1. Philippine NLE Board Exam: Psychiatric Nursing Question & Answer w/ rationale
PSYCHIATRIC NURSING
1. Mental health is defined as:
A. The ability to distinguish what is real from what is not.
B. A state of well-being where a person can realize his own abilities can cope with normal stresses of
life and work productively.
C. Is the promotion of mental health, prevention of mental disorders, nursing care of patients during
illness and rehabilitation
D. Absence of mental illness
Answer: (B) A state of well-being where a person can realize his own abilities can cope with normal
stresses of life and work productively.
Mental health is a state of emotional and psychosocial well being. A mentally healthy individual is
self aware and self directive, has the ability to solve problems, can cope with crisis without assistance
beyond the support of family and friends fulfill the capacity to love and work and sets goals and
realistic limits. A. This describes the ego function reality testing. C. This is the definition of Mental
Health and Psychiatric Nursing. D. Mental health is not just the absence of mental illness.
2. Which of the following describes the role of a technician?
A. Administers medications to a schizophrenic patient.
B. The nurse feeds and bathes a catatonic client
C. Coordinates diverse aspects of care rendered to the patient
D. Disseminates information about alcohol and its effects.
Answer: (A) Administers medications to a schizophrenic patient.
Administration of medications and treatments, assessment, documentation are the activities of the
nurse as a technician. B. Activities as a parent surrogate. C. Refers to the ward manager role. D. Role
as a teacher.
3. Liza says, “Give me 10 minutes to recall the name of our college professor who failed many
students in our anatomy class.” She is operating on her:
A. Subconscious
B. Conscious
C. Unconscious
D. Ego
Answer: (A) Subconscious
Subconscious refers to the materials that are partly remembered partly forgotten but these can be
recalled spontaneously and voluntarily. B. This functions when one is awake. One is aware of his
thoughts, feelings actions and what is going on in the environment. C. The largest potion of the mind
that contains the memories of one’s past particularly the unpleasant. It is difficult to recall the
unconscious content. D. The conscious self that deals and tests reality.
4. The superego is that part of the psyche that:
A. Uses defensive function for protection.
B. Is impulsive and without morals.
C. Determines the circumstances before making decisions.
D. The censoring portion of the mind.
Answer: (D) The censoring portion of the mind.
The critical censoring portion of one’s personality; the conscience. A. This refers to the ego function
that protects itself from anything that threatens it.. B. The Id is composed of the untamed, primitive
drives and impulses. C. This refers to the ego that acts as the moderator of the struggle between the id
and the superego.
5. Primary level of prevention is exemplified by:
A. Helping the client resume self care.
B. Ensuring the safety of a suicidal client in the institution.
C. Teaching the client stress management techniques
D. Case finding and surveillance in the community
Answer: (C) Teaching the client stress management techniques
Primary level of prevention refers to the promotion of mental health and prevention of mental illness.
This can be achieved by rendering health teachings such as modifying ones responses to stress. A.
This is tertiary level of prevention that deals with rehabilitation. B and D. Secondary level of
prevention which involves reduction of actual illness through early detection and treatment of illness.
6. Situation: In a home visit done by the nurse, she suspects that the wife and her child are victims of

2. abuse.
Which of the following is the most appropriate for the nurse to ask?
A. “Are you being threatened or hurt by your partner?
B. “Are you frightened of you partner”
C. “Is something bothering you?”
D. “What happens when you and your partner argue?”
Answer: (A) “Are you being threatened or hurt by your partner?
The nurse validates her observation by asking simple, direct question. This also shows empathy. B,
C, and D are indirect questions which may not lead to the discussion of abuse.
7. The wife admits that she is a victim of abuse and opens up about her persistent distaste for sex.
This sexual disorder is:
A. Sexual desire disorder
B. Sexual arousal Disorder
C. Orgasm Disorder
D. Sexual Pain Disorder
Answer: (A) Sexual desire disorder
Has little or no sexual desire or has distaste for sex. B. Failure to maintain the physiologic
requirements for sexual intercourse. C. Persistent and recurrent inability to achieve an orgasm. D.
Also called dyspareunia. Individuals with this disorder suffer genital pain before, during and after
sexual intercourse.
8. What would be the best approach for a wife who is still living with her abusive husband?
A. “Here’s the number of a crisis center that you can call for help .”
B. “Its best to leave your husband.”
C. “Did you discuss this with your family?”
D. “ Why do you allow yourself to be treated this way”
Answer: (A) “Here’s the number of a crisis center that you can call for help .”
Protection is a priority concern in abuse. Help the victim to develop a plan to ensure safety. B. Do not
give advice to leave the abuser. Making decisions for the victim further erodes her esteem. However
discuss options available. C. The victim tends to isolate from friends and family. D. This is
judgmental. Avoid in anyway implying that she is at fault.
9. Which comment about a 3 year old child if made by the parent may indicate child abuse?
A. “Once my child is toilet trained, I can still expect her to have some"
B. “When I tell my child to do something once, I don’t expect to have to tell"
C. “My child is expected to try to do things such as, dress and feed.”
D. “My 3 year old loves to say NO.”
Answer: (B) “When I tell my child to do something once, I don’t expect to have to tell"
Abusive parents tend to have unrealistic expectations on the child. A,B and C are realistic
expectations on a 3 year old.
10. The primary nursing intervention for a victim of child abuse is:
A. Assess the scope of the problem
B. Analyze the family dynamics
C. Ensure the safety of the victim
D. Teach the victim coping skills
Answer: (C) Ensure the safety of the victim
The priority consideration is the safety of the victim. Attend to the physical injuries to ensure the
physiologic safety and integrity of the child. Reporting suspected case of abuse may deter recurrence
of abuse. A,B and D may be addressed later.
11. Situation: A 30 year old male employee frequently complains of low back pain that leads to
frequent absences from work. Consultation and tests reveal negative results.
The client has which somatoform disorder?
A. Somatization Disorder
B. Hypochondriaisis
C. Conversion Disorder
D. Somatoform Pain Disorder
Answer: (D) Somatoform Pain Disorder
This is characterized by severe and prolonged pain that causes significant distress. A. This is a

3. chronic syndrome of somatic symptoms that cannot be explained medically and is associated with
psychosocial distress. B. This is an unrealistic preoccupation with a fear of having a serious illness.
C. Characterized by alteration or loss in sensory or motor function resulting from a psychological
conflict.
12. Freud explains anxiety as:
A. Strives to gratify the needs for satisfaction and security
B. Conflict between id and superego
C. A hypothalamic-pituitary-adrenal reaction to stress
D. A conditioned response to stressors
Answer: (B) Conflict between id and superego
Freud explains anxiety as due to opposing action drives between the id and the superego. A. Sullivan
identified 2 types of needs, satisfaction and security. Failure to gratify these needs may result in
anxiety. C. Biomedical perspective of anxiety. D. Explanation of anxiety using the behavioral model.
13. The following are appropriate nursing diagnosis for the client EXCEPT:
A. Ineffective individual coping
B. Alteration in comfort, pain
C. Altered role performance
D. Impaired social interaction
Answer: (D) Impaired social interaction
The client may not have difficulty in social exchange. The cues do not support this diagnosis. A. The
client maladaptively uses body symptoms to manage anxiety. B. The client will have discomfort due
to pain. C. The client may fail to meet environmental expectations due to pain.
14. The following statements describe somatoform disorders:
A. Physical symptoms are explained by organic causes
B. It is a voluntary expression of psychological conflicts
C. Expression of conflicts through bodily symptoms
D. Management entails a specific medical treatment
Answer: (C) Expression of conflicts through bodily symptoms
Bodily symptoms are used to handle conflicts. A. Manifestations do not have an organic basis. B.
This occurs unconsciously. D. Medical treatment is not used because the disorder does not have a
structural or organic basis.
15. What would be the best response to the client’s repeated complaints of pain:
A. “I know the feeling is real tests revealed negative results.”
B. . “I think you’re exaggerating things a little bit.”
C. “Try to forget this feeling and have activities to take it off your mind”
D. “So tell me more about the pain”
Answer: (A) “I know the feeling is real tests revealed negative results.”
Shows empathy and offers information. B. This is a demeaning statement. C. This belittles the
client’s feelings. D. Giving undue attention to the physical symptom reinforces the complaint.
16. Situation: A nurse may encounter children with mental disorders. Her knowledge of these various
disorders is vital.
When planning school interventions for a child with a diagnosis of attention deficit hyperactivity
disorder, a guide to remember is to:
A. provide as much structure as possible for the child
B. ignore the child’s overactivity.
C. encourage the child to engage in any play activity to dissipate energy
D. remove the child from the classroom when disruptive behavior occurs
Answer: (A) provide as much structure as possible for the child
Decrease stimuli for behavior control thru an environment that is free of distractions, a calm non –
confrontational approach and setting limit to time allotted for activities. B. The child will not benefit
from a lenient approach. C. Dissipate energy through safe activities. D. This indicates that the
classroom environment lacks structure.
17. The child with conduct disorder will likely demonstrate:
A. Easy distractibility to external stimuli.
B. Ritualistic behaviors
C. Preference for inanimate objects.
D. Serious violations of age related norms.

