3.
The Dental Health Program of the DOH has committed to contribute to the
improvement of the quality
of life of Filipinos through its project Sang Milyong Sepilyo for which strategy?
a. Operation research study
b. Social mobilization
c. Partnership with other sector
d. Capability building and value formation
Answer: B
The Dental Health Program conceptualizes a strategy through Sang Milyong
Sepilyo project for Social
Mobilization.
Source: DOH (Green and Yellow) pp. 123
4. The setting under which health assessment will be made is best decided by:
a. What is practical and effective
b. The public health supervisor
c. What is the agencies standard operating procedure
d. Both the nurse and the client
Answer: D
The nursing care plan is prepared jointly with the family. This is consistent with the
principle that the
nurse works with and not for the family. She involves the family in determining
health needs and
problems in establishing priorities, in selecting appropriate courses of actions,
implementing them and
evaluating outcomes. Through participatory planning, the nurse makes the family
feel that the health of
its members is a family responsibility and commitment.
Source: Nursing Practice in the Community 4th Ed, pp. 84
10. Which of the following is the health concern in the primary level of prevention?
a. Development of health habits and practices
b. Poverty alleviation
c. Early and prompt treatment
d. Case finding
Answer: A
Primary prevention is directed to the healthy population, focusing on prevention of
emergence of risk
factors and removal of the risk factors or reduction of their levels.
Secondary prevention aims to identify and treat existing health problems at the
earliest problems. The
interventions at this stage can still lead to the control or eradication of the health
problem. Such
interventions include screening, casefinding, disease surveillance, prompt and
appropriate treatment.
Tertiary prevention limits disability progression. The nurse attempts to reduce the
magnitude or severity
of the residual effects of both infectious diseases and non communicable ones.
Source: Nursing Practice in the Community 4th Ed, pp.180
11. Which one of the following is not a pillar of PHC?
a. Multi sectoral approach
b. Community involvement
c. Appropriate technology
d. Qualification of health providers
Answer: D
The four cornerstones or pillars of Primary Health Care are active community
participation, multisectoral
linkages, use of appropriate technology and support mechanisms made available.
Source: DOH ( Green and Yellow ) pp. 69
10. Which of the following is the health concern in the primary level of prevention?
a. Development of health habits and practices
b. Poverty alleviation
c. Early and prompt treatment
d. Case finding
Answer: A
Primary prevention is directed to the healthy population, focusing on prevention of
emergence of risk
factors and removal of the risk factors or reduction of their levels.
Secondary prevention aims to identify and treat existing health problems at the
earliest problems. The
interventions at this stage can still lead to the control or eradication of the health
problem. Such
interventions include screening, casefinding, disease surveillance, prompt and
appropriate treatment.
Tertiary prevention limits disability progression. The nurse attempts to reduce the
magnitude or severity
of the residual effects of both infectious diseases and non communicable ones.
Source: Nursing Practice in the Community 4th Ed, pp.180
11. Which one of the following is not a pillar of PHC?
a. Multi sectoral approach
b. Community involvement
c. Appropriate technology
d. Qualification of health providers
Answer: D
The four cornerstones or pillars of Primary Health Care are active community
participation, multisectoral
linkages, use of appropriate technology and support mechanisms made available.
Source: DOH ( Green and Yellow ) pp. 69
13. Infant mortality rate means death under one year of age per 1000 live births.
Which formula below is
correct?
a.
Deaths under one year X 100
Live births of the same year
b.
Deaths under one year X 1000
Live births of the same year
c.
Live births of the same year X 100
Deaths under one year
d.
Live births of the same year X 1000
Deaths under one year
Answer: B
Infant mortality rate measures the risk of dying during the 1st year of life. It is a
good index of the general
health condition of a community since it reflects the changes in the environmental
and medical conditions
of a community.
Source: DOH ( Green and Yellow ) pp. 330
14. These are essential characteristics you must consider most in providing primary
health care except:
a.
Accessibility of health service
b.
Health Programs financial assistance
c.
Multisectoral approach to health care
d.
Appropriate technology
Answer: B
A, C and D together with the support mechanism made available characterized the
primary health care.
Source: DOH ( Green and Yellow ) pp. 69
Situation 2: The following 2006 data are available in your health center. You analyze
these for planning
purposes.
