SITUATION 1: In the Asia, Japanese Encephalitis is the most common cause of vaccine-preventable encephalitis.

The Philippine
Department of Health has been working to include JE vaccine in the existing Expanded Program on Immunization.
1. As a public health nurse, the focus on clientele management is prevention of infected mosquito bites. Which among the following
options is considered as appropriate characteristics of the mosquito specie causing JE?
1. Culex mosquitoes are day biter.
2. Culex mosquitoes are night biter.
3. Female mosquitoes require animal blood meal in order to produce egg.
4. Female mosquitoes require human blood meal in order to produce egg.
5. HIV replicate in mosquitoes but does not survive in them
6. HIV survives in mosquitoes but does not replicate in them.
A. 1 and 3 only
B. 2 and 4 only
C. 1, 3 and 5 only
D. 2, 4 and 6 only
2. The culex mosquitoes are all important vectors responsible for the transmission of all the following apart from:
A. Japanese encephalitis virus
B. St. Louis encephalitis virus
C. Urban Yellow Fever virus
D. West Nile virus
3. As per the recommendation of Center for Disease Control, who among the following will be recommended to receive vaccine
against Japanese Encephalitis virus?
A. A family who is going to stay for undisclosed duration in an area where JE is endemic.
B. A family who will be having a 3-day trekking activity in area where JE is endemic.
C. A person who is going to travel in an area where JE has been declared epidemic.
D. A person who is going to work in a JE endemic area for half a year.
4. Though generally asymptomatic, initial symptoms of this infection include fever, headache and vomiting. One of the audience
during a public discussion asked the public health nurse for the onset of these manifestations. As a nurse you know that these
manifestations are expected to occur, counting from the day of infection, for no longer than:
A. 5 days
B. 10 days
C. 15 days
D. 20 days
5. Among patients who will develop encephalitis, 20-30% can eventually lead to mortality. Which of the following figures can also
be used to represent the lethality of this infection?
A. Out of every five reported cases, one leads to death.
B. Out of every five reported cases, two leads to death.
C. Out of every five reported cases, three leads to death.
D. Out of every five reported cases, four leads to death.
SITUATION 2: The Field Health Services and Information System (FHSIS) composed of various components is being utilized in the
public health nursing to provide summary of data on health services delivery and selected health program accomplished all throughout
the nation.
6. Apart from the provided above, all of the following are included objectives of the FHSIS except:
A. Complete the picture of acute and chronic diseases
B. Ensure that the data reported are useful and accurate and are disseminated in a timely and easy to use fashion.
C. Minimize the recording and reporting burden at the service delivery level in order to allow more time for patient care and
promotive activities.
D. Provide a standardized, facility level database which can be accessed for a more in-depth studies.
7. The weekly report of notifiable diseases, monthly field health services activity report, quarterly dental facility inspection report
and annual nutrition report food supplement are forms used in which component of the FHSIS?
A. Family treatment record
B. Output reports
C. Reporting forms
D. Target client list
8. To monitor clients registered in the National Tuberculosis Program, which component of the reporting system will be most
useful?
A. Family treatment record
B. Output reports
C. Reporting forms
D. Target client list
9. When FHSIS and other sources of data are combined, a public health nurse will be able to use the collated data for program
monitoring and evaluation purposes. FHSIS alone is comprised of four components, the family treatment record, target client list,
 reporting forms and output reports. As a nurse one must be able to distinguish the function of each component. Which one is
correct?
A. Family treatment record constitute the second building block of the FHSIS
B. Output reports is primarily designed to make reports useful for monitoring or management purposes at each level of
DOH management.
C. Reporting forms are passed up passed up to the next higher level facility in the DOH system for review and consolidation in
the current system.
D. Target client list is the fundamental building block or foundation of the FHSIS.
10. The Rural Health Unit was asked to submit their monthly report required by the FHSIS. Which of the following incorrectly
corresponds to the form number and report title of the FHSIS?
I. FHSIS/M-1: Family Planning Subsidized Surgical Procedure Report
II. FHSIS/M-2: Monthly Field Health Services Activity Report
III. FHSIS/M-3: Monthly Dental Health Service Report
IV. FHSIS/M-4: Monthly Laboratory Report
V. FHSIS/M-5: Monthly Mortality Report
VI. FHSIS/M-6: Monthly Natality Report
VII. FHSIS/M-7: Monthly Social Hygiene Clinic Activity Report
A. All except I and VII
B. All except II and VI
C. All except III and V
D. All except IV
SITUATION 3: Quality documentation and reporting are necessary for individualized patient care. Nurse Angelo is assigned to a
diabetic patient named Dandy.
11. Nurse Angelo is aware that a record should contain descriptive, objective observations about what the nurse hears, sees, feels and
smells. The following describes what a record ought to be, except:
A. Dandy appears sad.
B. Dandy is restless as manifested by constant change in bed and disarrayed beddings.
C. Dandy is uncooperative as manifested by refusal to participate in activities of daily living.
D. Dandy states; “I wish I am already going to die”
12. When documenting the intake-output of Dandy, Nurse Angelo must remember that he must use precise measurements to ensure
accuracy. Which of the following does not reflect accuracy?
I. Dandy drank a liberal amount of fluid during the shift
II. Dandy’s intake during the shift is 350 ml.
III. Dandy’s wound is 1 centimeter in length.
IV. Dandy’s wound is large, gaping and malodorous
A. 1 and 2
B. 2 and 3
C. 3 and 4
D. 1 and 4
13. When Nurse Angelo administers the medication, all but one should be included in the immediate documentation after the
procedure for purposes of completion:
A. Any preliminary observations
B. Nursing measure taken for negative response
C. Patient’s response
D. Time, dose and route of medication given
14. Nurses are ethically obligated to keep information about client’s illness and treatment confidential. The person who has the
legitimate access to the patient’s record is the:
A. Attending physician
B. Husband
C. Patient
D. Primary Nurse
15. Nurse Angelo should prevent or reduce infectious agents primarily through the following practices except:
A. Clean the room with antiseptic solutions.
B. Improve safety administration of medicines.
C. Mandatory handwashing upon entry to the hospital.
D. Proper garbage disposal
SITUATION 4: In the achievement of optimum level of functioning, all resources must be managed adequately. One of the resources
employed in the community health nursing is the Integrated Management on Childhood Illnesses. The following questions apply.
