COMPREHENSIVE EXAM

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MID COMPREHENSIVE EXAMINATIONS

NURSING PRACTICE III- COMMUNITY HEALTH NURSING

General Instructions:1. This test booklet contains 100 test questions.2. Read INSTRUCTIONS TO EXAMINEES printed on your answer sheet.3. Shade only one (1) box for each question on your answer sheets. Two or more boxes shaded will invalidate your answer.4. AVOID ERASURES.

INSTRUCTIONS: 1. Detach one (1) answer sheet from the bottom of your Examinee ID/Answer Sheet Set.2. Write the subject title Nursing Practice I on the box provided.3. Shade Set Box A on your answer sheet if your test booklet is Set A; Set Box B if your test booklet is Set B.______________________________________________________________________________________

SITUATION 1 Mr. E is a clinical instructor, begins his lecture with the basic concepts in CHN. The following are the important points that she discussed with her students.

1. In Community Health Nursing, despite the availability and use of many equipment and devices to facilitate the job of the community health nurse, the best tool any nurse should be well prepared to apply is a scientific approach. This approach ensures quality of care even at the community setting. This in nursing parlance is nothing less than the:

1

1. Nursing diagnosis1. Nursing protocol1. Nursing research1. Nursing process

1. The term Public Health Nursing was coined by:

0. Florence Nightingale0. Lilian Wald0. Dorothea Orem0. Annie Sand

1. To be able to work as a public health nurse, the minimum requirement that should be met is:

2. BSN, RN2. BSN, RN, MAN2. BSN, RN, 1 year experience2. BSN,RN,21 years old,1 year experience

1. A nurse working in the community assumes different roles. When the nurse acts as community organizer, she does which of the following functions:3. Motivate and enhance community participation when planning and implementing health programs and services3. Develops familys capability to take care of a sick member3. Identifies needs, priorities, and problems of individuals, families and community3. Coordinates with government and nongovernment organization in the implementation of research and studies1. A garment factory does not have an occupational nurse. Who shall provide the occupational health needs of the factory workers? 4. Occupational health nurse at the Provincial Health Office 4. Physician employed by the factory 4. Public health nurse of the RHU of their municipality 4. Rural sanitary inspector of the RHU of their municipality 1. The WHO defines public health nursing as one of the following? 5. 5. Teamwork based in social and natural science5. Assessment of clients health needs5. Achievement of human potentials5. Special field in nursing including social assistance1. 1. In terms of CHN practice, the nurse in the community is trained as:

7. Nurse-midwife7. Practical nurse7. Nurse Generalist7. Specialist in CHN

1. The rural health midwife is supervised by the:

8. Rural health nurse8. Municipal mayor8. Barangay Captain8. Rural health physician

1. In the Philippine Primary Health Care Delivery System, the secondary level of health service is provided by the:

9. Regional Hospitals9. Rural Health Units9. Provincial Hospitals9. Puericulture Centers1. When a traditional birth attendants and midwifes attend to home delivery the care provided for is classified as:

10. Primary level of care10. Secondary level of care10. Tertiary level of care10. Folk healing practice

1. If the condition in the community is always changing, it is necessary to:1. Isolate community problems from societal problems1. Develop a community health plan1. Identify sources of conflicts in the community1. Continuously monitor community situation1. The nurse is practicing CHN when she:1. Visited an old woman in her home to change her post-surgical dressing1. Instructs a couple on newborn care1. Sets up a support program for teen-aged pregnant women1. Does any of these1. The devolution of health services to the local government unit was mandated by:

13. RA 716013. PD 85613. RA 671313. RA 8749

1. The Republic Act that refers to the Magna Carta of Public Health Workers:

14. RA 238214. RA 108214. RA 730514. RA 6425

1. At all times, the community health nurse must provide quality nursing services based on:

1. Standards of practice1. CHN principle and philosophy1. Nursing goals and objectives1. Concepts and theories of CHN

SITUATION 2 One important tool a community health nurse uses in the conduct of his/her activities is the CHN BAG.

1. The Community/Public Health Bag is:1. As essential and indispensable equipment of the community health nurse1. A tool used by the Community health nurse in rendering the effective nursing procedures during a home visit1. Contains basic medications and articles used by the community health nurse1. A requirement for home visits1. Which of the following is the content of a bag?