No. of population -24,000
Population under 1 year -600
No. of infant deaths -3
No. of live births -600
No. of maternal deaths -6
Total deaths from all causes -900
No. of deaths from Pneumonia -100
No. of Pneumonia cases -450
15. The crude birth rate for 2006 is:
a. 24/1000
b. 25/1000
c. 30/1000
d. 32/1000
Answer: B
Crude Birth Rate=Total # of live births registered in a given calendar year X 1000
Mid Year Population
= 600 X 1000
24000
= 600000
24000
= 25/1000
Source: DOH ( Green and Yellow ) pp. 330
16. The maternal mortality rate is:
a. 10/1000
b. 20/1000
c. 12/1000
d. 15/1000
Answer: A
MMR =Total # of deaths from maternal causes registered for a given year X 1000
Total # of livebirths registered of same year
= 6_ X 1000
600
= 6000
600
= 10/1000
Source: DOH ( Green and Yellow ) pp. 330
17. The infant mortality rate is:
a. 5/1000
b. 4/1000
c. 3/1000
d. 2/1000
Answer: A
IMR=Total # of deaths under 1yr of age registered in a given calendar year X 1000
Total # of registered live births of same calendar year
= 3 X 1000
600
= 3000
600
=5
Source: DOH ( Green and Yellow ) pp. 330
18. The case fatality rate for Pneumonia is:
a. 40%
b. 30%
c. 22%
d. 35%
Answer: C
CFR=No. of registered deaths from a specific disease for a given year X 100
No of registered cases from same specific disease in same year
= 100 X 100
450
= 10000
450
= 22%
Source: DOH ( Green and Yellow ) pp. 333
19. The crude death rate is:
a. 41/1000
b. 38/1000
c. 31/1000
d. 25/1000
Answer. A
Crude Death Rate= Total # of deaths registered in a given calendar year X 1000
Mid Year Population
= 900 X 1000
24000
= 900000
24000
= 37.5/1000
= 38/1000
Source: DOH ( Green and Yellow ) pp. 333
20. What is believed to be a guarantee of effective delivery of health services?
a. Integration
b. Reorganization
c. Devolution
d. Promotion
Answer: C
One of the most significant laws that radically changed the landscape of health care
delivery system in
the country is RA 7160 or more commonly known as the Local Government Code.
The Code aims to
transform local government units into self reliant communities and active partners
in the attainment of
national goals through a more responsive and accountable local government
structure instituted through
a system of decentralization.
Source: Nursing Practice in the Community 4th Ed, pp. 25
21. Why was there devolution?
a. To bring services nearer to the people
b. To empower local politicians
c. To become self reliant
d. To stop funding from national funds
Answer: C
One of the most significant laws that radically changed the landscape of health care
delivery system in
the country is RA 7160 or more commonly known as the Local Government Code.
The Code aims to
transform local government units into self reliant communities and active partners
in the attainment of
national goals through a more responsive and accountable local government
structure instituted through
a system of decentralization.
Source: Nursing Practice in the Community 4th Ed, pp. 25
22. For a group of children where interaction with causative agents of disease has
not taken place, the
nurse concern is to provide:
a. Diagnostic and curative type
b. All this type of care
c. Promotive and preventive care
d. Rehabilitative care
Answer: C
Primary prevention is directed to the healthy population, focusing on prevention of
emergence of risk
factors and removal of the risk factors or reduction of their levels. In communicable
disease prevention,
activities on primary prevention are targeted at intervening before the agent enters
the host and cause
pathological changes.
Secondary prevention aims to identify and treat existing health problems at the
earliest problems. The
interventions at this stage can still lead to the control or eradication of the health
problem. Such
interventions include screening, case-finding, disease surveillance, prompt and
appropriate treatment.
Tertiary prevention limits disability progression. The nurse attempts to reduce the
magnitude or severity
of the residual effects of both infectious diseases and non communicable ones.
Source: Nursing Practice in the Community 4th Ed, pp.180
23. When modifying harmful health practices, among minority families, the most
important factor to
remember is:
a. Ensure that the change blends with their culture
b. Increase health knowledge of the family
c. Involve the family in bringing about change
d. Persuade family to change practices.
Answer: C
Involve the family in bringing about change. Active participation of individuals,
families, and the health
community, in planning and making decisions for their health care needs, determine
to a large extent, the
success of community health nursing program. Organized community groups are
encouraged to
participate in activities thnat will meet community needs and interest.
