PHILIPPINE NURSING LICENSURE EXAM (PNLE)

TEST BANK
NURSING PRACTICE I: COMMUNITY HEALTH NURSING (100 QUESTIONS)

Fundamentals of Community Health Nursing

1. Which level of prevention is exemplified by a community health nurse providing
immunization to children in a barangay?
A. Primary prevention
B. Secondary prevention
C. Tertiary prevention
D. Quaternary prevention
Rationale: The correct answer is A. Primary prevention focuses on preventing disease before it
occurs through measures such as immunization, health education, and environmental sanitation.
Secondary prevention involves early detection and prompt treatment. Tertiary prevention aims
to reduce complications and disabilities. Quaternary prevention refers to avoiding unnecessary
medical interventions.
2. A nurse is conducting a community health needs assessment. Which of the following data
collection methods would best capture the community's perceived health needs?
A. Review of hospital records
B. Focus group discussions
C. Analysis of mortality statistics
D. Observation of community infrastructure
Rationale: The correct answer is B. Focus group discussions directly engage community
members to express their perceived health needs and priorities. Hospital records (A) provide
information about treated conditions but not perceived needs. Mortality statistics (C) show
causes of death but not perceived needs. Observational assessment (D) provides objective data
about the environment but not community perspectives.
3. Which of the following community organizing approaches emphasizes community
empowerment and collective action to address social determinants of health?
A. Medical model
B. Social action model
C. Locality development model
D. Planning model
Rationale: The correct answer is B. The social action model emphasizes community
empowerment and collective action to address social inequities and determinants of health. The
medical model (A) focuses on curative approaches. The locality development model (C) builds
community capacity but doesn't necessarily focus on social determinants. The planning model
(D) emphasizes systematic program development.
4. A nurse working in a rural community notices increasing cases of malnutrition among
children. Which of the following interventions demonstrates the PRIMARY HEALTH CARE
principle of appropriate technology?
A. Referring all cases to the tertiary hospital
B. Teaching mothers to prepare nutritious meals using locally available foods
C. Advocating for imported food supplements
D. Implementing a complex nutritional assessment protocol
Rationale: The correct answer is B. Appropriate technology in primary health care involves using
methods that are practical, acceptable, and affordable within local contexts—such as utilizing
locally available foods. Options A and C rely on external resources rather than building local
capacity. Option D introduces unnecessary complexity.
5. Which of the following statements correctly describes the concept of community as partner
in health care?
A. The community passively receives health services
B. The community participates in identifying problems and developing solutions
C. Health professionals make all decisions regarding community health
D. Community members follow instructions from health professionals
Rationale: The correct answer is B. The community-as-partner model views the community as
an active participant in identifying health issues and developing solutions, not as passive
recipients (A). Options C and D describe authoritative approaches that do not recognize
community partnership and autonomy.

Epidemiology and Public Health

6. A community health nurse is investigating a sudden increase in diarrheal cases in a
community. This represents which type of epidemiologic study?
A. Case-control study
B. Cohort study
C. Cross-sectional study
D. Outbreak investigation
Rationale: The correct answer is D. An outbreak investigation examines a sudden increase in
disease occurrence above expected levels. A case-control study (A) compares individuals with
a condition to those without it. A cohort study (B) follows groups over time to determine disease
development. A cross-sectional study (C) examines prevalence at a specific point in time.
7. Which of the following best describes the concept of herd immunity?
A. Individual immunity against disease
B. Immunity developed through vaccination
C. Protection of susceptible individuals when a large portion of the population is immune
D. Immunity transferred from mother to infant
Rationale: The correct answer is C. Herd immunity occurs when a significant portion of a
population becomes immune to a disease, thereby providing indirect protection to those who are
not immune. Individual immunity (A) refers to a single person's resistance. Option B describes
active immunity. Option D describes passive immunity.
8. In calculating the infant mortality rate of a municipality, which formula is correct?
A. (Number of infant deaths / Number of live births) × 1,000
B. (Number of infant deaths / Total population) × 1,000
C. (Number of infant deaths / Number of children under 5) × 1,000
D. (Number of infant deaths / Number of pregnant women) × 1,000
Rationale: The correct answer is A. Infant mortality rate is calculated by dividing the number of
deaths of infants under one year old by the number of live births in the same year, multiplied by
1,000. Options B, C, and D use incorrect denominators, which would result in different rates.
9. A nurse is analyzing disease patterns in a community and notes that dengue fever occurs
year after year with higher cases during rainy seasons. This pattern is best described as:
A. Epidemic
B. Pandemic
C. Endemic with seasonal variation
D. Sporadic
Rationale: The correct answer is C. Endemic with seasonal variation describes a disease that is
constantly present in a population but shows predictable increases during certain seasons. An
epidemic (A) is a sudden increase above expected levels. A pandemic (B) involves multiple
countries or continents. Sporadic cases (D) occur irregularly and infrequently.
10. When analyzing the link between smoking and lung cancer, which type of epidemiologic
association is being studied?
A. Direct causation
B. Risk factor association
C. Coincidental relationship
D. Reverse causality
Rationale: The correct answer is B. Smoking is a risk factor that increases the probability of
developing lung cancer, but it's not a direct 100% causative agent (A). The relationship is not
coincidental (C) as it has been established through numerous studies. Reverse causality (D)
would imply lung cancer causes smoking, which is incorrect.

Environmental Health
11. Which of the following is the primary purpose of proper waste segregation in communities?
A. To generate income for waste collectors
B. To reduce waste volume and facilitate recycling
C. To comply with government regulations only
D. To create jobs in the waste management sector
Rationale: The correct answer is B. The primary purpose of waste segregation is to reduce the
volume of waste going to landfills and to facilitate recycling and proper disposal. While it may
also create economic opportunities (A, D) and comply with regulations (C), these are secondary
benefits, not the primary purpose.
12. A nurse assessing a community's water supply should be most concerned with which of the
following findings?
A. Water that appears slightly cloudy
B. Water with a faint chlorine smell
C. Water from a deep well without treatment
D. Water with coliform bacteria present
Rationale: The correct answer is D. The presence of coliform bacteria indicates fecal
contamination and poses an immediate health risk. Slightly cloudy water (A) may contain
sediments but not necessarily pathogens. A faint chlorine smell (B) is normal for treated water.
Untreated deep well water (C) may be safe if the well is properly constructed and maintained.
13. In advising a community about vector control for dengue prevention, which of the following
should the nurse emphasize?
A. Daily fogging with insecticides
B. Regular elimination of standing water
C. Keeping windows closed at all times
D. Application of mosquito repellent only
Rationale: The correct answer is B. Regular elimination of standing water addresses breeding
sites of Aedes mosquitoes, which is the most effective community-level intervention for dengue
prevention. Fogging (A) provides only temporary relief and can lead to insecticide resistance.
Keeping windows closed (C) and applying repellent (D) are individual protection measures that
don't address the source of the problem.
14. Which environmental health hazard is most directly associated with improper disposal of
heavy metals?
A. Dengue fever
B. Soil and water contamination
C. Air pollution
D. Food poisoning
Rationale: The correct answer is B. Improper disposal of heavy metals directly leads to soil and
water contamination, which can persist for decades. Dengue fever (A) is vector-borne, not
related to heavy metals. While heavy metals can contribute to air pollution (C) in some cases, soil
and water contamination is more direct. Food poisoning (D) is typically caused by biological
contaminants.
15. A community health nurse is conducting a sanitary inspection of food establishments. Which
of the following findings requires immediate intervention?
A. Food handlers wearing clean uniforms
B. Food stored in sealed containers
C. Food handlers with untreated skin infections
D. Food preparation area with adequate lighting
Rationale: The correct answer is C. Food handlers with untreated skin infections pose an
immediate risk of contaminating food and spreading infection. Options A, B, and D are all proper
sanitary practices that should be maintained, not corrected.
Family Health Nursing
16. Which nursing theory is most applicable when assessing family dynamics and interactions?
A. Orem's Self-Care Deficit Theory
B. Bowen's Family Systems Theory
C. Roy's Adaptation Model
D. Nightingale's Environmental Theory
Rationale: The correct answer is B. Bowen's Family Systems Theory specifically addresses
family dynamics, viewing the family as an emotional unit with complex interactions. Orem's
theory (A) focuses on self-care abilities. Roy's model (C) addresses adaptation to environmental
changes. Nightingale's theory (D) emphasizes environmental factors affecting health.
17. A community health nurse identifies that a family is experiencing difficulty adapting to a
child's newly diagnosed chronic illness. Which nursing diagnosis is most appropriate?
A. Ineffective family coping
B. Caregiver role strain
C. Interrupted family processes
D. Deficient knowledge
Rationale: The correct answer is A. Ineffective family coping addresses the family's difficulty in
adapting to a stressful situation (the child's diagnosis). Caregiver role strain (B) would focus on a
specific caregiver's stress. Interrupted family processes (C) would be appropriate if family
routines were disrupted. Deficient knowledge (D) focuses on information needs rather than
coping mechanisms.
18. When conducting a family health assessment, which of the following tools helps visualize the
family's relationships with community resources?
A. Genogram
B. Ecomap
C. Family timeline
D. Family health tree
Rationale: The correct answer is B. An ecomap specifically visualizes a family's connections with
external systems and community resources. A genogram (A) displays family composition and
health history. A family timeline (C) shows significant events chronologically. A family health tree
(D) focuses on hereditary conditions.
19. A community health nurse is working with a family with multiple health issues. Using the
family-centered approach, which of the following actions is most appropriate?
A. Making decisions for the family based on professional expertise
B. Involving only the head of the family in health planning
C. Recognizing the family as experts on their own situation and involving them in decision-
making
D. Focusing interventions only on the family member with the most acute condition
Rationale: The correct answer is C. Family-centered care recognizes families as experts on their
own situation and involves them in decision-making. Option A disregards family autonomy.
Option B limits participation to one member. Option D ignores the holistic nature of family health.
20. Which of the following best describes a functional family according to family health nursing
concepts?
A. A family without any health problems
B. A family that maintains rigid roles and structures
C. A family that adapts to challenges while maintaining stability
D. A family that never experiences conflict
Rationale: The correct answer is C. Functional families can adapt to challenges while maintaining
stability, not necessarily avoiding all health problems (A) or conflicts (D). Rigid roles (B) may
actually indicate dysfunction as flexibility is important for family adaptability.

