

33. Which immunization produces a permanent scar?

A. DPT
B. BCG
C. Measles vaccination
D. Hepatitis B vaccination

34. 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

35. 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

36. 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

37. 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

38. 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

39. 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

40. 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

41. 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

42. 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

43. 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

44. 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
45. 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

46. 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

47. 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

48. Which is the primary goal of community health nursing?

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

49. 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

50. 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

“The difference between a successful person and others is not a lack of strength, not a lack of knowledge, but rather a lack in will.”
~Vince Lombardi

PREPARED BY:
ARNIE JUDE CARIDO, RN, MD, MPH
 Community Health Nursing and Care of the Mother and Child

II.
1. You performed Leopold’s maneuver and found the following: breech presentation, fetal back at the
right side of the mother. Based on these findings, you can hear the fetal heart beat (PMI) BEST in which
location?
A. Left lower quadrant
B. Right lower quadrant
C. Left upper quadrant
D. Right upper quadrant

2. In Leopold’s maneuver step #1, you palpated a soft, broad mass that moves with the rest of the mass.
The correct interpretation of this finding is:
A. The mass palpated at the fundal part is the head part.
B. The presentation is breech.
C. The mass palpated is the back
D. The mass palpated is the buttocks.

3. In Leopold’s maneuver step # 3 you palpated a hard round movable mass at the supra pubic area. The
correct interpretation is that the mass palpated is:
A. The buttocks because the presentation is breech.
B. The mass palpated is the head.
C. The mass is the fetal back.
D. The mass palpated is the small fetal part

4. The hormone responsible for a positive pregnancy test is:

A. Estrogen
B. Progesterone
C. Human Chorionic Gonadotropin
D. Follicle Stimulating Hormone

5. The hormone responsible for the maturation of the Graafian follicle is:
A. Follicle stimulating hormone
B. Progesterone
C. Estrogen
D. Luteinizing hormone

6. The most common normal position of the fetus in utero is:

A. Transverse position
B. Vertical position
C. Oblique position
D. None of the above

7. In the later part of the 3rd trimester, the mother may experience shortness of breath. This complaint
maybe explained as:
A. A normal occurrence in pregnancy because the fetus is using more oxygen
B. The fundus of the uterus is high pushing the diaphragm upwards
C. The woman is having allergic reaction to the pregnancy and its hormones
D. The woman maybe experiencing complication of pregnancy

8. Which of the following findings in a woman would be consistent with a pregnancy of two months
duration?
A. Weight gain of 6-10 lbs. And the presence of striae gravidarum
B. Fullness of the breast and urinary frequency
C. Braxton Hicks contractions and quickening
D. Increased respiratory rate and ballottement

9. Which of the following is a positive sign of pregnancy?

A. Fetal movement felt by mother
B. Enlargement of the uterus
C. (+) pregnancy test
D. (+) ultrasound

10. What event occurring in the second trimester helps the expectant mother to accept the pregnancy?
A. Lightening
B. Ballotment
C. Pseudocyesis
D. Quickening

11. Shoes with low, broad heels, plus a good posture will prevent which prenatal discomfort?
A. Backache
B. Vertigo
C. Leg cramps
D. Nausea

12. When a pregnant woman experiences leg cramps, the correct nursing intervention to relieve the
muscle cramps is:
A. Allow the woman to exercise
B. Let the woman walk for a while
C. Let the woman lie down and dorsiflex the foot towards the knees
D. Ask the woman to raise her legs

13. From the 33rd week of gestation till full term, a healthy mother should have a prenatal check up
every:
A. week
B. 2 weeks
C. 3 weeks
D. 4 weeks

14. The expected weight gain in a normal pregnancy during the 3rd trimester is
A. 1 pound a week
B. 2 pounds a week
C. 10 lbs a month
D. 10 lbs total weight gain in the 3rd trimester

15. In Bartholomew’s rule of 4, when the level of the fundus is midway between the umbilicus and
xiphoid process the estimated age of gestation (AOG) is:
A. 5th month
B. 6th month
C. 7th month
D. 8th month

