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Iloilo Doctors College

College of Nursing
FINAL EXAMINATION
Competency Appraisal 1
Nursing Practice 2
(CHN)
SY 2013 2014
Instructions:
1. Use Mongol Pencil No. 2 for shading. (All pencils must be sharpened and ready for use before
the examination)
2. Use the recommended answer sheet for C. A. examination. Properly fill-up the data needed in
the front cover.
3. Shade the circle of the corresponding letter of the correct answer. (full shading)
4. Never erase your answer.
5. Put off all cellphones.
6. Only calculators are allowed for computations.
7. All bags and other things must be placed at the back or in the front. Keep your valuables in your
pockets.
8. Listen to any instructions and corrections
MULTIPLE CHOICE (50 ITEMS)
SITUATION 1. (1-5) Nurse Gaurana is the new PHN in the town of Culasi, Antique. She just had her
license and IV therapy training and completion and very excited about his new job.
1. As a nurse, Nurse Gaurana can perform very well all of these functions presented. What is not
included as a PHN?
A. Assist in home deliveries
B. Perform Leopolds maneuver at the home settings
C. Conduct lectures on the importance of prenatal visits
D. Suture 2
nd
degree vaginal laceration during deliveries.

2. He is fully aware that one of the following statements is not true.
A. All public health nurses are employed by the government
B. All public health nurses provide care in public health settings
C. All community health nurse are employed by the government
D. All community health nurse provides care in the community setting



3. Which of the following is correct about CHN concept?
A. The goal of CHN is achieved through sectoral efforts.
B. In CHN, the client is considered as a passive recipient of care and not an active
partner
C. CHN is independent from the health care system and the larger human services
system
D. CHN practice is affected by development in health technology in particular and
changes in society in general society

4. On the other hand, she had reports on the rampant drug addiction and substance abuse among
the out of school youth in the whole municipality. These groups dont care about themselves
and their behavior according to the parents if they indulge in substance abuse. She was asked to
be a resource person for this group by the local PNP. What will be the focus of her topic in
relation to this community health problem identified?
A. School health
B. Mental health
C. Personal hygiene
D. Responsible youth

5. Nurse Gaurana recalled her concepts on mental health and mental health disorders based on
the concept and definition of the WHO. Mental health problems have four (4) facets as a public
health burden. Most of the cases reported comes from families that has difficulty to accept that
their family member is under substance abuse. They are either rejected or considered as a
disgrace to the family. How will Nurse Gaurana classify this condition?
A. Defined burden
B. Undefined burden
C. Hidden burden
D. Future burden
Situation 2. (6-11) The family is a basic unit of society. It means that families are components of a
community. Health problem of an individual affects the health of the family while health problems of
groups of families will become community health problems.
6. Home visit allows the health worker to assess the home and family situation. What are the
guidelines that a PHN has to follow regarding frequency of home visits? Select all that apply.
A. A home visit must have a purpose or an objective
B. There is no definite rule to be followed
C. The schedule may vary according to the patient/family needs
D. In planning for a visit, one should consider the familys priority.



7. What will come first among the choices in conducting home visits?
A. Perform nursing care needed and give health teachings
B. Put the bad in a convenient place and perform bag technique
C. Observe the patient and determine the health needs
D. Perform health assessment/physical examination

8. In family assessment, a health problem becomes a nursing problem once it is modified by
nursing interventions. What is your tool to determine the presence of any health problem in the
family?
A. Initial data base for family nursing practice
B. Typology of nursing problem
C. Scale for ranking of health problems
D. Family coping index

9. The family of Antonio Lagdameo is one of the families in Brgy. Kauswagan. He is a regular
construction worker who earns P2, 000/6 days with one day off/week. His wife has a small sari-
sari store that earns P300/day as gross income. They have two children aging 5 months and 5
yrs. old. She is on exclusive breastfeeding and children were immunized. Assessing this family,
how will you categorize the health problem presented?
A. Wellness state
B. Health threat
C. Health deficit
D. Foreseeable crisis

10. Looking into the community data of your RHM in this barangay, you found out that 35% of
married couples of reproductive age (MCRA) do not practice family planning and responsible
parenthood. How will you categorize this health problem when you compute it for ranking the
priorities?
A. Nature of the problem
B. Magnitude of the problem
C. Modifiability of the problem
D. Preventive potential
E. Salience

11. You and your PHN did an ocular survey of the barangay and you have observed that most of the
households do not maintain the cleanliness of the surroundings. How will you classify this as a
community health problem?
A. Wellness state
B. Health status
C. Health resources
D. Health related

Situation 3. (12-15) Accurate recording and reporting health data is one responsibility of a PHN. The
PHN documents pertinent health data utilizing DOH forms.

