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HOME NURSING NOTES  PRACTICE EXAMS  MNEMONICS

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Home  Practice Exams  Philippine Nursing Licensure Exam (PNLE) 
 PNLE: Community Health Nursing Exam 4

PNLE: Community
FOLLOW
Health Nursing Exam US

4 

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2

PNLE
:
Open
Medical
1. In immunizing school entrants with BCG, you Surgical
Nursing
are not obliged to secure parental consent. This Exam
is because of which legal document? 3
  0

A. P.D. 996
PNLE
B. R.A. 7846 IV
C. Presidential Proclamation No. 6 for
Care
D. Presidential Proclamation No. 46
of
Clients
2. Which immunization produces a permanent with …
scar?   0

PNLE
A. DPT V
B. BCG for
Care
C. Measles vaccination of
D. Hepatitis B vaccination Clients
with …
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3. A 4-week old baby was brought to the health
center for his ]rst immunization. Which can be PNLE:

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 given to him? Community
Health
Nursing
A. DPT1 Exam
B. OPV1 3
C. Infant BCG   0

D. Hepatitis B vaccine 1

4. You will not give DPT 2 if the mother says that

the infant had

A. Seizures a day after DPT 1.

B. Fever for 3 days after DPT 1.
C. Abscess formation after DPT 1.
D. Local tenderness for 3 days after DPT 1.

5. A 2-month old infant was brought to the health

center for immunization. During assessment, the
infant’s temperature registered at 38.1°C. Which
is the best course of action that you will take?

A. Go on with the infant’s immunizations.

B. Give Paracetamol and wait for his fever to
subside.
C. Refer the infant to the physician for further
assessment.
D. Advise the infant’s mother to bring him back
for immunization when he is well.

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 6. A pregnant woman had just received her 4th
dose of tetanus toxoid. Subsequently, her baby
will have protection against tetanus for how
long?

A. 1 year
B. 3 years
C. 10 years
D. Lifetime

7. A 4-month old infant was brought to the health

center because of cough. Her respiratory rate is
42/minute. Using the Integrated Management of
Child Illness (IMCI) guidelines of assessment, her
breathing is considered

A. Fast
B. Slow
C. Normal

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 D. Insigni]cant

8. Which of the following signs will indicate that

a young child is suffering from severe
pneumonia?

A. Dyspnea
B. Wheezing
C. Fast breathing
D. Chest indrawing

9. Using IMCI guidelines, you classify a child as

having severe pneumonia. What is the best
management for the child?

A. Prescribe an antibiotic.
B. Refer him urgently to the hospital.
C. Instruct the mother to increase juid intake.

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 D. Instruct the mother to continue
breastfeeding.

10. A 5-month old infant was brought by his

mother to the health center because of diarrhea
occurring 4 to 5 times a day. His skin goes back
slowly after a skin pinch and his eyes are sunken.
Using the IMCI guidelines, you will classify this
infant in which category?

A. No signs of dehydration
B. Some dehydration
C. Severe dehydration
D. The data is insukcient.

11. Based on assessment, you classi]ed a 3-

month old infant with the chief complaint of
diarrhea in the category of SOME DEHYDRATION.

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 Based on IMCI management guidelines, which of
the following will you do?

A. Bring the infant to the nearest facility where

IV juids can be given.
B. Supervise the mother in giving 200 to 400
ml. of Oresol in 4 hours.
C. Give the infant’s mother instructions on
home management.
D. Keep the infant in your health center for
close observation.

12. A mother is using Oresol in the management

of diarrhea of her 3-year old child. She asked you
what to do if her child vomits. You will tell her to

A. Bring the child to the nearest hospital for

further assessment.
B. Bring the child to the health center for
intravenous juid therapy.
C. Bring the child to the health center for
assessment by the physician.
D. Let the child rest for 10 minutes then
continue giving Oresol more slowly.