4. Answer: (D) Serious violations of age related norms.
This is a disruptive disorder among children characterized by more serious violations of social
standards such as aggression, vandalism, stealing, lying and truancy. A. This is characteristic of
attention deficit disorder. B and C. These are noted among children with autistic disorder.
18. Ritalin is the drug of choice for chidren with ADHD. The side effects of the following may be
noted:
A. increased attention span and concentration
B. increase in appetite
C. sleepiness and lethargy
D. bradycardia and diarrhea
Answer: (A) increased attention span and concentration
The medication has a paradoxic effect that decrease hyperactivity and impulsivity among children
with ADHD. B, C, D. Side effects of Ritalin include anorexia, insomnia, diarrhea and irritability.
19. School phobia is usually treated by:
A. Returning the child to the school immediately with family support.
B. Calmly explaining why attendance in school is necessary
C. Allowing the child to enter the school before the other children
D. Allowing the parent to accompany the child in the classroom
Answer: (A) Returning the child to the school immediately with family support.
Exposure to the feared situation can help in overcoming anxiety. A. This will not help in relieving the
anxiety due separation from a significant other. C. and C. Anxiety in school phobia is not due to
being in school but due to separation from parents/caregivers so these interventions are not
applicable. D. This will not help the child overcome the fear
20. A 10 year old child has very limited vocabulary and interaction skills. She has an I.Q. of 45. She
is diagnosed to have Mental retardation of this classification:
A. Profound
B. Mild
C. Moderate
D. Severe
Answer: (C) Moderate
The child with moderate mental retardation has an I.Q. of 35-50 Profound Mental retardation has an
I.Q. of below 20; Mild mental retardation 50-70 and Severe mental retardation has an I.Q. of 20-35.
21. The nurse teaches the parents of a mentally retarded child regarding her care. The following
guidelines may be taught except:
A. overprotection of the child
B. patience, routine and repetition
C. assisting the parents set realistic goals
D. giving reasonable compliments
Answer: (A) overprotection of the child
The child with mental retardation should not be overprotected but need protection from injury and the
teasing of other children. B,C, and D Children with mental retardation have learning difficulty. They
should be taught with patience and repetition, start from simple to complex, use visuals and
compliment them for motivation. Realistic expectations should be set and optimize their capability.
22. The parents express apprehensions on their ability to care for their maladaptive child. The nurse
identifies what nursing diagnosis:
A. hopelessness
B. altered parenting role
C. altered family process
D. ineffective coping
Answer: (B) altered parenting role
Altered parenting role refers to the inability to create an environment that promotes optimum growth
and development of the child. This is reflected in the parent’s inability to care for the child. A. This
refers to lack of choices or inability to mobilize one’s resources. C. Refers to change in family
relationship and function. D. Ineffective coping is the inability to form valid appraisal of the stressor
or inability to use available resources
23. A 5 year old boy is diagnosed to have autistic disorder.
Which of the following manifestations may be noted in a client with autistic disorder?
A. argumentativeness, disobedience, angry outburst

5. B. intolerance to change, disturbed relatedness, stereotypes
C. distractibility, impulsiveness and overactivity
D. aggression, truancy, stealing, lying
Answer: (B) intolerance to change, disturbed relatedness, stereotypes
These are manifestations of autistic disorder. A. These manifestations are noted in Oppositional
Defiant Disorder, a disruptive disorder among children. C. These are manifestations of Attention
Deficit Disorder D. These are the manifestations of Conduct Disorder
24. The therapeutic approach in the care of an autistic child include the following EXCEPT:
A. Engage in diversionary activities when acting -out
B. Provide an atmosphere of acceptance
C. Provide safety measures
D. Rearrange the environment to activate the child
Answer: (D) Rearrange the environment to activate the child
The child with autistic disorder does not want change. Maintaining a consistent environment is
therapeutic. A. Angry outburst can be rechannelled through safe activities. B. Acceptance enhances a
trusting relationship. C. Ensure safety from self-destructive behaviors like head banging and hair
pulling.
25. According to Piaget a 5 year old is in what stage of development:
A. Sensory motor stage
B. Concrete operations
C. Pre-operational
D. Formal operation
Answer: (C) Pre-operational
Pre-operational stage (2-7 years) is the stage when the use of language, the use of symbols and the
concept of time occur. A. Sensory-motor stage (0-2 years) is the stage when the child uses the senses
in learning about the self and the environment through exploration. B. Concrete operations (7-12
years) when inductive reasoning develops. D. Formal operations (2 till adulthood) is when abstract
thinking and deductive reasoning develop.
26. Situation : The nurse assigned in the detoxification unit attends to various patients with
substance-related disorders.
A 45 years old male revealed that he experienced a marked increase in his intake of alcohol to
achieve the desired effect This indicates:
A. withdrawal
B. tolerance
C. intoxication
D. psychological dependence
Answer: (B) tolerance
tolerance refers to the increase in the amount of the substance to achieve the same effects. A.
Withdrawal refers to the physical signs and symptoms that occur when the addictive substance is
reduced or withheld. B. Intoxication refers to the behavioral changes that occur upon recent ingestion
of a substance. D. Psychological dependence refers to the intake of the substance to prevent the onset
of withdrawal symptoms.
27. The client admitted for alcohol detoxification develops increased tremors, irritability,
hypertension and fever. The nurse should be alert for impending:
A. delirium tremens
B. Korsakoff’s syndrome
C. esophageal varices
D. Wernicke’s syndrome
Answer: (A) delirium tremens
Delirium Tremens is the most extreme central nervous system irritability due to withdrawal from
alcohol B. This refers to an amnestic syndrome associated with chronic alcoholism due to a
deficiency in Vit. B C. This is a complication of liver cirrhosis which may be secondary to
alcoholism . D. This is a complication of alcoholism characterized by irregularities of eye movements
and lack of coordination.
28. The care for the client places priority to which of the following:
A. Monitoring his vital signs every hour
B. Providing a quiet, dim room
C. Encouraging adequate fluids and nutritious foods

6. D. Administering Librium as ordered
Answer: (A) Monitoring his vital signs every hour
Pulse and blood pressure are usually elevated during withdrawal, Elevation may indicate impending
delirium tremens B. Client needs quiet, well lighted, consistent and secure environment. Excessive
stimulation can aggravate anxiety and cause illusions and hallucinations. C. Adequate nutrition with
sulpplement of Vit. B should be ensured. D. Sedatives are used to relieve anxiety.
29. Another client is brought to the emergency room by friends who state that he took something an
hour ago. He is actively hallucinating, agitated, with irritated nasal septum.
A. Heroin
B. cocaine
C. LSD
D. marijuana
Answer: (B) cocaine
The manifestations indicate intoxication with cocaine, a CNS stimulant. A. Intoxication with heroine
is manifested by euphoria then impairment in judgment, attention and the presence of papillary
constriction. C. Intoxication with hallucinogen like LSD is manifested by grandiosity, hallucinations,
synesthesia and increase in vital signs D. Intoxication with Marijuana, a cannabinoid is manifested by
sensation of slowed time, conjunctival redness, social withdrawal, impaired judgment and
hallucinations.
30. A client is admitted with needle tracts on his arm, stuporous and with pin point pupil will likely
be managed with:
A. Naltrexone (Revia)
B. Narcan (Naloxone)
C. Disulfiram (Antabuse)
D. Methadone (Dolophine)
Answer: (B) Narcan (Naloxone)
Narcan is a narcotic antagonist used to manage the CNS depression due to overdose with heroin. A.
This is an opiate receptor blocker used to relieve the craving for heroine C. Disulfiram is used as a
deterrent in the use of alcohol. D. Methadone is used as a substitute in the withdrawal from heroine
31. Situation: An old woman was brought for evaluation due to the hospital for evaluation due to
increasing forgetfulness and limitations in daily function.
The daughter revealed that the client used her toothbrush to comb her hair. She is manifesting:
A. apraxia
B. aphasia
C. agnosia
D. amnesia
Answer: (C) agnosia
This is the inability to recognize objects. A. Apraxia is the inability to execute motor activities
despite intact comprehension. B. Aphasia is the loss of ability to use or understand words. D.
Amnesia is loss of memory.
32. She tearfully tells the nurse “I can’t take it when she accuses me of stealing her things.” Which
response by the nurse will be most therapeutic?
A. ”Don’t take it personally. Your mother does not mean it.”
B. “Have you tried discussing this with your mother?”
C. “This must be difficult for you and your mother.”
D. “Next time ask your mother where her things were last seen.”
Answer: (C) “This must be difficult for you and your mother.”
This reflecting the feeling of the daughter that shows empathy. A and D. Giving advise does not
encourage verbalization. B. This response does not encourage verbalization of feelings.
33. The primary nursing intervention in working with a client with moderate stage dementia is
ensuring that the client:
A. receives adequate nutrition and hydration
B. will reminisce to decrease isolation
C. remains in a safe and secure environment
D. independently performs self care
Answer: (C) remains in a safe and secure environment
Safety is a priority consideration as the client’s cognitive ability deteriorates.. A is appropriate