Primary Health Care and Health Programs

21. Which of the following best represents the concept of accessibility in primary health care?
A. Availability of specialized medical equipment
B. Health services that are geographically, financially, and culturally accessible to all
C. Focus on hospital-based services
D. Care provided only by physicians
Rationale: The correct answer is B. Accessibility in primary health care means services must be
geographically, financially, and culturally accessible to all community members. Specialized
equipment (A) relates to secondary or tertiary care. Hospital-based services (C) and physician-
only care (D) contradict primary health care principles of community-based services and
appropriate use of health workers.
22. A barangay health worker is implementing which primary health care principle when
teaching mothers to prepare oral rehydration solution at home?
A. Equitable distribution
B. Community participation
C. Appropriate technology
D. Intersectoral coordination
Rationale: The correct answer is C. Appropriate technology involves using practical, affordable,
and acceptable methods suitable for local conditions. Teaching mothers to prepare ORS at home
exemplifies this principle. Equitable distribution (A) involves fair access to resources. Community
participation (B) involves community involvement in planning. Intersectoral coordination (D)
involves collaboration between different sectors.
23. Which Philippine health program specifically targets nutritional deficiencies among children?
A. Expanded Program on Immunization
B. Garantisadong Pambata
C. DOTS strategy
D. Family Planning Program
Rationale: The correct answer is B. Garantisadong Pambata is a comprehensive program that
addresses nutritional deficiencies and other child health concerns. The Expanded Program on
Immunization (A) focuses on vaccinations. The DOTS strategy (C) addresses tuberculosis. The
Family Planning Program (D) focuses on reproductive health.
24. The implementation of Barangay Health Emergency Response Teams (BHERTs) during the
COVID-19 pandemic demonstrates which element of primary health care?
A. Curative care emphasis
B. Technology-dependent healthcare
C. Community participation in health
D. Specialized care delivery
Rationale: The correct answer is C. BHERTs represent community participation in health through
local response teams. They do not emphasize curative care (A) but focus on surveillance and
prevention. BHERTs use appropriate rather than complex technology (B) and provide basic
rather than specialized care (D).
25. Which of the following is a primary goal of the Philippine Health Insurance Corporation
(PhilHealth)?
A. Providing specialized medical equipment to hospitals
B. Training health professionals
C. Enhancing financial access to healthcare services
D. Building healthcare facilities
Rationale: The correct answer is C. PhilHealth aims to enhance financial access to healthcare
through health insurance coverage. It does not directly provide medical equipment (A), train
professionals (B), or build facilities (D), which are functions of other government agencies.

Communicable Disease Control

26. Which of the following is the correct case finding strategy for tuberculosis in the community?
A. Mass chest X-ray screening
B. Passive case finding only
C. Screening of symptomatic individuals and contacts
D. Annual tuberculin skin testing for all community members
Rationale: The correct answer is C. The recommended strategy combines screening
symptomatic individuals and contact investigation of confirmed cases. Mass chest X-ray
screening (A) is resource-intensive and not recommended for routine use. Passive case finding
only (B) misses many cases. Annual tuberculin testing for all (D) is not cost-effective.
27. In implementing the DOTS strategy for tuberculosis control, which of the following is a key
component?
A. Self-medication by patients
B. Directly observed treatment by a health worker
C. Monthly follow-up only
D. Treatment limited to six weeks
Rationale: The correct answer is B. Directly observed treatment, where a health worker
observes the patient taking medications, is a cornerstone of the DOTS strategy. Self-medication
(A) contradicts the supervisory aspect. Monthly follow-up only (C) is insufficient for ensuring
adherence. Treatment duration (D) is typically six months, not six weeks.
28. A community health nurse is investigating a diarrheal disease outbreak. Which of the
following control measures should be implemented first?
 A. Mass deworming of the entire community
B. Identification and elimination of the source of infection
C. Prophylactic antibiotics for all community members
D. Closing of all food establishments
Rationale: The correct answer is B. Identifying and eliminating the source of infection (e.g.,
contaminated water supply) is the priority to prevent new cases. Mass deworming (A) is not
appropriate for most diarrheal outbreaks. Prophylactic antibiotics (C) are not recommended for
entire communities. Closing all food establishments (D) is excessive without evidence they are
the source.
29. In dengue prevention, which of the following activities demonstrates the "search and
destroy" approach?
A. Fogging operations
B. Identifying and eliminating mosquito breeding sites
C. Wearing long-sleeved clothing
D. Taking paracetamol for fever
Rationale: The correct answer is B. The "search and destroy" approach involves identifying and
eliminating mosquito breeding sites. Fogging operations (A) provide temporary relief but don't
address breeding sites. Wearing protective clothing (C) is personal protection. Taking
paracetamol (D) is symptomatic treatment, not prevention.
30. Which of the following is the most appropriate prevention strategy for leptospirosis in flood-
prone communities?
A. Mass vaccination
B. Prophylactic antibiotics
C. Environmental management and health education
D. Isolation of all cases
Rationale: The correct answer is C. Environmental management (proper waste disposal, rodent
control) combined with health education is the most sustainable approach. Mass vaccination (A)
is not routinely recommended for leptospirosis. Prophylactic antibiotics (B) are sometimes used
for high-risk exposures but not as a general strategy. Isolation (D) doesn't prevent environmental
exposure.