Source: CHN by DOH page 31.
24. The following are approved types of toilet facilities under level I except:
a. pit latrines
b. reed odorless earth closet
c. pour flush toilet
d. water sealed and flush type with septic vault
Answer: D.
Level I
Non water carriage toilet facility no water is necessary to wash the waste into the
receiving
space. Ex: pit latrines, reed odorless wart closet
Toilet facilities requiring small amount of water to wash the waste into the receiving
space. Ex:
pour flush toilet and aqua privies.
Level II
on site toilet facilities of the water carriage type with water sealed and flush type
with septic
vault/tank disposal facilities.
Level III
-water carriage types of toilet facilities connected to septic tanks and/ or to
sewerage system to
treatment plant.
Source: Community Health Nursing Services in the Philippines, p. 317
25. An approved type of water supply facility which is composed of a source, a
reservoir, a piped
distribution network and communal faucets, located at not more than 25 meters
from the farthest house is
level:
a. II
b. I
c. IV
d. III
Answer: A.
Level II (Communal faucet system or Stand Posts) a system composed of a source, a
reservoir, a piped
distribution network and communal faucets, located at not more than 25 meters
from the farthest
house. The system is designed to deliver 40-80 liters of water per capital per day to
an average of
100 households.
Level I (Point source) a protected well or developed spring with an outlet but without
a distribution system,
generally adaptable for rural areas where the house are thinly scattered. It serves
around 15-25
households and its outreach must not be more than 250 meters from the farthest
user. The yield
or discharge is generally from 40-140 liters per minute.
Level III (Waterworks system or Individual House Connections) A system with a
source, a reservoir, a
piped distributor network and household taps. It is generally suited for densely
populated urban
areas; this type of facility requires a minimum treatment of disinfection.
Source: Community Health Nursing Services in the Philippines, p. 315
27.
Which one of the following is the local government code?
a.
RA 4073
b.
RA 3573
c.
EO 119
d.
RA 7160
Answer: D
RA 7160 or commonly known as Local Governement Code.
RA 4073 liberalizes the treatment of leprosy
RA 3573 declares that all communicable diseases should be reported to the nearest
health station.
28. Which laws cover Ethical Conduct of Public Officials?
a.
RA 7305
b.
LOI 949
c.
RA 6713
d.
RA 6675
Answer: A
RA 7305 is known as the Magna Carta for Public Health Workers.
LOI 949 Legal basis for PHC
RA 6713- Code of Conduct and Ethical Standards for Public Officials and Employees
RA 6675- Generics Act of 1988
29. RA No. 7277 is otherwise known as:
a. Magna Carta for Public Health workers.
b. Magna carta for Disabled persons
c. National Immunization Days
d. Traditional and Alternative Health Care
Answer: B.
RA 7305 is Magna Carta for Public Health workers
RA 8423 is Traditional and Alternative Health Care
Source: Community Health Nursing Services in the Philippines, p. 354
30. It is an act requiring compulsory immunization against hepatitis B for infants
and children below eight
(8) years old.
a. RA7846
b. RA 6365
c. RA 6758
d. RA 8749
Answer: A.
RA 7846 is an act requiring compulsory immunization against hepatitis B for infants
and children below
eight (8) years old.
Source: Community Health Nursing Services in the Philippines, p.100
RA 6365 established a National Policy on Population and created the Commission of
Population.
RA 6758 standardized the salaries of government employess which included the
nursing personnel.
RA 8749 is the Clean air Act. Approved in year 2000 but took effect on January of
2001.
Source: Community Health Nursing Services in the Philippines, pp. 352-353
41. Expected results of Sentrong Sigla Movement for the individuals includes all of
the following except:
a. Adopt healthy lifestyle
b. Demand for quality health services
c. Develop systems for surveillance/ merits
d. Promote well-being
Answer: C
Expected Results of Sentrong Sigla Movement
44. Which of the following is a primary element of EPI?
a. Logistic management
b. Target setting
c. Information campaign
d. Surveillance and Research
Answer: B
Elements of EPI:
1. Target Setting
2. Cold chain logistic management
3. Information, education, and communication
4. Assessment and evaluation of the programs overall performance.
5. Surveillance, studies and research
Source: Community Health Nursing Services in the Philippines, p. 109
45. Isolation techniques in the home are difficult to do but fundamental principles
must be followed.
