Aside from this, I plan to post some NCLEX exam practice tests for those
who are aspiring to have a license in the US. Like what I’ve said, a nursing
review is equally important to ensure your success in the board exam, and we
should continually answer some sample questions in order to have an idea on how
to attack such questions.
For this post, let’s have a CHN sample test, and this time I’ve prepared
50 questions (unlike my previous posts) so that we can also develop your
test-taking endurance. Try to gauge your knowledge regarding concepts in
community health nursing and answer this test in 1 hour.
Situation: Prevention still remains to be the best alternative to
treatment with the increasing number of cancer cases.
1.
The
primary focus of cancer prevention would be which of the following?
a.
Diagnosis and treatment
b.
Early detection
c.
Elimination of causes and risk factors
d.
Early stage treatment
2.
The
community health nurse knows that his/her most important function in cancer
prevention and control involves which of the following activities?
a. Leading community
assemblies
b. Referring symptomatic clients to a cancer
specialist
c. Teach the public about proper and correct
nutrition
d. Using cancer warning signs as criteria for
detecting, controlling and treating the disease
3. Who among the following qualify for secondary
level of care for cancer?
a. Clients scheduled for surgery
b. Clients under early case detection
c. Clients under post care treatment
d. Clients undergoing treatment
4. Who among the following qualify for tertiary
level of care for cancer?
a. Clients scheduled for surgery
b. Clients under early detection
c. Clients under early treatment
d. Clients under supportive care
5. Even if equipment and devices are readily
available to assist the community health nurse, the nurse knows that the best action
to ensure quality care for clients with cancer is
a. Knowledge of medical and nursing diagnosis
b. Application of the nursing process
c. Adherence to nursing protocol
d. Application of nursing research to case
studies
Situation: Dengue hemorrhagic fever is a common health concern in the Philippines,
and is a leading cause of mortality among children.
6. An important role of the community health
nurse in the prevention and control of dengue hemorrhagic fever includes:
a. Advising the elimination of vectors by
keeping water containers covered
b.
Conducting
strong health education drives/campaign directed towards proper garbage disposal
c. Explaining to the
individuals, families, groups and community the nature of the disease and its
etiology
d. Practicing residual spraying with
insecticides
7. Community health nurses should be alert in
observing a Dengue suspect. The following is NOT an indication for hospitalization
of H-fever suspects:
a. Anorexia, abdominal pain and vomiting
b. Decreased platelet count
c. Fever for more than 2 days
d. Persistent headache
8. The community health nurses’ primary concern
in the immediate control of hemorrhage among patients with dengue is:
a. Advising low fiber and non-fat diet
b. Keeping the patient at rest
c. Observing closely for changes in vital signs
d. Providing warmth through light weight covers
9. Which of these signs may NOT be regarded as
an indicative sign of dengue H-fever?
a. Appearance of approximately 5-6 petechiae on
a tourniquet test
b. Decreasing platelet count
c. Prolonged bleeding time
d. Steadily increasing hematocrit count
10. Which of the following is the most important
treatment of patients with Dengue H-Fever?
a. Avoid unnecessary movement of patient
b. Give aspirin for fever
c. Ice cap over the abdomen in case of melena
d. Replacement of body fluids
Situation: Two children were brought to the community health center. One experiences
chest indrawing while the other has diarrhea.
11. Using Integrated Management and Childhood
Illness (IMCI) approach, how would you classify the 1st child?
a. Bronchopneumonia
b. No pneumonia: cough or cold
c. Pneumonia
d. Severe pneumonia
12. The 1st child is 13 months old, and has a
respiratory rate of 60 breaths per minute. The nurse appropriately documents
this as
a. Normal breathing
b. Fast breathing
c. Slow breathing
d. Data cannot be interpreted
13. Nina, the 2nd child, has diarrhea for 5
days. There is no blood in the stool. She is irritable, and her eyes are
sunken. The nurse offered fluids and the child drinks eagerly. How would you classify
Nina’s illness?
