May 30, 2009

Anorexia Nervosa

Anorexia nervosa

by brewed

Anorexia nervosa is the most serious of the presently recognized eating disorders which also include bulimia nervosa and binge eating disorder.

While bulimia nervosa is characterized by eating binges that are followed by compensatory behavior such as vomiting or laxative abuse to prevent weight gain and binge eating disorder refers to eating binges without purging, anorexia nervosa involves maintaining a below minimally-normal body weight by restricting one’s intake of food.

About half of all people with anorexia nervosa also suffer from bulimia nervosa. Also, the eating disorders are often associated with other psychiatric conditions such as depression and substance abuse.

Anorexia affects females more than males; 85-95 percent of those that suffer from the condition are females. It is more common among teenagers than the other age groups and affects primarily those belonging to the middle and upper social classes. In Western societies, it is estimated that between 0.5 to 3.7 percent of females will suffer from anorexia nervosa within their lifetime.

People who develop anorexia nervosa have an extreme fear of obesity or gaining weight. They are obsessed with becoming and remaining thin. Worse, they believe themselves to be still fat even when they are already thin and emaciated.

People with anorexia literally starve themselves. They avoid highcalorie foods and pick out a few food items which they eat in small amounts. Curiously, among people with anorexia nervosa, eating small amounts of food often starts as a voluntary behavior aimed at maintaining one’s weight to what society considers being thin, but at some point, the behavior becomes pathologic.

The exact reason people develop anorexia isn’t known. It is generally believed that the eating disorder is an attempt to cope with emotional problems. Some experts link the disorder to hereditary factors. But social factors definitely also play a role in the occurrence of the disease because in most societies, being slim is more desirable than being fat. People with anorexia nervosa are usually perfectionists with above average intelligence.

Typically, people with anorexia are more than 15 percent underweight. They have dry skin and have a growth of fine hair all over their body. They have low heart rate, blood pressure and body temperature such that they feel cold all the time.

Some develop edema (manas, in Filipino), while girls with the disorder usually stop having menstrual periods.

The health problems associated with anorexia nervosa are essentially those that occur in malnutrition. Malnutrition affects practically all organs in the body. If severe, it causes life-threatening fluids and electrolytes imbalance, abnormal heart rhythms and heart failure. As many as 20 percent of people who have been diagnosed with anorexia nervosa die from either the complications of the disease (usually heart failure and electrolyte imbalance) or from suicide secondary to a co-existing depression.

The course of anorexia nervosa is very variable. Sometimes it is mild and transient with the person recovering completely after an episode. At other times, it is a recurring behavior. While still at other times, it becomes a chronic condition that sometimes ends tragically.

The treatment of anorexia nervosa consists of two parts. The first part is aimed at restoring body weight and is best done in a hospital setting where the person is encouraged to eat. If this fails, forced feeding via a nasogastric tube or intravenous line can be resorted to.

The second part of the treatment, which starts when body weight has been restored, consists of individual and family psychotherapy to prevent a relapse.


Note: I italicized some paragraphs because those were the answers in the questions asked last June 2006 exam on test 5 about anorexia nervosa. This eating disorder is commonly asked in the board exam.. Maybe this can give you a hint kahit papano..


May 27, 2009

Mastering ANTIEMETICS : A story towards mastery

Mastering ANTIEMETICS : A story towards mastery
by Budek

This story will let you master all anti emetic drugs that are usually prescribed to the patients with nausea and vomiting.

I created this story because of frustration on how to retain those anti-emetics that are very very frequently asked in the local board exams and in NCLEX / CG Books. Also take note that TAGAMET and PEPCID are antacids used for heartburn that are also used to prevent nausea and vomiting. MAALOX has many many uses, but it is mainly an Antacid. The rest, are intended for nausea and vomiting. I did not include BENADRYL because it has variety of purpose, one is to prevent nausea, vomiting and dizziness specially for patients with Endolymphatic Hydrops [ Menieres Disease ]

Si Marinol At Penny

Inap na Inap [INAPRINE] na si marinol [MARINOL] sa kakaantay sa kanyang maal [MAALOX] na si penny. [PHENERGAN]

Dumating na si penny, [PHENERGAN] na Tagamet-ro [TAGAMET] manila pa.

Zofra ka na! [ZOFRAN] Sabay Compaz [COMPAZINE] ng kamay si marinol [MARINOL] para manampal.

Naubos ko na ang pepsi [PEPCID] dito sa tindahan, Ni regla [REGLAN] na ako kaantay bakit ngayon ka lang?

Honey, and drama drama [DRAMAMINE] mo naman.

------

Easy lang to remember no? Hayyyy... atleast wala ng magkakamali. Tinanong sa exam yang Zofran na yan pati yang Reglan madalas tanungin. Kala ko pampa regla ang reglan, yung zofran naman, kala ko yung nilalagay sa fried chicken. Jufran pala iyon.

May 24, 2009

ABOUT BREAST FEEDING

ABOUT BREAST FEEDING
by: Jeddah

I. Physiology of Breast milk production

As soon as delivery of the placenta is over there will be an abrupt decrease on both Estrogen and Progesterone -----> this will stimulate the APG to secrete PROLACTIN.

note: Be aware that sucking also stimulates Prolactin secretion as this will stimuate the nerves and impulse will travel from the nipple to the Hypothalamus

PROLACTIN will act on the acini cells (alveolar cells) of the breast to produce milk. This milk is called FOREMILK and is stored in the lactiferous sinus. FOREMILK is contiously being produced.

What happens next?

When the baby sucks on the breast of the mother OXYTOCIN is stimulated and oxytocin will act on 2 organs.

1. Breast (Let down reflex)
2. Uterus (promotes Involutions)

OXYTOCIN will cause the mammary galnds to contract and push the milk forward making it available for the baby.

What will stimulate the Let Down reflex?
1. Sucking of the baby
2. Sound of the baby's cry

note: After the Let Down Reflex a new milk will be formed and this is called HINDMILK and this contains more FATS that is needed for the growing newborn

STAGES OF BREASTMILK:
1. Colostrum - 2-4 days present
-content: decrease fats, increase IgA, dec CHO, dec CHON, inc minerals, -inc fat soluble minerals
2. Transitional milk- 4 – 14 days
-content: inc lactose, inc water soluble vit., inc minerals

3. Mature milk- 14 & up
-content: inc fats (linoleic acid) – resp for devt of brain & integrity of skin
-inc CHO- lactose – easily digested, baby not constipated.- esp of sour milk smelling odor of stool.

-Lactose intolerance- deficiency of enzyme LACTASE that digest LACTOSE
-Decrease CHON- lactalbumin

Difference with cow's milk

Cows milk
–inc fats -Dec CHO
-Inc CHON – casing- has curd that’s hard to digest.
-Inc minerals–traumatic effect on kidneys of babies. Can trigger stone formation.
-Inc phosphorusnote:

Note Baby who are breastfed are least likely to develop tetany. It is seen that botlle fed infants have more difficulty in regulating calcium and phosporus. Because cow's milk have more fat contents, this fatty acids may bind with calcium in the GIT causing more decrease in calcium.

Note: Breast feeding can be iniated
if had Cesarian Section- after 4 hours
if NSD, ASAP

Advantages of Breast feeding
1. Economical
2. Always available
3. Breastfed babies have higher IQ than bottle fed babies.
4. It facilitates rapid involution
5. Decrease incidence of breast cancer.
6. Has antibodiesI(gA), lactoferrin, lyzozymes and interferon (inhibit and/or destroy pathogenic bacteria and viruses)
7. Has lactobacillius bifidus- interferes with attack of pathogenic bacteria in GIT
8. Has macrophages
Store milk- plastic storage container
Store milk – good for 6 months from freezer- put rm temp. don’t heat

Disadvantages:
1. Possibility of transfer HEP B, HIV, cytomegalo virus.
2. No iron
3. Father can’t feed & bond as well

Proper breast feeding technique

1. Be in a comfortable position
(Most appropriate is Upright sitiing for this position avoids tension)
2. Entire body of teh baby should be turned towards the mother's breast.
3. Initiate feeding by stimulating the Rooting reflex- by touching the side of lips/cheeks then baby will turn to stimulus. Disappear by 6 weeks- by 6 weeks baby can focus. Reflex will be gone-
Purpose rooting- to look for food.