Health Education and Promotion

31. Which of the following health education methods is most appropriate for teaching proper
handwashing technique to preschool children?
A. Lecture
B. Demonstration with return demonstration
C. Group discussion
D. Printed handouts
Rationale: The correct answer is B. Demonstration with return demonstration allows children to
observe and practice the skill, which is most effective for psychomotor learning. Lectures (A)
and group discussions (C) are less effective for young children learning skills. Printed handouts
(D) would be inappropriate for preschoolers who typically cannot read.
32. A nurse is planning a health education program on hypertension prevention. Which adult
learning principle is demonstrated when the nurse assesses what participants already know
about hypertension?
A. Building on prior knowledge
B. Creating a competitive environment
C. Using complex medical terminology
D. Focusing only on theoretical concepts
Rationale: The correct answer is A. Building on prior knowledge is a key adult learning principle,
recognizing that adults bring existing knowledge and experience. Creating competition (B) may
be counterproductive. Using complex terminology (C) creates barriers to learning. Focusing only
on theory (D) ignores adults' preference for practical, applicable information.
33. When evaluating the effectiveness of a nutrition education program, which of the following
indicates the most meaningful outcome?
A. Participants expressing satisfaction with the program
B. High attendance at all sessions
C. Demonstrated changes in dietary behaviors
D. Participants' ability to recite nutritional information
Rationale: The correct answer is C. Demonstrated behavioral changes represent the most
meaningful outcome, as the ultimate goal of health education is behavior change. Satisfaction
(A) and attendance (B) are process measures but don't indicate learning. Reciting information
(D) shows knowledge but not necessarily application.
34. Which of the following best exemplifies the health promotion strategy of "creating
supportive environments"?
A. Telling individuals to exercise more
B. Establishing smoking cessation counseling services
C. Creating walking paths and bicycle lanes in communities
D. Diagnosing and treating hypertension
Rationale: The correct answer is C. Creating supportive environments involves modifying
physical and social environments to facilitate healthy choices, such as creating infrastructure for
physical activity. Telling individuals to exercise (A) is advisory only. Cessation counseling (B) is a
health service. Treating hypertension (D) is a clinical intervention.
35. A community health nurse is planning a health education session on family planning for
couples. Which of the following demonstrates cultural sensitivity?
A. Using the same approach for all cultural groups
B. Considering cultural beliefs about family size and contraception
C. Imposing the nurse's personal beliefs on participants
D. Avoiding discussion of sensitive topics
Rationale: The correct answer is B. Cultural sensitivity involves understanding and respecting
cultural beliefs and adapting approaches accordingly. Using the same approach for all groups
(A) ignores cultural differences. Imposing personal beliefs (C) disrespects others' values.
Avoiding sensitive topics (D) fails to address important health needs.
Community Health Assessment and Diagnosis
36. Which of the following data collection methods is most appropriate for gathering information
about community values and beliefs regarding health?
A. Review of census data
B. Collection of biological specimens
C. Focus group discussions
D. Analysis of mortality statistics
Rationale: The correct answer is C. Focus group discussions allow community members to
express their values, beliefs, and perspectives in their own words. Census data (A) and mortality
statistics (D) provide quantitative information but not values and beliefs. Biological specimens
(B) provide physiological data but not cultural information.
37. When conducting a windshield survey of a community, which of the following observations
would be most relevant?
A. Individual residents' medical histories
B. Community infrastructure, housing conditions, and gathering places
C. Hospital admission rates
D. Laboratory test results of water samples
Rationale: The correct answer is B. A windshield survey focuses on observable community
characteristics like infrastructure, housing, and gathering places. Individual medical histories (A)
would not be observable. Hospital rates (C) and laboratory results (D) require specific data
collection, not observation.
38. Which of the following best represents a community health diagnosis?
A. Mr. Santos has Type 2 Diabetes Mellitus
B. Increased risk for dengue fever related to improper waste disposal
C. Impaired mobility related to fractured femur
D. Mrs. Garcia has hypertension requiring medication
Rationale: The correct answer is B. A community health diagnosis identifies a health problem
affecting a population group, along with contributing factors. Options A, C, and D are individual
nursing diagnoses, not community health diagnoses.
39. In community health assessment, which data source would provide the most accurate
information about the leading causes of death in the community?
A. Hospital admission records
B. Internet search trends
C. Vital statistics from the civil registry
D. Newspaper reports
Rationale: The correct answer is C. Vital statistics from civil registries systematically collect and
classify causes of death. Hospital records (A) capture only those who died in hospitals. Internet
search trends (B) and newspaper reports (D) are subject to bias and reporting limitations.
40. A community health nurse identifies that a barangay has high rates of child malnutrition. This
finding represents which step in the community health nursing process?
A. Planning
 B. Assessment
C. Implementation
D. Evaluation
Rationale: The correct answer is B. Identifying a health problem through data collection and
analysis is part of the assessment phase. Planning (A) involves developing interventions.
Implementation (C) involves carrying out interventions. Evaluation (D) involves measuring
outcomes of interventions.

Non-communicable Disease Prevention

41. Which of the following is the most effective community-level approach to preventing
cardiovascular diseases?
A. Providing emergency cardiac care services
B. Promoting healthy lifestyle and addressing modifiable risk factors
C. Screening only high-risk individuals
D. Focusing exclusively on medication management
Rationale: The correct answer is B. Community-level prevention of cardiovascular diseases is
most effective through health promotion and addressing modifiable risk factors like diet,
exercise, and smoking. Emergency services (A) address acute events, not prevention. Limited
screening (C) and medication management (D) are important but not sufficient as
comprehensive prevention approaches.
42. A community with high prevalence of Type 2 Diabetes would benefit most from which of the
following interventions?
A. Building more dialysis centers
B. Community-wide weight management and physical activity programs
C. Restricting the sale of glucose monitoring devices
D. Focusing exclusively on insulin distribution
Rationale: The correct answer is B. Community-wide lifestyle interventions addressing key risk
factors (obesity, physical inactivity) represent primary prevention. Building dialysis centers (A)
addresses complications, not prevention. Restricting monitoring devices (C) would reduce
disease management capacity. Insulin distribution (D) is treatment, not prevention.
43. In implementing a hypertension control program, which strategy focuses on secondary
prevention?
A. Community-wide sodium reduction campaign
B. Regular blood pressure screening and early treatment
C. Cardiac rehabilitation services
D. Health education about cardiovascular risks in schools
Rationale: The correct answer is B. Secondary prevention involves early detection and prompt
treatment, which regular screening and early intervention accomplish. A sodium reduction
campaign (A) and school education (D) are primary prevention. Cardiac rehabilitation (C) is
tertiary prevention.
44. Which of the following is a key component of a community-based cancer prevention
program?
 A. Focusing exclusively on treatment facilities
B. Promoting awareness of warning signs and screening
C. Advocating for less cancer research
D. Restricting access to cancer information
Rationale: The correct answer is B. Effective cancer prevention includes promoting awareness
of warning signs and appropriate screening. Focusing only on treatment (A) neglects prevention.
Advocating against research (C) and restricting information (D) would be counterproductive to
public health goals.
45. A community health nurse is planning interventions for chronic obstructive pulmonary
disease (COPD) prevention. Which of the following would be most effective?
A. Distributing inhalers to all community members
B. Anti-smoking campaigns and reduction of air pollution
C. Annual chest X-rays for all residents
D. Focusing only on genetic counseling
Rationale: The correct answer is B. Since smoking and air pollution are the primary preventable
causes of COPD, these interventions address root causes. Distributing inhalers (A) is treatment,
not prevention. Annual X-rays (C) are not recommended for COPD screening. Genetic factors
(D) play a minimal role in most COPD cases compared to environmental factors.

Disaster Preparedness and Management

46. Which of the following best defines the mitigation phase of disaster management?
A. Actions taken immediately after a disaster
B. Measures taken to reduce the impact of disasters
C. Preparation for immediate disaster response
D. Rebuilding affected communities
Rationale: The correct answer is B. Mitigation involves long-term measures taken to reduce
disaster impact, such as building codes or environmental policies. Actions immediately after a
disaster (A) describe the response phase. Preparation for response (C) describes the
preparedness phase. Rebuilding (D) describes the recovery phase.
47. A nurse in a community frequently affected by typhoons should prioritize which of the
following activities during the preparedness phase?
A. Damage assessment
B. Identification of evacuation centers and planning evacuation routes
C. Distribution of relief goods
D. Rehabilitation of infrastructure
Rationale: The correct answer is B. Identifying evacuation centers and planning routes occur
during the preparedness phase, before a disaster strikes. Damage assessment (A) and relief
distribution (C) occur during response. Infrastructure rehabilitation (D) occurs during recovery.
48. Which of the following represents a community health nurse's role in the disaster response
phase?
A. Conducting a vulnerability assessment
B. Developing disaster preparedness plans
 C. Providing triage and emergency care to victims
D. Implementing long-term mental health programs
Rationale: The correct answer is C. During the response phase, nurses provide immediate care
to victims, including triage and emergency care. Vulnerability assessment (A) and preparedness
planning (B) occur before disasters. Long-term mental health programs (D) are implemented
during recovery.
49. A community has experienced flooding. During the recovery phase, which of the following
nursing interventions is most appropriate?
A. Warning community members about imminent flooding
B. Conducting rapid evacuation
C. Monitoring for waterborne disease outbreaks
D. Developing evacuation plans for future flooding
Rationale: The correct answer is C. During recovery, monitoring for post-disaster health threats
like disease outbreaks is essential. Warning about imminent flooding (A) and evacuation (B)
occur during preparedness and response phases. Developing future plans (D) is part of
mitigation and preparedness.
50. In assessing a community's vulnerability to disasters, which of the following factors indicates
increased vulnerability?
A. Strong community organization
B. High proportion of elderly, children, and persons with disabilities
C. Multiple access roads
D. Robust early warning systems
Rationale: The correct answer is B. Communities with higher proportions of vulnerable
populations (elderly, children, persons with disabilities) have increased disaster vulnerability.
Strong community organization (A), multiple access roads (C), and early warning systems (D) all
reduce vulnerability.