1. Tissue paper1. Benedicts solution1. Blood pressure apparatus1. Prescription paper

1. How many scissors are in the public health bag?

18. 118. 218. 318. 5

1. What is the rationale for the use of bag technique during home visits?1. It should minimize or prevent the spread of infection from individuals to families1. It saves time and effort of the nurse in the performance of nursing procedure1. It helps render effective nursing care to clients or other members of the family1. It should not overshadow concerns for the patient1. Which among the following is important in the use of the bag technique during home visit? 1. Minimize if not totally prevent the spread of infection1. Arrangement of the bags contents must be convenient to the nurse1. Be sure to thoroughly clean your bag especially when exposed to communicable cases1. The bag should contain all necessary supplies and equipment ready for use1. Which one of the following is the basic procedure a nurse must do before and after nursing care or treatment?

21. Wash hands with soap and water21. Protect bag from contamination21. Render comfort measure to clients21. Protect caregiver always

1. In consideration of the steps in applying the bag technique, which side of the paper lining of the CHN bag is considered clean to make a non-contaminated work area?

1. The upper tip1. The outer surface 1. The inside surface1. The lower tip

SITUATION 3 Nurse Anna is a new BSN graduate and has just passed her Licensure Examination for Nurses in the Philippines. She has likewise been hired as a new Community Health Nurse in one of the Rural Health Units in their City, which of the following conditions may be acceptable TRUTHS applied to Community Health Nursing Practice.

1. Which of the following is the primary focus of community health nursing practice?

1. Prevention of illness1. Cure of illnesses1. Rehabilitation back to health1. Promotion of health

1. In community health nursing, which of the following is our unit of service as nurses?

1. The community1. The family1. The individual members of the Barangay1. The extended members of every family

1. A very important part of the Community Health Nursing Assessment Process includes:1. Evaluation structures and qualifications of health center team1. Carrying out nursing procedures as per plan of Action1. The application of professional judgment in estimating importance of facts to family and community1. Coordination with other sectors in relation to health concerns1. The initial step in Planning process in order to engage in any project or activities at the community level involves:

1. Evaluation of data1. Monitoring 1. Goal-setting1. Provision of data

1. In community health nursing, it is important to take into account the family health data coupled with the equally important need to perform ocular inspection of the area as activities which are powerful elements of:

27. Assessment phase27. Planning phase27. Implementation phase27. Evaluation phase

1. When the nurse refers an indigent patient to the Red Cross to obtain blood, she is at what phase of the nursing process?

28. Assessment phase28. Planning phase28. Implementation phase28. Evaluation phase

1. When the RHU nurse provides health teaching to individual or families, this process is:

1. Intervention1. Planning1. Assessment1. Evaluation

SITUATION 4 The accepted definition of Primary Heath Care (PHC) is that of the World Health Organization (WHO).

1. Which of the following is the definition of WHO?1. Strategy which focuses responsibility for health in the individuals towards development of self-reliant people1. Essential health care done universally accessible to individuals and families by means acceptable to them through their participation1. Care characterized by partnership and empowerment of people that permits care strategy1. Health care system that increases opportunities and conditions wherein people will manage their own health1. The four cornerstones of Primary Health Care are here below but which one is NOT?

1. Use of appropriate technology 1. Intra and intersectoral linkages1. Adequate supplies from donors1. Active community participation

1. Which of the following is the vital strategy of PHC?1. Immunization and control of communicable diseases1. The orientation and reorganization of National Health Care System1. Provision of medical care and emergency families1. Provision of essential drugs and treatment1. Intersectoral linkages refers to:33. Coordination among government and nongovernment agencies in providing health services to the people33. Effective referral system among the different units of DOH33. Discouraging outside help to encourage self reliance among the community members33. Linking people to the services provided by the government1. The goal of primary health care in the Philippine framework is:34. Health is wealth34. Health in the Hands of the People by Year 202034. Partnership and empowerment of the People by Year 200034. Quality Health Care for All

1. In 1978, the International Conference of Primary Health Care was in Alma Ata. What is the legal basis of PHC in the Philippine?

1. UNICEF in 19781. Presidential E.O. 9491. LOI 949 of Pres. Marcos1. WHO in 1978

SITUATION 5 Primary Health Care is the premiere approach of the DOH in implementing the national health plan of our country.

1. The mission of PHC must be embodied in the hearts of health care providers. Which one strengthens the health care system?

1. Supporting conditions for healthy habits1. Increasing opportunities to be healthy1. Letting the people manage their own health care1. Financing health program

1. The first international conference on Primary Health Care was held in:

1. Switzerland1. Paris1. USA1. USSR

1. Primary Heath Care is effective when nurses:

1. Provide support program for organizing work1. Develop mutual trust with the people1. Launch community mobilization1. Exercise correct leadership in the community

1. Which of the following is NOT included in the components of the Primary Health Care?

1. Environmental Sanitation1. Support mechanism1. Immunization1. Control of communicable diseases

1. Which of the following Primary Health strategies refers to cooperation with local officials?

1. Devolved authority due to Code 19911. Referral to local government units1. Increased community participation1. Increased linkages with local health sectors

SITUATION 6 Health Care services are classified into categories. Nurses should be cognizant of these categories to be able to render appropriate nursing intervention.