Soiled articles with discharges should be boiled in water before laundry. How long
should these articles
be boiled?
a. One hour
b. Two hours
c. One half day
d. Thirty minutes
Answer: D
Articles soiled with discharges should first be boiled in water 30 minutes before
laundering. Those which
could be burned should be burned.
Source: DOH ( Blue and Yellow) pp. 62
46. Disinfection of water supply sources are required on the following except:
a. newly constructed water supply facilities
b. water supply facility that has been repaired/improved
c. water supply sources found to be negative bacteriologically by laboratory
analysis.
d. Container disinfection of drinking water collected from a water facility that is
subject to recontamination
like open dug wells, unimproved springs and surface water.
Answer: C.
Disinfection of water supply sources is required on the following:
49. The ten elements of reproductive health includes all of the following except:
a. Maternal and child health and nutrition
b. Mens reproductive health
c. Violence against women
d. Rehabilitation on reproductive health disorders
Answer: D
Ten Elements of Reproductive Health
a. Maternal and Child Health and Nutrition
b. Family Planning
c. Prevention and Management of Abortion Complications
d. Prevention and Treatment of Reproductive Tract Infection
e. Education and Counseling on Sexuality and Sexual Health
f. Breast and Reproductive Tract Cancers and Other Gynecological conditions
g. Mens Reproductive Health
h. Adolescent Reproductive Health
i. Violence Against Women
j. Prevention and Treatment of Infertility and Sexual Disorder
Source: Community Health Nursing Services in the Philippines, p. 86
a. newly constructed water supply facilities
b. water supply facility that has been repaired/improved
c. water supply sources found to be positive bacteriologically by laboratory analysis.
d. Container disinfection of drinking water collected from a water facility that is
subject to recontamination
like open dug wells, unimproved springs and surface water.
Source: Community Health Nursing Services in the Philippines, p. 316
53. Preventive and Promotive health as a policy statement of the Department of
Health (DOH) refers to
the following except:
a.
The hospitals and other center for curative care are not required to integrate
Promotive/ preventive
health programs and health care delivery.
b.
Preventive and Promotive care will be the priority of the DOH and its partners in
health
c.
Hospitals will also become centers of wellness
d.
The DOH will promote health and prevent disease and disability in work-sites,
schools, industrial
areas and commercial centers.
Answer: A
It is on the DOH mandate.
The DOHs primary function is the promotion, protection, preservation restoration of
the health of the
people through the provision and delivery of health services and through the
regulation and
encouragement of providers of health goods and services.
Source: CHN by DOH (Blue book) page 1
54. Following are initial steps to gain entry in Organizing a Community for Health
Action
1. Gather initial information about the community from other members of the RHU
or from
records and reports
2.
Make your courtesy calls
3.
Prepare agenda for the first meeting
4.
Arrange meeting with identified leaders, request barangay officials to sign for a
meeting
a.
1, 2, 3, 4
b.
2, 4, 1, 3
c.
3, 1, 4, 2
d.
1, 2, 4, 3
Answer: D
The following are initial steps to be done:
1. Gather initial information about the community from other members of the RHU
or from records and
reports.
2. List down names of persons to contact for a courtesy call
3. Arrange first meeting with identified key leaders, request barangay officials to
sign invitation for a
meeting
4. Prepare agenda for the first meeting.
Source: CHN Services in the Phil. Dept of Health, 9th ed., p. 312.
57. We consider a 2-year-old a fully immunized child when he was able to receive:
a. 1 BCG, 2 DPT, 2 OPV, 3 Hepatitis, 1 measles
b. 2 BCG, 3 DPT, 3 OPV, 3 Hepatitis, 1 measles
c. 1 BCG, 3 DPT, 3 OPV, 3 Hepatitis, 1 measles
d. 1 BCG, 3 DPT, 3 OPV, 3 Hepatitis, 2 measles
Answer: C
Source: CHN by DOH 9th Ed page 110-111
58. Which is a primary element of EPI?
a. Target setting
b. Assesment
c. Surveillance
d. Education
Answer: A
Elements of EPI includes target setting, cold chain logistic management,
information, education and
communication, Assessment and evaluation of programs overall performance; and
surveillance, studies
and research. Choices B, C, and D are incomplete
Source: CHN by DOH 9th Ed
67. We have three levels of assessment. In the first level assessment, which among
these problems is
not a health threat?
a. broken stairs
b. strained marital relationship
c. self medication
d. illegitimacy
Answer: D
Illegitimacy is listed under foreseeable crisis. A, B and C are all health threats.