7. interventions because the client’s cognitive impairment can affect the client’s ability to attend to his
nutritional needs, but it is not the priority B. Patient is allowed to reminisce but it is not the priority.
D. The client in the moderate stage of Alzheimer’s disease will have difficulty in performing
activities independently
34. She says to the nurse who offers her breakfast, “Oh no, I will wait for my husband. We will eat
together” The therapeutic response by the nurse is:
A. “Your husband is dead. Let me serve you your breakfast.”
B. “I’ve told you several times that he is dead. It’s time to eat.”
C. “You’re going to have to wait a long time.”
D. “What made you say that your husband is alive?
Answer: (A) “Your husband is dead. Let me serve you your breakfast.”
The client should be reoriented to reality and be focused on the here and now.. B. This is not a helpful
approach because of the short term memory of the client. C. This indicates a pompous response. D.
The cognitive limitation of the client makes the client incapable of giving explanation.
35. Dementia unlike delirium is characterized by:
A. slurred speech
B. insidious onset
C. clouding of consciousness
D. sensory perceptual change
Answer: (B) insidious onset
Dementia has a gradual onset and progressive deterioration. It causes pronounced memory and
cognitive disturbances. A,C and D are all characteristics of delirium.
36. Situation: A 17 year old gymnast is admitted to the hospital due to weight loss and dehydration
secondary to starvation.
Which of the following nursing diagnoses will be given priority for the client?
A. altered self-image
B. fluid volume deficit
C. altered nutrition less than body requirements
D. altered family process
Answer: (B) fluid volume deficit
Fluid volume deficit is the priority over altered nutrition (A) since the situation indicates that the
client is dehydrated. A and D are psychosocial needs of a client with anorexia nervosa but they are
not the priority.
37. What is the best intervention to teach the client when she feels the need to starve?
A. Allow her to starve to relieve her anxiety
B. Do a short term exercise until the urge passes
C. Approach the nurse and talk out her feelings
D. Call her mother on the phone and tell her how she feels
Answer: (C) Approach the nurse and talk out her feelings
The client with anorexia nervosa uses starvation as a way of managing anxiety. Talking out feelings
with the nurse is an adaptive coping. A. Starvation should not be encouraged. Physical safety is a
priority. Without adequate nutrition, a life threatening situation exists. B. The client with anorexia
nervosa is preoccupied with losing weight due to disturbed body image. Limits should be set on
attempts to lose more weight. D. The client may have a domineering mother which causes the client
to feel ambivalent. The client will not discuss her feelings with her mother.
38. The client with anorexia nervosa is improving if:
A. She eats meals in the dining room.
B. Weight gain
C. She attends ward activities.
D. She has a more realistic self concept.
Answer: (B) Weight gain
Weight gain is the best indication of the client’s improvement. The goal is for the client to gain 1-2
pounds per week. (A)The client may purge after eating. (C) Attending an activity does not indicate
improvement in nutritional state. (D) Body image is a factor in anorexia nervosa but it is not an
indicator for improvement.
39. The characteristic manifestation that will differentiate bulimia nervosa from anorexia nervosa is
that bulimic individuals
A. have episodic binge eating and purging

8. B. have repeated attempts to stabilize their weight
C. have peculiar food handling patterns
D. have threatened self-esteem
Answer: (A) have episodic binge eating and purging
Bulimia is characterized by binge eating which is characterized by taking in a large amount of food
over a short period of time. B and C are characteristics of a client with anorexia nervosa D. Low
esteem is noted in both eating disorders
40. A nursing diagnosis for bulimia nervosa is powerlessness related to feeling not in control of
eating habits. The goal for this problem is:
A. Patient will learn problem solving skills
B. Patient will have decreased symptoms of anxiety.
C. Patient will perform self care activities daily.
D. Patient will verbalize how to set limits on others.
Answer: (A) Patient will learn problem solving skills
if the client learns problem solving skills she will gain a sense of control over her life. (B) Anxiety is
caused by powerlessness. (C) Performing self care activities will not decrease ones powerlessness (D)
Setting limits to control imposed by others is a necessary skill but problem solving skill is the
priority.
41. In the management of bulimic patients, the following nursing interventions will promote a
therapeutic relationship EXCEPT:
A. Establish an atmosphere of trust
B. Discuss their eating behavior.
C. Help patients identify feelings associated with binge-purge behavior
D. Teach patient about bulimia nervosa
Answer: (B) Discuss their eating behavior.
The client is often ashamed of her eating behavior. Discussion should focus on feelings. A,C and D
promote a therapeutic relationship
42. Situation: A 35 year old male has intense fear of riding an elevator. He claims “ As if I will die
inside.” This has affected his studies
The client is suffering from:
A. agoraphobia
B. social phobia
C. Claustrophobia
D. xenophobia
Answer: (C) Claustrophobia
Claustrophobia is fear of closed space. A. Agoraphobia is fear of open space or being a situation
where escape is difficult. B. Social phobia is fear of performing in the presence of others in a way
that will be humiliating or embarrassing. D. Xenophobia is fear of strangers.
43. Initial intervention for the client should be to:
A. Encourage to verbalize his fears as much as he wants.
B. Assist him to find meaning to his feelings in relation to his past.
C. Establish trust through a consistent approach.
D. Accept her fears without criticizing.
Answer: (D) Accept her fears without criticizing.
The client cannot control her fears although the client knows its silly and can joke about it. A. Allow
expression of the client’s fears but he should focus on other productive activities as well. B and C.
These are not the initial interventions.
44. The nurse develops a countertransference reaction. This is evidenced by:
A. Revealing personal information to the client
B. Focusing on the feelings of the client.
C. Confronting the client about discrepancies in verbal or non-verbal behavior
D. The client feels angry towards the nurse who resembles his mother.
Answer: (A) Revealing personal information to the client
A. Countertransference is an emotional reaction of the nurse on the client based on her unconscious
needs and conflicts. B and C. These are therapeutic approaches. D. This is transference reaction

9. where a client has an emotional reaction towards the nurse based on her past.
45. Which is the desired outcome in conducting desensitization:
A. The client verbalize his fears about the situation
B. The client will voluntarily attend group therapy in the social hall.
C. The client will socialize with others willingly
D. The client will be able to overcome his disabling fear.
Answer: (D) The client will be able to overcome his disabling fear.
The client will overcome his disabling fear by gradual exposure to the feared object. A,B and C are
not the desired outcome of desensitization.
46. Which of the following should be included in the health teachings among clients receiving
Valium:
A. Avoid taking CNS depressant like alcohol.
B. There are no restrictions in activities.
C. Limit fluid intake.
D. Any beverage like coffee may be taken
Answer: (A) Avoid taking CNS depressant like alcohol.
Valium is a CNS depressant. Taking it with other CNS depressants like alcohol; potentiates its effect.
B. The client should be taught to avoid activities that require alertness. C. Valium causes dry mouth
so the client must increase her fluid intake. D. Stimulants must not be taken by the client because it
can decrease the effect of Valium.
47. Situation: A 20 year old college student is admitted to the medical ward because of sudden onset
of paralysis of both legs. Extensive examination revealed no physical basis for the complaint.
The nurse plans intervention based on which correct statement about conversion disorder?
A. The symptoms are conscious effort to control anxiety
B. The client will experience high level of anxiety in response to the paralysis.
C. The conversion symptom has symbolic meaning to the client
D. A confrontational approach will be beneficial for the client.
Answer: (C) The conversion symptom has symbolic meaning to the client
the client uses body symptoms to relieve anxiety. A. The condition occurs unconsciously. B. The
client is not distressed by the lost or altered body function. D. The client should not be confronted by
the underlying cause of his condition because this can aggravate the client’s anxiety.
48. Nina reveals that the boyfriend has been pressuring her to engage in premarital sex. The most
therapeutic response by the nurse is:
A. “I can refer you to a spiritual counselor if you like.”
B. “You shouldn’t allow anyone to pressure you into sex.”
C. “It sounds like this problem is related to your paralysis.”
D. “How do you feel about being pressured into sex by your boyfriend?”
Answer: (D) “How do you feel about being pressured into sex by your boyfriend?”
Focusing on expression of feelings is therapeutic. The central force of the client’s condition is
anxiety. A. This is not therapeutic because the nurse passes the responsibility to the counselor. B.
Giving advice is not therapeutic. C. This is not therapeutic because it confronts the underlying cause.
49. Malingering is different from somatoform disorder because the former:
A. Has evidence of an organic basis.
B. It is a deliberate effort to handle upsetting events
C. Gratification from the environment are obtained.
D. Stress is expressed through physical symptoms.
Answer: (B) It is a deliberate effort to handle upsetting events
Malingering is a conscious simulation of an illness while somatoform disorder occurs unconscious.
A. Both disorders do not have an organic or structural basis. C. Both have primary gains. D. This is a
characteristic of somatoform disorder.
50. Unlike psychophysiologic disorder Linda may be best managed with:
A. medical regimen
B. milieu therapy
C. stress management techniques
D. psychotherapy
Answer: (C) stress management techniques
Stree management techniques is the best management of somatoform disorder because the disorder is