1. Which of the following interventions are classified as primary care?1. Screening patients for tuberculosis1. Provision of direct nursing care to patients in the ward1. Counseling newly married couples on the appropriate family planning method1. Teaching diabetic patients how to self-inject1. Which of the following can be classified under secondary level of prevention?1. Assisting in open heart surgery1. Implementing Direct Observed Therapy (DOT) in the control of Tuberculosis1. Attending to the delivery of G2P1 mother1. Participating in immunization campaign against policy1. Doing active and passive exercise with a CVA patient after a bed bath

1. 2,3 and 41. 3,4 and 51. 1,4 and 51. 1,2 and 3

1. The provision of health information in the rural areas nationwide through television and radio programs and video conferencing is referred to as:

43. Global Health and Wellness Program43. Wellness Program43. Telehealth Program43. Technological Advancement Program

1. The top ten morbidity rates in the Philippines include tuberculosis, diarrhea among children to name a few. Many of these conditions are preventable and have implications in the development of which nursing competencies?

44. Execution of nursing procedures and techniques44. Health education44. Therapeutic use of self44. Administration of treatment and medication

1. Nurse Bea is providing tertiary prevention of Mrs. De Villa. An example of tertiary prevention is:

45. Poison control45. Identifying complication of diabetes45. Self examination of breast cancer45. Marriage counselling

1. Mrs. Ostrea has a schedule for Pap smear. She has a strong history of cervical cancer. This is an example of:

46. Primary prevention46. Secondary prevention46. Tertiary prevention46. Health screening

1. At present, government hospitals are expected to offer comprehensive health service to include illness prevention and health promotion. In which of the following unit or services are these services integrated?

47. Rehabilitation Center47. Intensive Care Center47. Newborn Screening Center47. Wellness Center

1. Wellness clinics and health education activities have been integrated in the government hospitals to render appropriate services. Which of the following purposes LEAST helps clients in cases of these health promotions activities?

48. Reduce the cost of health care48. Maintain maximum functions48. Identify disease symptoms48. Promotes health habits

1. Tertiary care by the home health nurse is directed toward children with:

1. Problems in mobility1. Short-term needs1. Minor problems1. Clinically apparent disease

SITUATION 7 The community nurse orients the staff to community development work and basic principles of CHN.

1. While community health nurses focus on the individual or the family, which of the following do they also have as their final objective?

1. The well-being of the chronically ill1. The financial well-being of the family1. The well-being of the extended family1. The well-being of the community

1. To which level of care should the community health worker refer the cases beyond Primary Health Care units?

A. Provincial HospitalB. Rural Health UnitC. Regional HospitalD. District Hospital

1. The Community Health Nurse spends long periods of time with the family as a client. What kind of health care service is provided to members of families?

1. Referrals only1. Selected problem1. All types1. Priority cases

1. Steven is a trained community worker in the community. Steven is identified at what level of primary health care worker?

53. Intermediate level health worker53. BHW53. Trained hilot53. Volunteer

1. What is the basic purpose of research in CHN?

1. Sources of future and other resources1. Nurse protection1. Improvement of health care1. Proof of competence

SITUATION 8 As a nurse you are aware of the health statistic of the Philippines as published by the Department of Health.

1. Which of the following is the FIRST leading cause of morbidity in our country since 1998?

1. Pneumonia1. Bronchitis1. Diarrhea1. Influenza

1. Which of the following is the FIRST leading cause of mortality?

1. Tuberculosis1. Pneumonia1. Cancer1. Heart diseases

1. First among the ten leading causes of infant mortality in the Philippine is:

1. Congenital anomalies1. Diarrheal diseases1. Birth injury1. Pneumonia

1. First among the TEN leading causes of maternal mortality in our country is:1. Postpartum hemorrhage1. Complication related to pregnancy occurring in labor, delivery and puerperium1. Death related to abortive outcomes1. Hypertension as complication of pregnancy child birth and puerperium1. Which of the following is the top leading cause of mortality among the older persons?

1. Tuberculosis in all forms1. Disease of the heart1. Malignancies1. Diabetes mellitus

SITUATION 9 A community health nurse must be knowledgeable on the vital statistics of the community she is serving.