Sucking Mechanism (breast)
a. Lips of the infant should clamp a C-shape
b. The tounge thrusts forward to grasp nipple and areola
c. The nipple is brought against the ahrd palate as the tounge pulls the areola into the mouth
d. the gums compresses the areola, squezing milk at the back of the throat

Sucking mechanism (bottle)
The large rubber nipple strikes the soft palate and interferes with the action of the tounge. The tounge moves forwards against the gum to control overflow of milk in the espphagous (same reason why dental malocllusion is prone to bottle fed babies, because they thrust their tounge FORWARD causing problem in the formation od the dental arch)

4. Burp or Bubble the babyduring and after feeding to allow escape of air (preventing colic). Sit infant on lap, flexed forward, then rub or pat the back (note: avoid jarring the infant)

Criteria of Effective Sucking
a.) Baby’s mouth is hiked up to areola
b.) Mom experiences after pain.
c.) Other nipple is also flowing with milk.

NOTE: Make sure that the mother feeds the baby at the same breast she last feed her baby. THis is to facilitated complete emptying of the breast and thereby promote complete filling of milk.

Contra Indications in Breast Feeding:
a. Maternal Conditions:
1. HIV, CMV, Hepa B
2. Recieving Coumadin, Lithium or Methotrexate
3. has breast cancer
4. has herpes lesion on breast

b.Newborn Condition - Inborn errors of metabolism usch asErythrobastosis Fetalis – Rh incompatibility, Hydrops Fetalis, Phenylketonuria, Galactosemia, Tay Sachs disease

Problems experienced in Breastfeeding :

3RD day changes in breast post partuma.1
1)Engorged breast- feeling of fullness & tension in breast. - sometimes accompanied by fever known as MILK FEVER.
Mgt:Warm compress- for breastfeeding momCold compress
– for bottle feeding & wear supportive bra.
When is involution of breast- 4 weeks

b.) Sore nipple – cracked with painful nipple
Mgt: 1.) exposure to air – remove bra & wear dress, if not, expose to 20 Watt bulbavoid wearing plastic liner bra-will create moisture, cotton only

c.) Mastitis- inflammation of breast : staphylococcus aureus
Factors:
1. Improper breast emptying
2. Unhealthy sexual practices
- manually express inflamed breastfeed on unaffected breast- give antibiotics
– can still feed on unaffected breast

Type of stools with different milk products:

1. Transitional stool - - green loose & shiny, like diarrhea to the untrained eye
2. Breastfed stool
- golden yellow, soft, mushy with sour milk smell, frequently passed
- recur every feeding
3.. Bottlefed stool –
- pale yellow, formed hard with typical offensive odor, seldom passed, 2–3 x/day
- with food added -brown & odorous

May 21, 2009

COMMUNITY HEALTH NURSING EXAMINATION PART I

COMMUNITY HEALTH NURSING EXAMINATION PART I
By : Budek
http://pinoybsn.blogspot.com

Outline :

I. Epidemiology
II. Vital Statistics
III. FHSIS
IV. COPAR
V. Health Education


SITUATION : Epidemiology and Vital statistics is a very important tool that a nurse could use in controlling the spread of disease in the community and at the same time, surveying the impact of the disease on the population and prevent it’s future occurrence.

1. It is concerned with the study of factors that influence the occurrence and distribution of diseases, defects, disability or death which occurs in groups or aggregation of individuals.

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

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

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

3. Which of the following type of research could show how community expectations can result in the actual provision of services?

A. Basic Research
B. Operational Research
C. Action Research
D. Applied Research

4. An outbreak of measles has been reported in Community A. As a nurse, which of the following is your first action for an Epidemiological investigation?

A. Classify if the outbreak of measles is epidemic or just sporadic
B. Report the incidence into the RHU
C. Determine the first day when the outbreak occurred
D. Identify if it is the disease which it is reported to be

5. After the epidemiological investigation produced final conclusions, which of the following is your initial step in your operational procedure during disease outbreak?

A. Coordinate personnel from Municipal to the National level
B. Collect pertinent laboratory specimen to confirm disease causation
C. Immunize nearby communities with Measles
D. Educate the community in future prevention of similar outbreaks

6. The main concern of a public health nurse is the prevention of disease, prolonging of life and promoting physical health and efficiency through which of the following?

A. Use of epidemiological tools and vital health statistics
B. Determine the spread and occurrence of the disease
C. Political empowerment and Socio Economic Assistance
D. Organized Community Efforts

7. In order to control a disease effectively, which of the following must first be known?

1. The conditions surrounding its occurrence
2. Factors that do not favor its development
3. The condition that do not surround its occurrence
4. Factors that favors its development

A. 1 and 3
B. 1 and 4
C. 2 and 3
D. 2 and 4

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

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

9. Before reporting the fact of presence of an epidemic, which of the following is of most importance to determine?

A. Are the facts complete?
B. Is the disease real?
C. Is the disease tangible?
D. Is it epidemic or endemic?

10. An unknown epidemic has just been reported in Barangay Dekbudekbu. People said that affected person demonstrates hemorrhagic type of fever. You are designated now to plan for epidemiological investigation. Arrange the sequence of events in accordance with the correct outline plan for epidemiological investigation.

1. Report the presence of dengue
2. Summarize data and conclude the final picture of epidemic
3. Relate the occurrence to the population group, facilities, food supply and carriers
4. Determine if the disease is factual or real
5. Determine any unusual prevalence of the disease and its nature; is it epidemic, sporadic, endemic or pandemic?
6. Determine onset and the geographical limitation of the disease.

A. 4,1,3,5,2,6
B. 4,1,5,6,3,2
C. 5,4,6,2,1,3
D. 5,4,6,1,2,3
E. 1,2,3,4,5,6

11. In the occurrence of SARS and other pandemics, which of the following is the most vital role of a nurse in epidemiology?

A. Health promotion
B. Disease prevention
C. Surveillance
D. Casefinding

12. Measles outbreak has been reported in Barangay Bahay Toro, After conducting an epidemiological investigation you have confirmed that the outbreak is factual. You are tasked to lead a team of medical workers for operational procedure in disease outbreak. Arrange the correct sequence of events that you must do to effectively contain the disease

1. Create a final report and recommendation
2. Perform nasopharyngeal swabbing to infected individuals
3. Perform mass measles immunization to vulnerable groups
4. Perform an environmental sanitation survey on the immediate environment
5. Organize your team and Coordinate the personnels
6. Educate the community on disease transmission

A. 1,2,3,4,5,6
B. 6,5,4,3,2,1
C. 5,6,4,2,3,1
D. 5,2,3,4,6,1

13. All of the following are function of Nurse Budek in epidemiology except

A. Laboratory Diagnosis
B. Surveillance of disease occurrence
C. Follow up cases and contacts
D. Refer cases to hospitals if necessary
E. Isolate cases of communicable disease

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

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

15. Which of the following is the final output of data reporting in epidemiological operational procedure?

A. Recommendation
B. Evaluation
C. Final Report
D. Preliminary report

16. The office in charge with registering vital facts in the Philippines is none other than the

A. PCSO
B PAGCOR
C. DOH
D. NSO

17. The following are possible sources of Data except:

A. Experience
B. Census
C. Surveys
D. Research

18. This refers to systematic study of vital events such as births, illnesses, marriages, divorces and deaths

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

19. In case of clerical errors in your birth certificate, Where should you go to have it corrected?

A. NSO
B. Court of Appeals
C. Municipal Trial Court
D. Local Civil Registrar

20. Acasia just gave birth to Lestat, A healthy baby boy. Who are going to report the birth of Baby Lestat?

A. Nurse
B. Midwife
C. OB Gyne
D. Birth Attendant

21. In reporting the birth of Baby Lestat, where will he be registered?

A. At the Local Civil Registrar
B. In the National Statistics Office
C. In the City Health Department
D. In the Field Health Services and Information System Main Office

22. Deejay, The birth attendant noticed that Lestat has low set of ears, Micrognathia, Microcephaly and a typical cat like cry. What should Deejay do?

