Expanded Program on Immunization

SCENARIO I

Baby James, 2-months old, is scheduled for his immunization.

1. Which of the following immunization should baby James receive at his age?
a. BCG, DPT, OPV, Measles
b. BCG, DPT 2, OPV 2, MMR
c. BCG 2, DPT 2, OPV 2, Hepa B 2
d. BCG, DPT 1, OPV 1, Hepa B 1

2. What would you tell his mother if she refuses the immunization?
a. Immunization is okay for your baby
b. Vaccine is expensive, you get it free
c. It’s up to you if your baby gets sick
d. Vaccines will prevent diseases

3. Which biological used in Expanded Program on Immunization (EPI) is stored in the freezer?
a. DPT
b. Tetanus toxoid
c. Measles vaccine
d. Hepatitis B vaccine

4. During assessment, the infant’s temperature registered at 38.1°C. Which is the best course of action that you
will take?
a. Go on with the infant’s immunizations.
b. Give Paracetamol and wait for his fever to subside.
c. Refer the infant to the physician for further assessment.
d. Advise the infant’s mother to bring him back for immunization when he is well.

5. You will not give DPT 2 if the mother says that the infant had
a. Seizures a day after DPT 1.
b. Fever for 3 days after DPT 1.
c. Abscess formation after DPT 1.
d. Local tenderness for 3 days after DPT 1.

Integrated Management of Child Illness (IMCI)

SCENARIO J

A 4-month old infant named Baby Rev was brought to the health center because of cough. Her respiratory rate is 42
breaths/minute.

1. Using the Integrated Management of Child Illness (IMCI) guidelines of assessment, her breathing is considered
a. Fast
b. Slow
c. Normal
d. Insignificant
 2. Which of the following signs will indicate that Baby Rev is suffering from severe pneumonia?
a. Dypnea
b. Wheezing
c. Fast Breathing
d. Chest Indrawing

SCENARIO J 1

Mrs. Oncomelania brought Elena her 3 year old daughter to the center due to cough for 1 week, unusual irritability and
episodes of vomiting.

1. On assessment, you noted coryza, reddish posterior palate, temperature of 37.6, nagging cough and respiratory rate
of 47 breaths per minute. Using assessment, the sick child chart, Elena can be classified under:

a. Very severe disease

b.Severe Pneumonia
c.Pneumonia
d. No Pneumonia

2. Based on Elena's classification, you plan to take which of the following actions?
a.Refer Elena to the nearest hospital
b. Give the first dose of Cotrimoxazole
c. Give the first dose of procaine penicillin
d. Soothe the throat with safe remedies

3. She may present with fast breathing if her respiration is

a. 40 bpm and above
b. 50 bpm and above
c. 60 bpm and above
d. 70 bpm and above

4. If you are to provide antibiotics, which one is appropriate for Elena?

a.Procaine penicillin 800,000 IU
b. Procaine penicillin 400,000 IU
c. Cotrimoxazole BID
d. Cotrimoxazole TID

5. Your instructions to Mrs. Oncomelania include:

I. Soothe the throat with safe remedies

II. Provide sugar water or milk to prevent low blood sugar level
III. Bring her back to the center after 2 days
IV. Bring her immediately to the center if her condition worsens

a. I, II, III, IV
b. I, III, IV
c. I, II, III
d. II, III, IV
SCENARIO J 2

The WHO is concerned of the unnecessary deaths of children below 5 years old in the developing countries. IMCI is
trying to fight these unnecessary deaths.

1. According to WHO, the most common cause of death among these under 5 children is:

a. Diarrhea c. Pneumonia
b. Malaria d. Malnutrition

2. If the child has only one of the danger sign implicitly stated in the IMCI guideline, this child will be classified
under what color?
a. Pink c. Yellow
b. Blue d. Green

3. Which vital sign is important in classifying a child with pneumonia from those who do not have?
a. Temperature
b. RR
c. Stridor
d. Chest indrawing

Nutrition Program

Scenario K

Pearl a public health nurse is conducting a microteaching about nutrition to the newly hired BHW of brgy. Lapu-lapu.

1. Pearl states that the 3 major micro nutrients deficiency emphasize by the WHO are the following:
1-Vitamin A deficiency a. 1,2 and 4
2-Vitamin E deficiency b. 1,3, and 4
3-Iron deficiency anemia c. 2, 3 and 4
4-Iodine deficiency disorder d. 1, 3 and 6
5-Vitamin B deficiency
6-Protein- Energy malnutrition

2. Pearl gave examples of macro nutrients. These are:

1-Fats a. 1, 2 and 3
2-Minerals b. 2, 5 and 6
3-Vitamins c. 1, 4 and 5
4-Proteins d. 2, 3 and 4
5-Carbohydrates
6-Calories
3. Food fortification involves the addition of a micro nutrient deficient in the diet to the following:
1-Soy sauce a. All except 6
2-Catsup b. 2, 4 and 6
3-Salt c. 3 and 5
4-Margarine d. All of the above
5-MSG
6-Noodles
 4. She explains that the following are some of the best sources of vitamin A, EXCEPT

a. Malunggay
b. Breastmilk
c. Wheat bread
d. Eggs

5. Iodine deficiency disorders may result in the following EXCEPT

a. Goiter
b. Stillbirth
c. Mental retardation
d. Blindness

Control of Non-communicable diseases

Cardiovascular Diseases (Hypertension)

Scenario L

Public Health Nurse Rica was conducting a home visit in Brgy. Dao when Mang Isid approached her and requested that
his blood pressure taken. It was the first time for nurse Rica to meet Mang Isid. Upon assessment, Mang Isid blood
pressure was 150/100 mmHg.