1. Which of the following refers to the systematic study of vital events in a certain community?

1. Epidemiology1. Population census1. Community statistics1. Vital statistics

1. Major factors affecting population include the following, EXCEPT:

1. Births1. Deaths1. Migration1. Morbidity

1. Which of the following patterns is intermittent and confined to certain geographical area or locality?

1. Sporadic1. Endemic1. Epidemic1. Pandemic

1. Seasonal fluctuation of diseases is considered:

63. Common source epidemic63. Cyclic variation63. Secular variation63. Endemic

1. A sensitive index of the health conditions obtained in the community which is influenced more by environmental rather than endogenous factors is the:

1. Crude death rate1. Infant mortality rate1. Fetal death rate1. Maternal mortality rate

1. The crude birth rate of Community Kwenek is 30. This means:1. 30 births in every 100 population 1. 30 births in every 1000 population1. 30 births in 100 population of woman 15-49 years old1. 30 births in 1000 population of woman 15-49 years old1. Barrio Aragon has an estimated population of 750 persons as of July 2009. On the last month of 2009, there were 70 infants born but 5 of them did not survive upon birth as was surveyed January of the same year. What is the crude birth rate of Barrio Aragon?

1. 93.331. 86.671. 88.661. 71.43

1. On the same year, it was recorded that among the registered live births, 5 neonates had died of different causes about a month after birth. What is the Neonatal Death Rate of Barrio Aragon?

1. 76.291. 71.431. 76.921. 6.67

1. While giving birth, 2 mothers who gave birth through the traditional birth attendants at home died due to profuse bleeding. What is the Maternal Mortality Rate of Barrio Aragon?

1. 2.671. 30.671. 30.771. 28.57

SITUATION 10 Home Visit is a family-nurse contact which allows the health worker to assess the home and family situations in order to provide necessary nursing care.

1. When the nurse reviews records of the family in the clinic, in what phase of the visit is this?

1. Preparatory phase1. Home visit phase1. Post visit phase1. Recording phase

1. The nurse records the home visit and makes referral during what phase of the visit?

1. Before conducting the visit1. In the preparatory phase1. While doing the home visit phase1. Post visit phase

1. Which of the following is an advantage of a home visit? 71. It allows the nurse to provide nursing care to a greater number of people. 71. It provides an opportunity to do first hand appraisal of the home situation. 71. It allows sharing of experiences among people with similar health problems. 71. It develops the familys initiative in providing for health needs of its members. 1. Which of the following is the first step that nurse Febe must do when conducting home visit?0. Place the PHN Bag in convenient place before doing bag technique?0. Greet client or household member and introduce yourself0. Explain the purpose of visit0. Look into detailed aspects of the household1. Which of the following is a professional priority factor to determine the frequency of home visit?

a. Acceptance of the familyb. Flexible and practicalc .Available informationd. Policy of the department of health

1. When working with family, nurse Febe must remember that the most important principle in goal setting is that:1. The goal targets the most serious problem of the family1. The goal is within the budget of the family1. The goal would be involve interventions that the nurse is capable of doing1. The goal is approved by the family1. In performing home visit, it is important that the nurse should accomplish which of the following to meet the needs of the clients and achieve the best results of desired outcome?1. 1. Develop family nursing care plan1. Apply the nursing process and prioritize needs of the client1. Performing bag technique1. Formulate plan of visit1. 1. Upon arriving at a clients home, which of the following will the community health nurse do as first step in performing a nursing procedure?77. Place the bag outside of work area77. Open bag, take the linen, spread over work field area77. Place the bag on the table or any flat surface lined with paper lining77. Put on apron right side out and wrong side with crease touching the body 1. Planning for a home visit is an essential tool in achieving best results in health care. The following are principles in a home visit except:1. Planning should be flexible and practical1. Home visit should have a purpose1. Plans are based in available information including those from other agencies that may rendered services to the family1. Planning of continuing care must be developed by the nurse

SITUATION 11 The application of CHN concepts and processes.

1. Which of the following statements is NOT correct?1. As part of participation to policy formulation, the nurse plays an active role in lobbying for amendments to the nursing law1. In the community, the nurse raises the level of awareness of the people to identify existing problems and potentiate to address such problems1. If the people in the community wants free medicines, the nurse complies as the basis of services should be on what people demands1. If many of the trained community health workers resigned, the nurse has to start all over again and never gives up1. If a particular health service fails, the most basic question is:

1. Is this what people demanded?1. What went wrong?1. Is this what the people need?1. Who is responsible for the failure?

1. The primary goal of CHN is to:1. Support and supplement the efforts of the medical professions in the promotion of health and prevention of illness1. Enhance the capacity of individuals, families, and communities to cope with their health needs1. Increase the productivity of the people1. Contribute to national development1. The nurse actively participates in the development of the community health plan in order to:1. Represent the community in the health team1. Impress the other members of the planning phase of the nursing process1. Ensure that there is a nursing component in any health undertaking1. See to it that the steps in planning phase are carried out

SITUATION 12 The context of CHN is an instrument to community development.