Special Community Health Concerns

51. Which of the following is the most appropriate nursing intervention for addressing
malnutrition in a resource-limited community?
A. Recommending expensive imported foods
B. Promoting breastfeeding and locally available nutritious foods
C. Distributing ready-to-eat meals indefinitely
D. Focusing solely on vitamin supplementation
Rationale: The correct answer is B. Promoting breastfeeding and locally available nutritious
foods represents a sustainable, culturally appropriate approach. Recommending expensive
imports (A) is unsustainable. Indefinite distribution (C) creates dependency. Focusing only on
supplements (D) ignores dietary fundamentals.
52. A community health nurse identifies high rates of adolescent pregnancy in a community.
Which of the following interventions would be most comprehensive?
A. Distributing contraceptives only
B. Prohibiting adolescents from dating
 C. Comprehensive sexuality education and youth development programs
D. Promoting abstinence-only education
Rationale: The correct answer is C. A comprehensive approach combining education, skill-
building, and youth development addresses multiple factors contributing to adolescent
pregnancy. Distributing contraceptives only (A) addresses access but not knowledge or skills.
Prohibition (B) is unrealistic and potentially harmful. Abstinence-only education (D) has not
shown consistent effectiveness.
53. When addressing substance abuse in a community, which approach is most aligned with
public health principles?
A. Criminalization and punishment of all users
B. Comprehensive prevention, harm reduction, and treatment services
C. Mandatory religion-based rehabilitation for all users
D. Ignoring the problem to avoid stigmatizing the community
Rationale: The correct answer is B. A comprehensive public health approach includes
prevention, harm reduction, and evidence-based treatment. Criminalization (A) can increase
harm and prevent access to services. Mandatory religious approaches (C) may not be effective
or acceptable for all. Ignoring the problem (D) allows harm to continue.
54. Which of the following best exemplifies a community-based approach to mental health?
A. Building more psychiatric hospitals
B. Integrating mental health services into primary health care
C. Mandatory institutionalization of all persons with mental illness
D. Focusing exclusively on medication treatment
Rationale: The correct answer is B. Integrating mental health into primary care makes services
more accessible and reduces stigma. Building more hospitals (A) promotes institutionalization
rather than community care. Mandatory institutionalization (C) violates rights and worsens
outcomes. Exclusive focus on medication (D) ignores psychosocial needs.
55. In addressing malaria in endemic areas, which intervention demonstrates an integrated
vector management approach?
A. Mass drug administration only
B. Combination of bed nets, environmental management, and selective spraying
C. Reliance solely on insecticide spraying
D. Focus exclusively on treatment of cases
Rationale: The correct answer is B. Integrated vector management combines multiple
complementary approaches. Mass drug administration (A) targets parasites, not vectors.
Relying solely on spraying (C) leads to resistance and environmental problems. Focusing only on
treatment (D) neglects prevention.

Occupational Health Nursing

56. When conducting an occupational health assessment in a factory, which of the following
would be classified as a chemical hazard?
A. Excessive noise
B. Poor ergonomic design
 C. Exposure to solvents and acids
D. Repetitive motion
Rationale: The correct answer is C. Chemical hazards include exposure to substances like
solvents and acids. Noise (A) is a physical hazard. Poor ergonomic design (B) and repetitive
motion (D) are ergonomic hazards.
57. Which of the following is the primary purpose of pre-employment health examinations?
A. To discriminate against certain applicants
B. To establish baseline health status and fitness for work
C. To reduce company health insurance costs
D. To diagnose all underlying medical conditions
Rationale: The correct answer is B. Pre-employment examinations establish baseline health and
determine fitness for specific job requirements. They should not be used for discrimination (A).
While they may affect insurance costs (C), this is not their primary purpose. They are not
comprehensive enough to diagnose all conditions (D).
58. A nurse is implementing hearing conservation programs in a manufacturing plant. Which
intervention should be prioritized according to the hierarchy of controls?
A. Providing hearing protection devices to workers
B. Reducing noise at the source through engineering controls
C. Limiting exposure time through administrative controls
D. Conducting regular audiometric testing
Rationale: The correct answer is B. The hierarchy of controls prioritizes elimination or
engineering controls (reducing noise at source) as most effective. Personal protective equipment
(A) is considered less effective. Administrative controls (C) are intermediate. Audiometric testing
(D) is monitoring, not control.
59. An occupational health nurse notes that several office workers are reporting wrist pain.
Which of the following is the most likely cause?
A. Chemical exposure
B. Poor ergonomics and repetitive motion
C. Excessive noise
D. Inadequate lighting
Rationale: The correct answer is B. Wrist pain in office workers is typically related to ergonomic
factors and repetitive motion (e.g., computer use). Chemical exposure (A), noise (C), and lighting
(D) would not typically cause wrist pain.
60. Which of the following is the most appropriate role of the occupational health nurse in
workplace health promotion?
A. Focusing exclusively on treating injuries
B. Implementing comprehensive wellness programs
C. Avoiding workplace health issues unless injuries occur
D. Focusing only on regulatory compliance
Rationale: The correct answer is B. Occupational health nurses should implement
comprehensive wellness programs addressing both prevention and health promotion. Focusing
only on injuries (A), avoiding health issues (C), or focusing only on compliance (D) represents an
incomplete approach to workplace health.

Vulnerable Populations
61. Which of the following is a key nursing intervention when working with indigenous
communities?
A. Imposing mainstream health practices without consideration of cultural beliefs
B. Integrating traditional healing practices with modern healthcare approaches
C. Avoiding discussion of traditional practices
D. Replacing all traditional practices with modern approaches
Rationale: The correct answer is B. Integrating traditional and modern approaches respects
cultural identity while providing evidence-based care. Imposing mainstream practices (A) and
replacing traditional practices (D) disregard cultural values. Avoiding discussion (C) misses
opportunities for cultural understanding.
62. When planning health programs for communities with high poverty rates, which approach is
most effective?
A. Implementing programs without community input
B. Providing high-cost interventions only
C. Addressing social determinants of health along with clinical services
D. Focusing exclusively on individual behavior change
Rationale: The correct answer is C. Addressing social determinants (income, education,
housing) alongside clinical services is most effective for poverty-affected communities.
Implementing without input (A) ignores community needs. High-cost interventions (B) are
unsustainable. Individual behavior focus (D) ignores structural barriers.
63. Which of the following represents the most appropriate approach to healthcare for persons
with disabilities?
A. Making all decisions for them without consultation
B. Creating separate but equal health facilities
C. Ensuring physical accessibility and accommodations in mainstream services
D. Focusing exclusively on their disability rather than holistic health
Rationale: The correct answer is C. Accessibility and accommodations within mainstream
services promote inclusion and comprehensive care. Making decisions without consultation (A)
disregards autonomy. Separate facilities (B) promote segregation. Exclusive focus on disability
(D) neglects other health needs.
64. When providing healthcare to older adults in the community, which of the following
approaches is most appropriate?
A. Assuming all have cognitive impairment
B. Promoting independence while ensuring safety
C. Making all decisions for them regardless of capacity
D. Focusing exclusively on physical ailments
Rationale: The correct answer is B. Promoting independence while ensuring safety respects
autonomy while addressing increased risks. Assuming cognitive impairment (A) is ageist. Making
all decisions (C) disregards autonomy. Focusing only on physical aspects (D) neglects
psychosocial needs.
65. Which statement best reflects the community health nurse's role in addressing gender-
based violence?
A. Considering it a private family matter only
B. Screening, supporting survivors, and participating in prevention efforts
C. Focusing only on physical injuries
D. Encouraging reconciliation in all cases
Rationale: The correct answer is B. A comprehensive approach includes screening, support, and
prevention. Considering it private (A) perpetuates harmful norms. Focusing only on physical
injuries (C) neglects psychological impact. Encouraging reconciliation in all cases (D) may
endanger survivors.