16. The following are ways of determining expected date of delivery (EDD) when the LMP is unknown
EXCEPT:
A. Naegele’s rule
B. Quickening
C. McDonald’s rule
D. Batholomew’s rule of 4

17. If the LMP is Jan. 30, the expected date of delivery (EDD) is
A. Oct. 7
B. Oct. 24
C. Nov. 7
D. Nov. 8

18. Kegel’s exercise is done in pregnancy in order to:

A. Strengthen perineal muscles
B. Relieve backache
C. Strengthen abdominal muscles
D. Prevent leg varicosities and edema

19. Pelvic rocking is an appropriate exercise in pregnancy to relieve which discomfort?

A. Leg cramps
B. Urinary frequency
C. Orthostatic hypotension
D. Backache

20. The main reason for an expected increased need for iron in pregnancy is:
A. The mother may have physiologic anemia due to the increased need for red blood cell mass as well as
the fetal requires about 350-400 mg of iron to grow
B. The mother may suffer anemia because of poor appetite
C. The fetus has an increased need for RBC which the mother must supply
D. The mother may have a problem of digestion because of pica

21. The diet that is appropriate in normal pregnancy should be high in

A. Protein, minerals, and vitamins
B. Carbohydrates and vitamins
C. Proteins, carbohydrates, and fats
D. Fats and minerals

22. Which of the following signs will require a mother to seek immediate medical attention?
A. When the first fetal movement is felt
B. No fetal movement is felt on the 6th month
C. Mild uterine contraction
D. Slight dyspnea on the last month of gestation

23. You want to perform a pelvic examination on one of your pregnant clients. You prepare your client
for the procedure by:
A. Asking her to void
B. Taking her vital signs and recording the readings
C. Giving the client a perineal care
D. Doing a vaginal prep

24. When preparing the mother who is in her 4th month of pregnancy for an abdominal ultrasound, the
nurse should instruct her to:
A. Observe NPO from midnight to avoid vomiting
B. Do perineal flushing properly before the procedure
C. Drink at least 2 liters of fluid 2 hours before the procedure and not void until the procedure is done
D. Void immediately before the procedure for better visualization

25. The nursing intervention to relieve “morning sickness” in a pregnant woman is by giving
A. Dry carbohydrate food like crackers
B. Low sodium diet
C. Intravenous infusion
D. Antacid

26. By the end of which of the following would the nurse most commonly expect a child’s birth weight to
triple?
A. 4 months
B. 7 months
C. 9 months
D. 12 months
27. Which of the following best describes parallel play between two toddlers?
A. Sharing crayons to color separate pictures
B. Playing a board game with a nurse
C. Sitting near each other while playing with separate dolls
D. Sharing their dolls with two different nurses

28. Which of the following would the nurse identify as the initial priority for a child with acute
lymphocytic leukemia?
A. Instituting infection control precautions
B. Encouraging adequate intake of iron-rich foods
C. Assisting with coping with chronic illness
D. Administering medications via IM injections

29. Which of the following information, when voiced by the mother, would indicate to the nurse that
she understands home care instructions following the administration of diphtheria, tetanus, and
pertussis injection?
A. Measures to reduce fever
B. Need for dietary restrictions
C. Reasons for subsequent rash
D. Measures to control subsequent diarrhea

30. Which of the following actions by a community health nurse is most appropriate when noting
multiple bruises and burns on the posterior trunk of an 18-month-old child during a home visit?
A. Report the child’s condition to Protective Services immediately.
B. Schedule a follow-up visit to check for more bruises.
C. Notify the child’s physician immediately.
D. Don nothing because this is a normal finding in a toddler.

31. Which of the following is being used when the mother of a hospitalized child calls the student nurse
and states, “You idiot, you have no idea how to care for my sick child”?
A. Displacement
B. Projection
C. Repression
D. Psychosis

32. Which of the following should the nurse expect to note as a frequent complication for a child with
congenital heart disease?
A. Susceptibility to respiratory infection
B. Bleeding tendencies
C. Frequent vomiting and diarrhea
D. Seizure disorder

33. Which of the following would the nurse do first for a 3-year-old boy who arrives in the emergency
room with a temperature of 105 degrees, inspiratory stridor, and restlessness, who is leaning forward
and drooling?
A. Auscultate his lungs and place him in a mist tent.
B. Have him lie down and rest after encouraging fluids.
C. Examine his throat and perform a throat culture
D. Notify the physician immediately and prepare for intubation.