13. A 1 ½ year old child was classi]ed as having

3rd degree protein energy malnutrition,
kwashiorkor. Which of the following signs will be
most apparent in this child?

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 A. Voracious appetite
B. Wasting
C. Apathy
D. Edema

14. Assessment of a 2-year old child revealed

“baggy pants”. Using the IMCI guidelines, how
will you manage this child?

A. Refer the child urgently to a hospital for

con]nement.
B. Coordinate with the social worker to enroll
the child in a feeding program.
C. Make a teaching plan for the mother,
focusing on menu planning for her child.
D. Assess and treat the child for health
problems like infections and intestinal
parasitism.

15. During the physical examination of a young

child, what is the earliest sign of xerophthalmia
that you may observe?

A. Keratomalacia
B. Corneal opacity
C. Night blindness
D. Conjunctival xerosis

16. To prevent xerophthalmia, young children are

given Retinol capsule every 6 months. What is

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 the dose given to preschoolers?

A. 10,000 IU
B. 20,000 IU
C. 100,000 IU
D. 200,000 IU

17. The major sign of iron de]ciency anemia is

pallor. What part is best examined for pallor?

A. Palms
B. Nailbeds
C. Around the lips
D. Lower conjunctival sac

18. Food forti]cation is one of the strategies to

prevent micronutrient de]ciency conditions. R.A.
8976 mandates forti]cation of certain food
items. Which of the following is among these
food items?

A. Sugar
B. Bread
C. Margarine
D. Filled milk

19. What is the best course of action when there

is a measles epidemic in a nearby municipality?

A. Give measles vaccine to babies aged 6 to 8

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 months.
B. Give babies aged 6 to 11 months one dose
of 100,000 I.U. of Retinol
C. Instruct mothers to keep their babies at
home to prevent disease transmission.
D. Instruct mothers to feed their babies
adequately to enhance their babies’
resistance.

20. A mother brought her daughter, 4 years old, to

the RHU because of cough and colds. Following
the IMCI assessment guide, which of the
following is a danger sign that indicates the need
for urgent referral to a hospital?

A. Inability to drink
B. High grade fever
C. Signs of severe dehydration
D. Cough for more than 30 days

21. Management of a child with measles

includes the administration of which of the
following?

A. Gentian violet on mouth lesions

B. Antibiotics to prevent pneumonia
C. Tetracycline eye ointment for corneal opacity
D. Retinol capsule regardless of when the last
dose was given

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 22. A mother brought her 10 month old infant for
consultation because of fever, which started 4
days prior to consultation. To determine malaria
risk, what will you do?

A. Do a tourniquet test.
B. Ask where the family resides.
C. Get a specimen for blood smear.
D. Ask if the fever is present everyday.

23. The following are strategies implemented by

the Department of Health to prevent mosquito-
borne diseases. Which of these is most effective
in the control of Dengue fever?

A. Stream seeding with larva-eating ]sh

B. Destroying breeding places of mosquitoes
C. Chemoprophylaxis of non-immune persons
going to endemic areas
D. Teaching people in endemic areas to use
chemically treated mosquito nets

24. Secondary prevention for malaria includes

A. Planting of neem or eucalyptus trees

B. Residual spraying of insecticides at night
C. Determining whether a place is endemic or
not
D. Growing larva-eating ]sh in mosquito
breeding places

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 25. Scotch tape swab is done to check for which
intestinal parasite?

A. Ascaris
B. Pinworm
C. Hookworm
D. Schistosoma

26. Which of the following signs indicates the

need for sputum examination for AFB?

A. Hematemesis
B. Fever for 1 week
C. Cough for 3 weeks
D. Chest pain for 1 week

27. Which clients are considered targets for

DOTS Category I?

A. Sputum negative cavitary cases

B. Clients returning after a default
C. Relapses and failures of previous PTB
treatment regimens
D. Clients diagnosed for the ]rst time through a
positive sputum exam

28. To improve compliance to treatment, what

innovation is being implemented in DOTS?