A. Bring Lestat immediately to the nearest hospital
B. Ask his assistant to call the nearby pediatrician
C. Bring Lestat to the nearest pediatric clinic
D. Call a Taxi and together with Acasia, Bring Lestat to the nearest hospital

23. Deejay would suspect which disorder?

A. Trisomy 21
B. Turners Syndrome
C. Cri Du Chat
D. Klinefelters Syndrome

24. Deejay could expect which of the following congenital anomaly that would accompany this disorder?

A. AVSD
B. PDA
C. TOF
D. TOGV

26. Which presidential decree orders reporting of births within 30 days after its occurrence?

A. 651
B. 541
C. 996
D. 825

25. These rates are referred to the total living population, It must be presumed that the total population was exposed to the risk of occurrence of the event.

A. Rate
B. Ratio
C. Crude/General Rates
D. Specific Rate

26. These are used to describe the relationship between two numerical quantities or measures of events without taking particular considerations to the time or place.

A. Rate
B. Ratios
C. Crude/General Rate
D. Specific Rate

27. This is the most sensitive index in determining the general health condition of a community since it reflects the changes in the environment and medical conditions of a community

A. Crude death rate
B. Infant mortality rate
C. Maternal mortality rate
D. Fetal death rate

28. According to the WHO, which of the following is the most frequent cause of death in children underfive worldwide in the 2003 WHO Survey?

A. Neonatal
B. Pneumonia
C. Diarrhea
D. HIV/AIDS

29. In the Philippines, what is the most common cause of death of infants according to the latest survey?

A. Pneumonia
B. Diarrhea
C. Other perinatal condition
D. Respiratory condition of fetus and newborn

30. The major cause of mortality from 1999 up to 2002 in the Philippines are

A. Diseases of the heart
B. Diseases of the vascular system
C. Pneumonias
D. Tuberculosis

31. Alicia, a 9 year old child asked you “ What is the common cause of death in my age group here in the Philippines? “ The nurse is correct if he will answer

A. Pneumonia is the top leading cause of death in children age 5 to 9
B. Malignant neoplasm if common in your age group
C. Probability wise, You might die due to accidents
D. Diseases of the respiratory system is the most common cause of death in children

32. In children 1 to 4 years old, which is the most common cause of death?

A. Diarrhea
B. Accidents
C. Pneumonia
D. Diseases of the heart

33. Working in the community as a PHN for almost 10 years, Aida knew the fluctuation in vital statistics. She knew that the most common cause of morbidity among the Filipinos is

A. Diseases of the heart
B. Diarrhea
C. Pneumonia
D. Vascular system diseases

34. Nurse Aida also knew that most maternal deaths are caused by

A. Hemorrhage
B. Other Complications related to pregnancy occurring in the course of labor, delivery and puerperium
C. Hypertension complicating pregnancy, childbirth and puerperium
D. Abortion

SITUATION : Barangay PinoyBSN has the following data in year 2006

1. July 1 population : 254,316
2. Livebirths : 2,289
3. Deaths from maternal cause : 15
4. Death from CVD : 3,029
5. Deaths under 1 year of age : 23
6. Fetal deaths : 8
7. Deaths under 28 days : 8
8. Death due to rabies : 45
9. Registered cases of rabies : 45
10. People with pneumonia : 79
11. People exposed with pneumonia : 2,593
12. Total number of deaths from all causes : 10,998

The following questions refer to these data

35. What is the crude birth rate of Barangay PinoyBSN?

A. 90/100,000
B. 9/100
C. 90/1000
D. 9/1000

36. What is the cause specific death rate from cardiovascular diseases?

A. 27/100
B. 1191/100,000
C. 27/100,000
D. 1.1/1000

37. What is the Maternal Mortality rate of this barangay?

A. 6.55/1000
B. 5.89/1000
C. 1.36/1000
D. 3.67/1000

38. What is the fetal death rate?

A. 3.49/1000
B. 10.04/1000
C. 3.14/1000
D. 3.14/100,000

39. What is the attack rate of pneumonia?

A. 3.04/1000
B. 7.18/1000
C. 32.82/100
D. 3.04/100

40. Determine the Case fatality ratio of rabies in this Barangay

A. 1/100
B. 100%
C. 1%
D. 100/1000

41. The following are all functions of the nurse in vital statistics, which of the following is not?

A. Consolidate Data
B. Collects Data
C. Analyze Data
D. Tabulate Data

42. The following are Notifiable diseases that needs to have a tally sheet in data reporting, Which one is not?

A. Hypertension
B. Bronchiolitis
C. Chemical Poisoning
D. Accidents

43. Which of the following requires reporting within 24 hours?

A. Neonatal tetanus
B. Measles
C. Hypertension
D. Tetanus

44. Which Act declared that all communicable disease be reported to the nearest health station?

A. 1082
B. 1891
C. 3573
D. 6675

45. In the RHU Team, Which professional is directly responsible in caring a sick person who is homebound?

A. Midwife
B. Nurse
C. BHW
D. Physician

46. During epidemics, which of the following epidemiological function will you have to perform first?

A. Teaching the community on disease prevention
B. Assessment on suspected cases
C. Monitor the condition of people affected
D. Determining the source and nature of the epidemic

47. Which of the following is a POINT SOURCE epidemic?

A. Dengue H.F
B. Malaria
C. Contaminated Water Source
D. Tuberculosis

48. All but one is a characteristic of a point source epidemic, which one is not?

A. The spread of the disease is caused by a common vehicle
B. The disease is usually caused by contaminated food
C. There is a gradual increase of cases
D. Epidemic is usually sudden

49. The only Microorganism monitored in cases of contaminated water is

A. Vibrio Cholera
B. Escherichia Coli
C. Entamoeba Histolytica
D. Coliform Test

50. Dengue increase in number during June, July and August. This pattern is called

A. Epidemic
B. Endemic
C. Cyclical
D. Secular

SITUATION : 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.

51. All of the following are objectives of FHSIS Except

A. To complete the clinical picture of chronic disease and describe their natural history
B. To provide standardized, facility level data base which can be accessed for more in depth studies
C. To minimize recording and reporting burden allowing more time for patient care and promotive activities
D. To ensure that data reported are useful and accurate and are disseminated in a timely and easy to use fashion

52. What is the fundamental block or foundation of the field health service information system?

A. Family treatment record
B. Target Client list
C. Reporting forms
D. Output record

53. What is the primary advantage of having a target client list?

A. Nurses need not to go back to FTR to monitor treatment and services to beneficiaries thus saving time and effort
B. Help monitor service rendered to clients in general
C. Facilitate monitoring and supervision of services
D. Facilitates easier reporting

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

A. Family treatment record
B. Target Client list
C. Reporting forms
D. Output record

55. In using the tally sheet, what is the recommended frequency in tallying activities and services?

A. Daily
B. Weekly
C. Monthly
D. Quarterly

56. When is the counting of the tally sheet done?

A. At the end of the day
B. At the end of the week
C. At the end of the month
D. At the end of the year

57. Target client list will be transmitted to the next facility in the form of

A. Family treatment record
B. Target Client list
C. Reporting forms
D. Output record

58. All but one of the following are eligible target client list

A. Leprosy cases
B. TB cases
C. Prenatal care
D. Diarrhea cases

59. This is the only mechanism through which data are routinely transmitted from once facility to another

A. Family treatment record
B. Target Client list
C. Reporting forms
D. Output record

60. FHSIS/Q-3 Or the report for environmental health activities is prepared how frequently?

A. Daily
B. Weekly
C. Quarterly
D. Yearly

61. Nurse Budek is preparing the reporting form for weekly notifiable diseases. He knew that he will code the report form as

A. FHSIS/E-1
B. FHSIS/E-2
C. FHSIS/E-3
D. FHSIS/M-1

62. In preparing the maternal death report, which of the following correctly codes this occurrence?

A. FHSIS/E-1
B. FHSIS/E-2
C. FHSIS/E-3
D. FHSIS/M-1

63. Where should Nurse Budek bring the reporting forms if he is in the BHU Facility?

A. Rural health office
B. FHSIS Main office
C. Provincial health office
D. Regional health office

64. After bringing the reporting forms in the right facility for processing, Nurse Budek knew that the output reports are solely produced by what office?