a. Dysentery
b. No dehydration
c. Severe dehydration
d. Some dehydration
14. Nina’s treatment should include the
following EXCEPT:
a. Do not give any other food to the child for
home treatment
b. For infants under 6 months old who are not
breastfed, give 100-200 ml of clean water
c. Give the recommended amount of ORS for 4
hours
d. Reasses the child and classify her as
“dehydration”
15. While on treatment, Nina, 18 months old
weighed 18 kg and her temperature is at 370C. Her mother says she
developed cough 3 days ago. Nina has no general danger signs; respiratory rate
is at 45 breaths/minute, no chest in-drawing, no stridor. Based on the given
data, Nina would be appropriately classified as
a. Bronchopneumonia
b. No pneumonia
c. Pneumonia
d. Severe pneumonia
Situation: Eula, 26 years old,
is a postpartum client who was referred to the Public Health Nurse for family
nursing care. Her 1 month-old son was
premature at birth. Her other children
are aged 4, 3 and 2 years.
16. The
main objective of family nursing care is to:
a. Coordinate
with other agency representative for the care of the family
b. Evaluate
the effect of nursing interventions done
c. Help
family achieve optimum wellness
d. Study
the family and learn their dynamics
17. In
working with Eula’s family, the nurse remember that her main patient is:
a. Both
Eula and her 1 month-old son
b. Eula,
the postpartum mother
c. The
family as a unit
d. The
premature infant
18. When
conducting an initial home visit, the nurse should know that the most important
part of assessment is:
a. Asking
the family what their needs are
b. The
family’s environmental conditions
c. The
family’s past generations
d. Relationships
within family members
19. Advising
Eula to always wash her hands before caring for her premature infants is in
line with which principle of premature care?
a. Maintenance
of normal body temperature
b. Minimal
handling
c. Prevention
of infection
d. Proper
feeding
20. The
nursing interventions done for Eula and the members of her family must be evaluated
in terms of:
a. The
relationships within the family
b. Each
family member’s lifestyle and health practices
c. The
set outcomes for each member’s plan of care
d. The
medical diagnosis for each family member
Situation: Family Planning is
one of the programs that are routinely implemented in rural health settings.
21. The
National Family Planning Program emphasizes the following, EXCEPT:
a. Department
of Health’s role as facilitator rather than a regulator
b. Informing
the public regarding the best contraceptive
c. Freedom
to choose family planning methods to use
d. Respect
for the value of life
22. As
a resource person you discuss the effectiveness of contraceptive methods. Which
of these is least effective?
a. Condom
b. IUD
c. Oral
contraceptive
d. Tubal
ligation
23. The
IUD should not be given to women with:
a. Anemia
b. Dysmenorrhea
c. Heart
disease
d. Pelvic
Inflammatory Disease
24. A
man who has undergone vasectomy is considered sterile with which conditions?
a. After
a zero sperm count
b. After
25 ejaculations
c. Immediately
after the procedure
d. One
week after the procedure
25. As
a nurse who facilitates family planning, you would know that you’re an
effective counselor if you are are able to:
a. Constantly
give good advice to your clients
b. Convince
clients to follow instructions
c. Help
clients identify their own problems an act on them
d. Identify
the problems of your clients
Situation: The Public Health
Nurse plans and implements nursing care services in the light of the guiding concepts
and objectives.