16. A child who presents coughing or difficulty breathing may have pneumonia, wherein the lungs become stiff. Which of the
following assessments will qualify a classification of severe pneumonia for a 3-year old child?
A. Has a harsh noise when the child breathes in.
B. Lower chest wall goes in when the child breathes in.
 C. Noted to have a difficulty breathing
D. Respiratory rate that is more than the normal cut-off.
17. Baby Lea, who will be turning 2 months old tomorrow, was brought in the rural health unit. The nurse assessing Baby Lea will
classify fast breathing for this client if the respiratory rate is equal to or more than:
A. 30 breaths/min
B. 40 breaths/min
C. 50 breaths/min
D. 60 breaths/min
18. A 12-month old child was brought in the rural health unit who presents with stridor. As a public health nurse you know that this
assessment was evident because of all reasons apart from:
A. A harsh noise when the child breathes in.
B. A soft musical noise heard when the child breathes out.
C. Interferes with air entering the lungs.
D. It happens when there is swelling of larynx, trachea and epiglottis.
19. Aling Juana came in at the barangay health station together with her baby because of diarrhea for almost 5 days. Further
assessment and data shows no blood in the stool, the child is neither abnormally sleepy nor restless or irritable, no sunken eyes
noted. The nurse offers fluid to the child to which he drinks eagerly. When the nurse pinched the child’s skin, it goes back
immediately. This is classified as:
A. No Dehydration
B. Persistent Diarrhea
C. Severe Dehydration
D. Some Dehydration
20. The 1-month old daughter of Aling Maria has diarrhea for more than 5 days. The following data were obtained by the nurse: no
blood in the stool, both eyes are sunken, the child is irritable. When the nurse pinched the abdomen of the child, it went back
slowly. The nurse then offered some water to which the child drank eagerly. Which of the following classification can be made?
A. No Dehydration
B. Persistent Diarrhea
C. Severe Dehydration
D. Some Dehydration
SITUATION 5: A nurse is guided by various theories to support in clinical practice. The applicability of these different theories
makes nursing practice on a more scientific ground. The following questions apply.
21. The nurse is taking care of an obstetric patient. As basic to her role, she reviewed Hildegard Peplau’s Theory of Interpersonal
Relationships which identified four phases and determines that the first stage is when the pregnant:
A. Begins to have feeling of belongingness.
B. Demonstrates self-reliance in caring for herself.
C. Feels the need to seek professional assistance.
D. Understands the communication of nurse regarding the services offered.
https://books.google.com.ph/books?id=NFG-
CwAAQBAJ&pg=PA20&dq=PEPLAU+ORIENTATION+BEGINS+TO+HAVE+FEELING+OF+BELONGING&hl=en&sa=X&ved
=0ahUKEwilxcDwg7HXAhXDnJQKHY6pA4EQ6AEIJDAA#v=onepage&q=PEPLAU%20ORIENTATION%20BEGINS%20TO%2
0HAVE%20FEELING%20OF%20BELONGING&f=false
22. The nurse learns there are five principles of goal setting according to Locke and Latham’s Theory of Goal Setting and Task
Performance. In which of the following stage does a senior nurse must provide enough time for a colleague to improve
performance?
A. Challenge
B. Commitment
C. Feedback
D. Task Complexity
http://slideplayer.com/slide/5907121/
23. The nurse took note that evaluating the staff is an ongoing function of nursing management. Which of the following is not among
the reasons for conducting evaluation?
A. Dissuade self-evaluation of the staff.
B. Ensures that quality nursing care is provided.
C. Justify the use of resources
D. Provides an indication of the costs of poor quality.
24. Who will be the appropriate individuals suited to become Community Health Workers for the organized community?
A. The existing barangay leaders of other committees.
B. The interested members of the community who volunteered.
C. Those appointed based on the criteria provided by the nurse.
D. Those persons elected from the small groups.
The term "barangay health worker" refers to a person who has undergone training programs under any accredited government and
non-government organization and who voluntarily renders primary health care services in the community after having been accredited
to function as such by the local health board in accordance with the guidelines promulgated by the Department of Health (DOH).
25. The nurse includes airborne precautions in addition to standard precautions to be observed at all times. These include, except:
A. Hand washing techniques
B. Limited patient transport.
C. Positioning and draping of patients.
D. Wearing of mask and gloves
SITUATION 6: Public Health Nurse Annie is assigned to the family of Mr. and Mrs. Lawrence. Kris, a lawyer by profession is
married to Jennifer, a gynecologist. They were blessed with 2 sons, Stephen and Miro, ages 19 and 16, and a daughter, Sierra, who just
turned eight years old. Before Jennifer, Kris was married to Mystica, but ended up with divorce after realizing they were not meant to
be together as happy couple due to irreconcilable differences. Kris found out that Mystica was pregnant but submitted herself to
abortive process which then enraged Kris so much that he decided to move to dissolve their marriage legally. Since both Mr. and Mrs.
Lawrence has been succumbed to their career growth, their children mostly grew up with their Mama, a friend of Jennifer who has
been hired as their maid since Stephen’s birth. The following questions apply.