34. Which of the following would the nurse need to keep in mind as a predisposing factor when
formulating a teaching plan for a child with a urinary tract infection?
A. A shorter urethra in females
B. Frequent emptying of the bladder
C. Increased fluid intake
D. Ingestion of acidic juices
35. Which of the following should the nurse do first for a 15-year-old boy with a full leg cast who is
screaming in unrelenting pain and exhibiting right foot pallor signifying compartment syndrome?
A. Medicate him with acetaminophen.
B. Notify the physician immediately
C. Release the traction
D. Monitor him every 5 minutes

36. At which of the following ages would the nurse expect to administer the varicella zoster vaccine to a
child?
A. At birth
B. 2 months
C. 6 months
D. 12 months

37. When discussing normal infant growth and development with parents, which of the following toys
would the nurse suggest as most appropriate for an 8-month-old?
A. Push-pull toys
B. Rattle
C. Large blocks
D. Mobile

38. Which of the following aspects of psychosocial development is necessary for the nurse to keep in
mind when providing care for the preschool child?
A. The child can use complex reasoning to think out situations.
B. Fear of body mutilation is a common preschool fear
C. The child engages in competitive types of play
D. Immediate gratification is necessary to develop initiative.

39. Which of the following is characteristic of a preschooler with mid-mental retardation?

A. Slow to feed self
B. Lack of speech
C. Marked motor delays
D. Gait disability

40. Which of the following assessment findings would lead the nurse to suspect Down syndrome in an
infant?
A. Small tongue
B. Transverse palmar crease
C. Large nose
D. Restricted joint movement

41. While assessing a newborn with cleft lip, the nurse would be alert that which of the following will
most likely be compromised?
A. Sucking ability
B. Respiratory status
C. Locomotion
D. GI function

42. When providing postoperative care for the child with a cleft palate, the nurse should position the
child in which of the following positions?
A. Supine
B. Prone
C. In an infant seat
D. On the side

43. While assessing a child with pyloric stenosis, the nurse is likely to note which of the following?
A. Regurgitation
B. Steatorrhea
C. Projectile vomiting
D. “Currant jelly” stools

44. Which of the following nursing diagnoses would be inappropriate for the infant with
gastroesophageal reflux (GER)?
A. Fluid volume deficit
B. Risk for aspiration
C. Altered nutrition: less than body requirements
D. Altered oral mucous membranes

45. Which of the following parameters would the nurse monitor to evaluate the effectiveness of
thickened feedings for an infant with gastroesophageal reflux disease (GERD)?
A. Vomiting
B. Stools
C. Uterine
D. Weight

46. Discharge teaching for a child with celiac disease would include instructions about avoiding which of
the following?
A. Rice
B. Milk
C. Wheat
D. Chicken

47. Which of the following would the nurse expect to assess in a child with celiac disease having a celiac
crisis secondary to an upper respiratory infection?
A. Respiratory distress
B. Lethargy
C. Watery diarrhea
D. Weight gain

48. Which of the following should the nurse do first after noting that a child with Hirschsprung disease
has a fever and watery explosive diarrhea?
A. Notify the physician immediately
B. Administer antidiarrheal medications
C. Monitor child ever 30 minutes
D. Nothing, this is characteristic of Hirschsprung disease

49. A newborn’s failure to pass meconium within the first 24 hours after birth may indicate which of the
following?
A. Hirschsprung disease
B. Celiac disease
C. Intussusception
D. Abdominal wall defect

50. When assessing a child for possible intussusception, which of the following would be least likely to
provide valuable information?
A. Stool inspection
B. Pain pattern
C. Family history
D. Abdominal palpation

“The difference between a successful person and others is not a lack of strength, not a lack of knowledge, but rather a lack in will.”
~Vince Lombardi

PREPARED BY:
ARNIE JUDE CARIDO, RN, MD, MPH