26. Health
is viewed today on a more individual basis as:
a. Absence
of disease in an individual
b. Complete
physical, mental and social well-being
c. Each
person’s maximum capacity to live happily and productively
d. Psychosomatic
well-being of a person
27. The
level of community health is influenced by the following factors, EXCEPT:
a. Physical
factors
b. Political
factors
c. Socioeconomic
factors
d. None
of the above
28. The
objectives of community health nursing includes:
a. Disability
prevention and rehabilitation only
b. Early
diagnosis, prompt and appropriate treatment only
c. Health
promotion and disease prevention only
d. Health
promotion, disease prevention, early diagnosis treatment, disability prevention and rehabilitation
29. In
a community setting, a person’s psychosocial and somatic well-being is
influenced by which of the following factors?
a. Delivery
of health care services
b. Hereditary
factors
c. Hereditary
factors, personal behavior, environmental factors and delivery of health care
services
d. Personal
behavior
30. Community
health nursing is focused on populations. This means that the:
a. Services
are focused on the high risk members of the community
b. Services
are directed to the health of all, regardless of age or demographic
c. Practice
of nursing is ecologically oriented
d. The
unit of care is the individual
Situation: A professional
nurse is assumed to update herself about the profession to maintain competency.
31. In
this millennium, the factor that would
probably most influence nursing would be
a. Economic
issues
b. Nursing
education
c. Social
issues
d. Technological
advances
32. In
the next century, the professional nurse is expected to be:
a. A
primary health care expert
b. Globally
competitive
c. In
the community setting
d. Mostly
working in the tertiary setting
33. It
is envisioned that the nursing practice setting will be mainly
a. Community
based
b. Home
based
c. Hospital
based
d. In
any health setting
Situation: As a community
health nurse, it is imperative to understand the community and the processes
involved in diagnosing nursing problems in order to plan and carry out services
effectively.
34. The
following is/are of primary importance about the community that the nurse should
know:
a. Composition
and character of the population
b. Developmental
perspective of the community
c. Roles
and capabilities of the population
d. All
of the above
35. In
conducting community-wide assessment and intervention, the nurse can gather data
about the community from which these sources?
a. Police
reports, media records and physician’s records
b. School
health records and personal interviews
c. Vital
statistics and census tables
d. All
of the above
36. The
assessment of community health status is traditionally determined epidemiologically
through which of the following?
a. Availability
of health service facilities
b. Mortality
and morbidity statistics
c. Population
characteristics
d. Population
distribution and environmental health conditions
37. Community
diagnosis is based upon constantly changing, interdependent conditions. Which
of these refer to the potential of the community to address its problems?
a. Community
health capability
b. Community
health status
c. Community
likelihood
d. Socioeconomic
condition
38. The
following are the processes involved in community diagnosis. Arrange this in sequence:
1.
Data presentation
2.
Data collection
3.
Data organization
4.
Identification of health problems
5. Data analysis and interpretation
a. 3,
1, 5, 2, 4
b. 2,
3, 1, 4, 5
c. 2,
3, 1, 5, 4
d. 1,
2, 3, 4, 5
Situation: Minority groups in
the Philippines are an underprivileged sector where health services are generally
inadequate.
39. What
is the most important factor to consider when providing nursing care to minority
families?
a. Close
family ties
b. Environmental
control
c. Family
time orientation
d. Meaningful
communication
40. A
community’s response to health and illness is reflected in:
a. The
morbidity rate
b. The
community’s organization for health
c. The
number of vulnerable families
d. The
prevalence of endemic disease
41. To
effectively give nursing care to your monitory family should first:
a. Assess
health beliefs and practices
b. Share
health experiences
c. Understand
the cultural group
d. Work
with faith healers
42. When
modifying harmful health practices, among monitory 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 changes
d. Persuade
family to change practice
43. To
maintain and sustain health behavior change, Selye’s change process framework
emphasizes which of the following principles?
a. Awareness
of the need to change
b. Make
change part of every day
c. Removing
barriers of change
d. Trial
of health behavior
44. Which
of the above terms refer to sudden increases in the incidence of a contagious disease?
a. Endemic
b. Epidemic
c. Pandemic
d. Sporadic
45. Which
of the following is confined to a certain geographical area or locality?
a. Endemic
b. Epidemic
c. Pandemic
d. Sporadic
46. These
diseases only occur in few cases at a time:
a. Endemic
b. Epidemic
c. Pandemic
d. Sporadic
47. When
a communicable disease occurs nationwide or worldwide, it is now referred to as
a/an
a. Epidemic
b. Endemic
c. Pandemic
d. Sporadic
48. An
individual harboring pathogenic organisms but has no apparent signs is a
a. Carrier
b. Contact
c. Fomite
d. Vector
49. This
occurs when poisonous products of pathogens are distributed throughout the body
and produce generalized symptoms:
a. Bacteremia
b. Septicemia
c. Toxemia
d. Viremia
50. This
occurs when bacteria are present and multiply in the blood:
a. Bacteremia
b. Septicemia
c. Toxemia
d. Viremia
Here are the answers:
1.