26. Considering the previous marriage of Kris to Mystica, PHN Annie will classify Kris and Jennifer’s family as:
A. Blended Family
B. Cohabiting Family
C. Extended Family
D. Nuclear Family
FAMORCA, 101
27. In the conduct of the family health assessment, which of the following should PHN Annie bear in mind?
A. Data for assessment can only be obtained through interview with members of the family individually to increase the
objectivity of the assessment.
B. Mama will be counted as member of the family since she’s been in contact with the family for a long time already.
C. One can limit its data collection to observation since objectivity is highly important for this process.
D. Talking to other health workers to whom the family has been previously assigned can be used in the achievement of
the assessment process.
FAMORCA, 106
28. During an early family interview, PHN Annie may use the genogram. Though not demonstrating the typical structure of a Filipino
family, it is a useful too that would help PHN Annie in outlining the family structure. In the creation of this structure, which of the
following is the most appropriate manner that PHN Annie should follow?
A. Jennifer’s name must be closer to Kris followed by Mystica when depicting the parental lineage. For the children lineage,
Sierra’s name must be seen in the leftmost and Stephen’s name on the rightmost.
B. Jennifer’s name must be closer to Kris followed by Mystica when depicting the parental lineage. For the children lineage,
Stephen’s name must be seen in the leftmost and Sierra’s name on the rightmost.
C. Mystica’s name must be closer to Kris followed by Jennifer when depicting the parental lineage. For the children lineage,
Sierra’s name must be seen in the leftmost and Stephen’s name on the rightmost.
D. Mystica’s name must be closer to Kris followed by Jennifer when depicting the parental lineage. For the children
lineage, Stephen’s name must be seen in the leftmost and Sierra’s name on the rightmost.
FAMORCA, 107
29. PHN Annie knows that family fulfills two important purposes: to meet the needs of the society and to meet the needs of
individual family members. In which of the following manner can a family meet the needs of the society, EXCEPT:
A. Family assumes the role as first teacher of children when it comes to understanding and abiding societal rules to maintain
harmony.
B. Family becomes the source of motivation and morale.
C. Family remains to be the universally accepted institution for reproductive function and child rearing, either through natural or
adopted process.
D. Family serves as a unit of production.
FAMORCA, 101-102
30. PHN Annie reminds herself of the critical components of a family interview. Which of the following will help PHN Annie engage
the family during the interview and assessment process?
A. Manners
B. Therapeutic Conversations
C. Therapeutic Questions
D. Both B and C
FAMORCA, 111
SITUATION 7: Nurses, regardless of being in clinical or community setting, must be knowledgeable with the expected growth and
development of pediatric patients. Understanding growth and development will facilitate in the pediatric care.
31. Which age group is required to be immunized as per Presidential Decree No. 996?
A. Children below eight years old.
B. Children with special needs.
 C. Out of school youth
D. School children
32. A school nurse was called to attend to a 4-year old preschool pupil who sustained bruising in the skin. When attending to the
needs of this child, the nurse should remember that children of this age are afraid of:
A. Death
B. Isolation
C. Mutilation
D. Starvation
33. A mother wants to know what to do when her 3-year old son has temper tantrums. The nurse should suggest to the parents to
allow their child to express his anger by the use of a:
A. Ball and bat
B. Pegs and pounding board
C. Punching bag
D. Wad of clay

34. 3-day old Baby Andrea develops yellowish discoloration of the skin. This condition can be explained as:
A. Disorder of the blood clotting mechanism
B. Disorder of the digestive system.
C. Dysfunction of the liver
D. Normal physiologic jaundice
35. Rose was very kind to her intelligent sister but deep inside had hostile feelings toward her. She is manifesting what type of
defense mechanism?
A. Displacement
B. Projection
C. Reaction Formation
D. Sublimation
SITUATION 6: Communicable diseases is among the triple burden of diseases being focused by the present administration with the
intention of securing better health outcomes.
36. To protect a vendor from the dangers of rabies, the public health nurse advises the client to clean the wound thoroughly with soap
and water, consult a physician and receive anti-rabies vaccination. Which among the following vaccine can provide active
immunity?
I. Equine rabies immunoglobulin
II. Human rabies immunoglobulin
III. Purified duck embryo vaccine
IV. Purified Vero cell vaccine
A. I and II
B. I and IV
C. II and III
D. III and IV
37. Another term to connote gonorrhea is, except:
A. Bad Blood
B. GC
C. Morning Drop
D. Strain
Bad Blood is SYPHILIS.
38. Patient with Acquired Immunodeficiency Syndrome are said to be immunocompromised. Which of the following interventions
would the nurse likely best perform to prevent further infection?
A. Administration of antibiotics as ordered.
B. Always check laboratory records of white blood cells and CD4 T-Cells.
C. Hand washing.
D. Monitor for oral infection and meningitis
39. Characteristics of German measles rash includes all of the following except:
A. Pink-red maculopapular rash
B. Rash disappearance is characterized by fine flaking
C. Rashes appears on face going to the trunk to the extremities
D. Rashes are slightly bigger than measles.
After the 1 to 5 days of prodromal signs, a discrete pink-red maculopapular rash begins on the face then spreads downward to the
trunk and extremities. On the 3rd day, the rash disappears. There is generally no desquamation (peeling); if present it is primarily fine
flaking of the skin.
40. Protection that a nurse should employ to prevent herself from being infected by the human immunodeficiency virus include the
following except:
A. Careful handling of syringe to prevent accidentally pricking herself with needles.
B. Use of gloves during delivery.
C. Use of goggles.
D. Use of mask
Use of mask is not necessary in the prevention of AIDS because HIV is not airborne.
SITUATION 9: Investing in eHealth is another vision the present administration would like to focus that will assist the nurse in the
efficiency of health management. This innovation may put pressure on nurses because of its dynamic effort to catch up to the growing
demands of the clientele.
41. Data, when it comes to implementation of information and communications technology, is considered to be as the fundamental
element of cognition. Which of the following is true about data?