10. related to stress and it does not have a medical basis. A. This disorder is not supported by organic
pathology so no medical regimen is required. B and D. Milieu therapy and psychotherapy may be
used a therapeutic modalities but these are not the best.
51. Which is the best indicator of success in the long term management of the client?
A. His symptoms are replaced by indifference to his feelings
B. He participates in diversionary activities.
C. He learns to verbalize his feelings and concerns
D. He states that his behavior is irrational.
Answer: (C) He learns to verbalize his feelings and concerns
C. The client is encouraged to talk about his feelings and concerns instead of using body symptoms to
manage his stressors. A. The client is encouraged to acknowledge feelings rather than being
indifferent to her feelings. B. Participation in activities diverts the client’s attention away from his
bodily concerns but this is not the best indicator of success. D. Help the client recognize that his
physical symptoms occur because of or are exacerbated by specific stressor, not as irrational.
52. Situation: A young woman is brought to the emergency room appearing depressed. The nurse
learned that her child died a year ago due to an accident.
The initial nursing diagnosis is dysfunctional grieving. The statement of the woman that supports this
diagnosis is:
A. “I feel envious of mothers who have toddlers”
B. “I haven’t been able to open the door and go into my baby’s room “
C. “I watch other toddlers and think about their play activities and I cry.”
D. “I often find myself thinking of how I could have prevented the death.
Answer: (B) “I haven’t been able to open the door and go into my baby’s room “
This indicates denial. This defense is adaptive as an initial reaction to loss but an extended,
unsuccessful use of denial is dysfunctional. A. This indicates acknowledgement of the loss.
Expressing feelings openly is acceptable. C. This indicates the stage of depression in the grieving
process. D. Remembering both positive and negative aspects of the deceased love one signals
successful mourning.
53. The client said “I can’t even take care of my baby. I’m good for nothing.” Which is the
appropriate nursing diagnosis?
A. Ineffective individual coping related to loss.
B. Impaired verbal communication related to inadequate social skills.
C. Low esteem related to failure in role performance
D. Impaired social interaction related to repressed anger.
Answer: (C) Low esteem related to failure in role performance
This indicates the client’s negative self evaluation. A sense of worthlessness may accompany
depression. A,B and D are not relevant. The cues do not indicate inability to use coping resources,
decreased ability to transmit/process symbols, nor insufficient quality of social exchange
54. The following medications will likely be prescribed for the client EXCEPT:
A. Prozac
B. Tofranil
C. Parnate
D. Zyprexa
Answer: (D) Zyprexa
This is an antipsychotic. A. This is a SSRI antidepressant. B. This antidepressant belongs to the
Tricyclic group. C. This is a MAOI antidepressant.
55. Which is the highest priority in the post ECT care?
A. Observe for confusion
B. Monitor respiratory status
C. Reorient to time, place and person
D. Document the client’s response to the treatment
Answer: (B) Monitor respiratory status
A side effect of ECT which is life threatening is respiratory arrest. A and C. Confusion and
disorientation are side effects of ECT but these are not the highest priority.
56. Situation: A 27 year old writer is admitted for the second time accompanied by his wife. He is
demanding, arrogant talked fast and hyperactive.

11. Initially the nurse should plan this for a manic client:
A. set realistic limits to the client’s behavior
B. repeat verbal instructions as often as needed
C. allow the client to get out feelings to relieve tension
D. assign a staff to be with the client at all times to help maintain control
Answer: (A) set realistic limits to the client’s behavior
The manic client is hyperactive and may engage in injurious activities. A quiet environment and
consistent and firm limits should be set to ensure safety. B. Clear, concise directions are given
because of the distractibility of the client but this is not the priority. C. The manic client tend to
externalize hostile feelings, however only non-destructive methods of expression should be allowed
D. Nurses set limit as needed. Assigning a staff to be with the client at all times is not realistic.
57. An activity appropriate for the client is:
A. table tennis
B. painting
C. chess
D. cleaning
Answer: (D) cleaning
The client’s excess energy can be rechanelled through physical activities that are not competitive like
cleaning. This is also a way to dissipate tension. A. Tennis is a competitive activity which can
stimulate the client.
58. The client is arrogant and manipulative. In ensuring a therapeutic milieu, the nurse does one of
the following:
A. Agree on a consistent approach among the staff assigned to the client.
B. Suggest that the client take a leading role in the social activities
C. Provide the client with extra time for one on one sessions
D. Allow the client to negotiate the plan of care
Answer: (A) Agree on a consistent approach among the staff assigned to the client.
A consistent firm approach is appropriate. This is a therapeutic way of to handle attempts of
exploiting the weakness in others or create conflicts among the staff. Bargaining should not be
allowed. B. This is not therapeutic because the client tends to control and dominate others. C. Limits
are set for interaction time. D. Allowing the client to negotiate may reinforce manipulative behavior.
59. The nurse exemplifies awareness of the rights of a client whose anger is escalating by:
A. Taking a directive role in verbalizing feelings
B. Using an authoritarian, confrontational approach
C. Putting the client in a seclusion room
D. Applying mechanical restraints
Answer: (A) Taking a directive role in verbalizing feelings
The client has the right to be free from unnecessary restraints. Verbalization of feelings or “talking
down” in a non-threatening environment is helpful to relieve the client’s anger. B. This is a
threatening approach. C and D. Seclusion and application restraints are done only when less
restrictive measures have failed to contain the client’s anger.
60. A client on Lithium has diarrhea and vomiting. What should the nurse do first:
A. Recognize this as a drug interaction
B. Give the client Cogentin
C. Reassure the client that these are common side effects of lithium therapy
D. Hold the next dose and obtain an order for a stat serum lithium level
Answer: (D) Hold the next dose and obtain an order for a stat serum lithium level
Diarrhea and vomiting are manifestations of Lithium toxicity. The next dose of lithium should be
withheld and test is done to validate the observation. A. The manifestations are not due to drug
interaction. B. Cogentin is used to manage the extra pyramidal symptom side effects of
antipsychotics. C. The common side effects of Lithium are fine hand tremors, nausea, polyuria and
polydipsia.
61. Situation: A widow age 28, whose husband died one year ago due to AIDS, has just been told that
she has AIDS.
Pamela says to the nurse, “Why me? How could God do this to me?” This reaction is one of:
A. Depression

12. B. Denial
C. anger
D. bargaining
Answer: (C) anger
Anger is experienced as reality sets in. This may either be directed to God, the deceased or displaced
on others. A. Depression is a painful stage where the individual mourns for what was lost. B. Denial
is the first stage of the grieving process evidenced by the statement “No, it can’t be true.” The
individual does not acknowledge that the loss has occurred to protect self from the psychological pain
of the loss. D. In bargaining the individual holds out hope for additional alternatives to forestall the
loss, evidenced by the statement “If only…”
62. The nurse’s therapeutic response is:
A. “I will refer you to a clergy who can help you understand what is happening to you.”
B. “ It isn’t fair that an innocent like you will suffer from AIDS.”
C. “That is a negative attitude.”
D. ”It must really be frustrating for you. How can I best help you?”
Answer: (D) ”It must really be frustrating for you. How can I best help you?”
This response reflects the pain due to loss. A helping relationship can be forged by showing empathy
and concern. A. This is not therapeutic since it passes the buck or responsibility to the clergy. B. This
response is not therapeutic because it gives the client the impression that she is right which prevents
the client from reconsidering her thoughts. C. This statement passes judgment on the client.
63. One morning the nurse sees the client in a depressed mood. The nurse asks her “What are you
thinking about?” This communication technique is:
A. focusing
B. validating
C. reflecting
D. giving broad opening
Answer: (D) giving broad opening
Broad opening technique allows the client to take the initiative in introducing the topic. A,B and C
are all therapeutic techniques but these are not exemplified by the nurse’s statement.
64. The client says to the nurse ” Pray for me” and entrusts her wedding ring to the nurse. The nurse
knows that this may signal which of the following:
A. anxiety
B. suicidal ideation
C. Major depression
D. Hopelessness
Answer: (B) suicidal ideation
The client’s statement is a verbal cue of suicidal ideation not anxiety. While suicide is common
among clients with major depression, this occurs when their depression starts to lift. Hopelessness
indicates no alternatives available and may lead to suicide, the statement and non verbal cue of the
client indicate suicide.
65. Which of the following interventions should be prioritized in the care of the suicidal client?
A. Remove all potentially harmful items from the client’s room.
B. Allow the client to express feelings of hopelessness.
C. Note the client’s capabilities to increase self esteem.
D. Set a “no suicide” contract with the client.
Answer: (A) Remove all potentially harmful items from the client’s room.
Accessibility of the means of suicide increases the lethality. Allowing patient to express feelings and
setting a no suicide contract are interventions for suicidal client but blocking the means of suicide is
priority. Increasing self esteem is an intervention for depressed clients bur not specifically for suicide.
66. Situation: A 14 year old male was admitted to a medical ward due to bronchial asthma after
learning that his mother was leaving soon for U.K. to work as nurse.
The client has which of the following developmental focus:
A. Establishing relationship with the opposite sex and career planning.
B. Parental and societal responsibilities.
C. Establishing ones sense of competence in school.
D. Developing initial commitments and collaboration in work