Answer: C
Rationale: Primary cancer prevention is focused
on developing a healthy lifestyle and includes all practices to avoid exposure
from carcinogens and health promotion. Primary prevention is about preventing cancer
from ever developing or delaying the development of a malignancy.
2. Answer:
C
Rationale:
Although all choices are tasks that are expected from a community health nurse,
the most important of these would be the one that puts focus on the client, and
that is informing them on how to prevent cancer through a healthy lifestyle.
3. Answer:
B
Rationale: Secondary
prevention involves
the early detection and treatment of subclinical and
asymptomatic cases of individuals without obvious signs or symptoms of cancer.
The other choices are addressed by tertiary prevention.
4. Answer:
C
Rationale:
Choice B is a secondary preventive measure. While A and D may fall under
tertiary prevention, we have to consider the community setting, thus the
applicable answer is C.
5. Answer:
B
Rationale:
Whatever state-of-the-art device or instrument may be available for the nurse
to utilize, the core of nursing practice in a community setting is still the
nursing process. It is the problem solving process that is implemented by all
nurses in all clinical settings to ensure that proper nursing care is rendered.
6. Answer:
A
Rationale:
Although B and C are also important tasks by a community health nurse in the
prevention of dengue H-fever, the more crucial intervention in a public health setting
is to teach people on how the disease spreads. Choice D is a task that is
coordinated with local government authorities, and the actual spraying of
insecticides is not within the nurse’s tasks.
7. Answer:
B
Rationale:
Choices A, C and D are subsequent signs that can be managed at home with the
proper nursing interventions. B involves a serious condition that might lead to
massive bleeding and shock, thus it is imperative to refer such a case in the
hospital for proper treatment.
8. Answer:
C
Rationale: Hemorrhage
can lead to hypovolemic shock, and one parameter to monitor for shock is by
careful assessment of vital signs. Remember “hypo-tachy-tachy” – hypotension,
tachycardia and tachypnea, which can be associated with shock. Choice A is
irrelevant to this condition, while B and D may address different nursing
problems.
9. Answer:
A
Rationale: B,
C, D are signs related to hemorrhage. With low platelet count, it is expected
that the bleeding time increases, and with the shift of fluid from
intravascular spaces, it is expected that blood solute concentration will
increase, resulting in a higher hematocrit count. Choice A is not a positive
result – a positive tourniquet test should indicate at least 20 petechiae or
more.
10. Answer:
D
Rationale:
The most significant nursing problem with clients experiencing Dengue H-fever
is bleeding, thus the replacement of lost fluids is paramount. Although the
limiting of movement promotes safety for the patient, fluid replacement is a
more important intervention. Placing ice caps on the abdomen to prevent
bleeding is not supported by evidence, while giving aspirin is contraindicated.
11. Answer:
D
Rationale:
Based on the IMCI chart, a case of chest indrawing is classified as “Severe
Pneumonia” or “Very Severe Disease”.
12. Answer:
B
Rationale:
Based on the IMCI chart, this client’s respiratory rate is higher than normal
(40 breaths per minute).
13. Answer:
D
Rationale:
Based on the IMCI chart, the child would be appropriately classified as “Some
Dehydration”.
14. Answer:
A
Rationale:
Based on Plan B in the IMCI chart, B, C and D are indicated for this case. On
the contrary, the child should be fed if she is treated at home.