A. Data are analyzed facts that do not imply meaning.
B. Data are analyzed facts that imply meaning.
C. Data are unanalyzed facts that do not imply meaning.
D. Data are unanalyzed facts that imply meaning.
FAMORCA, 359
42. The Department of Health’s Philippine Health Atlas tracks the frequency and locale of diseases in real time. Which of the
following is not true about this Geographic Information System (GIS)?
A. A complete solution to understanding the distribution of disease and the problems of public health.
B. Allows health care providers to deliver patient-centered care and targeted disease prevention and management programs.
C. Enables detailed maps to be generated with relative speed and ease.
D. Provides public health practitioners with the ability to provide quick response to questions or concerns raised in community
meeting.
FAMORCA, 360
43. In a data entry through electronic medical records where same information are found in each header of each pages in the
electronic record with neither missing nor incorrect input, which qualities of good data are being exemplified?
I. Accuracy
II. Accessibility
III. Comprehensiveness
IV. Consistency
V. Currency
VI. Definition
A. I, II and III
B. I and III
C. IV, V, VI
D. IV and VI
FAMORCA, 361
44. In the Philippines, it is typical to see diverse and unrelated eHealth projects developing all over the country such as those in
Tarlac and Iloilo due to the legal autonomous power provided to the local government units. Though unifying the systems would
be difficult, it would make consultation across different facilities easier. Which legal act explains this current variety in the
eHealth of Philippines?
A. Republic Act 10028
B. Republic Act 6713
C. Republic Act 7160
D. Republic Act 9173
FAMORCA, 363
45. Which of the following is considered to be the most important key factor in the effectiveness of eHealth?
A. Hardware procurement
B. Software development
C. Staff training
D. System maintenance
FAMORCA, 363
SITUATION 10: A 21-year old beauty pageant finalist was involved in a motor vehicular accident. She was then pieced with traction
and admitted in the surgical ward. Nurse Joshy is assigned to this patient. She has been frustrated because she cannot do her usual
daily activities.
46. The nursing diagnosis that is most appropriate for this patient is:
A. Activity Intolerance
B. Impaired Physical Mobility
 C. Potential for Immobility
D. Risk for Injury and Pathologic Fractures
47. Limitation in the routine activity exercises of the patient affects her self-esteem. To help increase the patient’s self-esteem, the
nurse understands that:
A. Being confined in bed with no productive activity causes depression.
B. Self-esteem depends upon having a feeling of usefulness and independence.
C. Self-esteem is dictated by one’s state of physical health and beauty.
D. The current problem exacerbates the patient’s already low self-esteem.
48. Nurse Joshy maintains the patient’s good body alignment while she is in traction in order to:
A. Decrease workload of the heart.
B. Maintain body posture and strength.
C. Promote efficient circulation and enhance lung expansion.
D. Promote proper body balance and optimal brain functioning.
49. Nurse Joshy should make sure to include all but one of the following principles to come up with effective interventions when
taking care for this patient:
A. Patients on traction need adequate skin care and proper positioning.
B. Steady pull from both directions keep the fractured bone in place.
C. Traction can be used to correct or prevent deformities.
D. Weights should be kept resting on the floor.
50. Part of a nursing care for a patient on traction is giving instructions for isometric exercises in order to:
A. Improve lung capacity
B. Maintain muscle strength
C. Normalize blood pressure
D. Prevent decubitus ulcer
SITUATION 11: Prior to Duterte Health Agenda, the Philippines follow under the Primary Health Care the strategy of FOURmula
one to achieve the maximum level of wellness of Filipinos.
51. Which of the following statements is incorrect?
A. Better health outcomes is among of the goals enlisted in the implementation.
B. FOURmula ONE for Health is the framework for implementation which intends to implement critical interventions as a
single package.
C. Health Sector Reform Agenda is the overriding goal of Department of Health.
D. The strategy for achievement of the goal contains three vital elements which include Health Financing.
52. In which of the following scenario does the National Health Insurance Program demonstrates its role in terms of governance?
A. NHIP acts as a driver for improved performance in the health sector
B. NHIP demands fair compensation for the costs of care directed at providing essential goods and services in health
C. NHIP is a prudent purchaser of health care thereby influencing the health care market and related institutions
D. NHIP reduces the financial burden placed on Filipinos by health care costs.
53. Health Regulation, as an element of FOURmula ONE for Health, specifically ensures which important characteristic of public
health services?
A. Accessibility and Affordability
B. Accessibility and Availability
C. Affordability and Quality
D. Availability and Quality
54. The Philippine Health Insurance Corporation and Department of Health are expected to collaborate to lead which element of the
strategy?
A. Good Governance
B. Health Financing
C. Health Regulation
D. Health Service Delivery
55. When the PhilHealth demands for justifiable compensation in exchange of a quality health services, which supporting role is
demonstrated?
A. Financing
B. Governance
C. Regulation
D. Service Delivery
SITUATION 12: Nursing profession is well regulated by the Professional Regulatory Board of Nursing to ensure the safety of the
patient. A managerial function is important in the event of any ethical and legal questions, a nurse will be able to act prudently.
56. A new staff nurse is attending an orientation program. The supervisor emphasizes close collaboration with the health team as an
important function of the nurses. The nurse demonstrates this when she:
A. Creates a discharge plan as soon as the patient is admitted to the ward.
B. Identifies the community health centers that the patient can visit when discharged.
C. Leaves the decision making to the doctor who is the recognized leader of the multidisciplinary team.
 D. Shares her knowledge and expertise with other nurse and solicits the expertise of others.
57. A staff nurse in the emergency room is well-liked by her colleagues because she could easily relate well with co-workers. For the
past two months she has been absent four to five times. She had been given a written admonishment for unexcused absences.
Which of the following is the best course of action of the head nurse?