A. Rural health office
B. FHSIS Main office
C. Provincial health office
D. Regional health office

65. Mang Raul entered the health center complaining of fatigue and frequent syncope. You assessed Mang Raul and found out that he is severely malnourished and anemic. What record should you get first to document these findings?

A. Family treatment record
B. Target Client list
C. Reporting forms
D. Output record

66. The information about Mang Raul’s address, full name, age, symptoms and diagnosis is recorded in

A. Family treatment record
B. Target Client list
C. Reporting forms
D. Output record

67. Another entry is to be made for Mang Raul because he is in the target client’s list, In what TCL should Mang Raul’s entry be documented?

A. TCL Eligible Population
B. TCL Family Planning
C. TCL Nutrition
D. TCL Pre Natal

68. The nurse uses the FHSIS Record system incorrectly when she found out that

A. She go to the individual or FTR for entry confirmation in the Tally/Report Summary
B. She refer to other sources for completing monthly and quarterly reports
C. She records diarrhea in the Tally sheet/Report form with a code FHSIS/M-1
D. She records a Child who have frequent diarrhea in TCL : Under Five

69. The BHS Is the lowest level of reporting unit in FHSIS. A BHS can be considered a reporting unit if all of the following are met except

A. It renders service to 3 barangays
B. There is a midwife the regularly renders service to the area
C. The BHS Have no mother BHS
D. It should be a satellite BHS

70. Data submitted to the PHO is processed using what type of technology?

A. Internet
B. Microcomputer
C. Supercomputer
D. Server Interlink Connections

SITUATION : Community organizing is a process by which people, health services and agencies of the community are brought together to act and solve their own problems.

71. Mang ambo approaches you for counseling. You are an effective counselor if you

A. Give good advice to Mang Ambo
B. Identify Mang Ambo’s problems
C. Convince Mang Ambo to follow your advice
D. Help Mang Ambo identify his problems

72. As a newly appointed PHN instructed to organize Barangay Baritan, Which of the following is your initial step in organizing the community for initial action?

A. Study the Barangay Health statistics and records
B. Make a courtesy call to the Barangay Captain
C. Meet with the Barangay Captain to make plans
D. Make a courtesy call to the Municipal Mayor

73. Preparatory phase is the first phase in organizing the community. Which of the following is the initial step in the preparatory phase?

A. Area selection
B. Community profiling
C. Entry in the community
D. Integration with the people

74. the most important factor in determining the proper area for community organizing is that this area should

A. Be already adopted by another organization
B. Be able to finance the projects
C. Have problems and needs assistance
D. Have people with expertise to be developed as leaders

75. Which of the following dwelling place should the Nurse choose when integrating with the people?

A. A simple house in the border of Barangay Baritan and San Pablo
B. A simple house with fencing and gate located in the center of Barangay Baritan
C. A modest dwelling place where people will not hesitate to enter
D. A modest dwelling place where people will not hesitate to enter located in the center of the community

76. In choosing a leader in the community during the Organizational phase, Which among these people will you choose?

A. Miguel Zobel, 50 years old, Rich and Famous
B. Rustom, 27 years old, Actor
C. Mang Ambo, 70, Willing to work for the desired change
D. Ricky, 30 years old, Influential and Willing to work for the desired change

77. Which type of leadership style should the leaders of the community practice?

A. Autocratic
B. Democratic
C. Laissez Faire
D. Consultative

78. Setting up Committee on Education and Training is in what phase of COPAR?

A. Preparatory
B. Organizational
C. Education and Training
D. Intersectoral Collaboration
E. Phase out

79. Community diagnosis is done to come up with a profile of local health situation that will serve as basis of health programs and services. This is done in what phase of COPAR?

A. Preparatory
B. Organizational
C. Education and Training
D. Intersectoral Collaboration
E. Phase out

80. The people named the community health workers based on the collective decision in accordance with the set criteria. Before they can be trained by the Nurse, The Nurse must first

A. Make a lesson plan
B. Set learning goals and objective
C. Assess their learning needs
D. Review materials needed for training

81. Nurse Budek wrote a letter to PCSO asking them for assistance in their feeding programs for the community’s nutrition and health projects. PCSO then approved the request and gave Budek 50,000 Pesos and a truckload of rice, fruits and vegetables. Which phase of COPAR did Budek utilized?

A. Preparatory
B. Organizational
C. Education and Training
D. Intersectoral Collaboration
E. Phase out

82. Ideally, How many years should the Nurse stay in the community before he can phase out and be assured of a Self Reliant community?

A. 5 years
B. 10 years
C. 1 year
D. 6 months

83. Major discussion in community organization are made by

A. The nurse
B. The leaders of each committee
C. The entire group
D. Collaborating Agencies

84. The nurse should know that Organizational plan best succeeds when

1. People sees its values
2. People think its antagonistic professionally
3. It is incompatible with their personal beliefs
4. It is compatible with their personal beliefs

A. 1 and 3
B. 2 and 4
C. 1 and 2
D. 1 and 4

85. Nurse Budek made a proposal that people should turn their backyard into small farming lots to plant vegetables and fruits. He specified that the objective is to save money in buying vegetables and fruits that tend to have a fluctuating and cyclical price. Which step in Community organizing process did he utilized?

A. Fact finding
B. Determination of needs
C. Program formation
D. Education and Interpretation

86. One of the critical steps in COPAR is becoming one with the people and understanding their culture and lifestyle. Which critical step in COPAR will the Nurse try to immerse himself in the community?

A. Integration
B. Social Mobilization
C. Ground Work
D. Mobilization

87. The Actual exercise of people power occurs during when?

A. Integration
B. Social Mobilization
C. Ground Work
D. Mobilization

88. Which steps in COPAR trains indigenous and informal leaders?

A. Ground Work
B. Mobilization
C. Core Group formation
D. Integration

89. As a PHN, One of your role is to organize the community. Nurse Budek knows that the purposes of community organizing are

1. Move the community to act on their own problems
2. Make people aware of their own problems
3. Enable the nurse to solve the community problems
4. Offer people means of solving their own problems

A. 1,2,3
B. 1,2,3,4
C. 1,2
D. 1,2,4

90. This is considered the first act of integrating with the people. This gives an in depth participation in community health problems and needs.

A. Residing in the area of assignment
B. Listing down the name of person to contact for courtesy call
C. Gathering initial information about the community
D. Preparing Agenda for the first meeting

SITUATION : Health education is the process whereby knowledge, attitude and practice of people are changed to improve individual, family and community health.

91. Which of the following is the correct sequence in health education?

1. Information
2. Communication
3. Education

A. 1,2,3
B. 3,2,1
C. 1,3,2
D. 3,1,2

92. The health status of the people is greatly affected and determined by which of the following?

A. Behavioral factors
B. Socioeconomic factors
C. Political factors
D. Psychological factors

93. Nurse Budek is conducting a health teaching to Agnesia, 50 year old breast cancer survivor needing rehabilitative measures. He knows that health education is effective when

A. Agnesia recites the procedure and instructions perfectly
B. Agnesia’s behavior and outlook in life was changed positively
C. Agnesia gave feedback to Budek saying that she understood the instruction
D. Agnesia requested a written instruction from Budek

94. Which of the following is true about health education?

A. It helps people attain their health through the nurse’s sole efforts
B. It should not be flexible
C. It is a fast and mushroom like process
D. It is a slow and continuous process

95. Which of the following factors least influence the learning readiness of an adult learner?

A. The individuals stage of development
B. Ability to concentrate on information to be learned
C. The individual’s psychosocial adaptation to his illness
D. The internal impulses that drive the person to take action

96. Which of the following is the most important condition for diabetic patients to learn how to control their diet?

A. Use of pamphlets and other materials during instructions
B. Motivation to be symptom free
C. Ability of the patient to understand teaching instruction
D. Language used by the nurse

97. An important skill that a primigravida has to acquire is the ability to bathe her newborn baby and clean her breast if she decides to breastfeed her baby, Which of the following learning domain will you classify the above goals?

