1. In the Philippines, which condition is the most D.

MMR
frequent cause of death associated with
6. You will conduct outreach immunization in a
schistosomiasis?
barangay with a population of about 1500. Estimate the
A. Liver cancer number of infants in the barangay.

B. Liver cirrhosis A. 45

C. Bladder cancer B. 50

D. Intestinal perforation C. 55

2. What is the most effective way of controlling D. 60

schistosomiasis in an endemic area?
7. In Integrated Management of Childhood Illness,
A. Use of molluscicides severe conditions generally require urgent referral to a
hospital. Which of the following severe conditions DOES
B. Building of foot bridges
NOT always require urgent referral to a hospital?
C. Proper use of sanitary toilets
A. Mastoiditis
D. Use of protective footwear, such as rubber
B. Severe dehydration
boots
C. Severe pneumonia
3. When residents obtain water from an artesian well in
the neighborhood, the level of this approved type of D. Severe febrile disease
water facility is
8. A client was diagnosed as having Dengue fever. You
A. I will say that there is slow capillary refill when the color
of the nailbed that you pressed does not return within
B. II
how many seconds?
C. III
A. 3
D. IV
B. 5
4. For prevention of hepatitis A, you decided to conduct
C. 8
health education activities. Which of the following is
IRRELEVANT? D. 10

A. Use of sterile syringes and needles 9. A 3-year old child was brought by his mother to the
health center because of fever of 4-day duration. The
B. Safe food preparation and food handling by
child had a positive tourniquet test result. In the
vendors
absence of other signs, which is the most appropriate
C. Proper disposal of human excreta and personal measure that the PHN may carry out to prevent Dengue
hygiene shock syndrome?

D. Immediate reporting of water pipe leaks and A. Insert an NGT and give fluids per NGT.
illegal water connections
B. Instruct the mother to give the child Oresol.
5. Which biological used in Expanded Program on
C. Start the patient on intravenous fluids STAT.
Immunization (EPI) should NOT be stored in the
freezer? D. Refer the client to the physician for appropriate
management.
A. DPT
10. The pathognomonic sign of measles is Koplik’s spot.
B. Oral polio vaccine
You may see Koplik’s spot by inspecting the _____.
C. Measles vaccine
 A. Nasal mucosa C. Destruction of breeding places of the mosquito
vector
B. Buccal mucosa
D. Use of mosquito-repelling soaps, such as those
C. Skin on the abdomen
with basil or citronella
D. Skin on the antecubital surface
16. A 4-year old client was brought to the health center
11. Among the following diseases, which is airborne? with the chief complaint of severe diarrhea and the
passage of “rice water” stools. The client is most
A. Viral conjunctivitis probably suffering from which condition?
B. Acute poliomyelitis A. Giardiasis
C. Diphtheria B. Cholera
D. Measles C. Amebiasis
12. Among children aged 2 months to 3 years, the most D. Dysentery
prevalent form of meningitis is caused by which
microorganism? 17. In the Philippines, which specie of schistosoma is
endemic in certain regions?
A. Hemophilus influenzae
A. S. mansoni
B. Morbillivirus
B. S. japonicum
C. Steptococcus pneumoniae
C. S. malayensis
D. Neisseria meningitidis
D. S. haematobium
13. Human beings are the major reservoir of malaria.
Which of the following strategies in malaria control is 18. A 32-year old client came for consultation at the
based on this fact? health center with the chief complaint of fever for a
week. Accompanying symptoms were muscle pains and
A. Stream seeding body malaise. A week after the start of fever, the client
B. Stream clearing noted yellowish discoloration of his sclera. History
showed that he waded in flood waters about 2 weeks
C. Destruction of breeding places before the onset of symptoms. Based on his history,
D. Zooprophylaxis which disease condition will you suspect?