A. Dismissal
B. Suspension
C. Verbal Admonishment
D. Warning
58. Which of the following should the nurse take into consideration when the patient has a DNR order?
A. Consider the views of the family who are against DNR.
B. The competent patient’s values and choices should always be given highest priority.
C. The DNR order is not separate from other aspects of patient’s care.
D. The order of the physician is final and not subjected to explicit discussion.
59. A nurse in the cancer unit is in a quandary in carrying out a DNR order due to personal beliefs. Which of these is an appropriate
nursing action in this situation?
A. Consider a change of assignment
B. Ignore personal beliefs and feelings in the situation.
C. Seek comfort and allay one’s fears through stress management.
D. Seek counseling session with the nurse supervisor on duty.
60. Doctor’s order are medical interventions that the nurse is expected to implement. By education and training, the nurse may choose
not to follow doctor’s order. Which of statements is not true?
A. By carrying out a wrong order, the nurse is just as liable as the person who wrote the order.
B. Clarifying an order is competent nursing practice and protects the client from potential harm.
C. The knowledge base of the professional nurse allows her to recognize errors and to correct it.
D. The nurse has less training than the doctor and clarifying an order is against hospital protocol.
SITUATION 13: A researcher investigated the effect of crossing of a leg at the knee during blood pressure measurement of clients’
blood pressure. Participants were recruited from outpatient of a government training consisting of fifty males and fifty females, twenty
one to seventy years of age with diagnosis of hypertension.
61. Which of the following describes this type of research?
A. Applied research
B. Basic research
C. Qualitative research
D. Quantitative research
62. The researcher explains to the participants the nature of the study. Which of the following describes the action of the researcher?
A. Full Disclosure
B. Human Dignity
C. Informed Consent
D. Self-Determination
63. The research question for this study may be stated as follows:
A. What is the blood pressure of the participants before crossing a leg at the knee?
B. What is the effect of crossing a leg at the knee on the blood pressure of the participants?
C. What is the initial blood pressure of the participants with a leg crossed at the knee?
D. What should be the position of the leg when measuring blood pressure?
64. Which of the following is the most appropriate instrument in the measuring the dependent variable?
A. Observational rating instrument
B. Participants observation
C. Self-report method
D. Support system
65. The researcher found out that the blood pressure measurements are higher when a leg is crossed at the knee and the probability is
less than one in 10,000. With these findings, the researcher concludes that:
A. Crossing the leg at the knee is significantly related to the blood pressure.
B. The blood pressure decreases when a leg crossed at the knee.
C. There is an increase in blood pressure when a leg is crossed at the knee.
D. There is no change in the blood pressure reading when a leg is crossed at the knee.
SITUATION 14: With the incumbent political regime, the health sector is guided by a new protocol otherwise the Philippine Health
Agenda 2016-2022 sharing almost the same goals as with the previous health programs.
66. Similar to FOURmula One, Better Health Outcome is among the goals of the Philippine Health Agenda 2016-2022. Particularly it
intends to advance quality health promotion and primary care. Which of the following is not included among the key activities in
the achievement of this strategy?
A. Conduct annual health visits for all poor families and special population.
B. Enhance and enforce PhilHealth contracting policies for better viability and sustainability
C. Support local government units in advancing pro-health resolutions or ordinances.
 D. Transform selected DOH hospitals into mega-hospitals with capabilities for multi-specialty training and teaching and
reference laboratory.
67. Which key activities will allow the realization of the agenda’s goal toward responsiveness?
I. Eliminate queuing, guarantee decent accommodation and clean restrooms in all government hospitals.
II. Expand PhilHealth benefits to cover outpatient diagnostics, medicines and blood products.
III. Raise more revenues for health such as improving premium collection efficiency.
IV. Reduce turnaround time and improve transparency of processes at all DOH health facilities.
A. I and II
B. I and IV
C. II and III
D. III and IV
68. In which of the following methods can the public health agency enforce standards, accountability and transparency?
I. Establish expert bodies for health promotion and surveillance and response
II. Harness and align the private sector in planning supply side investments
III. Publish health information that can trigger better performance.
IV. Set up dedicated performance monitoring unit to track progress of reforms
A. I and II
B. I and IV
C. II and III
D. III and IV
69. Another main strategy of this agenda is to harness the power of strategic development of human resources for health, particularly
through making fully-funded scholarships available for HRH hailing from geographically-isolated and disadvantaged areas
(GIDA). Apart from scholarships, which of the following is also included in the activities to meet this strategy?
A. Formulate mechanisms for mandatory return of services schemes for all health graduates.
B. Update frontline staffing complement standards from competency-based to profession based.
C. Both A and B
D. Neither A Nor B
70. Furthermore, which strategy of the agenda allows for the realization of the Guarantee 3 of the same agenda?
A. Advance quality, health promotion and primary care.
B. Cover all Filipinos against health-related financial risk.
C. Invest in eHealth and data for decision making.
D. Value all clients and patients, especially the poor, marginalized and vulnerable.
SITUATION 15: Recently, the Department of Health issued a fun way to remind Filipino parents to bring their baby back to bakuna
because of the reported decreased in the patronization of these safe agents. As a public health nurse one can encourage the community
with continued patronage through competent practice.
71. As a public health nurse one must not only be familiar with the indication of vaccines, but also with its composition and form.
Which of the following vaccines are freeze-dried and necessitates special diluent for reconstitution?