A. Psychomotor
B. Cognitive
C. Affective
D. Attitudinal

98. When you prepare your teaching plan for a group of hypertensive patients, you first formulate your learning objectives. Which of the following steps in the nursing process corresponds to the writing of the learning objectives?

A. Planning
B. Implementing
C. Evaluation
C. Assessment

99. Rose, 50 years old and newly diagnosed diabetic patient must learn how to inject insulin. Which of the following physical attribute is not in anyway related to her ability to administer insulin?

A. Strength
B. Coordination
C. Dexterity
D. Muscle Built

100. Appearance and disposition of clients are best observed initially during which of the following situation?

A. Taking V/S
B. Interview
C. Implementation of the initial care
D. Actual Physical examination

95-100 are taken from actual board questions, However the answer key given in the compilation are incorrect.

CORRECT ANSWERS

SITUATION : Epidemiology and Vital statistics is a very important tool that a nurse could use in controlling the spread of disease in the community and at the same time, surveying the impact of the disease on the population and prevent it’s future occurrence.

1. It is concerned with the study of factors that influence the occurrence and distribution of diseases, defects, disability or death which occurs in groups or aggregation of individuals.

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

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

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

3. Which of the following type of research could show how community expectations can result in the actual provision of services?

A. Basic Research
B. Operational Research
C. Action Research
D. Applied Research

4. An outbreak of measles has been reported in Community A. As a nurse, which of the following is your first action for an Epidemiological investigation?

A. Classify if the outbreak of measles is epidemic or just sporadic
B. Report the incidence into the RHU
C. Determine the first day when the outbreak occurred
D. Identify if it is the disease which it is reported to be

5. After the epidemiological investigation produced final conclusions, which of the following is your initial step in your operational procedure during disease outbreak?

A. Coordinate personnel from Municipal to the National level
B. Collect pertinent laboratory specimen to confirm disease causation
C. Immunize nearby communities with Measles
D. Educate the community in future prevention of similar outbreaks

6. The main concern of a public health nurse is the prevention of disease, prolonging of life and promoting physical health and efficiency through which of the following?

A. Use of epidemiological tools and vital health statistics
B. Determine the spread and occurrence of the disease
C. Political empowerment and Socio Economic Assistance
D. Organized Community Efforts

7. In order to control a disease effectively, which of the following must first be known?

1. The conditions surrounding its occurrence
2. Factors that do not favor its development
3. The condition that do not surround its occurrence
4. Factors that favors its development

A. 1 and 3
B. 1 and 4
C. 2 and 3
D. 2 and 4

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

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

9. Before reporting the fact of presence of an epidemic, which of the following is of most importance to determine?

A. Are the facts complete?
B. Is the disease real?
C. Is the disease tangible?
D. Is it epidemic or endemic?

10. An unknown epidemic has just been reported in Barangay Dekbudekbu. People said that affected person demonstrates hemorrhagic type of fever. You are designated now to plan for epidemiological investigation. Arrange the sequence of events in accordance with the correct outline plan for epidemiological investigation.

1. Report the presence of dengue
2. Summarize data and conclude the final picture of epidemic
3. Relate the occurrence to the population group, facilities, food supply and carriers
4. Determine if the disease is factual or real
5. Determine any unusual prevalence of the disease and its nature; is it epidemic, sporadic, endemic or pandemic?
6. Determine onset and the geographical limitation of the disease.

A. 4,1,3,5,2,6
B. 4,1,5,6,3,2
C. 5,4,6,2,1,3
D. 5,4,6,1,2,3
E. 1,2,3,4,5,6

11. In the occurrence of SARS and other pandemics, which of the following is the most vital role of a nurse in epidemiology?

A. Health promotion
B. Disease prevention
C. Surveillance
D. Casefinding

12. Measles outbreak has been reported in Barangay Bahay Toro, After conducting an epidemiological investigation you have confirmed that the outbreak is factual. You are tasked to lead a team of medical workers for operational procedure in disease outbreak. Arrange the correct sequence of events that you must do to effectively contain the disease

1. Create a final report and recommendation
2. Perform nasopharyngeal swabbing to infected individuals
3. Perform mass measles immunization to vulnerable groups
4. Perform an environmental sanitation survey on the immediate environment
5. Organize your team and Coordinate the personnels
6. Educate the community on disease transmission

A. 1,2,3,4,5,6
B. 6,5,4,3,2,1
C. 5,6,4,2,3,1
D. 5,2,3,4,6,1

13. All of the following are function of Nurse Budek in epidemiology except

A. Laboratory Diagnosis
B. Surveillance of disease occurrence
C. Follow up cases and contacts
D. Refer cases to hospitals if necessary
E. Isolate cases of communicable disease

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

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

15. Which of the following is the final output of data reporting in epidemiological operational procedure?

A. Recommendation
B. Evaluation
C. Final Report
D. Preliminary report

16. The office in charge with registering vital facts in the Philippines is none other than the

A. PCSO
B PAGCOR
C. DOH
D. NSO

17. The following are possible sources of Data except:

A. Experience
B. Census
C. Surveys
D. Research

18. This refers to systematic study of vital events such as births, illnesses, marriages, divorces and deaths

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

19. In case of clerical errors in your birth certificate, Where should you go to have it corrected?

A. NSO
B. Court of Appeals
C. Municipal Trial Court
D. Local Civil Registrar

20. Acasia just gave birth to Lestat, A healthy baby boy. Who are going to report the birth of Baby Lestat?

A. Nurse
B. Midwife
C. OB Gyne
D. Birth Attendant

21. In reporting the birth of Baby Lestat, where will he be registered?

A. At the Local Civil Registrar
B. In the National Statistics Office
C. In the City Health Department
D. In the Field Health Services and Information System Main Office

22. Deejay, The birth attendant noticed that Lestat has low set of ears, Micrognathia, Microcephaly and a typical cat like cry. What should Deejay do?

A. Bring Lestat immediately to the nearest hospital
B. Ask his assistant to call the nearby pediatrician
C. Bring Lestat to the nearest pediatric clinic
D. Call a Taxi and together with Acasia, Bring Lestat to the nearest hospital

23. Deejay would suspect which disorder?

A. Trisomy 21
B. Turners Syndrome
C. Cri Du Chat
D. Klinefelters Syndrome

24. Deejay could expect which of the following congenital anomaly that would accompany this disorder?

A. AVSD
B. PDA
C. TOF
D. TOGV

26. Which presidential decree orders reporting of births within 30 days after its occurrence?

A. 651
B. 541
C. 996
D. 825

25. These rates are referred to the total living population, It must be presumed that the total population was exposed to the risk of occurrence of the event.

A. Rate
B. Ratio
C. Crude/General Rates
D. Specific Rate

26. These are used to describe the relationship between two numerical quantities or measures of events without taking particular considerations to the time or place.

A. Rate
B. Ratios
C. Crude/General Rate
D. Specific Rate

27. This is the most sensitive index in determining the general health condition of a community since it reflects the changes in the environment and medical conditions of a community

A. Crude death rate
B. Infant mortality rate
C. Maternal mortality rate
D. Fetal death rate

28. According to the WHO, which of the following is the most frequent cause of death in children underfive worldwide in the 2003 WHO Survey?