13. Answer: (A) Establishing relationship with the opposite sex and career planning.
The client belongs to the adolescent stage. The adolescent establishes his sense of identity by making
decisions regarding familial, occupational and social roles. The adolescent emancipates himself from
the family and decides what career to pursue, what set of friends to have and what value system to
uphold. B. This refers to the middle adulthood stage concerned with transmitting his values to the
next generation to ensure his immortality through the perpetuation of his culture. C. This reflects
school age which is concerned with the pursuit of knowledge and skills to deal with the environment
both in the present and in the future. D. The stage of young adulthood is concerned with development
of intimate relationship with the opposite sex, establishment of a safe and congenial family
environment and building of one’s lifework.
67. The personality type of Ryan is:
A. conforming
B. dependent
C. perfectionist
D. masochistic
Answer: (B) dependent
A client with dependent personality is predisposed to develop asthma. A. The conforming non-
assertive client is predisposed to develop hypertension because of the tendency to repress rage. C.
The perfectionist and compulsive tend to develop migraine. D. The masochistic, self sacrificing type
are prone to develop rheumatoid arthritis.
68. The nurse ensures a therapeutic environment for the client. Which of the following best describes
a therapeutic milieu?
A. A therapy that rewards adaptive behavior
B. A cognitive approach to change behavior
C. A living, learning or working environment.
D. A permissive and congenial environment
Answer: (C) A living, learning or working environment.
A therapeutic milieu refers to a broad conceptual approach in which all aspects of the environment
are channeled to provide a therapeutic environment for the client. The six environmental elements
include structure, safety, norms, limit setting, balance and unit modification. A. Behavioral approach
in psychiatric care is based on the premise that behavior can be learned or unlearned through the use
of reward and punishment. B. Cognitive approach to change behavior is done by correcting distorted
perceptions and irrational beliefs to correct maladaptive behaviors. D. This is not congruent with
therapeutic milieu.
69. Included as priority of care for the client will be:
A. Encourage verbalization of concerns instead of demonstrating them through the body
B. Divert attention to ward activities
C. Place in semi-fowlers position and render O2 inhalation as ordered
D. Help her recognize that her physical condition has an emotional component
Answer: (C) Place in semi-fowlers position and render O2 inhalation as ordered
Since psychopysiologic disorder has organic basis, priority intervention is directed towards disease-
specific management. Failure to address the medical condition of the client may be a life threat. A
and B. The client has physical symptom that is adversely affected by psychological factors.
Verbalization of feelings in a non threatening environment and involvement in relaxing activities are
adaptive way of dealing with stressors. However, these are not the priority. D. Helping the client
connect the physical symptoms with the emotional problems can be done when the client is ready.
70. The client is concerned about his coming discharge, manifested by being unusually sad. Which is
the most therapeutic approach by the nurse?
A. “You are much better than when you were admitted so there’s no reason to worry.”
B. “What would you like to do now that you’re about to go home?”
C. “You seem to have concerns about going home.”
D. “Aren’t you glad that you’re going home soon?”
Answer: (C) “You seem to have concerns about going home.”
. This statement reflects how the client feels. Showing empathy can encourage the client to talk which
is important as an alternative more adaptive way of coping with stressors.. A. Giving false
reassurance is not therapeutic. B. While this technique explores plans after discharge, it does not
focus on expression of feelings. D. This close ended question does not encourage verbalization of
feelings.
71. Situation: The nurse may encounter clients with concerns on sexuality.

14. The most basic factor in the intervention with clients in the area of sexuality is:
A. Knowledge about sexuality.
B. Experience in dealing with clients with sexual problems
C. Comfort with one’s sexuality
D. Ability to communicate effectively
Answer: (C) Comfort with one’s sexuality
The nurse must be accepting, empathetic and non-judgmental to patients who disclose concerns
regarding sexuality. This can happen only when the nurse has reconciled and accepted her feelings
and beliefs related to sexuality. A,B and D are important considerations but these are not the priority.
72. Which of the following statements is true for gender identity disorder?
A. It is the sexual pleasure derived from inanimate objects.
B. It is the pleasure derived from being humiliated and made to suffer
C. It is the pleasure of shocking the victim with exposure of the genitalia
D. It is the desire to live or involve in reactions of the opposite sex
Answer: (D) It is the desire to live or involve in reactions of the opposite sex
Gender identity disorder is a strong and persistent desire to be the other sex. A. This is fetishism. B.
This refers to masochism. C. This describes exhibitionism.
73. The sexual response cycle in which the sexual interest continues to build:
A. Sexual Desire
B. Sexual arousal
C. Orgasm
D. Resolution
Answer: (B) Sexual arousal
Sexual arousal or excitement refers to attaining and maintaining the physiologic requirements for
sexual intercourse. A. Sexual Desire refers to the ability, interest or willingness for sexual
stimulation. C. Orgasm refers to the peak of the sexual response where the female has vaginal
contractions for the female and ejaculatory contractions for the male. D. Resolution is the final phase
of the sexual response in which the organs and the body systems gradually return to the unaroused
state.
74. The inability to maintain the physiologic requirements in sexual intercourse is:
A. Sexual Desire Disorder
B. Sexual Arousal Disorder
C. Orgasm Disorder
D. Sexual Pain disorder
Answer: (B) Sexual Arousal Disorder
This describes sexual arousal disorder. A. Sexual Desire Disorder refers to the persistent and
recurrent lack of desire or willingness for sexual intercourse. C. Orgasm Disorder is the inability to
complete the sexual response cycle because of the inability to achieve an orgasm. D. Sexual Pain
Disorder is characterized by genital pain before, during or after sexual intercourse.
75. The nurse asks a client to roll up his sleeves so she can take his blood pressure. The client replies
“If you want I can go naked for you.” The most therapeutic response by the nurse is:
A. “You’re attractive but I’m not interested.”
B. “You wouldn’t be the first that I will see naked.”
C. “I will report you to the guard if you don’t control yourself.”
D. “I only need access to your arm. Putting up your sleeve is fine.”
Answer: (D) “I only need access to your arm. Putting up your sleeve is fine.”
The nurse needs to deal with the client with sexually connotative behavior in a casual, matter of fact
way. A and B. These responses are not therapeutic because they are challenging and rejecting. C.
Threatening the client is not therapeutic.
76. Situation: Knowledge and skills in the care of violent clients is vital in the psychiatric unit. A
nurse observes that a client with a potential for violence is agitated, pacing up and down the hallway
and making aggressive remarks.
Which of the following statements is most appropriate to make to this patient?
A. What is causing you to become agitated?
B. You need to stop that behavior now.
C. You will need to be restrained if you do not change your behavior.
D. You will need to be placed in seclusion.

15. Answer: (A) What is causing you to become agitated?
In a non-violent aggressive behavior, help the client identify the stressor or the true object of
hostility. This helps reveal unresolved issues so that they may be confronted. B. Pacing is a tension
relieving measure for an agitated client. C. This is a threatening statement that can heighten the
client’s tension. D. Seclusion is used when less restrictive measures have failed.
77. The nurse closely observes the client who has been displaying aggressive behavior. The nurse
observes that the client’s anger is escalating. Which approach is least helpful for the client at this
time?
A. Acknowledge the client’s behavior
B. Maintain a safe distance from the client
C. Assist the client to an area that is quiet
D. Initiate confinement measures
Answer: (D) Initiate confinement measures
The proper procedure for dealing with harmful behavior is to first try to calm patient verbally. . When
verbal and psychopharmacologic interventions are not adequate to handle the aggressiveness,
seclusion or restraints may be applicable. A, B and C are appropriate approaches during the
escalation phase of aggression.
78. The charge nurse of a psychiatric unit is planning the client assignment for the day. The most
appropriate staff to be assigned to a client with a potential for violence is which of the following:
A. A timid nurse
B. A mature experienced nurse
C. an inexperienced nurse
D. a soft spoken nurse
Answer: (B) A mature experienced nurse
The unstable, aggressive client should be assigned to the most experienced nurse. A, C and D. A shy,
inexperienced, soft spoken nurse may feel intimidated by the angry patient.
79. The nurse exemplifies awareness of the rights of a client whose anger is escalating by:
A. Taking a directive role in verbalizing feelings
B. Using an authoritarian, confrontational approach
C. Putting the client in a seclusion room
D. Applying mechanical restraints
Answer: (A) Taking a directive role in verbalizing feelings
Taking a directive role in the client’s verbalization of feelings can deescalate the client’s anger. B. A
confrontational approach can be threatening and adds to the client’s tension. C and D. Use of
restraints and isolation may be required if less restrictive interventions are unsuccessful.
80. The client jumps up and throws a chair out of the window. He was restrained after his behavior
can no longer be controlled by the staff. Which of these documentations indicates the safeguarding of
the patient’s rights?
A. There was a doctor’s order for restraints/seclusion
B. The patient’s rights were explained to him.
C. The staff observed confidentiality
D. The staff carried out less restrictive measures but were unsuccessful.
Answer: (D) The staff carried out less restrictive measures but were unsuccessful.
This documentation indicates that the client has been placed on restraints after the least restrictive
measures failed in containing the client’s violent behavior.
81. Situation: Clients with personality disorders have difficulties in their social and occupational
functions.
Clients with personality disorder will most likely:
A. recover with therapeutic intervention
B. respond to antianxiety medication
C. manifest enduring patterns of inflexible behaviors
D. Seek treatment willingly from some personally distressing symptoms
Answer: (C) manifest enduring patterns of inflexible behaviors
Personality disorders are characterized by inflexible traits and characteristics that are lifelong. A and
D. This disorder is manifested by life-long patterns of behavior. The client with this disorder will not
likely present himself for treatment unless something has gone wrong in his life so he may not
recover from therapeutic intervention. B. Medications are generally not recommended for personality
disorders.