A. Anti-measles and BCG vaccines
B. Hepatitis B and Measles-Mumps-Rubella vaccines
C. Oral Polio and Pentavalent vaccines.
D. Rotavirus and Tetanus toxoid vaccines
FAMORCA, 226
72. Nurses in the community are likewise expected to competently administer vaccines utilizing the right technique to prevent further
issue on immunizations. All vaccines are administered parenterally except for:
A. Rotavirus vaccine only.
B. Rotavirus and Polio vaccines only.
C. Rotavirus, Polio and Pentavalent vaccines only.
D. Rotavirus, Polio, Pentavalent and Measles-Mumps-Rubella vaccines only
FAMORCA, 225
73. Which of the following guarantees safety when it comes to immunization administration?
A. Vaccines that are freeze-dried can be reconstituted with a fluid vaccine.
B. Vaccines can be administered simultaneously.
C. Vaccines can be mixed in a single syringe.
D. None of the above
FAMORCA, 228
74. Following a community delivery, the public health nurse obtains a cloudy liquid immunization and administers half ml
subcutaneously. The PHN reported to the mother that it is a monovalent hepatitis B vaccine. Which of the following is a possible
infraction committed by the PHN?
A. Failure to check the consistency of the vaccine. Cloudy liquids are considered expired and should not have been
administered.
B. Improper route of administration since this vaccine is given intramuscularly.
C. Incorrect dosage since it should be given at 0.05 ml only.
 D. Nothing.
FAMORCA, 225-226
75. Mang Joe brings his 1 year-old child to the community health facility for immunization. The baby has no record of receiving the
AMV1 vaccine and Mang Joe is also not aware if his baby received the vaccine since it is his departed wife that mostly attended
to the health needs of their son. The PHN should advise Mang Joe to return to the facility after how weeks for the schedule of
AMV2?
A. 2 weeks
B. 4 weeks
C. 6 weeks
D. 8 weeks
FAMORCA, 229
SITUATION 16: Congenital disorders are the most common reasons for pediatric surgery experience. The following are questions
pertaining to nursing responsibilities when dealing with pediatric surgeries.
76. At which of the following ages would a child typically experience the most age-related psychological stress from a hypospadias
repair?
A. 2 years
B. 4 years
C. 6 years
D. 8 years
Rationale: The child around age 4 would experience the most psychological stress from a hypospadias repair because preschoolers
are in the genital stage and have castration anxiety, further heightened by genital surgery. 2-year-olds would have no more stress with
their surgery than they would with other comparable surgery. Schoolagers, while being embarrassed, would not experience the most
age-related stress for this type of surgery.
77. After uncomplicated abdominal surgery, which of the following would be most appropriate when determining if an alert school-
aged child is ready to drink oral fluids?
A. Ask if the child wants something to drink
B. Auscultate the child’s abdomen for bowel sounds
C. Determine that the child has a gag reflex
D. Palpate the epigastric area for discomfort
Rationale: After uncomplicated abdominal surgery, fluid intake is resumed early in the postoperative period. However, before fluids
are given, the nurse needs to auscultate the child’s abdomen for bowel sounds indicating the return of peristalsis and a functioning
gastrointestinal tract. Fluids are withheld until bowel sounds are heard. Asking the child if he or she wants something to drink is
inappropriate because medications used before and during surgery may cause thirst. Additionally, the child’s degree of thirst is not an
indicator for peristalsis. Determining if a gag reflex is present would be more appropriate for the child having undergone upper
gastrointestinal procedures such as gastroscopy. Having a gag reflex is usually not a concern in a child who is alert and has had
uncomplicated abdominal surgery. Palpating the epigastric area or abdomen for discomfort provides no information about the
function of the gastrointestinal tract. Complaints of pain are likely because the client has had abdominal surgery.
78. After teaching the parents of a 15-month-old child who has undergone cleft palate repair how to use elbow restraints, which of the
following statements by the parents indicates effective teaching?
A. “The restraints should be taped directly to our child’s arms so that they will stay in one place.”
B. “We can take off the restraints while our child is playing but we’ll make sure to put them back on at night.”
C. “We’ll keep the restraints in place continuously until the doctor says it’s okay to remove them.”
D. “We’ll remove the restraints temporarily at least three times a day to check his skin then put them right back on.”
Rationale: Elbow restraints help to keep the child from placing fingers or any other object in the mouth that would cause injury to the
operative site. The restraints are worn at all times except when they are removed to check the skin. Because of the risk for skin
breakdown, the restraints are removed periodically during the day to assess the child’s underlying skin. It is advisable to remove only
one restraint at a time while keeping hold of the child’s hand on the unrestrained side. Toddlers are quick and usually want to explore
the area in the mouth that the surgery has made feel different. The restraints should be in place at all times during sleep and play to
prevent inadvertent injury to the operative site. Toddlers are quick and usually want to explore the area in the mouth that the surgery
has made feel different. Taping the restraints directly to the skin is not advised because skin breakdown can occur when tape is
reapplied to the same area over several weeks. The restraints can be fastened to clothing to keep them from slipping.
79. A 9 year-old is taken to the emergency room with right lower quadrant pain and vomiting. When preparing the child for an
emergency appendectomy, what must the nurse expect to be the child’s greatest fear?
A. An unfamiliar environment
B. Change in body image
C. Guilt over being hospitalized
D. Perceived loss of control
Rationale: The correct answer is Perceived loss of control. For school age children, major fears are loss of control and separation
from friends/peers.
80. A preschool client immobilized in a spica cast complains of having trouble eating after meals. Which of the following actions
would be best?
A. Encourage the client to drink more between meals
 B. Give the client a laxative after meals
C. Offer the client small feedings several times a day
D. Teach the child pursed-lip breathing
Rationale: A hip spica cast extends up over the abdomen. Because the abdomen is in a fixed space, abdominal distention secondary to
eating pushes the abdominal contents against the diaphragm resulting in decreased chest expansion and subsequent possible
respiratory distress. Because the client’s complaints are associated with meals, offering small frequent meals provides nutritional
support while minimizing distention. Encouraging increased drinking would increase the abdominal distention thus increasing the
child’s respiratory distress. With a hip spica cast, the child’s complaints are due to decreased chest expansion from the abdomen
pushing up against the diaphragm. Pursed lip breathing would be effective in preventing air trapping not decreased chest expansion.