A. Neonatal
B. Pneumonia
C. Diarrhea
D. HIV/AIDS

29. In the Philippines, what is the most common cause of death of infants according to the latest survey?

A. Pneumonia
B. Diarrhea
C. Other perinatal condition
D. Respiratory condition of fetus and newborn

30. The major cause of mortality from 1999 up to 2002 in the Philippines are

A. Diseases of the heart
B. Diseases of the vascular system
C. Pneumonias
D. Tuberculosis

31. Alicia, a 9 year old child asked you “ What is the common cause of death in my age group here in the Philippines? “ The nurse is correct if he will answer

A. Pneumonia is the top leading cause of death in children age 5 to 9
B. Malignant neoplasm if common in your age group
C. Probability wise, You might die due to accidents
D. Diseases of the respiratory system is the most common cause of death in children

32. In children 1 to 4 years old, which is the most common cause of death?

A. Diarrhea
B. Accidents
C. Pneumonia
D. Diseases of the heart

33. Working in the community as a PHN for almost 10 years, Aida knew the fluctuation in vital statistics. She knew that the most common cause of morbidity among the Filipinos is

A. Diseases of the heart
B. Diarrhea
C. Pneumonia
D. Vascular system diseases

34. Nurse Aida also knew that most maternal deaths are caused by

A. Hemorrhage
B. Other Complications related to pregnancy occurring in the course of labor, delivery and puerperium
C. Hypertension complicating pregnancy, childbirth and puerperium
D. Abortion

SITUATION : Barangay PinoyBSN has the following data in year 2006

1. July 1 population : 254,316
2. Livebirths : 2,289
3. Deaths from maternal cause : 15
4. Death from CVD : 3,029
5. Deaths under 1 year of age : 23
6. Fetal deaths : 8
7. Deaths under 28 days : 8
8. Death due to rabies : 45
9. Registered cases of rabies : 45
10. People with pneumonia : 79
11. People exposed with pneumonia : 2,593
12. Total number of deaths from all causes : 10,998

The following questions refer to these data

35. What is the crude birth rate of Barangay PinoyBSN?

A. 90/100,000
B. 9/100
C. 90/1000
D. 9/1000

36. What is the cause specific death rate from cardiovascular diseases?

A. 27/100
B. 1191/100,000
C. 27/100,000
D. 1.1/1000

37. What is the Maternal Mortality rate of this barangay?

A. 6.55/1000
B. 5.89/1000
C. 1.36/1000
D. 3.67/1000

38. What is the fetal death rate?

A. 3.49/1000
B. 10.04/1000
C. 3.14/1000
D. 3.14/100,000

39. What is the attack rate of pneumonia?

A. 3.04/1000
B. 7.18/1000
C. 32.82/100
D. 3.04/100

40. Determine the Case fatality ratio of rabies in this Barangay

A. 1/100
B. 100%
C. 1%
D. 100/1000

41. The following are all functions of the nurse in vital statistics, which of the following is not?

A. Consolidate Data
B. Collects Data
C. Analyze Data
D. Tabulate Data

42. The following are Notifiable diseases that needs to have a tally sheet in data reporting, Which one is not?

A. Hypertension
B. Bronchiolitis
C. Chemical Poisoning
D. Accidents

43. Which of the following requires reporting within 24 hours?

A. Neonatal tetanus
B. Measles
C. Hypertension
D. Tetanus

44. Which Act declared that all communicable disease be reported to the nearest health station?

A. 1082
B. 1891
C. 3573
D. 6675

45. In the RHU Team, Which professional is directly responsible in caring a sick person who is homebound?

A. Midwife
B. Nurse
C. BHW
D. Physician

46. During epidemics, which of the following epidemiological function will you have to perform first?

A. Teaching the community on disease prevention
B. Assessment on suspected cases
C. Monitor the condition of people affected
D. Determining the source and nature of the epidemic

47. Which of the following is a POINT SOURCE epidemic?


A. Dengue H.F
B. Malaria
C. Contaminated Water Source
D. Tuberculosis

48. All but one is a characteristic of a point source epidemic, which one is not?

A. The spread of the disease is caused by a common vehicle
B. The disease is usually caused by contaminated food
C. There is a gradual increase of cases
D. Epidemic is usually sudden

49. The only Microorganism monitored in cases of contaminated water is

A. Vibrio Cholera
B. Escherichia Coli
C. Entamoeba Histolytica
D. Coliform Test

50. Dengue increase in number during June, July and August. This pattern is called

A. Epidemic
B. Endemic
C. Cyclical
D. Secular

SITUATION : 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.

51. All of the following are objectives of FHSIS Except

A. To complete the clinical picture of chronic disease and describe their natural history
B. To provide standardized, facility level data base which can be accessed for more in depth studies
C. To minimize recording and reporting burden allowing more time for patient care and promotive activities
D. To ensure that data reported are useful and accurate and are disseminated in a timely and easy to use fashion

52. What is the fundamental block or foundation of the field health service information system?

A. Family treatment record
B. Target Client list
C. Reporting forms
D. Output record

53. What is the primary advantage of having a target client list?

A. Nurses need not to go back to FTR to monitor treatment and services to beneficiaries thus saving time and effort
B. Help monitor service rendered to clients in general
C. Facilitate monitoring and supervision of services
D. Facilitates easier reporting

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

A. Family treatment record
B. Target Client list
C. Reporting forms
D. Output record

55. In using the tally sheet, what is the recommended frequency in tallying activities and services?

A. Daily
B. Weekly
C. Monthly
D. Quarterly

56. When is the counting of the tally sheet done?

A. At the end of the day
B. At the end of the week
C. At the end of the month
D. At the end of the year

57. Target client list will be transmitted to the next facility in the form of

A. Family treatment record
B. Target Client list
C. Reporting forms
D. Output record

58. All but one of the following are eligible target client list

A. Leprosy cases
B. TB cases
C. Prenatal care
D. Diarrhea cases

59. This is the only mechanism through which data are routinely transmitted from once facility to another

A. Family treatment record
B. Target Client list
C. Reporting forms
D. Output record

60. FHSIS/Q-3 Or the report for environmental health activities is prepared how frequently?

A. Daily
B. Weekly
C. Quarterly
D. Yearly

61. Nurse Budek is preparing the reporting form for weekly notifiable diseases. He knew that he will code the report form as

A. FHSIS/E-1
B. FHSIS/E-2
C. FHSIS/E-3
D. FHSIS/M-1

62. In preparing the maternal death report, which of the following correctly codes this occurrence?

A. FHSIS/E-1
B. FHSIS/E-2
C. FHSIS/E-3
D. FHSIS/M-1


63. Where should Nurse Budek bring the reporting forms if he is in the BHU Facility?

A. Rural health office
B. FHSIS Main office
C. Provincial health office
D. Regional health office

64. After bringing the reporting forms in the right facility for processing, Nurse Budek knew that the output reports are solely produced by what office?

A. Rural health office
B. FHSIS Main office
C. Provincial health office
D. Regional health office

65. Mang Raul entered the health center complaining of fatigue and frequent syncope. You assessed Mang Raul and found out that he is severely malnourished and anemic. What record should you get first to document these findings?

A. Family treatment record
B. Target Client list
C. Reporting forms
D. Output record

66. The information about Mang Raul’s address, full name, age, symptoms and diagnosis is recorded in

A. Family treatment record
B. Target Client list
C. Reporting forms
D. Output record

67. Another entry is to be made for Mang Raul because he is in the target client’s list, In what TCL should Mang Raul’s entry be documented?

A. TCL Eligible Population
B. TCL Family Planning
C. TCL Nutrition
D. TCL Pre Natal

68. The nurse uses the FHSIS Record system incorrectly when she found out that

A. She go to the individual or FTR for entry confirmation in the Tally/Report Summary
B. She refer to other sources for completing monthly and quarterly reports
C. She records diarrhea in the Tally sheet/Report form with a code FHSIS/M-1
D. She records a Child who have frequent diarrhea in TCL : Under Five

69. The BHS Is the lowest level of reporting unit in FHSIS. A BHS can be considered a reporting unit if all of the following are met except

A. It renders service to 3 barangays
B. There is a midwife the regularly renders service to the area
C. The BHS Have no mother BHS
D. It should be a satellite BHS

70. Data submitted to the PHO is processed using what type of technology?

A. Internet
B. Microcomputer
C. Supercomputer
D. Server Interlink Connections

SITUATION : Community organizing is a process by which people, health services and agencies of the community are brought together to act and solve their own problems.

71. Mang ambo approaches you for counseling. You are an effective counselor if you

A. Give good advice to Mang Ambo
B. Identify Mang Ambo’s problems
C. Convince Mang Ambo to follow your advice
D. Help Mang Ambo identify his problems

72. As a newly appointed PHN instructed to organize Barangay Baritan, Which of the following is your initial step in organizing the community for initial action?

A. Study the Barangay Health statistics and records
B. Make a courtesy call to the Barangay Captain
C. Meet with the Barangay Captain to make plans
D. Make a courtesy call to the Municipal Mayor

73. Preparatory phase is the first phase in organizing the community. Which of the following is the initial step in the preparatory phase?