16. 82. A client tends to be insensitive to others, engages in abusive behaviors and does not have a sense
of remorse. Which personality disorder is he likely to have?
A. Narcissistic
B. Paranoid
C. Histrionic
D. Antisocial
Answer: (D) Antisocial
These are the characteristics of an individual with antisocial personality. A. Narcissistic personality
disorder is characterized by grandiosity and a need for constant admiration from others. B.
Individuals with paranoid personality demonstrate a pattern of distrust and suspiciousness and
interprets others motives as threatening. C. Individuals with histrionic have excessive emotionality,
and attention-seeking behaviors.
83. The client joins a support group and frequently preaches against abuse, is demonstrating the use
of:
A. denial
B. reaction formation
C. rationalization
D. projection
Answer: (B) reaction formation
Reaction formation is the adoption of behavior or feelings that are exactly opposite of one’s true
emotions. A. Denial is refusal to accept a painful reality. C. Rationalization is attempting to justify
one’s behavior by presenting reasons that sounds logical. D. Projection is attributing of one’s
behaviors and feelings to another person.
84. A teenage girl is diagnosed to have borderline personality disorder. Which manifestations support
the diagnosis?
A. Lack of self esteem, strong dependency needs and impulsive behavior
B. social withdrawal, inadequacy, sensitivity to rejection and criticism
C. Suspicious, hypervigilance and coldness
D. Preoccupation with perfectionism, orderliness and need for control
Answer: (A) Lack of self esteem, strong dependency needs and impulsive behavior
These are the characteristics of client with borderline personality. B. This describes the avoidant
personality. C. These are the characteristics of a client with paranoid personality D. This describes
the obsessive compulsive personality
85. The plan of care for clients with borderline personality should include:
A. Limit setting and flexibility in schedule
B. Giving medications to prevent acting out
C. Restricting her from other clients
D. Ensuring she adheres to certain restrictions
Answer: (D) Ensuring she adheres to certain restrictions
The client is manipulative. The client must be informed about the policies, expectations, rules and
regulation upon admission. A. Limits should be firmly and consistently implemented. Flexibility and
bargaining are not therapeutic in dealing with a manipulative client. B. There is no specific
medication prescribed for this condition. C. This is not part of the care plan. Interaction with other
clients are allowed but the client should be observed and given limits in her attempt to manipulate
and dominate others.
86. Situation: A 42 year old male client, is admitted in the ward because of bizarre behaviors. He is
given a diagnosis of schizophrenia paranoid type.
The client should have achieved the developmental task of:
A. Trust vs. mistrust
B. Industry vs. inferiority
C. Generativity vs. stagnation
D. Ego integrity vs. despair
Answer: (D) Ego integrity vs. despair
The client belongs to the middle adulthood stage (30 to 65 yrs.) The developmental task generativity
is characterized by concern and care for others. It is a productive and creative stage. (A) Infancy stage
(0 – 18 mos.) is concerned with gratification of oral needs (B) School Age child (6 – 12 yrs.) is
characterized by acquisition of school competencies and social skills (C) Late adulthood ( 60 and
above) Concerned with reflection on the past and his contributions to others and face the future.

17. 87. Clients who are suspicious primarily use projection for which purpose:
A. deny reality
B. to deal with feelings and thoughts that are not acceptable
C. to show resentment towards others
D. manipulate others
Answer: (B) to deal with feelings and thoughts that are not acceptable
Projection is a defense mechanism where one attributes ones feelings and inadequacies to others to
reduce anxiety. A. This is not true in all instances of projection C and D. This focuses on the self
rather than others
88. The client says “ the NBI is out to get me.” The nurse’s best response is:
A. “The NBI is not out to catch you.”
B. “I don’t believe that.”
C. “I don’t know anything about that. You are afraid of being harmed.”
D. “ What made you think of that.”
Answer: (C) “I don’t know anything about that. You are afraid of being harmed.”
This presents reality and acknowledges the clients feeling A and B. are not therapeutic responses
because these disagree with the client’s false belief and makes the client feel challenged D.
unnecessary exploration of the false
89. The client on Haldol has pill rolling tremors and muscle rigidity. He is likely manifesting:
A. tardive dyskinesia
B. Pseudoparkinsonism
C. akinesia
D. dystonia
Answer: (B) Pseudoparkinsonism
Pseudoparkinsonism is a side effect of antipsychotic drugs characterized by mask-like facies, pill
rolling tremors, muscle rigidity A. Tardive dyskinesia is manifested by lip smacking, wormlike
movement of the tongue C. Akinesia is characterized by feeling of weakness and muscle fatigue D.
Dystonia is manifested by torticollis and rolling back of the eyes
90. The client is very hostile toward one of the staff for no apparent reason. The client is manifesting:
A. Splitting
B. Transference
C. Countertransference
D. Resistance
Answer: (B) Transference
Transference is a positive or negative feeling associated with a significant person in the client’s past
that are unconsciously assigned to another A. Splitting is a defense mechanism commonly seen in a
client with personality disorder in which the world is perceived as all good or all bad C.
Counterttransference is a phenomenon where the nurse shifts feelings assigned to someone in her past
to the patient D. Resistance is the client’s refusal to submit himself to the care of the nurse
91. Situation: An 18 year old female was sexually attacked while on her way home from work. She is
brought to the hospital by her mother.
Rape is an example of which type of crisis:
A. Situational
B. Adventitious
C. Developmental
D. Internal
Answer: (B) Adventitious
Adventitious crisis is a crisis involving a traumatic event. It is not part of everyday life. A. Situational
crisis is from an external source that upset ones psychological equilibrium C and D. Are the same.
They are transitional or developmental periods in life
92. During the initial care of rape victims the following are to be considered EXCEPT:
A. Assure privacy.
B. Touch the client to show acceptance and empathy
C. Accompany the client in the examination room.
D. Maintain a non-judgmental approach.

18. Answer: (B) Touch the client to show acceptance and empathy
The client finds touch intrusive and therefore should be avoided. A. Privacy is one of the rights of a
victim of rape. C.The client is anxious. Accompanying the client in a quiet room ensures safety and
offers emotional support. D. Guilt feeling is common among rape victims. They should not be
blamed.
93. The nurse acts as a patient advocate when she does one of the following:
A. She encourages the client to express her feeling regarding her experience.
B. She assesses the client for injuries.
C. She postpones the physical assessment until the client is calm
D. Explains to the client that her reactions are normal
Answer: (C) She postpones the physical assessment until the client is calm
The nurse acts as a patient advocate as she protects the client from psychological harm A. The nurse
acts a a counselor B. The nurse acts as a technician D. This exemplifies the role of a teacher
94. Crisis intervention carried out to the client has this primary goal:
A. Assist the client to express her feelings
B. Help her identify her resources
C. Support her adaptive coping skills
D. Help her return to her pre-rape level of function
Answer: (D) Help her return to her pre-rape level of function
The goal of crisis intervention to help the client return to her level of function prior to the crisis. A,B
and C are interventions or strategies to attain the goal
95. Five months after the incident the client complains of difficulty to concentrate, poor appetite,
inability to sleep and guilt. She is likely suffering from:
A. Adjustment disorder
B. Somatoform Disorder
C. Generalized Anxiety Disorder
D. Post traumatic disorder
Answer: (D) Post traumatic disorder
Post traumatic stress disorder is characterized by flashback, irritability, difficulty falling asleep and
concentrating following an extremely traumatic event. This lasts for more that one month A.
Adjustment disorder is the maladaptive reaction to stressful events characterized by anxiety,
depression and work or social impairments. This occurs within 3 months after the event B.
Somatoform disorders are anxiety related disorders characterized by presence of physical symptoms
without demonstrable organic basis C. Generalized anxiety disorder is characterized by chronic,
excessive anxiety for at least 6 months
96. Situation: A 29 year old client newly diagnosed with breast cancer is pacing, with rapid speech
headache and inability to focus with what the doctor was saying.
The nurse assesses the level of anxiety as:
A. Mild
B. Moderate
C. Severe
D. Panic
Answer: (C) Severe
The client’s manifestations indicate severe anxiety. A Mild anxiety is manifested by slight muscle
tension, slight fidgeting, alertness, ability to concentrate and capable of problem solving. B. Moderate
muscle tension, increased vital signs, periodic slow pacing, increased rate of speech and difficulty in
concentrating are noted in moderate anxiety. D. Panic level of anxiety is characterized
immobilization, incoherence, feeling of being overwhelmed and disorganization
97. Anxiety is caused by:
A. an objective threat
B. a subjectively perceived threat
C. hostility turned to the self
D. masked depression
Answer: (B) a subjectively perceived threat
Anxiety is caused by a subjectively perceived threat A. Fear is caused by an objective threat C. A
depressed client internalizes hostility D. Mania is due to masked depression

19. 98. It would be most helpful for the nurse to deal with a client with severe anxiety by:
A. Give specific instructions using speak in concise statements.
B. Ask the client to identify the cause of her anxiety.
C. Explain in
detail the plan of care developed
D. Urge the client to focus on what the nurse is saying
Answer: (A) Give specific instructions using speak in concise statements.
The client has narrowed perceptual field. Lengthy explanations cannot be followed by the client. B.
The client will not be able to identify the cause of anxiety C and D. The client has difficulty
concentrating and will not be able to focus.
99. Which of the following medications will likely be ordered for the client?”
A. Prozac
B. Valium
C. Risperdal
D. Lithium
Answer: (B) Valium
Antianxiety A. Antidepressant C. Antipsychotic D. Antimanic
100. Which of the following is included in the health teachings among clients receiving Valium?:
A. Avoid foods rich in tyramine.
B. Take the medication after meals.
C. It is safe to stop it anytime after long term use.
D. Double up the dose if the client forgets her medication.
Answer: (B) Take the medication after meals.
Antianxiety medications cause G.I. upset so it should be taken after meals. A. This is specific for
antidepressant MAOI. Taking tyramine rich food can cause hypertensive crisis. C. Valium causes
dependency. In which case, the medication should be gradually withdrawn to prevent the occurrence
of convulsion. D The dose of Valium should not be doubled if the previous dose was not taken. It can
intensify the CNS depressant effects.
Philippine NLE Board Exam: Community Health Nursing Question & Answer w/ rationale
COMMUNITY HEALTH NURSING
1. Which is the primary goal of community health nursing?
A. To support and supplement the efforts of the medical profession in the promotion of health and
prevention of illness
B. To enhance the capacity of individuals, families and communities to cope with their health needs
C. To increase the productivity of the people by providing them with services that will increase their
level of health
D. To contribute to national development through promotion of family welfare, focusing particularly
on mothers and children.
Answer: (B) To enhance the capacity of individuals, families and communities to cope with their
health needs
To contribute to national development through promotion of family welfare, focusing particularly on
mothers and children.
2. CHN is a community-based practice. Which best explains this statement?
A. The service is provided in the natural environment of people.
B. The nurse has to conduct community diagnosis to determine nursing needs and problems.
C. The services are based on the available resources within the community.
D. Priority setting is based on the magnitude of the health problems identified.
Answer: (B) The nurse has to conduct community diagnosis to determine nursing needs and
problems.
Community-based practice means providing care to people in their own natural environments: the
home, school and workplace, for example.
3. Population-focused nursing practice requires which of the following processes?
A. Community organizing