With a hip spica cast, the child’s complaints are due to decreased chest expansion from the abdomen pushing up against the
diaphragm. Administering a laxative with meals would be ineffective in relieving the decreased chest expansion.
SITUATION 17: Assessment is vital nursing skill because it pictures the problem a patient may have. Nurse Vanessa is assigned in
the genitourinary unit of their department and is assigned to patient Zac.
81. Nurse Vanessa would like to know if Zac’s bladder is distended. This assessment is appropriately performed by:
A. auscultating the abdominal area.
B. evaluating the tissue turgor.
C. palpating the abdomen for tenderness.
D. percussing the abdomen.
ANS: The assessment skill needed to determine if the bladder is distended will avoid the risk of an overdistended bladder as well as
enhance the comfort level of the patient.
82. Following bladder assessment, Nurse Vanessa continues her assessment, particularly, checking for tenderness at the
costovertebral angle by placing the left hand over this area and striking it with the right fist. Normally, this percussion technique
produces which sound?
A. A dull sound
B. A flat sound
C. Hyperresonance
D. Tympany
Percussion over the costovertebral angle normally produces a dull, thudding sound, which is soft to moderately loud with a moderate
pitch and duration. This sound occurs over less dense, mostly fluid-filled matter, such as the kidneys, liver, and spleen. In contrast, a
flat sound occurs over highly dense matter such as muscle; hyperresonance occurs over the air-filled, overinflated lungs of a client
with pulmonary emphysema or the lungs of a child (because of a thin chest wall); and tympany occurs over enclosed structures
containing air, such as the stomach and bowel.
83. The physician has ordered a urinalysis and a serum osmolality (concentration) determination. Nurse Vanessa knows that the
kidneys are functioning appropriately if:
A. findings are incidental and unremarkable.
B. the osmolality of both the urine and the serum are high, or both are low.
C. the serum osmolality is high and the urine osmolality is low.
D. the serum osmolality is low and the urine osmolality is high.
If the blood osmolality is high, the kidneys need to dilute the blood and excrete more concentrated urine, and the reverse is true. This
helps determine the test taker's understanding of the function of the kidneys.
84. Zac has been acutely ill with a high fever, chills, nausea, and vomiting. He also complains of severe pain in the flank are. The
physician diagnoses Zac as having pyelonephritis. Nurse Vanesssa knows that the primary goal of treatment for Zac’s condition
is:
A. giving pain relief with analgesics and antispasmodics.
B. preventing further damage to his kidneys that could lead to renal failure.
C. providing adequate hydration with pulse and blood pressure within patient norms.
D. providing adequate nutrition with a stable body weight.
Pyelonephritis can cause scarring of the renal parenchyma and result in atrophy of the affected kidney, which means that the kidney is
failing.
85. Since Zac’s condition has progressed to severity, he had been placed on dialysis. When Nurse Vanessa assesses for Zac’s AV
fistula in the forearm, she noted that there is absence of a “trill” when she palpated the venous side of the fistula. Which of the
following should Nurse Vanessa do in this situation?
A. Apply warm compresses and lower the arm below heart level
B. Inject the ordered amount of heparin into the fistula
C. Report to the charge nurse that the fistula is occluded
D. Send the patient to dialysis for remedy
If there is no trill, the fistula is occluded and should be reported. Dialysis is not possible with the occlusion. Injecting the shunt is not
in the scope of practice. Warm compresses are not helpful.
SITUATION 18: Nurse Ashley is very young when she was appointed as unit manager of the pediatric ward. She has been appointed
despite the other members are more senior than she is, causing tension in their organization because the other members make her feel
uncomfortable. The following questions apply.
86. Apart from being senior in terms of experience, the members are very articulate, confident and sometimes aggressive. Ashley
feels uncomfortable believing that she is the scapegoat of everything that goes wrong in her department. Which of the following is
the best action that she must take?
A. Disregard what she feels and continue to work independently
B. Identify the source of the conflict and understand the points of friction
C. Quit her job and look for another employment.
D. Seek help from the Director of Nursing
Identify the source of the conflict and understand the points of friction. This involves a problem solving approach, which addresses the
root cause of the problem.
87. As a young manager, she knows that conflict occurs in any organization. Which of the following statements regarding conflict is
not true?
A. Can be destructive if the level is too high
B. Is not beneficial hence it should be prevented at all times
C. May create leaders
D. May result in poor performance
Conflicts are beneficial because it surfaces out issues in the open and can be solved right away. Likewise, members of the team
become more conscientious with their work when they are aware that other members of the team are watching them.
88. Their department participated in a research exposition with central focus on qualitative studies. She asked her members to suggest
a research topic that can presented for the exposition. Which among the following proposals of her members can she select to
qualify in the exposition?
A. Breast Screening in older women: an ethnography of developing health policy
B. The Effect of warm compress on tissue healing.
C. The Relationship between metabolic rate and dosage of insulin in type1 diabetes sufferers.
D. The Relationship between Self-Monitoring and Insight in Schizophrenia
89. Among the research that Nurse Ashley read during the exposition, a retrospective study primarily caught her interest. Which of
the following could probably be this research?
A. The effects of the present global crisis on demand for nurses in the next decade.
B. The healthcare needs of voters for the upcoming election.
C. The related causes of the 2011 decline on demand for health care nurses.
D. The relationship between noise and aircraft noise.
90. The charge nurse on the cardiac unit is planning assignments for the day. Which of the following is the most appropriate
assignment for the float nurse that has been reassigned from labor and delivery?
A. A one-week postoperative coronary bypass patient, who is being evaluated for placement of a pacemaker prior to
discharge.
B. A patient with unstable angina being closely monitored for pain and medication titration.
C. A post-operative valve replacement patient who was recently admitted to the unit because all surgical beds were filled.