A. Area selection
B. Community profiling
C. Entry in the community
D. Integration with the people

74. the most important factor in determining the proper area for community organizing is that this area should

A. Be already adopted by another organization
B. Be able to finance the projects
C. Have problems and needs assistance
D. Have people with expertise to be developed as leaders

75. Which of the following dwelling place should the Nurse choose when integrating with the people?

A. A simple house in the border of Barangay Baritan and San Pablo
B. A simple house with fencing and gate located in the center of Barangay Baritan
C. A modest dwelling place where people will not hesitate to enter
D. A modest dwelling place where people will not hesitate to enter located in the center of the community

76. In choosing a leader in the community during the Organizational phase, Which among these people will you choose?

A. Miguel Zobel, 50 years old, Rich and Famous
B. Rustom, 27 years old, Actor
C. Mang Ambo, 70, Willing to work for the desired change
D. Ricky, 30 years old, Influential and Willing to work for the desired change

77. Which type of leadership style should the leaders of the community practice?

A. Autocratic
B. Democratic
C. Laissez Faire
D. Consultative

78. Setting up Committee on Education and Training is in what phase of COPAR?

A. Preparatory
B. Organizational
C. Education and Training
D. Intersectoral Collaboration
E. Phase out

79. Community diagnosis is done to come up with a profile of local health situation that will serve as basis of health programs and services. This is done in what phase of COPAR?

A. Preparatory
B. Organizational
C. Education and Training
D. Intersectoral Collaboration
E. Phase out

80. The people named the community health workers based on the collective decision in accordance with the set criteria. Before they can be trained by the Nurse, The Nurse must first

A. Make a lesson plan
B. Set learning goals and objective
C. Assess their learning needs
D. Review materials needed for training

81. Nurse Budek wrote a letter to PCSO asking them for assistance in their feeding programs for the community’s nutrition and health projects. PCSO then approved the request and gave Budek 50,000 Pesos and a truckload of rice, fruits and vegetables. Which phase of COPAR did Budek utilized?

A. Preparatory
B. Organizational
C. Education and Training
D. Intersectoral Collaboration
E. Phase out

82. Ideally, How many years should the Nurse stay in the community before he can phase out and be assured of a Self Reliant community?

A. 5 years
B. 10 years
C. 1 year
D. 6 months

83. Major discussion in community organization are made by

A. The nurse
B. The leaders of each committee
C. The entire group
D. Collaborating Agencies

84. The nurse should know that Organizational plan best succeeds when

1. People sees its values
2. People think its antagonistic professionally
3. It is incompatible with their personal beliefs
4. It is compatible with their personal beliefs

A. 1 and 3
B. 2 and 4
C. 1 and 2
D. 1 and 4

85. Nurse Budek made a proposal that people should turn their backyard into small farming lots to plant vegetables and fruits. He specified that the objective is to save money in buying vegetables and fruits that tend to have a fluctuating and cyclical price. Which step in Community organizing process did he utilized?

A. Fact finding
B. Determination of needs
C. Program formation
D. Education and Interpretation

86. One of the critical steps in COPAR is becoming one with the people and understanding their culture and lifestyle. Which critical step in COPAR will the Nurse try to immerse himself in the community?

A. Integration
B. Social Mobilization
C. Ground Work
D. Mobilization

87. The Actual exercise of people power occurs during when?

A. Integration
B. Social Mobilization
C. Ground Work
D. Mobilization

88. Which steps in COPAR trains indigenous and informal leaders?

A. Ground Work
B. Mobilization
C. Core Group formation
D. Integration

89. As a PHN, One of your role is to organize the community. Nurse Budek knows that the purposes of community organizing are

1. Move the community to act on their own problems
2. Make people aware of their own problems
3. Enable the nurse to solve the community problems
4. Offer people means of solving their own problems

A. 1,2,3
B. 1,2,3,4
C. 1,2
D. 1,2,4

90. This is considered the first act of integrating with the people. This gives an in depth participation in community health problems and needs.

A. Residing in the area of assignment
B. Listing down the name of person to contact for courtesy call
C. Gathering initial information about the community
D. Preparing Agenda for the first meeting

SITUATION : Health education is the process whereby knowledge, attitude and practice of people are changed to improve individual, family and community health.

91. Which of the following is the correct sequence in health education?

1. Information
2. Communication
3. Education

A. 1,2,3
B. 3,2,1
C. 1,3,2
D. 3,1,2

92. The health status of the people is greatly affected and determined by which of the following?

A. Behavioral factors
B. Socioeconomic factors
C. Political factors
D. Psychological factors

93. Nurse Budek is conducting a health teaching to Agnesia, 50 year old breast cancer survivor needing rehabilitative measures. He knows that health education is effective when

A. Agnesia recites the procedure and instructions perfectly
B. Agnesia’s behavior and outlook in life was changed positively
C. Agnesia gave feedback to Budek saying that she understood the instruction
D. Agnesia requested a written instruction from Budek

94. Which of the following is true about health education?

A. It helps people attain their health through the nurse’s sole efforts
B. It should not be flexible
C. It is a fast and mushroom like process
D. It is a slow and continuous process

95. Which of the following factors least influence the learning readiness of an adult learner?

A. The individuals stage of development
B. Ability to concentrate on information to be learned
C. The individual’s psychosocial adaptation to his illness
D. The internal impulses that drive the person to take action

96. Which of the following is the most important condition for diabetic patients to learn how to control their diet?

A. Use of pamphlets and other materials during instructions
B. Motivation to be symptom free
C. Ability of the patient to understand teaching instruction
D. Language used by the nurse

97. An important skill that a primigravida has to acquire is the ability to bathe her newborn baby and clean her breast if she decides to breastfeed her baby, Which of the following learning domain will you classify the above goals?

A. Psychomotor
B. Cognitive
C. Affective
D. Attitudinal

98. When you prepare your teaching plan for a group of hypertensive patients, you first formulate your learning objectives. Which of the following steps in the nursing process corresponds to the writing of the learning objectives?

A. Planning
B. Implementing
C. Evaluation
C. Assessment

99. Rose, 50 years old and newly diagnosed diabetic patient must learn how to inject insulin. Which of the following physical attribute is not in anyway related to her ability to administer insulin?

A. Strength
B. Coordination
C. Dexterity
D. Muscle Built

100. Appearance and disposition of clients are best observed initially during which of the following situation?

A. Taking V/S
B. Interview
C. Implementation of the initial care
D. Actual Physical examination


May 13, 2009

RP nurses, caregivers most vulnerable to 'swine flu'

MANILA, Philippines - Filipino health care workers abroad are the most vulnerable to the dreaded A(H1N1) or swine flu virus, the Philippine Embassy in London said.

“The Embassy noted that the nurses and caregivers are among the most vulnerable to possible infection as they are exposed to the virus and their resistance levels may not be strong because of long work hours. They need to take care of themselves as they take care of others," Ambassador Edgardo B. Espiritu said Tuesday.

He said the Philippine Nurses Association of UK – the largest organization of Filipino nurses in the United Kingdom – has already helped them disseminate this advisory and other local government reminders regarding the A(H1N1) outbreak.

The embassy also advised Filipinos in the United Kingdom and Ireland to take precautionary measures in light of reported cases of A(H1N1) in the both countries.

The World Health Organization has reported 18 cases of A(H1N1) in the Britain and one in Ireland. There are more than 200,000 Filipinos in the UK and 12,000 in Ireland.

The embassy instructed the Philippine honorary consulates under its jurisdiction to closely monitor and report suspected and confirmed swine flu cases involving Filipino nationals.

Filipinos who have concerns regarding the A(H1N1) outbreak may call the embassy hotline at 07802790695. - Kimberly Jane T. Tan, GMANews.TV

May 11, 2009

Cardiovascular nursing questions

Medical Surgical Nursing review materials about Cardiovascular.


Make your own Quiz!