12. What is the use of vital statistics in determining the health status of the community?
A. It serves as indices of health and illness in the community
B. It is used to search causes of health and disease
C. It helps to study the work of health services to improve them
D. It diagnose the health of the community & condition of people

13. Field Health Services and Information System (FHSIS) provide summary data on health services
delivery and selected program accomplished indicators at the barangay level up to the national
level. What is considered as the fundamental building block or foundation of FHSIS?
A. Output reports
B. Reporting forms
C. Target client list
D. Treatment record

14. Nurse Gaurana prepared her yearly and report last November 2012 regarding 0-6 years old
children for immunization and TB clients receiving Short Course Therapy this year(2014).She is
PHN of the municipality Sta. Barbara. What record did she use?
A. FHSIS Report
B. Treatment Record
C. Target client list
D. Tally Sheet
15. Where will Nurse Gaurana submit all her FHSIS report?
A. District Hospital of same municipality
B. Provincial Health Office
C. City Health Office
D. Regional health Office

Situation 4. (16-23) Integrated Management of Childhood Illness is a one-package deal to strengthen
the provision of comprehensive and essential health package to the children.

16. Baby Frank, 10 months old was brought to the health center for consultation because of fever
and cough. You suspect that he has respiratory infection. When assessing Baby Frank, which of
the following is/are danger signs to observe?

1. Did Baby Frank experience convulsions In the course of his illness?
2. Is he able to drink/breastfeed?
3. Did he vomit everything taken in?
4. Is abnormally sleepy
A. 1 & 4 C. All except 4
B. 2 & 3 D. All of the above

17. In this condition, it is important to assess his respirator status. You started to assess his
breathing. How would you consider it as fast breathing?
A. If her respiratory rate is 20 breaths/minute or more
B. If her respiratory rate is 40 breaths/minute or more
C. If her respiratory rate is 50 breaths/minute or more
D. If her respiratory rate is 60 breaths/minute or more

18. His respiratory rate is 40 breaths/min. This indicates that Baby Frank is classified as having:
A. very severe disease
B. severe pneumonia
C. pneumonia
D. no pneumonia: cough or cold

19. You further assess Baby Frank and found out that he has generalized rashes from hairline, chest,
back and her lower extremities. They are not living in a malaria or dengue risk area. With this, he
can be classified as having:
A. Fever: Malaria unlikely
B. Measles
C. Fever: DHF unlikely
D. Generalized allergy

20. A mother came in with her 18 months old child with diarrhea for 2 days. The PHN is assessed
Mark using the IMCI chart. Persistent diarrhea may be classified if Mark has:
A. 14 days or more diarrhea with no dehydration
B. 14 days or more with dehydration
C. 7 days or more without dehydration
D. 7 days or more with dehydration

21. Mark has some palmar pallor, and weak. What treatment is inappropriate in his condition?
A. Powderized & give mebendazole as a single dose
B. Follow-up in 7 days
C. Give ferrous sulfate for 14 days
D. Continue BF and adequate family food

22. The PHN Nurse assessed Mark for ear problem. She recommended immediate treatment plan
for chronic ear pain. This includes all but one of the following choices:
A. Instill quinolone otic drops for 2 weeks
B. Give paracetamol for pain
C. Dry ear by wicking
D. Follow up in 5 days

23. To make a sugar water solution, it is recommended to, do one of the following:
A. Dissolve 1 tablespoon sugar with 1 teaspoon salt and a glass of drinking water
B. Dissolve 4 level teaspoons sugar with a 200 mL cup of clean water
C. Dissolve 2 teaspoons sugar (20 gms.) in glass of mineral water
D. Dissolve 1 tablespoon of sugar in a cup of drinking water

Situation 5. (24-28) The DOH has a lot of priority programs for the elderly, disabled, blood and organ
donations, accessibility of medicines for the community and disaster preparedness.