Rural and Urban Health

66. Which of the following represents a key challenge in providing healthcare to rural
communities?
A. Excessive number of healthcare providers
B. Geographic isolation and transportation barriers
C. Too many specialized healthcare facilities
D. Lower rates of chronic disease
Rationale: The correct answer is B. Geographic isolation and transportation barriers are key
challenges in rural healthcare. Rural areas typically have shortages, not excesses, of providers
(A) and specialized facilities (C). Rural areas often have higher, not lower, rates of chronic
diseases (D).
67. A community health nurse working in an urban slum area should prioritize which of the
following health concerns?
A. Noise-induced hearing loss
B. Farm machinery accidents
C. Communicable diseases related to crowding and poor sanitation
D. Snake bites and other wildlife encounters
Rationale: The correct answer is C. Urban slum areas typically face communicable disease
challenges due to population density and inadequate sanitation. Noise-induced hearing loss (A)
is an occupational concern. Farm machinery accidents (B) and wildlife encounters (D) are rural
concerns.
68. Which of the following strategies would best address healthcare access issues in remote
rural areas?
A. Building large hospitals only in urban centers
B. Implementing telehealth services and mobile health units
C. Requiring all patients to travel to regional hospitals
D. Focusing exclusively on emergency evacuation services
Rationale: The correct answer is B. Telehealth and mobile units bring services closer to rural
populations. Building hospitals only in urban areas (A) and requiring travel (C) exacerbate
access problems. Focusing only on evacuation (D) neglects preventive and primary care.
69. When addressing health issues in rapidly urbanizing areas, which of the following should be
a priority concern?
A. Soil erosion from agricultural practices
B. Environmental health issues related to poor urban planning
C. Isolation and lack of social support
D. Lack of modern healthcare facilities
Rationale: The correct answer is B. Rapidly urbanizing areas often face environmental health
challenges due to unplanned development. Soil erosion (A) is primarily a rural agricultural issue.
While isolation (C) may occur in urban settings, it's more characteristic of rural areas. Urban
areas typically have more, not fewer, modern facilities (D).
70. Which approach would be most effective for community health nursing in informal urban
settlements?
A. Focusing exclusively on relocation of residents
B. Implementing vertical programs without community involvement
C. Community-based participatory approaches with resident involvement
D. Providing only emergency services
Rationale: The correct answer is C. Community-based participatory approaches engage
residents in identifying and addressing their own health priorities. Focusing only on relocation (A)
ignores immediate health needs. Vertical programs without involvement (B) may not address
community priorities. Providing only emergency services (D) neglects prevention and primary
care.

Research and Evidence-Based Practice

71. A community health nurse wants to determine if a new health education approach is more
effective than the current method. Which research design is most appropriate?
A. Case study
B. Descriptive study
C. Experimental study comparing both approaches
D. Qualitative phenomenological study
Rationale: The correct answer is C. An experimental study comparing outcomes between
groups receiving different approaches can determine comparative effectiveness. Case studies
(A) and descriptive studies (B) cannot establish causality. Phenomenological studies (D) explore
lived experiences but don't measure comparative effectiveness.
72. When implementing evidence-based practice in community health nursing, which of the
following is the correct sequence?
A. Implement changes, evaluate outcomes, assess current practice, review evidence
B. Assess current practice, review evidence, implement changes, evaluate outcomes
C. Review evidence, implement changes, assess current practice, evaluate outcomes
D. Evaluate outcomes, implement changes, review evidence, assess current practice
Rationale: The correct answer is B. Evidence-based practice follows a logical sequence:
assessing current practice, reviewing evidence for better approaches, implementing changes
based on evidence, and evaluating outcomes of those changes. The other options present these
steps in incorrect order.
73. A nurse is evaluating the effectiveness of a community hypertension program. Which of the
following would be the most meaningful outcome measure?
A. Number of educational sessions conducted
B. Reduction in average blood pressure readings in the target population
C. Amount of program funding received
D. Number of blood pressure machines purchased
Rationale: The correct answer is B. Reduction in blood pressure readings directly measures the
health impact of the program. Number of sessions (A), funding (C), and equipment (D) are
process or input measures, not outcome measures.
74. Which of the following represents an ethical consideration when conducting community
health research?
A. Obtaining community consent only, not individual consent
B. Ensuring both community engagement and individual informed consent
C. Focusing on research benefits while ignoring potential risks
D. Using data without permission if it benefits the community
Rationale: The correct answer is B. Ethical community research requires both community
engagement/consent and individual informed consent. Community consent alone (A) is
insufficient. Ignoring risks (C) and using data without permission (D) violate ethical principles of
beneficence and respect for autonomy.
75. When applying research findings to community health practice, which of the following must
be considered?
A. Research findings can be applied universally without adaptation
B. Only research conducted in similar communities is applicable
C. Applicability to the specific community context and population
D. Research findings should replace community input in decision-making
Rationale: The correct answer is C. Research findings must be evaluated for applicability to the
specific community context. Findings are not universally applicable without adaptation (A).
Research from dissimilar communities may still provide useful insights if appropriately adapted
(B). Research should inform, not replace, community input (D).

Health Systems and Policy

76. Which of the following best describes the principle of universal health care?
A. All people have access to free specialized medical services
B. All people have access to quality health services without financial hardship
C. Only citizens of a country receive healthcare services
D. Healthcare is provided only through government facilities
Rationale: The correct answer is B. Universal health care means all people can access quality
health services without financial hardship. It doesn't necessarily mean all services are free (A) or
limited to government facilities (D). It includes all residents, not just citizens (C).
77. A community health nurse is advocating for policy changes to improve healthcare access.
Which of the following approaches is most effective?
A. Working in isolation from other stakeholders
B. Using only personal opinions without supporting evidence
C. Building coalitions and using data to support recommendations
D. Focusing only on criticizing current policies
Rationale: The correct answer is C. Effective policy advocacy involves building coalitions with
diverse stakeholders and using data to support recommendations. Working in isolation (A)
reduces influence. Using only personal opinions (B) lacks credibility. Mere criticism (D) without
offering alternatives is less effective.
78. In the Philippine health system, which of the following represents the most basic unit of
healthcare delivery?
A. Provincial hospital
B. Rural health unit
C. Barangay health station
D. Regional medical center
Rationale: The correct answer is C. The barangay health station is the most basic unit of
healthcare delivery, providing primary care at the community level. The rural health unit (B)
supervises several barangay health stations. Provincial hospitals (A) and regional medical
centers (D) are higher-level facilities.
79. Which of the following best describes the role of a community health nurse in health policy
development?
A. Implementing policies without questioning
B. Informing policymakers about community health needs based on assessment data
C. Creating policies independently without consultation
D. Focusing only on clinical care, not policy matters
Rationale: The correct answer is B. Community health nurses should inform policy development
by providing data about community health needs. Implementing without questioning (A) ignores
professional advocacy responsibilities. Creating policies independently (C) overlooks the
multidisciplinary nature of policy development. Focusing only on clinical care (D) neglects the
policy dimension of public health.
80. The Department of Health's strategy of localizing health services through devolution to local
government units exemplifies which principle?
A. Centralization
B. Vertical programming
C. Decentralization
D. Privatization
Rationale: The correct answer is C. Devolution of health services to local government units
represents decentralization, bringing decision-making closer to the community level.
Centralization (A) would concentrate authority at the national level. Vertical programming (B)
refers to disease-specific programs. Privatization (D) involves transfer to private entities.
Ethics in Community Health Nursing
81. A community health nurse discovers that a TB patient is not taking medications as
prescribed and is potentially exposing others. Which ethical principle must be balanced with
beneficence in this situation?
A. Autonomy
B. Justice
C. Veracity
D. Fidelity
Rationale: The correct answer is A. The nurse must balance respect for the patient's autonomy
(self-determination) with beneficence (preventing harm to others). Justice (B) concerns fair
distribution of resources. Veracity (C) concerns truthfulness. Fidelity (D) concerns keeping
promises.
82. When conducting a community health assessment, which ethical consideration should guide
the collection and use of data?
A. Collecting only data that supports predetermined conclusions
B. Protecting privacy and confidentiality of information
C. Sharing identified personal health information with community leaders
D. Using community data without permission
Rationale: The correct answer is B. Protecting privacy and confidentiality is an essential ethical
consideration in data collection and use. Collecting only supportive data (A) introduces bias.
Sharing identified information (C) and using data without permission (D) violate privacy and
autonomy.
83. A nurse is planning a community-based nutrition program with limited resources. Which
ethical principle guides the decision to focus on the most undernourished areas first?
A. Autonomy
B. Beneficence
C. Justice
D. Non-maleficence
Rationale: The correct answer is C. Justice involves fair distribution of resources, often
prioritizing those with greatest need. Autonomy (A) concerns self-determination. Beneficence (B)
involves doing good. Non-maleficence (D) involves avoiding harm. While all are important, justice
specifically addresses resource allocation.
84. Which of the following situations represents an ethical dilemma in community health nursing?
A. Following established protocols for tuberculosis treatment
B. Documenting nursing interventions accurately
C. Balancing limited resources between preventive services and urgent care needs
D. Referring clients to appropriate specialists
Rationale: The correct answer is C. An ethical dilemma involves competing ethical principles or
obligations, such as balancing prevention versus immediate care with limited resources.
Following protocols (A), accurate documentation (B), and appropriate referrals (D) represent
standard practice without inherent ethical conflicts.
85. A community requests that health education materials exclude certain reproductive health
topics due to cultural sensitivities. Which ethical approach best addresses this situation?
A. Imposing all topics regardless of cultural values
B. Respecting cultural values while finding acceptable ways to address essential health
information
C. Completely omitting all sensitive topics
D. Delegating responsibility to external organizations
Rationale: The correct answer is B. Cultural sensitivity requires respecting values while still
finding appropriate ways to communicate essential health information. Imposing topics (A)
disrespects cultural values. Completely omitting topics (C) may withhold vital information.
Delegating responsibility (D) avoids addressing the issue.