20. B. Nursing process
C. Community diagnosis
D. Epidemiologic process
Answer: (C) Community diagnosis
Population-focused nursing care means providing care based on the greater need of the majority of
the population. The greater need is identified through community diagnosis.
4. R.A. 1054 is also known as the Occupational Health Act. Aside from number of employees, what
other factor must be considered in determining the occupational health privileges to which the
workers will be entitled?
A. Type of occupation: agricultural, commercial, industrial
B. Location of the workplace in relation to health facilities
C. Classification of the business enterprise based on net profit
D. Sex and age composition of employees
Answer: (B) Location of the workplace in relation to health facilities
Based on R.A. 1054, an occupational nurse must be employed when there are 30 to 100 employees
and the workplace is more than 1 km. away from the nearest health center.
5. A business firm must employ an occupational health nurse when it has at least how many
employees?
A. 21
B. 101
C. 201
D. 301
Answer: (B) 101
Again, this is based on R.A. 1054.
6. When the occupational health nurse employs ergonomic principles, she is performing which of her
roles?
A. Health care provider
B. Health educator
C. Health care coordinator
D. Environmental manager
Answer: (D) Environmental manager
Ergonomics is improving efficiency of workers by improving the worker’s environment through
appropriately designed furniture, for example.
7. A garment factory does not have an occupational nurse. Who shall provide the occupational health
needs of the factory workers?
A. Occupational health nurse at the Provincial Health Office
B. Physician employed by the factory
C. Public health nurse of the RHU of their municipality
D. Rural sanitary inspector of the RHU of their municipality
Answer: (C) Public health nurse of the RHU of their municipality
You’re right! This question is based on R.A.1054.
8. “Public health services are given free of charge.” Is this statement true or false?
A. The statement is true; it is the responsibility of government to provide basic services.
B. The statement is false; people pay indirectly for public health services.
C. The statement may be true or false, depending on the specific service required.
D. The statement may be true or false, depending on policies of the government concerned.
Answer: (B) The statement is false; people pay indirectly for public health services.
Community health services, including public health services, are pre-paid services, though taxation,
for example.
9. According to C.E.Winslow, which of the following is the goal of Public Health?
A. For people to attain their birthrights of health and longevity
B. For promotion of health and prevention of disease
C. For people to have access to basic health services
D. For people to be organized in their health efforts
Answer: (A) For people to attain their birthrights of health and longevity
According to Winslow, all public health efforts are for people to realize their birthrights of health and
longevity.

21. 10. We say that a Filipino has attained longevity when he is able to reach the average lifespan of
Filipinos. What other statistic may be used to determine attainment of longevity?
A. Age-specific mortality rate
B. Proportionate mortality rate
C. Swaroop’s index
D. Case fatality rate
Answer: (C) Swaroop’s index
Swaroop’s index is the percentage of the deaths aged 50 years or older. Its inverse represents the
percentage of untimely deaths (those who died younger than 50 years).
11. Which of the following is the most prominent feature of public health nursing?
A. It involves providing home care to sick people who are not confined in the hospital.
B. Services are provided free of charge to people within the catchment area.
C. The public health nurse functions as part of a team providing a public health nursing services.
D. Public health nursing focuses on preventive, not curative, services.
Answer: (D) Public health nursing focuses on preventive, not curative, services.
The catchment area in PHN consists of a residential community, many of whom are well individuals
who have greater need for preventive rather than curative services.
12. According to Margaret Shetland, the philosophy of public health nursing is based on which of the
following?
A. Health and longevity as birthrights
B. The mandate of the state to protect the birthrights of its citizens
C. Public health nursing as a specialized field of nursing
D. The worth and dignity of man
Answer: (D) The worth and dignity of man
This is a direct quote from Dr. Margaret Shetland’s statements on Public Health Nursing.
13. Which of the following is the mission of the Department of Health?
A. Health for all Filipinos
B. Ensure the accessibility and quality of health care
C. Improve the general health status of the population
D. Health in the hands of the Filipino people by the year 2020
Answer: (B) Ensure the accessibility and quality of health care
(none)
14. Region IV Hospital is classified as what level of facility?
A. Primary
B. Secondary
C. Intermediate
D. Tertiary
Answer: (D) Tertiary
Regional hospitals are tertiary facilities because they serve as training hospitals for the region.
15. Which is true of primary facilities?
A. They are usually government-run.
B. Their services are provided on an out-patient basis.
C. They are training facilities for health professionals.
D. A community hospital is an example of this level of health facilities.
Answer: (B) Their services are provided on an out-patient basis.
Primary facilities government and non-government facilities that provide basic out-patient services.
16. Which is an example of the school nurse’s health care provider functions?
A. Requesting for BCG from the RHU for school entrant immunization
B. Conducting random classroom inspection during a measles epidemic
C. Taking remedial action on an accident hazard in the school playground
D. Observing places in the school where pupils spend their free time
Answer: (B) Conducting random classroom inspection during a measles epidemic
Random classroom inspection is assessment of pupils/students and teachers for signs of a health
problem prevalent in the community.
17. When the nurse determines whether resources were maximized in implementing Ligtas Tigdas,
she is evaluating
A. Effectiveness

22. B. Efficiency
C. Adequacy
D. Appropriateness
Answer: (B) Efficiency
Efficiency is determining whether the goals were attained at the least possible cost.
18. You are a new B.S.N. graduate. You want to become a Public Health Nurse. Where will you
apply?
A. Department of Health
B. Provincial Health Office
C. Regional Health Office
D. Rural Health Unit
Answer: (D) Rural Health Unit
R.A. 7160 devolved basic health services to local government units (LGU’s ). The public health
nurse is an employee of the LGU.
19. R.A. 7160 mandates devolution of basic services from the national government to local
government units. Which of the following is the major goal of devolution?
A. To strengthen local government units
B. To allow greater autonomy to local government units
C. To empower the people and promote their self-reliance
D. To make basic services more accessible to the people
Answer: (C) To empower the people and promote their self-reliance
People empowerment is the basic motivation behind devolution of basic services to LGU’s.
20. Who is the Chairman of the Municipal Health Board?
A. Mayor
B. Municipal Health Officer
C. Public Health Nurse
D. Any qualified physician
Answer: (A) Mayor
The local executive serves as the chairman of the Municipal Health Board.
21. Which level of health facility is the usual point of entry of a client into the health care delivery
system?
A. Primary
B. Secondary
C. Intermediate
D. Tertiary
Answer: (A) Primary
The entry of a person into the health care delivery system is usually through a consultation in out-
patient services.
22. The public health nurse is the supervisor of rural health midwives. Which of the following is a
supervisory function of the public health nurse?
A. Referring cases or patients to the midwife
B. Providing technical guidance to the midwife
C. Providing nursing care to cases referred by the midwife
D. Formulating and implementing training programs for midwives
Answer: (B) Providing technical guidance to the midwife
The nurse provides technical guidance to the midwife in the care of clients, particularly in the
implementation of management guidelines, as in Integrated Management of Childhood Illness.
23. One of the participants in a hilot training class asked you to whom she should refer a patient in
labor who develops a complication. You will answer, to the
A. Public Health Nurse
B. Rural Health Midwife
C. Municipal Health Officer
D. Any of these health professionals
Answer: (C) Municipal Health Officer
A public health nurse and rural health midwife can provide care during normal childbirth. A
physician should attend to a woman with a complication during labor.
24. You are the public health nurse in a municipality with a total population of about 20,000. There

23. are 3 rural health midwives among the RHU personnel. How many more midwife items will the RHU
need?
A. 1
B. 2
C. 3
D. The RHU does not need any more midwife item.
Answer: (A) 1
Each rural health midwife is given a population assignment of about 5,000.
25. If the RHU needs additional midwife items, you will submit the request for additional midwife
items for approval to the
A. Rural Health Unit
B. District Health Office
C. Provincial Health Office
D. Municipal Health Board
Answer: (D) Municipal Health Board
As mandated by R.A. 7160, basic health services have been devolved from the national government
to local government units.
26. As an epidemiologist, the nurse is responsible for reporting cases of notifiable diseases. What law
mandates reporting of cases of notifiable diseases?
A. Act 3573
B. R.A. 3753
C. R.A. 1054
D. R.A. 1082
Answer: (A) Act 3573
Act 3573, the Law on Reporting of Communicable Diseases, enacted in 1929, mandated the reporting
of diseases listed in the law to the nearest health station.
27. According to Freeman and Heinrich, community health nursing is a developmental service.
Which of the following best illustrates this statement?
A. The community health nurse continuously develops himself personally and professionally.
B. Health education and community organizing are necessary in providing community health
services.
C. Community health nursing is intended primarily for health promotion and prevention and
treatment of disease.
D. The goal of community health nursing is to provide nursing services to people in their own places
of residence.
Answer: (B) Health education and community organizing are necessary in providing community
health services.
The community health nurse develops the health capability of people through health education and
community organizing activities.
28. Which disease was declared through Presidential Proclamation No. 4 as a target for eradication in
the Philippines?
A. Poliomyelitis
B. Measles
C. Rabies
D. Neonatal tetanus
Answer: (B) Measles
Presidential Proclamation No. 4 is on the Ligtas Tigdas Program.
29. The public health nurse is responsible for presenting the municipal health statistics using graphs
and tables. To compare the frequency of the leading causes of mortality in the municipality, which
graph will you prepare?
A. Line
B. Bar
C. Pie
D. Scatter diagram
Answer: (B) Bar
A bar graph is used to present comparison of values, a line graph for trends over time or age, a pie
graph for population composition or distribution, and a scatter diagram for correlation of two
variables.