24. Citadel wishes to donate her organ if she dies. She asked you the qualification of being an organ
donor. What will be your appropriate response?
A. She should have an organ donor card or a drivers license stating her intention to be
an organ donor when she dies
B. She should be 18 yrs. of age or older with parental/spouse consent
C. She should be declared of brain death by a neurologist or attending physician
D. Consent for donation from the nearest kin in the absence of donor card

25. What health program is provided by the DOH for self-development and self-reliance of
disabled/handicapped persons?
A. Program for Disabled Persons
B. Bahay na Walang Hagdan Program
C. Golden Acres Rehabilitation Program
D. Community-Based Rehabilitation Program

26. The goal of this project is to promote equity in health by ensuring the availability and
accessibility of affordable but safe and effective quality essential drugs to all with priority for
marginalized, underserved, critical and hard to reach areas?
A. Gamot na Mura sa Abot Kaya at 50% discount (GMA 50)
B. Primary Health Care
C. Botika sa Barangay
D. Alternative Health Care (Herbal Medicine)

27. Health education is a responsibility of a Community Health Nurse. How will you know that your
health teaching is ineffective to your blood donor client? Select all that apply:
A. Ill take small frequent feedings with more fluid intake.
B. Ill take the adhesive dressing after 6 hours.
C. Im not going to use both arms to carry heavy loads/subjects.
D. Ill not smoke for the next 2 hours and avoid alcohol drink for the next 12 hours.

28. Disaster and Health Emergency Management has principles to follow when they respond in
times of disaster, calamity or emergency. PHNs are involved in this if there is occurrence in their
place of assignment. What will your first priority be as stapled in the general principles?
A. Dead individuals must be retrieved immediately
B. Protection of critical resources & systems
C. Identify population who are at risk
D. Refer calamity incident

Situation 6. (29-31) The DOH is the leader, staunch advocate and model in promoting Health for all in
the Philippines is the departments vision. This can only be met through its mission that will guarantee
equitable, sustainable and quality health for all Filipinos.


29. In relation to this, what is the overriding goal of DOH?
A. Health Sector Reform Agenda
B. FOURmula ONE for Health
C. Millennium Development Goals
D. Universal Health Care

30. There are 8 Millennium Development Goals. Among the choices, what is not health related?
A. Eradicate extreme poverty and hunger
B. Promote gender equality and empower women
C. Ensure environmental sustainability
D. Develops a global partnership for development

31. FOURmula ONE for Health has four elements of the strategy. What refers to the goal of ensuring
the quality and affordability of health goods and services?
A. Health financing
B. Health service facility
C. Good governance
D. Health regulation
Situation 7. (32-33) Family planning is part of the reproductive health and family health programs.
32. Taking of oral contraceptives as FP method are usually practiced by most mothers. What is the
disadvantage of using this among the choices?
A. It suppresses lactation
B. It is high risk for ovarian cancer
C. It increases susceptibility to endometrial cancer
D. It enhances dysmenorrheal and endometriosis
33. The use of LAM (Lactation amenorrhea method) has criteria to follow if a mother wants this
method or FP. All but one are in the criteria:
A. Absence of menstruation
B. Infant is less than 6 months
C. Uses other methods like use of condom
D. Exclusive BF
E. Take body temp. regularly
Situation 8. (34-38) According to the WHO, the Philippines rank 4
th
in the world for the number of cases
of PTB.
34. Mang Kanor came to the RHU with a chief complaint of cough for 4 weeks. The Community
Health Nurse knows that he is a PTB symptomatic if he has any of the following signs:
A. Fever, tiredness, back pain, progressive weight loss
B. Hemoptysis, chest pain, loss of appetite, night sweats
C. Muscle pain, back pain, blood-streaked sputum, tiredness
D. Hematemesis, muscle pain, fever, loss of appetite

35. A PTB smear positive patient should have the following criteria. Which of this is not considered
as smear positive patient?
A. A patient with at least 2 (+) sputum for AFB with or without chest x-ray
abnormalities consistent with active PTB
B. A patient with 1 (+) sputum for AFB and with chest x-ray abnormalities determined
by a doctor consistent with active PTB
C. A patient with 1 (+) sputum for AFB and with sputum culture for M. tuberculosis
D. A patient with negative results for 3 consecutive sputum exam and with chest x-ray
abnormalities

36. Mang Kanor was diagnosed to be a new seriously Ill-smear negative case with extensive
parenchymal involvement. How will the CHN nurse categorize him for treatment regimen?
A. Category I C. Category III
B. Category II D. Category IV

37. Preventing of PTB is still better than cure. Which of the following statements regarding
prevention is incorrect?
A. Coughing exercises improve ventilation in the lungs, thus preventing TB
B. Improvement of ventilation in houses is a simple method of preventing TB
C. Chlorox liquefies sputum and kills TB bacilli rapidly, thus this is recommended in
cleaning glass wares
D. Direct sunlight kills TB bacilli within 5 minutes, the exposure of blankets and towels
to sunlight are recommended