Leadership and Management

86. A community health nurse leads a team implementing multiple health programs. Which of
the following leadership approaches would be most effective in this context?
A. Authoritarian leadership with strict control
B. Laissez-faire leadership with minimal guidance
C. Democratic leadership with team participation in decision-making
D. Transactional leadership focused only on task completion
Rationale: The correct answer is C. Democratic leadership involving team participation is most
effective for complex community health work requiring collaboration. Authoritarian leadership (A)
discourages initiative. Laissez-faire leadership (B) provides insufficient guidance. Transactional
leadership (D) neglects relationship-building and motivation.
87. In managing community health programs with limited resources, which of the following
approaches is most appropriate?
A. Implementing all planned activities regardless of resource constraints
B. Setting priorities based on community needs assessment and available resources
C. Focusing only on programs with external funding
D. Abandoning all programs that cannot be fully implemented
Rationale: The correct answer is B. Setting priorities based on community needs and available
resources ensures efficient use of limited resources. Implementing all activities regardless of
constraints (A) risks quality. Focusing only on externally funded programs (C) may neglect
community priorities. Abandoning programs (D) fails to address any needs.
88. Which of the following exemplifies effective delegation in community health nursing?
A. Assigning tasks without considering team members' capabilities
B. Matching tasks to team members' skills while providing appropriate supervision
C. Delegating all responsibilities without follow-up
D. Refusing to delegate any tasks
Rationale: The correct answer is B. Effective delegation involves matching tasks to skills and
providing appropriate supervision. Assigning without considering capabilities (A) risks poor
outcomes. Delegating without follow-up (C) abdicates responsibility. Refusing to delegate (D)
creates inefficiency and prevents team development.
89. A community health nurse manager is developing the annual budget for health programs.
Which of the following approaches is most appropriate?
A. Allocating funds equally across all programs regardless of needs
B. Basing allocations on historical spending patterns only
C. Aligning resource allocation with program priorities and community needs
D. Focusing all resources on a single program area
Rationale: The correct answer is C. Aligning resources with priorities and needs ensures
effective use of funds. Equal allocation (A) ignores varying needs. Historical patterns (B) may
perpetuate inefficiencies. Focusing on a single area (D) neglects other important health needs.
90. Which of the following best describes the concept of transformational leadership in
community health nursing?
A. Focusing exclusively on completing tasks and meeting quotas
B. Inspiring and motivating team members toward a shared vision of community health
C. Maintaining the status quo and avoiding change
D. Making all decisions without team input
Rationale: The correct answer is B. Transformational leadership involves inspiring and motivating
toward a shared vision. Focusing exclusively on tasks (A) describes transactional leadership.
Maintaining status quo (C) and making decisions without input (D) describe ineffective
leadership approaches.

Quality Improvement
91. A community health nurse notices increasing numbers of missed follow-up appointments.
Which quality improvement approach would be most appropriate to address this issue?
A. Blaming patients for missed appointments
B. Continuing current practices without changes
C. Using Plan-Do-Study-Act (PDSA) cycles to test improvement strategies
D. Implementing major changes without analyzing root causes
Rationale: The correct answer is C. PDSA cycles allow for systematic testing and refinement of
improvement strategies. Blaming patients (A) fails to address system issues. Continuing without
changes (B) perpetuates the problem. Implementing changes without analysis (D) may not
address root causes.
92. Which of the following is an example of a process measure in evaluating a tuberculosis
control program?
A. Reduction in TB incidence
B. Percentage of TB patients completing full treatment course
C. Improvement in community knowledge about TB
D. Decreased TB mortality rate
Rationale: The correct answer is B. Process measures assess program implementation—how
well activities are carried out, such as treatment completion. Incidence reduction (A) and
mortality decrease (D) are outcome measures. Knowledge improvement (C) is an intermediate
outcome measure.
93. In continuous quality improvement, which of the following statements is true?
A. Focus is on identifying and punishing individuals who make errors
B. Improvement happens through major changes implemented all at once
C. The emphasis is on systematic improvement of processes, not blaming individuals
D. Quality assessment is done only when problems are reported
Rationale: The correct answer is C. Continuous quality improvement focuses on systematic
process improvement, not individual blame. Punishing individuals (A) creates a culture of fear.
Major changes all at once (B) can be disruptive. Reactive assessment only (D) misses
opportunities for proactive improvement.
94. A community health center is implementing a quality improvement project. Which of the
following represents the first step in this process?
A. Implementing multiple changes simultaneously
B. Identifying and analyzing the problem
C. Evaluating outcomes
D. Training staff on new procedures
Rationale: The correct answer is B. The quality improvement process begins with identifying
and analyzing the problem to understand root causes. Implementing changes (A) comes after
problem analysis and solution development. Evaluation (C) comes after implementation. Training
(D) comes after determining what changes are needed.
95. Which approach to quality improvement in community health nursing is most likely to
succeed?
A. Top-down directives without staff involvement
B. Focusing on documentation rather than actual care processes
C. Collaborative approach involving frontline staff and community members
D. Implementing changes without measuring outcomes
Rationale: The correct answer is C. A collaborative approach involving those who deliver and
receive care is most likely to succeed because it incorporates diverse perspectives and
increases buy-in. Top-down directives (A) may face resistance. Focus on documentation (B) may
not improve actual care. Implementing without measurement (D) prevents evaluation of
effectiveness.