15. Answer:
C
Rationale:
Based on the given data and the IMCI chart, the child is appropriately
classified as “Pneumonia”.
16. Answer:
C
Rationale:
Although the other choices are part of the objectives of family nursing care,
the ultimate goal is to assist families in achieving optimum wellness.
17. Answer:
C
Rationale: In
family nursing care, the family is considered as one unit, thus the nurse
caters to all nursing needs of the family members.
18. Answer:
A
Rationale:
Although B, C, D are valid parameters to assess for potential problems, what’s
more important are the current perceived needs of the family, and if problems
do exist, they should be prioritized. Remember, actual problems should be
addressed first.
19. Answer:
C
Rationale:
Hand washing is a universal procedure in preventing infection. Although C is
also related to proper feeding, the reason for doing it is still to prevent
infection.
20. Answer:
C
Rationale:
Evaluation is properly done if it is based on the outcomes set in a nursing
care plan, and these outcomes serve as a point of comparison to determine if
the nursing interventions are indeed effective.
21. Answer:
B
Rationale:
All are in line with the DOH National Family Planning program, except B. The
nurse should bear in mind that there is no single contraceptive that is most
effective for all types of cases.
22. Answer:
D
Rationale:
Based from the CDC reproductive health guidelines, tubal ligation comes first
at 99.5% effectiveness, followed by IUDs (99.2%), oral contraceptives (91%) and
condoms (82%).
23. Answer:
D
Rationale:
Intrauterine devices (IUDs) can potentially aggravate existing pelvic disorders
as it is inserted within, thus it is contraindicated for clients with acute
pelvic inflammatory disease.
24. Answer:
A
Rationale: A
is the most definitive way to determine if a male client is sterile
(azoospermia) after vasectomy. Although it is unlikely that a male person has
significant number of sperm cells after 25 ejaculations, birth control methods
are still recommended. It takes at least 2 months for a vasectomy client to be
considered as sterile.
25. Answer:
D
Rationale:
Counseling involves helping clients with the problem solving process, thus it
is not enough for the nurse to merely identify a client need. The nurse is a
facilitator, meaning that it should be the client who ultimately solves the
problem. The nurse is not there to give her personal advice or to convince
clients.
26. Answer:
B
Rationale:
Today, health is viewed on a holistic perspective, and it involves all aspects
of a person. In this case, the choice that is nearest is B.
27. Answer:
D
Rationale:
Since health is viewed on a holistic perspective, the nurse should consider all
factors that may influence the various aspects of a person.
28. Answer:
D
Rationale:
Community Health Nursing encompasses all levels and aspects of care; what’s
different about it is that it is only done in a community setting. The
community health nurse caters to all needs of individuals within the community,
regardless of whether the care rendered is promotive, preventive, curative or
rehabilitative, although the focus is on the first two levels.
Tip: If
you’re going to guess, make an intelligent one. When a choice has the word
“only”, chances are that choice is incorrect, because “only” limits the scope
of the answer. Thus it is logical for you to choose the answer that has a
larger scope. I’m not saying that choices with “only” are absolute wrong
choices, it’s just that they have a low probability of being right.
29. Answer:
C
Rationale: A
person’s psychosocial and somatic well-being can be influenced by all such
factors, since all of them can be interrelated.
30. Answer:
B
Rationale:
Being population-focused means that all people within the community have equal
right to avail of quality nursing care.
31. Answer:
D
Rationale:
While several changes are occurring in this millennium, the most significant of
these changes are those involving technology, and such changes correspondingly
change socioeconomic issues. Having that in mind, technology has a greater
impact on nursing practice than other factors.
32. Answer:
B
Rationale:
Globalization is shaping our world today, as the bridging of ideas and people
become faster with the advent of computer and information technology. With this,
nurses around the world are more interactive and aware of global standards of
nursing practice that can be applicable to all countries and cultures are being
developed.