1. Which among the following should nurse Rica do?

a. Ask Mang Isid to visit the health center after one week for further assessment, but in
the meantime, prescribe an antihypertensive drug.
b. Inform Mang Isid that he is hypertensive and prescribe antihypertensive
c. Ask Mang Isid to visit the health center for further assessment and encourage him to
practice healthy lifestyle.
d. Inform Mang Isid that he is hypertensive and encourage him to practice healthy
lifestyle.

3. After a few consecutive consultations at the health center, Mang Isid’s average blood pressure reading was
recorded at 140/90 mmHg. Nurse Rica knows that Mang Isid belongs to which category?
a. Normal blood pressure
b. Prehypertension
c. Hypertension, stage 1
d. Hypertension, stage 2

4. Nurse Rica is careful in choosing the equipment that will be used in BP taking. She knows very well that a BP
cuff that is too narrow will lead too.
a. False low systolic reading
b. False high diastolic reading
c. False low reading
d. False high reading

5. Nurse Rica taught Mang Isid lifestyle modification to help manage his hypertension. This includes a dietary
sodium inatake of less than.
a. 3 grams NaCl
b. 6 grams NaCl
c. 9 grams NaCl
d. 12 grams NaCl
5. Mang Isid asked if he could still drink beer with his friends especially during occasions. Nurse Rica informed Mang Isid
that the recommended dietary intake of regular beer should not exceed.
a. 1 bottle
b. 2 bottles
c. 3 bottles
d. 4 bottles

Cerebrovascular Disease or Stroke

Scenario M

A cerebrovascular disorder is an umbrella term that refers to a central nervous system functional abnormality due to the
disruption of the normal blood supply in the brain. CVA is the primary cerebrovascular disorder in the world. Stroke is
divided into two major categories: Ischemic and Hemorrhagic.

1. Mang Isid’s hypertension is the major risk factor identified in

a. Ischemic stroke
b. Hemorrhagic stroke
c. Both of these
d. Neither of these

2. Ischemic stroke is the most common type. Which of the following is the common symptom of
Ischemic stroke?
a. Exploding headache
b. Decreased level of consciousness
c. Tinnitus and dizziness
d. Numbness or weakness of the face, arm or leg, especially on one side of the body

3. Obesity is a risk factor for stroke. The recommended Body Mass Index ranges from 18.5kg/m2 to:
a. 19.9 kg/m2
b. 22.9 kg/m2
c. 24.9 kg/m2
d.29.9 kg/m2

Coronary Artery Disease

Scenario N

Student nurse Lena is studying Coronary artery disease. CAD is fast emerging as a cause of morbidity and mortality
among Filipinos.

1. Lena knows that the following are modifiable risk factors of CAD. Which of these are the major risk factors according
to studies?
1-Hypertension a. 1,2,3 and 4
2-Lack of exercise b. 1,3,5 and 7
3-High cholesterol c. 2,4,6 and 8
4-Personality d. 3,4,5 and 6
5-Cigarette smoking, tobacco use
6-Obesity
7-Diabetes Mellitus
8-High coagulability of the blood
 2. High cholesterol level is a risk factor in CAD. Screening for elevated blood levels of cholesterol
involves taking a small sample of blood and testing for total blood cholesterol. Which among the following
responsibilities should student nurse Lena bear in mind when doing this procedure?
a. Lena should ensure that the client has not eaten any food or has taken any drinks with calories for at
least eight hours prior to testing.
b. Lena should allow the intake of water prior to testing.
c. Lena should encourage the client to increase intake of water prior to testing.
d. Lena should ensure that the client has not eaten any food or has taken any drinks with calories for
at least four hours prior to testing.

3. Lena understands that in order to achieve the desired blood cholesterol levels, the goal is to have:
a. High LDL values and LOW HDL values
b. High LDL values and High HDL values
c. Low LDL values and High HDL values
b. Low LDL values and Low HDL values

CANCER
Scenario O

With the increasing prevalence of cancer in the country, the best alternative to treatment remains to be prevention.
The following conditions apply.