1. In addressing the health problems of the community, community health nurse ensures:1. People identify and prioritize their own problems1. Each health team member provides his/her share in health care1. People act as recipients of services1. DOH programs are being carried out1. The aim of partnership and collaboration with the people is to:1. Get people to work together to address concerns that affect them 1. Give people an opportunity to learn skills in intrapersonal relations1. Bar people in decision-making process1. Expect people to participate in the context of autocratic leadership1. The basic reasons why community organizers need to phase out from the community is to enable:1. Nurse to open CO work in other depressed communities1. People to exercise self-reliance1. The peoples organization to expand their coverage1. People to test their unity and strength1. The important foundation in community organization is to bring together several indigenous leaders. This is:

1. Integration1. Core group formation1. Representation1. Mobilization

1. What is the method of establishing rapport with the people and exercising effort to imbibe community lifestyle with them?

1. Integration1. Core group formation1. Representation1. Socialization

1. The nurse and other members of the health team provide training on basic health care and other concerns to organized group leaders. Which of the following phases of the COPAR process is the training done?

1. Sustenance and strengthening phase1. Organization-building phase1. Pre-entry phase1. Entry

SITUATION 13 Health and Wellness concepts.

1. The modern concept of health refers to:1. How individuals can be called disease-free1. How individuals can avail their immune system1. How individuals maintain maximum level of wellness1. How individuals avoid diseases1. The factor in ecosystem affecting the individuals health that is involved in the menance of population, basically man-made is:

1. Behavioral 1. Socio-economic1. Environmental influences1. Political

1. The factor in the ecosystem affecting the individuals health that is involved in the provision of essential health services whether community based, accessible, sustainable, and affordable is the:

1. Socio-economic1. Health Care Delivery System1. Behavioral1. Political

1. Which is not an example of behavioral influences in OLOF on health status?1. Cigarette smoking and alcohol drinking1. A grandmother with an adult-onset diabetes1. Sedentary lifestyle of an office worker1. Exposure to toxic substances in the workplace1. The level of health of an individual, family, group, population, or community is called:

a.Health assetsb. Health statusc. Health problemd. Health needs

1. In the health care delivery system, ideally, rehabilitation services begin:1. Upon admission of clients in the health care system1. Upon discharge of clients from health care system1. After the clients physical condition stabilizes1. Soon after the client has requested for rehab services

SITUATION 14 Family Health Nursing Practice is a subset of CHN which utilizes the nursing process in applying nursing procedures that facilitate welfare of the community.

1. Family health nursing assessment is the most crucial phase in the nursing process in family health nursing practice. It involves how many levels of assessment?

1. 11. 21. 31. As many as 4

1. First-level assessment is a process whereby existing and potential health problems of the family are determined, which are further categorized according to be nature of the problem. The typology of family nursing problems is used in the statement of nursing diagnosis in the care of families. The youngest child of the de los Reyes family has been diagnosed as mentally retarded. This is classified as a:96. 96. Health threat 96. Health deficit 96. Foreseeable crisis 96. Stress point 1. 1. The de los Reyes couple have a 6-year old child entering school for the first time. The de los Reyes family has a:A. B. Health threat C. Health deficit D. Health dependentE. Foreseeable crisis 1. 1. It refers to the blueprint of the care that the nurse designs to systematically minimize or eliminate the identified health and family nursing problems through explicitly formulated outcomes of care and deliberately chosen set of interventions, resources and evaluation criteria, standards, methods, and tools.

1. Nursing diagnosis1. Family nursing care plan1. Tender-loving-care1. NANDA

SITUATION 15 Field health services and information system provides summary data on health service delivery and selected program from the barangay level up to the national level. As a nurse, you should know the process on how these information became processed and consolidated.

1. . All of the following are objectives of FHSIS EXCEPT:101. To complete the clinical picture of chronic disease and describe their natural history101. To provide standardized, facility level data base which can be accessed for more in depth studies101. To minimize recording and reporting burden allowing more time for patient care and promotive activities101. To ensure that data reported are useful and accurate and are disseminated in a timely and easy to use fashion1. What is the fundamental block or foundation of the field health service information system?

102. Family treatment record102. Target Client list102. Reporting forms102. Output record

1. Which of the following is used to monitor particular groups that are qualified as eligible to a certain program of the DOH?

103. Family treatment record103. Target Client list103. Reporting forms103. Output record1.