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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

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