A. Having the health worker follow up the client

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 at home
B. Having the health worker or a responsible
family member monitor drug intake
C. Having the patient come to the health center
every month to get his medications
D. Having a target list to check on whether the
patient has collected his monthly supply of
drugs

29. Diagnosis of leprosy is highly dependent on

recognition of symptoms. Which of the following
is an early sign of leprosy?

A. Macular lesions
B. Inability to close eyelids
C. Thickened painful nerves
D. Sinking of the nosebridge

30. Which of the following clients should be

classi]ed as a case of multibacillary leprosy?

A. 3 skin lesions, negative slit skin smear

B. 3 skin lesions, positive slit skin smear
C. 5 skin lesions, negative slit skin smear
D. 5 skin lesions, positive slit skin smear

Answers and Rationales

1. Answer: (A) P.D. 996. Presidential Decree

996, enacted in 1976, made immunization in

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 the EPI compulsory for children under 8
years of age. Hepatitis B vaccination was
made compulsory for the same age group by
R.A. 7846.
2. Answer: (B) BCG. BCG causes the formation
of a super]cial abscess, which begins 2
weeks after immunization. The abscess
heals without treatment, with the formation
of a permanent scar.
3. Answer: (C) Infant BCG. Infant BCG may be
given at birth. All the other immunizations
mentioned can be given at 6 weeks of age.
4. Answer: (A) Seizures a day after DPT
1. Seizures within 3 days after administration
of DPT is an indication of hypersensitivity to
pertussis vaccine, a component of DPT. This
is considered a speci]c contraindication to
subsequent doses of DPT.
5. Answer: (A) Go on with the infant’s
immunizations. In the EPI, fever up to 38.5°C
is not a contraindication to immunization.
Mild acute respiratory tract infection, simple
diarrhea and malnutrition are not
contraindications either.
p. Answer: (A) 1 year. The baby will have
passive natural immunity by placental
transfer of antibodies. The mother will have
active arti]cial immunity lasting for about 10
years. 5 doses will give the mother lifetime
protection.

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 7. Answer: (C) Normal. In IMCI, a respiratory
rate of 50/minute or more is fast breathing
for an infant aged 2 to 12 months.
q. Answer: (D) Chest indrawing. In IMCI, chest
indrawing is used as the positive sign of
dyspnea, indicating severe pneumonia.
9. Answer: (B) Refer him urgently to the
hospital. Severe pneumonia requires urgent
referral to a hospital. Answers A, C and D are
done for a client classi]ed as having
pneumonia.
10. Answer: (B) Some dehydration. Using the
assessment guidelines of IMCI, a child (2
months to 5 years old) with diarrhea is
classi]ed as having SOME DEHYDRATION if
he shows 2 or more of the following signs:
restless or irritable, sunken eyes, the skin
goes back slow after a skin pinch.
11. Answer: (B) Supervise the mother in giving
200 to 400 ml. of Oresol in 4 hours. In the
IMCI management guidelines, SOME
DEHYDRATION is treated with the
administration of Oresol within a period of 4
hours. The amount of Oresol is best
computed on the basis of the child’s weight
(75 ml/kg body weight). If the weight is
unknown, the amount of Oresol is based on
the child’s age.
12. Answer: (D) Let the child rest for 10 minutes
then continue giving Oresol more slowly. If