14. The use of larvivorous fish in malaria control is the A. Hepatitis A

basis for which strategy of malaria control? B. Hepatitis B
A. Stream seeding C. Tetanus
B. Stream clearing D. Leptospirosis
C. Destruction of breeding places 19. MWSS provides water to Manila and other cities in
D. Zooprophylaxis Metro Manila. This is an example of which level of
water facility?
15. Mosquito-borne diseases are prevented mostly with
the use of mosquito control measures. Which of the A. I
following is NOT appropriate for malaria control? B. II
A. Use of chemically treated mosquito nets C. III
B. Seeding of breeding places with larva-eating fish D. IV
20. You are the PHN in the city health center. A client A. They prolong the life of the client with AIDS.
underwent screening for AIDS using ELISA. His result
B. They reduce the risk of opportunistic infections
was positive. What is the best course of action that you
may take? C. They shorten the period of communicability of
the disease.
A. Get a thorough history of the client, focusing on
the practice of high risk behaviors. D. They are able to bring about a cure of the
disease condition.
B. Ask the client to be accompanied by a
significant person before revealing the result. 25. A barangay had an outbreak of German measles. To
prevent congenital rubella, what is the BEST advice that
C. Refer the client to the physician since he is the
you can give to women in the first trimester of
best person to reveal the result to the client.
pregnancy in the barangay?
D. Refer the client for a supplementary test, such
A. Advice them on the signs of German measles.
as Western blot, since the ELISA result may be
false. B. Avoid crowded places, such as markets and
moviehouses.
21. Which is the BEST control measure for AIDS?
C. Consult at the health center where rubella
A. Being faithful to a single sexual partner
vaccine may be given.
B. Using a condom during each sexual contact
D. Consult a physician who may give them rubella
C. Avoiding sexual contact with commercial sex immunoglobulin.
workers
26. You were invited to be the resource person in a
D. Making sure that one’s sexual partner does not training class for food handlers. Which of the following
have signs of AIDS would you emphasize regarding prevention of
staphylococcal food poisoning?
22. The most frequent causes of death among clients
with AIDS are opportunistic diseases. Which of the A. All cooking and eating utensils must be
following opportunistic infections is characterized by thoroughly washed.
tonsillopharyngitis?
B. Food must be cooked properly to destroy
A. Respiratory candidiasis staphylococcal microorganisms.

B. Infectious mononucleosis C. Food handlers and food servers must have a

negative stool examination result.
C. Cytomegalovirus disease
D. Proper handwashing during food preparation is
D. Pneumocystis carinii pneumonia
the best way of preventing the condition.
23. To determine possible sources of sexually
27. In a mothers’ class, you discussed childhood
transmitted infections, which is the BEST method that
diseases such as chicken pox. Which of the following
may be undertaken by the public health nurse?
statements about chicken pox is correct?
A. Contact tracing
A. The older one gets, the more susceptible he
B. Community survey becomes to the complications of chicken pox.

C. Mass screening tests B. A single attack of chicken pox will prevent

future episodes, including conditions such as
D. Interview of suspects shingles.
24. Antiretroviral agents, such as AZT, are used in the C. To prevent an outbreak in the community,
management of AIDS. Which of the following is NOT an quarantine may be imposed by health
action expected of these drugs. authorities.
 D. Chicken pox vaccine is best given when there is effective, tehn urgent referral to the hospital is
an impending outbreak in the community. done.