Community Health Education and Communication

96. When developing health education materials for a community with low literacy levels, which
of the following approaches is most appropriate?
A. Using complex medical terminology to appear professional
B. Creating text-heavy materials with detailed explanations
C. Using simple language, visual aids, and practical demonstrations
D. Providing technical research articles
Rationale: The correct answer is C. Simple language, visual aids, and demonstrations make
information accessible to those with low literacy. Complex terminology (A), text-heavy materials
(B), and technical articles (D) create barriers to understanding for those with low literacy.
 97. Which of the following represents effective risk communication during a community health
threat?
A. Withholding information to prevent panic
B. Providing timely, accurate, and clear information about risks and protective actions.
C. Using highly technical language to demonstrate expertise
D. Emphasizing worst-case scenarios to maximize compliance
Rationale: The correct answer is B. Effective risk communication provides timely, accurate, clear
information that enables appropriate action. Withholding information (A) undermines trust.
Technical language (C) creates barriers to understanding. Emphasizing worst cases (D) may
cause unnecessary fear or distrust if outcomes differ.
98. A community health nurse wants to promote COVID-19 vaccination. Which communication
strategy would be most effective?
A. Dismissing all concerns as misinformation
B. Using fear tactics exclusively
C. Addressing concerns respectfully while providing accurate information
D. Avoiding discussion of potential side effects
Rationale: The correct answer is C. Addressing concerns respectfully while providing accurate
information builds trust and enables informed decision-making. Dismissing concerns (A)
alienates the audience. Using fear tactics exclusively (B) may backfire. Avoiding discussion of
side effects (D) appears deceptive and undermines trust.
99. Which of the following health education methods would be most effective for teaching
mothers how to prepare oral rehydration solution?
A. Lecture only
B. Demonstration with return demonstration
C. Written instructions only
D. Video presentation without discussion
Rationale: The correct answer is B. Demonstration with return demonstration allows for
observation, practice, feedback, and correction—ideal for skill-building. Lecture only (A), written
instructions (C), and video without discussion (D) don't provide opportunities for practice and
feedback.
100. In communicating with community members who hold health beliefs different from
biomedical models, which approach is most appropriate?
A. Dismissing traditional beliefs as incorrect
B. Respecting cultural beliefs while finding common ground to promote health
C. Avoiding discussion of biomedical concepts
D. Completely replacing traditional beliefs with biomedical concepts
Rationale: The correct answer is B. Respecting cultural beliefs while finding common ground
acknowledges cultural values while promoting evidence-based practices. Dismissing beliefs (A)
creates barriers to trust. Avoiding biomedical concepts (C) limits health promotion opportunities.
Completely replacing beliefs (D) disrespects cultural identity.
NURSING PRACTICE II: CARE OF HEALTHY/AT RISK MOTHER AND CHILD (100
QUESTIONS)

Antepartum Care
1. A woman in her first prenatal visit is estimated to be at 10 weeks gestation. Which of the
following assessments would be considered a normal finding?
A. Fetal heart tones heard with a Doppler at 130 bpm
B. Fundal height at the level of the umbilicus
C. Positive Chadwick's sign
D. Quickening reported by the mother
Rationale: The correct answer is C. Positive Chadwick's sign (bluish-purple discoloration of the
vagina) is a normal finding at 10 weeks due to increased vascularity. Fetal heart tones (A) are
typically not audible until 10-12 weeks. Fundal height (B) at the umbilicus would be expected at
20 weeks. Quickening (D) is typically felt between 16-20 weeks.
2. Calculate the estimated date of delivery (EDD) for a woman whose last menstrual period
(LMP) started on September 10, 2024.
A. June 3, 2025
B. June 17, 2025
C. July 3, 2025
D. July 17, 2025
Rationale: The correct answer is B. Using Naegele's rule: subtract 3 months (September →
June) and add 7 days (10 + 7 = 17) to the first day of the LMP, then add one year. So,
September 10, 2024 yields an EDD of June 17, 2025.
3. A pregnant woman at 26 weeks gestation has a blood pressure of 142/94 mmHg. The most
appropriate immediate nursing action is to:
A. Reassure her that this is normal due to pregnancy
B. Recheck the blood pressure after 5 minutes of rest
C. Advise bed rest at home with follow-up in one week
D. Immediately refer to a physician for evaluation
Rationale: The correct answer is D. A blood pressure of 142/94 mmHg at 26 weeks suggests
possible pregnancy-induced hypertension requiring immediate medical evaluation. This is not
normal (A) and exceeds the threshold for hypertension in pregnancy (≥140/90). Rechecking
after rest (B) or advising home bed rest (C) delays necessary medical intervention.
4. A pregnant woman at 32 weeks gestation has gained a total of 20 pounds (9 kg) since
conception. This weight gain is:
A. Excessive and requires dietary restriction
B. Within normal range
C. Insufficient and requires nutritional supplementation
D. Indicative of gestational diabetes
Rationale: The correct answer is B. Normal weight gain during pregnancy is 25-35 pounds total,
with most gained after the first trimester. At 32 weeks, 20 pounds is within normal range. It is not
excessive (A), insufficient (C), or necessarily indicative of gestational diabetes (D) without other
symptoms or diagnostic tests.
5. During assessment of a pregnant woman at 36 weeks gestation, which of the following
would warrant immediate referral?
A. Fetal movement 10 times in 2 hours
B. Braxton Hicks contractions
C. Vaginal discharge that is clear and odorless
D. Vaginal bleeding
Rationale: The correct answer is D. Vaginal bleeding at 36 weeks requires immediate evaluation
for placenta previa, placental abruption, or preterm labor. Fetal movement of 10 times in 2 hours
(A) is reassuring (normal is 10 movements in 2 hours). Braxton Hicks contractions (B) and clear,
odorless discharge (C) are normal findings at this gestation.
6. A pregnant woman at 12 weeks gestation reports persistent nausea and occasional vomiting
throughout the day. The most appropriate nursing intervention is:
A. Immediate IV hydration
B. Prescribing antiemetic medication
C. Suggesting small, frequent meals and avoiding triggers
D. Referring for hospitalization
Rationale: The correct answer is C. Suggesting small, frequent meals and avoiding triggers
represents appropriate first-line management for normal morning sickness. Immediate IV
hydration (A) and hospitalization (D) would be needed only for hyperemesis gravidarum with
dehydration or weight loss. Prescribing medication (B) is beyond the nurse's scope of practice.
7. During a prenatal visit at 34 weeks, the nurse finds that the fetus is in a breech presentation.
The most appropriate nursing action is to:
A. Schedule an immediate cesarean section
B. Teach the mother exercises to turn the baby
C. Inform the mother that breech presentation at this stage is concerning
D. Document the finding and inform the physician for continued monitoring
Rationale: The correct answer is D. At 34 weeks, breech presentation should be documented
and monitored, as many fetuses will spontaneously turn by term. An immediate cesarean section
(A) is not indicated; decisions about delivery method would be made closer to term. While
exercises may be suggested, teaching them (B) should follow physician consultation. Breech
presentation at 34 weeks (C) is not necessarily concerning yet.
8. A pregnant woman at 20 weeks gestation has a hemoglobin level of 9.5 g/dL. The most
appropriate nursing intervention is:
A. Reassurance that this is normal in pregnancy
B. Iron supplementation and dietary counseling
C. Immediate blood transfusion
D. Bedrest until hemoglobin improves
Rationale: The correct answer is B. A hemoglobin of 9.5 g/dL indicates mild anemia requiring
iron supplementation and dietary counseling. It is not within normal range (A), which should be
>11 g/dL in pregnancy. Blood transfusion (C) would be needed only for severe anemia or
symptomatic patients. Bedrest (D) is not indicated for mild anemia.
9. A 32-year-old G4P3 woman is at 10 weeks gestation. Based on her obstetric history, she
would be classified as:
A. Primigravida
B. Multigravida
C. Nullipara
D. Primipara
Rationale: The correct answer is B. Multigravida refers to a woman who has been pregnant
more than once (G4 means 4 pregnancies). Primigravida (A) is a woman in her first pregnancy.
Nullipara (C) is a woman who has never delivered a viable fetus. Primipara (D) refers to a woman
who has delivered one viable fetus.
10. During a prenatal visit, a woman at 28 weeks gestation reports sudden severe headache,
visual disturbances, and epigastric pain. This constellation of symptoms suggests:
A. Normal pregnancy discomforts
B. Migraine headache
C. Preeclampsia with severe features
D. Gestational diabetes
Rationale: The correct answer is C. The combination of severe headache, visual disturbances,
and epigastric pain strongly suggests preeclampsia with severe features, requiring immediate
medical attention. These are not normal pregnancy discomforts (A) or typical migraine
symptoms (B) in this context. These symptoms are not associated with gestational diabetes (D).
11. A woman at 24 weeks gestation is diagnosed with gestational diabetes. Which of the
following statements about her management is correct?
A. Insulin is always required for treatment
B. Diet and exercise modifications are first-line management
C. Oral hypoglycemic agents are the preferred treatment
D. She should restrict all carbohydrates entirely
Rationale: The correct answer is B. Diet and exercise modifications are first-line management for
gestational diabetes. Insulin (A) is not always required and is used when diet and exercise are
insufficient. Oral agents (C) are generally considered second-line after insulin if medication is
needed. Complete carbohydrate restriction (D) is inappropriate; balanced carbohydrate
distribution is recommended.
12. During a prenatal visit, a woman at 36 weeks gestation has a fundal height measurement of
30 cm. This finding suggests:
A. Normal progression of pregnancy
B. Possible intrauterine growth restriction
C. Multiple gestation
D. Polyhydramnios
Rationale: The correct answer is B. Fundal height in centimeters should approximately match
gestational age in weeks (±2 cm). A measurement of 30 cm at 36 weeks indicates a
discrepancy of 6 cm, suggesting possible intrauterine growth restriction. This is not normal
progression (A). Multiple gestation (C) and polyhydramnios (D) typically cause larger than
expected measurements, not smaller.
13. Which of the following assessments would be most important to perform during the first
prenatal visit?
A. Fetal heart rate monitoring
B. Comprehensive maternal health history
C. Screening for gestational diabetes
D. Vaginal examination to determine cervical dilation
Rationale: The correct answer is B. A comprehensive maternal health history is most important
at the first visit to identify risk factors and guide care. Fetal heart rate monitoring (A) may not be
possible in very early pregnancy. Gestational diabetes screening (C) is typically done at 24-28
weeks. Vaginal examination for cervical dilation (D) is not routinely performed at prenatal visits
unless indicated.
14. A pregnant woman at 18 weeks gestation asks when she should start attending childbirth
education classes. The most appropriate response is:
A. "It's too early to think about that now."
B. "Classes are unnecessary if you read books about childbirth."
C. "Around 28-32 weeks is a good time to start classes."
D. "You should have started classes immediately after confirming pregnancy."
Rationale: The correct answer is C. Starting childbirth education classes around 28-32 weeks
allows time to complete the course before delivery while the information remains fresh. Starting
earlier (D) means information may be forgotten. It's not too early to plan (A), and while reading is
helpful, classes offer practical skills and support that books alone cannot provide (B).
15. A pregnant woman at 8 weeks gestation reports taking which of the following medications
that would be of greatest concern?
A. Prenatal vitamins
B. Acetaminophen occasionally for headache
C. Isotretinoin for acne
D. Over-the-counter antacids
Rationale: The correct answer is C. Isotretinoin is a known teratogen (FDA Category X) with high
risk of severe birth defects. Prenatal vitamins (A) are recommended during pregnancy.
Occasional acetaminophen (B) is generally considered safe. Over-the-counter antacids (D) are
typically considered safe, though some formulations are preferred over others.