38. Mang Kanor is under PTB-DOTS therapy. The CHN nurse give instruction to him how to take it
and what are the possible drug reactions to watch out for. One of the side effects is peripheral
neuropath. Which among the anti-TB drugs may be responsible for this?
A. Pyrazinamide C. Ethambutol
B. Isoniazid D. Rifampicin
Situation 9. (39-43) Cancer, Cardiovascular disease, COPD and Diabetes are major concerns of the DOH
among the Filipino population. They are four major non-communicable diseases that are prevalent in
the Philippines according to the DOH statistics. Added non-CD that is increasing in number of cases is
bronchial asthma.
39. There are approaches made by the DOH to achieve significant reduction in mortality and
morbidity from major non-CDs. What approach refers to focuses on the primary prevention as in
prevention of emergence of risk factors and specific protection from non-CD by removal of risk
factors?
A. Community-based Approach
B. Integrated Approach
C. Primordial Approach
D. Comprehensive Approach

40. What are the key for prevention of stroke?
1. Smoking and control of hypertension
2. Avoid intravenous drug abuse and cocaine
3. Smoking cessation
4. Limit alcohol consumption to 2 drinks/day among women
5. Prevent all other risk factors of atherosclerosis


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

41. Cancer is believed to be caused by damaged DNA due to exposure from toxic substances in the
environment. What are these?
1. benzopyrene 3. radiation
2. viruses 4. Nitrosamines

A. 1, 2, 3, 4 C. 1 only
B. All except 2 D. 3 only

42. How can you prevent cancer?
1. control obesity
2. increase intake of high fiber foods
3. limit consumption of smoke or grilled food
4. avoid moldy foods

A. 1& 2 only C. all except 3
B. 1, 2, 3 only D. 1, 2, 3, 4

43. What are environmental factors that may trigger bronchial asthma according to data of DOH?
Select all the apply.
A. Parasitic infections
B. Obesity
C. Occupational sensitizers
D. Respiratory infections
E. Family size
Situation 10. (44-47) Diseases of the heart is the top most leading cause of death followed by vascular
diseases among Filipinos since 2002. This mainly due to hypertension, coronary heart disease and stroke
according to the DOH documented statistics.
44. Which of the following are considered as modifiable risk factors for coronary artery disease
(CAD)? Select all that apply.
A. Hypertension D. smoking
B. High cholesterol E. gender
C. Lack of estrogen (women)

45. To achieve the desired blood cholesterol levels, you will inform the high risk patient to achieve
what range of values?
A. High LDL, low HDL values
B. High LDL, high HDL values
C. Low LDL, high HDL values
D. Low LDL, low HDL values



46. High cholesterol level is a risk factor in cardiovascular diseases. Screening for elevated blood
levels of cholesterol involves taking small sample of blood and testing for total blood
cholesterol. Which among the following responsibilities should the nurse bear in mind when
doing this procedure?
A. Nurse should allow the intake of water prior to testing
B. Nurse should encourage the client to increase intake of water prior to testing
C. Nurse should ensure that the client has not eaten any food or drinks with calories 4
hours prior to testing
D. Nurse should ensure that the client has not eaten any food or drinks with calories 8
hours prior to testing

47. What will be the appropriate diet for patient with cardiac disease?
A. High fiber, low cholesterol, iodized salt
B. Low fat, low sodium, high fiber
C. Low sodium, low CHO soft diet
D. Low sodium, low calorie, low CHO

48. Good attachment in breastfeeding of a young infant is shown on the following, except:
A. Chin touching the lower upper areola
B. Mouth wide open
C. Lower lip turned down
D. More areola visible above than below the mouth

49. What are the sings that may classify a sick infant with jaundice?
A. Any jaundice if age is less than 24 hours
B. Jaundice appears after 24 hours
C. Palms and soles are yellow a day after
D. Jaundice anytime and yellow palms & soles

50. What is new treatment for dysentery?
A. Nalidixic acid
B. Tetracycline
C. Ciprofloxacin
D. Amoxicillin



Prepared by:
Noted by:
Ma. Rafaela Corazon Anerdis, RN, MSN Ma. Josephine B. Provido, RN, MAN

Jerry V. Able, RN, MAN

Ruby A. Leccio, RN, MN