Source: Nursing Practice in the Community 4th Ed., by Maglaya, pp. 68-70
68. In the Family service and Progress record, one item that should have an
answer regarding our
informant is marital status. What is the appropriate term given to a couple living
together as husband and
wife without the benefit of legal marriage?
a. married
b. live-in partner
c. single
d. common law
Answer: D
Common law is the cohabitation of a couple even when it does not constitute a legal
marriage. Married if
legally married. Single if those who have never been married. Live-in partner is not
an appropriate term.
Source: Merriam Websters Collegiate Dictionary 10th Ed, pp. 232
69. What refers to the familys evaluation of the problem in terms of seriousness
and urgency?
a. Nature of the problem
b. Modifiability of the problem
c. Salience
d. Preventive potential
Answer: C
A is categorized into health threat, health deficit and foreseeable crisis. B refers to
the probability of
minimizing or totally eradicating the problem. D refers to the nature or magnitude
of the future problems
that can be minimized or totally prevented if intervention is done on the problem.
Source: Nursing Practice in the Community 4th Ed., by Maglaya, pp. 86
76. Disinfection of water supply sources is required on a newly constructed well,
required water pipes,
contaminated water supply and container disinfections collected from all except:
a. Open wall
b. Surface water
c. River dam
d. Unimproved spring
Answer: C
Disinfections of water supply sources are required on the following:
1. Container disinfection of drinking water collected from a water facility that is
subject to
recontamination like open dug wells, unimproved springs and surface water.
2. Newly constructed water supply
3. Water supply facility that has been repaired or improved
4. Water supply sources found to be positive bacteriologically by laboratory
analysis.
Source: DOH ( Green and Yellow ) , pp. 316
77. The nurse should know that the examination of drinking water by the
government of non-government
must be coordinated by the municipality through RHU.
Certification of potability of an existing water source is issued by the:
a. Sanitary engineer
b. Municipality
c. Secretary of health or his representative
d. DOH
Answer: Certification of potability of an existing water source is issued by the
Secretary of Health or his
duly authorized representative .
Source: DOH ( Green and Yellow) , pp. 316
78. Every municipality through its RHU must formulate an operational for quality
monitoring and surveillance of their water supply every year using the area-
program based approach. Assistance may be solicited from the internal planning
Service in the collaboration with the:
a. DOH
b. Environmental Health Service
c. Secretary of health
d. Mayor
Answer: B
Every municipality through its RHU must formulate an operational for quality
monitoring and surveillance of their water supply every year using the area-
program based approach. Assistance may be solicited from the internal planning
Service in the collaboration with the Environmental Health Service.
Source: DOH ( Green and Yellow) , pp. 316
79.
The Sentrong Sigla Movement (SSM) is a joint program of the Department of
Health and the Local Government Units. What is the aim of this movement?
a. Promote availability of quality health services in health centers and hospitals and
make these
accessible to every Filipino
b. Certification and recognition program
c. Benefits for local executions and health workers
d. Foster better and more effective collaboration between DOH and LGU.
Answer: A
SSM aims to promote availability of quality health services in health centers and
hospitals and to make
these services accessible to every Filipino.
B- this is the main component of the program
D- objectives of SSM
Source : DOH ( Green and Yellow), pp. 125
81.
Guidelines no.2 in the Nutritional Guidelines for Filipinos is intended to promote
exclusive breastfeeding:
a. From birth to 4-6 months
b. from birth to 2 year or longer
c. from birth up to one year only
d. From birth to 5 years
Answer: A
Nutritional Guideline 2 states that breastfeed infants exclusively from birth to 4-6
months and then give
appropriate food while continuing breasfeeding.
Source: Source: DOH ( Green and Yellow ) , pp. 129
Situation: A home visit is a professional face to face contact made by a nurse to the
client or his family.