Intrapartum Care
16. A woman in labor has contractions every 3 minutes, lasting 60 seconds, of strong intensity.
The cervix is 6 cm dilated with 100% effacement. This describes which phase of labor?
A. Latent phase of first stage
B. Active phase of first stage
C. Transition phase of first stage
D. Second stage
Rationale: The correct answer is B. The active phase of the first stage is characterized by
regular contractions and cervical dilation from 6-8 cm. The latent phase (A) involves dilation up
to 5-6 cm. The transition phase (C) involves dilation from 8-10 cm with very frequent
contractions. The second stage (D) begins with complete dilation (10 cm) and ends with delivery.
17. During vaginal examination of a woman in labor, the fetal head is at +1 station. This finding
indicates that the presenting part is:
A. 1 cm above the ischial spines
B. 1 cm below the ischial spines
C. At the level of the perineum
D. Not yet engaged in the pelvis
Rationale: The correct answer is B. Station refers to the relationship of the presenting part to the
ischial spines, which are designated as zero (0) station. A +1 station means the presenting part is
1 cm below the ischial spines. A measurement of 1 cm above would be -1 station (A). The
perineum (C) would be around +4 or +5. Engagement occurs when the presenting part reaches
zero station or below, so the head is engaged (D is incorrect).
18. A woman in active labor has fetal heart rate decelerations that begin with the onset of
contractions and recover at the end of contractions. These are classified as:
A. Early decelerations
B. Late decelerations
C. Variable decelerations
D. Prolonged decelerations
Rationale: The correct answer is A. Early decelerations begin with contraction onset and recover
by the end of contractions, typically caused by fetal head compression and considered benign.
Late decelerations (B) begin after contraction onset and recover after the contraction ends,
indicating potential uteroplacental insufficiency. Variable decelerations (C) have varying onset,
depth, and recovery, typically from cord compression. Prolonged decelerations (D) last ≥2
minutes.
19. During the second stage of labor, the most appropriate maternal position to facilitate fetal
descent is:
A. Supine position
B. Lateral position
C. Upright position or squatting
D. Trendelenburg position
Rationale: The correct answer is C. Upright positions or squatting use gravity to facilitate fetal
descent and widen pelvic dimensions. The supine position (A) can cause supine hypotension
syndrome and doesn't optimize pelvic dimensions. Lateral position (B) may be comfortable but
doesn't maximize gravity's assistance. Trendelenburg position (D) works against gravity for fetal
descent.
20. A laboring woman who is fully dilated and feels the urge to push should be instructed to:
A. Hold her breath and push throughout each contraction
B. Push only when she feels the urge, following her body's cues
 C. Push between contractions
D. Avoid pushing until directed by the physician
Rationale: The correct answer is B. Following the urge to push works with physiological reflexes
and is associated with shorter second stage and fewer interventions. Prolonged breath-holding
(A) can reduce maternal cardiac output and fetal oxygenation. Pushing between contractions
(C) is ineffective. Delaying pushing despite the urge (D) works against physiological reflexes.
21. A primigravida in active labor has ruptured membranes with clear fluid. Two hours later, she
develops a temperature of 38.2°C, maternal tachycardia, and fetal tachycardia. These
findings suggest:
A. Normal labor progression
B. Chorioamnionitis
C. Maternal dehydration
D. Epidural effect
Rationale: The correct answer is B. Fever, maternal tachycardia, and fetal tachycardia after
membrane rupture suggest chorioamnionitis (intra-amniotic infection). This is not normal labor
progression (A). While dehydration (C) can cause some tachycardia, the combination with fever
after membrane rupture strongly suggests infection. Epidural (D) may cause some temperature
elevation but typically not this constellation of symptoms.
22. The nurse is caring for a woman in labor who has just received epidural anesthesia. Which of
the following nursing interventions is most important?
A. Encourage ambulation to speed labor
B. Monitor maternal blood pressure and fetal heart rate
C. Restrict all oral intake
D. Perform a vaginal examination every 30 minutes
Rationale: The correct answer is B. Monitoring blood pressure and fetal heart rate is critical after
epidural placement due to risks of hypotension and subsequent fetal heart rate changes.
Ambulation (A) is contraindicated after epidural due to leg weakness. While oral intake may be
restricted, this is not the most important intervention (C). Vaginal examinations every 30 minutes
(D) are excessive and increase infection risk.
23. During the third stage of labor, the nurse observes a sudden gush of blood and lengthening
of the umbilical cord. The most appropriate nursing action is to:
A. Pull firmly on the cord to deliver the placenta
B. Notify the physician that the placenta is separating
C. Massage the uterine fundus vigorously
D. Apply controlled cord traction with suprapubic counter-pressure
Rationale: The correct answer is D. Controlled cord traction with suprapubic counter-pressure is
the appropriate technique when signs of placental separation are present. Pulling firmly on the
cord (A) risks uterine inversion. While the physician should be aware, notifying them (B) is not an
action. Vigorous fundal massage (C) before placental delivery may cause partial separation and
bleeding.
24. A woman has been pushing for 2 hours in the second stage of labor. The fetal head is visible
at the perineum with contractions. The FHR is 110-120 bpm with good variability. The most
 appropriate nursing action is:
A. Prepare for emergency cesarean section
B. Continue to support pushing efforts
C. Administer oxygen by mask
D. Position the mother in Trendelenburg
Rationale: The correct answer is B. With the fetal head visible and reassuring FHR, continuing to
support pushing is appropriate. For a primigravida, up to 3 hours of pushing can be normal.
Emergency cesarean (A) is not indicated with visible fetal head and reassuring FHR. Oxygen (C)
is not needed with reassuring FHR. Trendelenburg position (D) works against gravity and fetal
descent.
25. A laboring woman receives narcotic analgesia. The nurse should monitor closely for which
potential side effect in the newborn?
A. Hyperactivity
B. Respiratory depression
C. Hyperthermia
D. Hypertension
Rationale: The correct answer is B. Respiratory depression is the primary concern for newborns
when mothers receive narcotics close to delivery. Narcotics typically cause CNS depression, not
hyperactivity (A). Hyperthermia (C) and hypertension (D) are not typical narcotic effects in
newborns.
26. During labor, which of the following findings would indicate potential fetal compromise
requiring immediate intervention?
A. F
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