28. Complications to infectious parotitis (mumps) may 8. Answer: (A) 3. Adequate blood supply to the
be serious in which type of clients? area allows the return of the color of the
nailbed within 3 seconds.
A. Pregnant women
9. Answer: (B) Instruct the mother to give the child
B. Elderly clients
Oresol. Since the child does not manifest any
C. Young adult males other danger sign, maintenance of fluid balance
and replacement of fluid loss may be done by
D. Young infants giving the client Oresol.
Answers and Rationales 10. Answer: (B) Buccal mucosa. Koplik’s spot may
1. Answer: (B) Liver cirrhosis. The etiologic agent be seen on the mucosa of the mouth or the
of schistosomiasis in the Philippines is throat.
Schistosoma japonicum, which affects the small 11. Answer: (D) Measles. Viral conjunctivitis is
intestine and the liver. Liver damage is a transmitted by direct or indirect contact with
consequence of fibrotic reactions to discharges from infected eyes. Acute
schistosoma eggs in the liver. poliomyelitis is spread through the fecal-oral
2. Answer: (C) Proper use of sanitary toilets. The route and contact with throat secretions,
ova of the parasite get out of the human body whereas diphtheria is through direct and
together with feces. Cutting the cycle at this indirect contact with respiratory secretions.
stage is the most effective way of preventing 12. Answer: (A) Hemophilus influenzae. Hemophilus
the spread of the disease to susceptible hosts. meningitis is unusual over the age of 5 years. In
3.  Answer: (B) II. A communal faucet or water developing countries, the peak incidence is in
standpost is classified as Level II. children less than 6 months of age. Morbillivirus
is the etiology of measles. Streptococcus
4. Answer: (A) Use of sterile syringes and pneumoniae and Neisseria meningitidis may
needles. Hepatitis A is transmitted through the cause meningitis, but age distribution is not
fecal oral route. Hepatitis B is transmitted specific in young children.
through infected body secretions like blood and
semen. 13. Answer: (D) Zooprophylaxis. Zooprophylaxis is
done by putting animals like cattle or dogs close
5.  Answer: (A) DPT. DPT is sensitive to freezing. to windows or doorways just before nightfall.
The appropriate storage temperature of DPT is The Anopheles mosquito takes his blood meal
2 to 8° C only. OPV and measles vaccine are from the animal and goes back to its breeding
highly sensitive to heat and require freezing. place, thereby preventing infection of humans.
MMR is not an immunization in the Expanded
Program on Immunization. 14. Answer: (A) Stream seeding. Stream seeding is
done by putting tilapia fry in streams or other
6. Answer: (A) 45. To estimate the number of bodies of water identified as breeding places of
infants, multiply total population by 3%. the Anopheles mosquito
7. Answer: (B) Severe dehydration. The order of 15. Answer: (C) Destruction of breeding places of
priority in the management of severe the mosquito vector. Anopheles mosquitoes
dehydration is as follows: intravenous fluid breed in slow-moving, clear water, such as
therapy, referral to a facility where IV fluids can mountain streams.
be initiated within 30 minutes,
Oresol/nasogastric tube, Oresol/orem. When 16. Answer: (B) Cholera. Passage of profuse watery
the foregoing measures are not possible or stools is the major symptom of cholera. Both
 amebic and bacillary dysentery are 25. Answer: (D) Consult a physician who may give
characterized by the presence of blood and/or them rubella immunoglobulin. Rubella vaccine
mucus in the stools. Giardiasis is characterized is made up of attenuated German measles
by fat malabsorption and, therefore, viruses. This is contraindicated in pregnancy.
steatorrhea. Immune globulin, a specific prophylactic against
German measles, may be given to pregnant
17. Answer: (B) S. japonicum. S. mansoni is found
women.
mostly in Africa and South America; S.
haematobium in Africa and the Middle East; 26. Answer: (D) Proper handwashing during food
and S. malayensis only in peninsular Malaysia. preparation is the best way of preventing the
condition. Symptoms of this food poisoning are
18. Answer: (D) Leptospirosis. Leptospirosis is
due to staphylococcal enterotoxin, not the
transmitted through contact with the skin or
microorganisms themselves. Contamination is
mucous membrane with water or moist soil
by food handling by persons with
contaminated with urine of infected animals,
staphylococcal skin or eye infections.
like rats.
27. Answer: (A) The older one gets, the more
19. Answer: (C) III. Waterworks systems, such as
susceptible he becomes to the complications of
MWSS, are classified as level III.
chicken pox. Chicken pox is usually more severe
20. Answer: (D) Refer the client for a in adults than in children. Complications, such
supplementary test, such as Western blot, since as pneumonia, are higher in incidence in adults.
the ELISA result may be false. A client having a
28. Answer: (C) Young adult males. Epididymitis and
reactive ELISA result must undergo a more
orchitis are possible complications of mumps. In
specific test, such as Western blot. A negative
post-adolescent males, bilateral inflammation
supplementary test result means that the ELISA
of the testes and epididymis may cause sterility.
result was false and that, most probably, the
client is not infected.

21. Answer: (A) Being faithful to a single sexual

partner. Sexual fidelity rules out the possibility
of getting the disease by sexual contact with
another infected person. Transmission occurs
mostly through sexual intercourse and exposure
to blood or tissues.

22. Answer: (B) Infectious

mononucleosis. Cytomegalovirus disease is an
acute viral disease characterized by fever, sore
throat and lymphadenopathy.

23. Answer: (A) Contact tracing. Contact tracing is

the most practical and reliable method of
finding possible sources of person-to-person
transmitted infections, such as sexually
transmitted diseases.

24. Answer: (D) They are able to bring about a cure

of the disease condition. There is no known
treatment for AIDS. Antiretroviral agents reduce
the risk of opportunistic infections and prolong
life, but does not cure the underlying
immunodeficiency.