33. Answer:
B
Rationale:
Health care professionals, groups and institutions around the world are now
searching for ways to shift the focus of health care in a home setting, based
on the philosophy that health promotion and disease prevention are easier to
implement and cost-effective. In this time, people are more aware that proper
education on a healthy lifestyle and early detection of illness are more vital
to decrease worldwide morbidity than setting up more hospitals and tertiary
institutions.
34. Answer:
D
Rationale:
All of the following parameters are of equal importance to determine the
characteristics of the population that the nurse assesses.
35. Answer:
D
Rationale:
Same as with item # 34, and with proper procedures, the nurse can have access
to these data.
36. Answer:
B
Rationale: As
emphasized by most community health nursing books, the nurse mainly obtains
health data from mortality and morbidity statistics. This is gradually
evolving, now that modern nurses look at other factors that affect the health
of a population.
37. Answer:
A
Rationale:
Community health status refers to the overall level and quality of health in a
community, and takes into account the composite status of all individuals and
groups. Part of assessing the community health status is determining the
community’s health capability, which is the potential of a community to address
its health problems.
38. Answer:
C
Rationale:
These steps comprise the implementation phase of community diagnosis, and the
correct sequence is (1) data collection, (2) data organization, (3) data
presentation, (4) data analysis, (5) identification of health problems, (6)
prioritization of health problems, (7) development of a health plan, and (8)
validation ad feedback.
39. Answer:
D
Rationale: Understanding
the culture is just the first half of what the nurse does to achieve cultural
competence, and it includes the observation of a cultural minority’s dynamics,
family ties, their cultural environment and social orientation. But what’s more
important is how the nurse would be able to provide meaningful nursing care to
these minorities, and it is virtually impossible to achieve it without
facilitating effective communication.
40. Answer:
B
Rationale:
Although the nurse can obtain substantial information about a community with
statistics, he/she can accurately determine the level of community preparedness
by looking at how the community organizes and implements healthcare measures.
41. Answer:
C
Rationale:
Although assessment is the first step of the nursing process, it would be more
important for the nurse to first have a general understanding of a minority’s
culture in order to appropriately execute an effective plan of care for that
minority group.
42. Answer:
C
Rationale:
Cultural beliefs and practices are embedded, and change takes considerable time
and effort to take place, thus the nurse must recognize that clients with
different ethnic and cultural background must be willing to incorporate change.
43. Answer:
B
Rationale:
Each person needs to maintain homeostatic mechanisms in order to maintain and sustain
health behavior change, and since the environment constantly creates stress to
an individual, he/she must accept the fact that change is inevitable and needs
to constantly adapt to stress.
44.
Answer: B
Rationale: By definition, an epidemic occurs when a given human
population experiences a sudden increase of cases of a contagious disease.
45.
Answer: A
Rationale: An endemic disease is a disease that normally occurs in a
specific geographic location or region. In Egypt, filariasis and traveler’s
diarrhea are endemic diseases.
46.
Answer: D
Rationale: A sporadic disease is a disease that occurs singly and/or in
scattered geographical areas.
47.
Answer: C
Rationale: A pandemic disease occurs when it spreads across large
populations and geographic regions or continents. An example of this was the
outbreak of Severe Acute Respiratory Syndrome (SARS) in 2003.
48.
Answer: A
Rationale: A carrier is a person that harbors a certain pathogen, but
does not manifest and signs and symptoms of the disease caused by the pathogen.
This occurs when the person has previously recovered from the disease and later
on developed resistance to it.
49.
Answer: C
Rationale: Toxemia occurs when poisonous products or toxins produced by
pathogens spread throughout the bloodstream and different tissues.
50.
Answer: B
Rationale: Bacteremia is the term for the mere presence of bacteria in
the blood, but septicemia occurs when they proliferate and actively multiply in
the bloodstream.
Hope you got at
least 38 answers (75%) right. Remember, it’s always better to set a high
standard in your nursing review to ensure that you’re rating is always on safe
ground. Read your books from time to time to master concepts, and always have
time to answer practice questions.
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