82. Which of the following is the first step a nurse must do when conducting a home
visit?
a. Place PHN bag in convenient place before doing bag technique
b. Greet client or household member and introduce yourself
c. Explain purpose of visit
d. Look into detailed aspects of the household
Answer: B
Source: DOH ( Green and Yellow) , pp. 53
83. A public health Nurse (PHN) bag is essential and indispensable when a nurse
conducts a home visit. Which of the following is the vital principle in the use of
the bag techniques?
a. Bag when in communicable cases should be thoroughly cleaned and disinfected
before keeping and using.
b. Should minimize if not totally prevent spread of infection from individuals to
families to the community.
c. Arrangements of the contents is convenient to the user
d. Should contain all necessary articles supplies and Equipment.
Answer: B
One of the principles of Bag Technique is that it should should minimize if not totally
prevent spread of
infection from individuals to families to the community.
Source: DOH ( Green and Yellow) , pp. 54
86. It is the certification recognition program that develops and promotes standard
for healthy facilities:
a. Sentrong Sigla Movement
b. Sang Milyong Sipilyo
c. Reproductive health
d. Expanded Program of Immunization (EPI)
Answer: A
SSMs main component is the certification recognition program that develops and
promotes standard for
healthy facilities.
Source: DOH ( Green and Yellow) , pp. 125
87. Among are the pillars of Sentrong Sigla Movement except:
a. Quality assurance
b. Award
c. International recognition
d. All of the above
Answer: C
The 4 Pillars of SSM are the following:
1. Quality Assurance Pillar
2. Grants and Technical Assistance
3. Health Promotion
4. Award Pillar
Source: DOH ( Green and Yellow) , pp. 126
88. All are the priorities of Sentrong Sigla Movement except:
a. EPI
b. Disease surveillance
c. Family Planning
d. Voluntary Blood Donation
Answer: D
A, B and C are the priorities of SSM.
Source: DOH ( Green and Yellow) , pp. 128
89. All of the following are the standard requirements of Sentrong Sigla Movement
except:
a. Infrastructure
b. Equipment
c. Pharmaceuticals
d. Herbal Medicine
Answer: D
The focus of SSMs standards and requirements will be inputs like basic
infrastructure, equipment,
pharmaceuticals, supplies and training that demonstrates preparedness or
readiness of facilities to deliver
quality services.
Source: DOH ( Green and Yellow) , pp. 128
90. An expected result of SSM in every individual is to:
a. Adapt healthy lifestyles
b. Develop policies
c. Develop a system for surveillance
d. Advocate law
Answer: A
B, C and D are expected results of SSM to institutions.
Source: DOH ( Green and Yellow) , pp. 126
Situation: Reproductive Health (RH) is the exercise of reproduction right with
responsibility. One of the goals of the reproductive health is to prevent
illness/injuries related to sexuality and reproduction.
91. The following are goals of RH except:
a. Every pregnancy should be intended
b. Every birth should be healthy
c. All married couple should use artificial contraceptive
d. Achieve a desired family size
Answer: C
A, B and D are goals of RH.
Source: DOH ( Green and Yellow) , pp. 84
92. In the international framework of RH, the focus is on:
a. Past 40 years group age
b. Womens health
c. Displaced people with RH problems
d. Barren couple
Answer: B
In the international framework, the focus is on womens health not only as a mother
during her child
bearing, but throuout life, from infancy to post reproductive health with full exercise
of her reproductive
life.
Source: DOH ( Green and Yellow) , pp. 85
93. Which of the following is not an element of RH?
a. Prevention and management of diseases
b. Violence against women
c. Self-employed
d. Mens reproductive health
Answer: C
A, B and D are among the ten elements of RH.
Source: DOH ( Green and Yellow) , pp. 86
94. In the Philippines, the focus of RH is on:
a. Men and women
b. Men only
c. Women only
d. Women and children
Answer: B
The focus of Philippine framework is the Reproductive Health Status in terms of its
elements. It doesnt
only address women but men and women.
Source: DOH ( Green and Yellow) , pp. 86
95. What factor generally affects reproductive health in the international framework:
a. Poverty
b. Underemployment
c. Environment
d. Gender discrimination
Answer: C
Factors that may affect womens health are the general environment like poverty
and under employment
which could deter them from availing of socials services to the maximum,
powerlessness or gender
discrimination which could deprive women achieve full self development, because
they cannot decide for
themselves, so they are left behind.
Source: DOH ( Green and Yellow) , pp. 85