D. A suspected myocardial infarction patient on telemetry, just admitted from the Emergency Department and scheduled for an
angiogram.
The charge nurse planning assignments must consider the skills of the staff and the needs of the patients. The labor and delivery nurse
who is not experienced with the needs of cardiac patients should be assigned to those with the least acute needs. The patient who is
one-week post-operative and nearing discharge is likely to require routine care. A new patient admitted with suspected MI and
scheduled for angiography would require continuous assessment as well as coordination of care that is best carried out by experienced
staff. The unstable patient requires staff that can immediately identify symptoms and respond appropriately. A post-operative patient
also requires close monitoring and cardiac experience.
SITUATION 19: Records contain those comprehensive descriptions of patient’s health conditions and needs and at the same serve as
evidences of every nurse’s accountability in the care giving process. Nursing records normally differ from institution to institution
nonetheless they follow similar patterns of meeting needs for specific types of information. The following pertains to
documentation/records management.
91. This special form is used when the patient is admitted to the unit. The nurse completes the information in this record particularly
his/her basic personal data, current illness, previous health history, health history of the family, emotional profile, environmental
history as well as physical assessment together with nursing diagnosis on admission. What do you call this record?
A. Discharge Summary
B. Medicine and Treatment Record
C. Nursing Health History and Assessment Worksheet
D. Nursing Kardex
92. These are sheets/forms which provide an efficient and time saving way to record information that must be obtained repeatedly at
regular and/or short intervals of time. This does not replace the progress notes; instead this record of information on vital signs,
intake and output, treatment, postoperative care, postpartum care, and diabetic regimen, etc. This is used whenever specific
measurements or observations are needed to be documented repeatedly. What is this?
A. Discharge Summary
B. Graphic Flow Sheets
C. Medicine and Treatment Record
 D. Nursing Kardex
93. These records show all medications and treatment provided on a repeated basis. What do you call this record?
A. Discharge Summary
B. Medicine and Treatment Record
C. Nursing Health History and Assessment Worksheet
D. Nursing Kardex
94. This flip-over card is usually kept in a portable file at the Nurse’s Station. It has 2-parts: the activity and treatment section and a
nursing care plan section. This carries information about basic demographic data, primary medical diagnosis, current orders of the
physician to be carried out by the nurse, written nursing care plan, nursing orders, scheduled tests and procedures, safety
precautions in patient care and factors related to daily living activities. This record is used in the charge-of-shift reports or during
the bedside rounds or walking rounds. What record is this?
A. Discharge Summary
B. Medicine and Treatment Record
C. Nursing Health History and Assessment Worksheet
D. Nursing Kardex
95. Most nurse regard this conventional recording of the date, time, and mode by which the patient leaves a healthcare unit but this
record includes importantly, directs of planning for discharge that starts soon after the person is admitted to a healthcare
institution. It is accepted that collaboration or multidisciplinary involvement (of all members of the health team) in discharge
results in comprehensive care. What do you call this?
A. Discharge Summary
B. Medicine and Treatment Record
C. Nursing Health History and Assessment Worksheet
D. Nursing Kardex
SITUATION 20: The following are questions pertaining to nutrition. It is among the responsibilities of the nurse to include nutritional
status assessment and evaluation to ensure adaptation on the holistic health of a patient.
96. A nurse is helping a client with her meal choices. Which breakfast selection indicates that the client understands her low-
potassium diet?
A. Bacon, toast, and orange juice
B. Banana, toast, and whole milk
C. Cantaloupe, raisin bran, and skim milk
D. Scrambled eggs and toast with tea
ANSWER: Eggs, bread, and tea are foods that have low potassium content. Bacon, orange juice, cantaloupe, raisin bran, bananas, and
milk are foods high in potassium.
97. A client with liver cancer receiving chemotherapy tells the nurse that some foods on the meal tray taste bitter. The nurse tries to
limit which of the following foods. which are most likely to cause this taste for the client
A. Beef
B. Cantaloupe
C. Custard
D. Potatoes
Chemotherapy may cause distortion of taste. Frequently beef and pork are reported to taste bitter or metallic. The nurse can promote
client nutrition by assisting the client to choose alternative sources of protein in the diet. Options 2, 3, and 4 are foods that are not
likely to cause this problem.
98. Because of chronic crampy pain, diarrhea, and cachexia, a young adult is to receive total parental nutrition (TPN) via a central
line. Before preparing the client for the insertion of the catheter, the nurse should understand that:
A. Fluoroscopy must be done before TPN is started
B. The feeding will be administered intermittently
C. The jugular vein is the most commonly used insertion site
D. There will be a moderate amount of pain
Although the central venous catheter remains in situ, total parental nutrition does not have to infuse continuously. Although a feeling
of pressure may be experienced, it is not a painful procedure. Placement of tube is verified by x-ray. The subclavian veins are used
most often; the jugular vein is too close to hair-growing areas, which increases the possibility of sepsis, and neck movements may
interfere with the integrity of the placement of the catheter.
99. The end product of protein digestion or the “Building blocks of Protein” is what we call
A. Amino Acids
B. Fatty acids
C. Glucose
D. Nucleotides
100. Which of the following consequences would the nurse anticipate noting in a client who has had prolonged carbohydrate (CHO)
deficiency?
A. Anemia, weight loss, and edema
B. Breakdown of proteins leading to ketosis and metabolic acidosis
 C. Dental caries and obesity
D. Skin lesions and weight loss
A state of prolonged CHO deficiency can lead to protein breakdown that results in formation of ketone bodies and altered acid-base
balance (metabolic acidosis). Options A and D are incorrect because they are associated with protein deficiency and lipid deficiency,
respectively. Option C is incorrect--these are associated with an increased amount of CHOs in the diet.