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 the child vomits persistently, that is, he
vomits everything that he takes in, he has to
be referred urgently to a hospital. Otherwise,
vomiting is managed by letting the child rest
for 10 minutes and then continuing with
Oresol administration. Teach the mother to
give Oresol more slowly.
13. Answer: (D) Edema. Edema, a major sign of
kwashiorkor, is caused by decreased
colloidal osmotic pressure of the blood
brought about by hypoalbuminemia.
Decreased blood albumin level is due a
protein-de]cient diet.
14. Answer: (A) Refer the child urgently to a
hospital for conTnement. “Baggy pants” is a
sign of severe marasmus. The best
management is urgent referral to a hospital.
15. Answer: (D) Conjunctival xerosis. The
earliest sign of Vitamin A de]ciency
(xerophthalmia) is night blindness. However,
this is a functional change, which is not
observable during physical [Link]
earliest visible lesion is conjunctival xerosis
or dullness of the conjunctiva due to
inadequate tear production.
1p. Answer: (D) 200,000 IU. Preschoolers are
given Retinol 200,000 IU every 6 months.
100,000 IU is given once to infants aged 6 to
12 months. The dose for pregnant women is
10,000 IU.

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 17. Answer: (A) Palms. The anatomic
characteristics of the palms allow a reliable
and convenient basis for examination for
pallor.
1q. Answer: (A) Sugar. R.A. 8976 mandates
forti]cation of rice, wheat jour, sugar and
cooking oil with Vitamin A, iron and/or
iodine.
19. Answer: (A) Give measles vaccine to babies
aged 6 to 8 months. Ordinarily, measles
vaccine is given at 9 months of age. During
an impending epidemic, however, one dose
may be given to babies aged 6 to 8 months.
The mother is instructed that the baby needs
another dose when the baby is 9 months old.
20. Answer: (A) Inability to drink. A sick child
aged 2 months to 5 years must be referred
urgently to a hospital if he/she has one or
more of the following signs: not able to feed
or drink, vomits everything, convulsions,
abnormally sleepy or dikcult to awaken.
21. Answer: (D) Retinol capsule regardless of
when the last dose was given. An infant 6 to
12 months classi]ed as a case of measles is
given Retinol 100,000 IU; a child is given
200,000 IU regardless of when the last dose
was given.
22. Answer: (B) Ask where the family
resides. Because malaria is endemic, the
]rst question to determine malaria risk is

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 where the client’s family resides. If the area
of residence is not a known endemic area,
ask if the child had traveled within the past 6
months, where he/she was brought and
whether he/she stayed overnight in that area.
23. Answer: (B) Destroying breeding places of
mosquitoes. Aedes aegypti, the vector of
Dengue fever, breeds in stagnant, clear
water. Its feeding time is usually during the
daytime. It has a cyclical pattern of
occurrence, unlike malaria which is endemic
in certain parts of the country.
24. Answer: (C) Determining whether a place is
endemic or not. This is diagnostic and
therefore secondary level prevention. The
other choices are for primary prevention.
25. Answer: (B) Pinworm. Pinworm ova are
deposited around the anal ori]ce.
2p. Answer: (C) Cough for 3 weeks. A client is
considered a PTB suspect when he has
cough for 2 weeks or more, plus one or more
of the following signs: fever for 1 month or
more; chest pain lasting for 2 weeks or more
not attributed to other conditions;
progressive, unexplained weight loss; night
sweats; and hemoptysis.
27. Answer: (D) Clients diagnosed for the Trst
time through a positive sputum
exam. Category I is for new clients
diagnosed by sputum examination and

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 clients diagnosed to have a serious form of
extrapulmonary tuberculosis, such as TB
osteomyelitis.
2q. Answer: (B) Having the health worker or a
responsible family member monitor drug
intake. Directly Observed Treatment Short
Course is so-called because a treatment
partner, preferably a health worker
accessible to the client, monitors the client’s
compliance to the treatment.
29. Answer: (C) Thickened painful nerves. The
lesion of leprosy is not macular. It is
characterized by a change in skin color
(either reddish or whitish) and loss of
sensation, sweating and hair growth over the
lesion. Inability to close the eyelids
(lagophthalmos) and sinking of the
nosebridge are late symptoms.
30. Answer: (D) 5 skin lesions, positive slit skin
smear. A multibacillary leprosy case is one
who has a positive slit skin smear and at
least 5 skin lesions.

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