1. Which among the following is the primary focus of the prevention of cancer?
a. Elimination of conditions causing cancer
b. Diagnosis and treatment
c. Treatment at early stage
d. Early detection

2. In the prevention and control of cancer, which of the following activities is the most
important function of the community health nurse?
a. Conduct of community assemblies
b. Referral of clients with symptoms of cancer to cancer specialists
c. Use of the 9 warning signs of cancers as parameters in the process of detection,
control, and treatment
d. Teaching women about proper or correct nutrition

KAR: Safe and Quality Nursing Care

3. Who among the following are recipients of secondary level of care for cancer cases?
a. Those under post care treatment
b. Those under early case detection
c. Those scheduled for surgery
d. Those undergoing treatment

4. Who among the following are recipients of the tertiary level of care for cancer cases?
a. Those under early treatment
b. Those under supportive care
c. Those under early case detection
d. Those scheduled for surgery of a localized mass
Diabetes Mellitus
Scenario P

Nurse Angel is preparing for a home visit to her TYPE 2 diabetic patient, Aling Tonya.

1. Nurse Angel knows very well that all of the following are risk factors for diabetes, EXCEPT
a. Obesity
b. Age 35 y.o and above
c. Hypertension
d. HDL cholesterol level less than 35 mg/dl

2. Nurse Angel wanted to correct aling tonya’s misconceptions regarding diabetes. Which among the following also
needs to be corrected?
a. Diabetes is a serious chronic cardiovascular disease characterized by an increase in blood sugar levels.
b. Diabetes occurs when insulin is not adequately produced by the pancreas.
c. Diabetes also happens when the body cannot properly use insulin.
d. Diabetes mellitus is characterized by hyperglycemia.

3. Nurse Angel started talking about the five components of diabetes management. These include the following EXCEPT
a. Pharmacologic therapy
b. Nutrition management
c. Exercise
d. Reduced smoking

4. Diet and weight control constitute the foundation of Diabetes management. Which of the following should Not Be
Included among the things that nurse Angel should discuss with aling Tonya?
a. Avoid simple sugar like cakes and chocolates
b. Consume complex carbohydrates like rice, pasta, cereals and fresh fruits
c. Eat more fiber rich foods like vegetables
d. Balance salt and sugar intake

5. Exercise lowers blood glucose by increasing the uptake of glucose by muscles and by improving insulin utilization.
Which among the following should be included in the general precautions for aling Tonya during exercise?
a. Use protective devices such as rubber boots to avoid injury to the foot
b. Exercise only during cold weather to promote comfort
c. Always carry quick sugar sources like candy or soft drinks to avoid hypoglycemia
d. Inspect foot daily for callous after exercise

Chronic Obstructive Pulmonary Disease

Scenario Q
Leo,a community health nurse at Brgy. Atiplo conducts monthly home visits to his COPD clients. During assessment
Mang Anton complains of coughing, fatigue, and sputum production.

1. Nurse Leo notes the barrel chest that is common in COPD patient. Which evaluation best explain these signs and
symptoms?
a. Ruptured bleb of the lung
b. Presence of an infection in the lung
c. An acute attack of asthma
d. Excessive residual volume of trapped air in the lung
2. An initial assessment of Mang Anton reveals a potential complication. It is:
a. He has never smoked cigarettes
b. His respiratory rate is 20 breaths/min
c. His wife smokes 2 packs of cigarettes a day
d. His hemoglobin is 16 gms/100 ml

3. Nurse Leo instructs Mang Anton to breathe:

a. At an increase rate within comfortable limits
b. With an open mouth during inspiration
c. While pursing lips during expiration
d. With an increased time of inspiration

4. During assessment, which breath sounds does nurse Leo hear in Mang Anton who is diagnosed with
emphysema?
a. rhonchi and expiratory wheezing
b. crackles and expiratory wheezing
c. rhonchi and inspiratory wheezing
d. no sounds related to alveoli destruction

5. In teaching Mang Anton about his disease, nurse Leo is aware that certain changes in the lungs are characteristic of
emphysema. The pathophysiology involves alveolar sacs that:

a. Are fibrotic
b. Collapse
c. Are filled with fluid
d. Are filled with CO2

Bronchial Asthma
Scenario R

Lito who diagnosed to have asthma is producing thick, white secretions. Visited the health center for further
management.

1. Which of the following nursing measures would be most appropriate for the nurse to include in her plan of care?
a. Increased fluid intake
b. Promote exercise
c. Administer oxygen
d. Encourage coughing

2. Which of the following comments by Lito indicates the need for additional teaching?

a. “ I’LL buy hypoallergenic bed pillows.”

b. “ I’LL dust and vacuum the house frequently.”
c. “I,LL slep with the windows open.”
d. “ I’LL stop this infecting my room with aerosol sprays.”

3. Lito says to the nurse, “ if you give me a cigarette, I’ll go to group therapy.”Which of the following responses by the
nurses would be therapeutic?
a. “here are your cigarettes.”
b. “ All clients in this brgy. are expected to go to group therapy.”
c. “ you can have 1 cigarette, then you must go to group therapy.”
d. “ other clients do not ask me for special treatment. Why are you the only one?”