Correct Answers

1. A home care nurse has given instructions to a client who is beginning therapy with digoxin(Lanoxin). The nurse would evaluate that the client needs reinforcement of the instructions if the client made which of the following statements?

a. " I should call the doctor if my daily pulse rate is under 60 or over 100. "
b. " If I miss a dose, I should just take two the next day. "
c. " I shouldn't change brands without asking the doctor first."
d. " The pills should be kept in the original container so that they don't get mixed up with my other medicines. "

2. A home care nurse who is visiting a client is preparing to remove a dressing from a leg ulcer, the nurse notes that the ulcer is pale and deep and is surrounded by tissue that is cool to touch. The nurse would document that the client's leg ulcer most appropriately identifies which type of ulcer?

a. A vascular ulcer
b. A venous stasis ulcer
c. An arterial ulcer
d. A stage one ulcer

3. A nurse is developing a plan of care for a client who will be admitted to the hospital with diagnosis of deep vein thrombosis (DVT) of the right leg. The nurse develops the plan expecting that the physiscian will precribe which of the following?

a. Maintain the affected leg in a dependent position.
b. Apply cool packs to the affected leg for 20 minutes every 4 hours
c. Maintain bed rest
d. Administer a narcotic analgesic every 4 hours around the clock

4. A nurse is monitoring a client with acute pericarditis for signs of cardiac tamponade. Which assessment finding would indicate the presence of this complication?

a. A pulse rate of 60 beheats per minute
b. Flat neck veins
c. Muffled or distant heart sounds
d. A blood pressure (BP) 0f 128/82 mmHg

5. A clinic nurse is providing instructions to a client with hypertension who will be taking captopril (Capoten). Which instruction would not be a component of the teaching plan?

a. Drink increased amounts of water
b. Change position slowly
c. Avoid taking hot baths or showers
d. Sit down and rest if dizziness or lightheadedness occurs

6. A nurse is providing instructions to a client with a diagnosis of hypertension about items to avoid that are high in sodium. The nurse instructs the client to avoid which of the following?

a. Cantaloupe
b. Broccoli
c. Mineral water
d. Bananas

7. A nurse is reviewing the medical record of a client transferred to the medical unit from the critical care unit. The nurse notes that the client received intraaortic balloon pump (IABP) therapy while in the critical care unit. The nurse would suspect that the client received this therapy for which the following conditions?

a. Congestive heart failure
b.Cardiogenic shock
c. Pulmonary edema
d. Aortic insufficiency

8. A nurse in the medical unit is reviewing the laboratory results of a client who has been transferred from the intensive care unit. The nurse notes that a cardiac troponin T level was drawn on the client while in the intensive care unit. The nurse determines that this test was performed to assisst in diagnosing which of the following conditions?

a. Myocardial Infarction
b. Congestive heart failure
c. Ventricular tachycardia
d. Atrial fibrillation

9. A nurse is caring for a client with cardiac disease who has been placed on cardiac monitor. The nurse notes that the client has developed atrial fibrillation and has a ventricular rate of 150 beats per minute. The nurse would next assess the client for which of the following?

a. Flat neck veins
b. Complaints of nausea
c. Complaints of headache
d. hypotension

10. A nurse is performing an assessment on a client with a diagnosis of left-sided heart failure. Which assessment would elicit specific information about the client's left-sided heart function?

a. Listening to lung sounds
b. Assessing for peripheral and sacral edema
c. Assessing for jugular vein distention
d. Monitoring for organomegaly

11. A clinic nurse is reviewing the assessment findings of a client who has been taking spironolactone (Aldactone) as a treatment for hypertension. Which of the following, if noted in the client's record, would indicate that the client is experiencing a side effects related to the medication?

a. A potassium level of 3.2 mEq/L
b. A potassium level of 5.8 mEq/L
c. Client complaints of contsipation
d. Client complaints of dry skin

12. A nurse is reviewing the electrocardiogram (ECG) rhythm strip obtained on a client with diagnosis of myocardial infarction. The nurse notes that the PR interval is 0.20 seconds. The nurse determines that this is:

a. A normal finding
b. Indicative of atrial flutter
c. Indicative of impending reinfarction
d. Indicative of atrial fibrillation

13. A nurse is documenting information in a client's chart when the ECG telemetry alarm sounds. The nurse notes that the client is in ventricular tachycardia (VT). The nurse quickly rushes to the bedside and performs which assessment first?

a. Blood Pressure
b. Cardiac rate
c. Respiratory rate
d. Responsiveness of the client

14. A left catheter is inserted into a client during cardiac surgery. The nurse is monitoring the left atrial pressure (LAP) and documents that the pressure is normal if which of the following pressure is noted?

a. 8 mm Hg
b. 15 mm Hg
c. 25 mm Hg
d. 32 mm Hg

15. A nurse is developing a plan of care for a client with varicose veins who develops skin breakdown as a result of the disorder and secondary infection. The nurse includes which of the following as a priority in the plan of care?

a. Keep the legs aligned with the heart.
b. Position the client onto the side every shift.
c. Clean the skin with alcohol every hour.
d. Elevate the legs higher than the heart.

16. A nurse is assisting in performing an arterial blood gas analysis on a client. The nurse prepares to initiate which of the following after the blood gas specimen is drawn?

a. Cover the site with 4x4 gauze
b. Apply warm packs to the site
c. Perform range of motion to the fingers of the hand
d. Apply pressure to the site

17. A nurse is caring for a client with a diagnosis of myocardial infarction (MI). The client is experiencing chest pain that is unrelieved by the administration of nitroglycerin, The nurse administers morphine to the client as prescribed by the physician. Following administration of the morphine sulfate, the nurse plans to monitor:

a. Mental status
b. Respirations and blood pressure
c. Urinary output
d. Temperature and blood pressure

18. A nurse is caring for a client with a diagnosis of myocardial infarction (MI). The client calls the nurse because the client is experiencing chest pain. The nurse administers a sublingual nitroglycerin tablet as prescribed. The chest pain is unrelieved by the nitroglycerin. The next nursing action is which of the following?

a. Administer another nitroglycerin tablet
b. Increase the flow rate of the oxygen
c. Contact the physican
d. Call the client's family

19. A nurse is performing an admission assessment of a client with a diagnosis of angina pectoris who takes nitroglycerin for chest pain at home. During the admission, the client complains of the chest pain. The nurse would immediately ask the client which of the following questions?
a. " Are you having any nausea? "
*b. "Where is the pain located?"
c. "Are you allergic to any medications?"
d. "Do you have your nitroglycerin with you?"

20. A client si going to have a cardiac catheterization to diagnose the extent of coronary artery disease. The nurse places highest priority on teaching the client to report which of the following sensations during the procedure?

a. Pressure at the insertion site
b. Urge to cough
c. Warm, flushed feeling
*d. Chest pain

21. A client admitted to the hospital with coronary artery disease complains of dyspnea at rest. A nurse caring for the client uses which of the following items as the best means to monitor respiratory status on an ongoing basis?

a. Oxygen flow meter
*b. Oxygen saturation monitor
c. Telemetry cardiac monitor
d. Apnea monitor

22. A client with a history of anginal pectoris tells the nurse that chest pain usually occurs after going up two flights of stairs or after walking four blocks. The nurse interprets that the client is experiencing which of the following types of angina?

a. Stable
b. unstable
c. Variant
d. Intractable

23. A client has experienced an episode of pulmonary edema. The nurse determines that the client's respiratory status is improving after this episode if which of the following breath sounds is noted?

a. Rales throughout the lung fields
b. Crackles in the bases
c. Wheezes
d. Rhonchi

24. A client is scheduled to begin therapy with acetazolamide (Diamox) for the management of glaucoma. Prior to the initiating therapy, the nurse assesses the client for a history of allergy or sensitivity to which of the following?

a. Corticosteroids
b. Nonsteroidal antiinflammatory agents
c. Penicillin
d. Sulfa drugs

25. A client's ECG strip shows atrial and ventricular rates of 70 complexes per minute. The P-R interval is 0.16 second, the QRS complex measures 0.06 second, and the P-R interval is slightly irregular. The nurse interprets this rhythm to be which of the following?

a. Sinus bradycardia
b. Normal sinus rhythm
c. Sinus tachycardia
d. Sinus arrythmia