24. 30. Which step in community organizing involves training of potential leaders in the community?
A. Integration
B. Community organization
C. Community study
D. Core group formation
Answer: (D) Core group formation
In core group formation, the nurse is able to transfer the technology of community organizing to the
potential or informal community leaders through a training program.
31. In which step are plans formulated for solving community problems?
A. Mobilization
B. Community organization
C. Follow-up/extension
D. Core group formation
Answer: (B) Community organization
Community organization is the step when community assemblies take place. During the community
assembly, the people may opt to formalize the community organization and make plans for
community action to resolve a community health problem.
32. The public health nurse takes an active role in community participation. What is the primary goal
of community organizing?
A. To educate the people regarding community health problems
B. To mobilize the people to resolve community health problems
C. To maximize the community’s resources in dealing with health problems
D. To maximize the community’s resources in dealing with health problems
Answer: (D) To maximize the community’s resources in dealing with health problems
Community organizing is a developmental service, with the goal of developing the people’s self-
reliance in dealing with community health problems. A, B and C are objectives of contributory
objectives to this goal.
33. An indicator of success in community organizing is when people are able to
A. Participate in community activities for the solution of a community problem
B. Implement activities for the solution of the community problem
C. Plan activities for the solution of the community problem
D. Identify the health problem as a common concern
Answer: (A) Participate in community activities for the solution of a community problem
Participation in community activities in resolving a community problem may be in any of the
processes mentioned in the other choices.
34. Tertiary prevention is needed in which stage of the natural history of disease?
A. Pre-pathogenesis
B. Pathogenesis
C. Prodromal
D. Terminal
Answer: (D) Terminal
Tertiary prevention involves rehabilitation, prevention of permanent disability and disability
limitation appropriate for convalescents, the disabled, complicated cases and the terminally ill (those
in the terminal stage of a disease)
35. Isolation of a child with measles belongs to what level of prevention?
A. Primary
B. Secondary
C. Intermediate
D. Tertiary
Answer: (A) Primary
The purpose of isolating a client with a communicable disease is to protect those who are not sick
(specific disease prevention).
36. On the other hand, Operation Timbang is _____ prevention.
A. Primary
B. Secondary
C. Intermediate
D. Tertiary

25. Answer: (B) Secondary
Operation Timbang is done to identify members of the susceptible population who are malnourished.
Its purpose is early diagnosis and, subsequently, prompt treatment.
37. Which type of family-nurse contact will provide you with the best opportunity to observe family
dynamics?
A. Clinic consultation
B. Group conference
C. Home visit
D. Written communication
Answer: (C) Home visit
Dynamics of family relationships can best be observed in the family’s natural environment, which is
the home.
38. The typology of family nursing problems is used in the statement of nursing diagnosis in the care
of families. The youngest child of the de los Reyes family has been diagnosed as mentally retarded.
This is classified as a
A. Health threat
B. Health deficit
C. Foreseeable crisis
D. Stress point
Answer: (B) Health deficit
Failure of a family member to develop according to what is expected, as in mental retardation, is a
health deficit.
39. The de los Reyes couple have a 6-year old child entering school for the first time. The de los
Reyes family has a
A. Health threat
B. Health deficit
C. Foreseeable crisis
D. Stress point
Answer: (C) Foreseeable crisis
Entry of the 6-year old into school is an anticipated period of unusual demand on the family.
40. Which of the following is an advantage of a home visit?
A. It allows the nurse to provide nursing care to a greater number of people.
B. It provides an opportunity to do first hand appraisal of the home situation.
C. It allows sharing of experiences among people with similar health problems.
D. It develops the family’s initiative in providing for health needs of its members.
Answer: (B) It provides an opportunity to do first hand appraisal of the home situation.
Choice A is not correct since a home visit requires that the nurse spend so much time with the family.
Choice C is an advantage of a group conference, while choice D is true of a clinic consultation.
41. Which is CONTRARY to the principles in planning a home visit?
A. A home visit should have a purpose or objective.
B. The plan should revolve around family health needs.
C. A home visit should be conducted in the manner prescribed by the RHU.
D. Planning of continuing care should involve a responsible family member.
Answer: (C) A home visit should be conducted in the manner prescribed by the RHU.
The home visit plan should be flexible and practical, depending on factors, such as the family’s needs
and the resources available to the nurse and the family.
42. The PHN bag is an important tool in providing nursing care during a home visit. The most
important principle of bag technique states that it
A. Should save time and effort.
B. Should minimize if not totally prevent the spread of infection.
C. Should not overshadow concern for the patient and his family.
D. May be done in a variety of ways depending on the home situation, etc.
Answer: (B) Should minimize if not totally prevent the spread of infection.
Bag technique is performed before and after handling a client in the home to prevent transmission of
infection to and from the client.
43. To maintain the cleanliness of the bag and its contents, which of the following must the nurse do?
A. Wash his/her hands before and after providing nursing care to the family members.

26. B. In the care of family members, as much as possible, use only articles taken from the bag.
C. Put on an apron to protect her uniform and fold it with the right side out before putting it back into
the bag.
D. At the end of the visit, fold the lining on which the bag was placed, ensuring that the contaminated
side is on the outside.
Answer: (A) Wash his/her hands before and after providing nursing care to the family members.
Choice B goes against the idea of utilizing the family’s resources, which is encouraged in CHN.
Choices C and D goes against the principle of asepsis of confining the contaminated surface of
objects.
44. The public health nurse conducts a study on the factors contributing to the high mortality rate due
to heart disease in the municipality where she works. Which branch of epidemiology does the nurse
practice in this situation?
A. Descriptive
B. Analytical
C. Therapeutic
D. Evaluation
Answer: (B) Analytical
Analytical epidemiology is the study of factors or determinants affecting the patterns of occurrence
and distribution of disease in a community.
45. Which of the following is a function of epidemiology?
A. Identifying the disease condition based on manifestations presented by a client
B. Determining factors that contributed to the occurrence of pneumonia in a 3 year old
C. Determining the efficacy of the antibiotic used in the treatment of the 3 year old client with
pneumonia
D. Evaluating the effectiveness of the implementation of the Integrated Management of Childhood
Illness
Answer: (D) Evaluating the effectiveness of the implementation of the Integrated Management of
Childhood Illness
Epidemiology is used in the assessment of a community or evaluation of interventions in community
health practice.
46. Which of the following is an epidemiologic function of the nurse during an epidemic?
A. Conducting assessment of suspected cases to detect the communicable disease
B. Monitoring the condition of the cases affected by the communicable disease
C. Participating in the investigation to determine the source of the epidemic
D. Teaching the community on preventive measures against the disease
Answer: (C) Participating in the investigation to determine the source of the epidemic
Epidemiology is the study of patterns of occurrence and distribution of disease in the community, as
well as the factors that affect disease patterns. The purpose of an epidemiologic investigation is to
identify the source of an epidemic, i.e., what brought about the epidemic.
47. The primary purpose of conducting an epidemiologic investigation is to
A. Delineate the etiology of the epidemic
B. Encourage cooperation and support of the community
C. Identify groups who are at risk of contracting the disease
D. Identify geographical location of cases of the disease in the community
Answer: (A) Delineate the etiology of the epidemic
Delineating the etiology of an epidemic is identifying its source.
48. Which is a characteristic of person-to-person propagated epidemics?
A. There are more cases of the disease than expected.
B. The disease must necessarily be transmitted through a vector.
C. The spread of the disease can be attributed to a common vehicle.
D. There is a gradual build up of cases before the epidemic becomes easily noticeable.
Answer: (D) There is a gradual build up of cases before the epidemic becomes easily noticeable.
A gradual or insidious onset of the epidemic is usually observable in person-to-person propagated
epidemics.
49. In the investigation of an epidemic, you compare the present frequency of the disease with the
usual frequency at this time of the year in this community. This is done during which stage of the
investigation?
A. Establishing the epidemic

27. B. Testing the hypothesis
C. Formulation of the hypothesis
D. Appraisal of facts
Answer: (A) Establishing the epidemic
Establishing the epidemic is determining whether there is an epidemic or not. This is done by
comparing the present number of cases with the usual number of cases of the disease at the same time
of the year, as well as establishing the relatedness of the cases of the disease.
50. The number of cases of Dengue fever usually increases towards the end of the rainy season. This
pattern of occurrence of Dengue fever is best described as
A. Epidemic occurrence
B. Cyclical variation
C. Sporadic occurrence
D. Secular variation
Answer: (B) Cyclical variation
A cyclical variation is a periodic fluctuation in the number of cases of a disease in the community.
51. In the year 1980, the World Health Organization declared the Philippines, together with some
other countries in the Western Pacific Region, “free” of which disease?
A. Pneumonic plague
B. Poliomyelitis
C. Small pox
D. Anthrax
Answer: (C) Small pox
The last documented case of Small pox was in 1977 at Somalia.
52. In the census of the Philippines in 1995, there were about 35,299,000 males and about 34,968,000
females. What is the sex ratio?
A. 99.06:100
B. 100.94:100
C. 50.23%
D. 49.76%
Answer: (B) 100.94:100
Sex ratio is the number of males for every 100 females in the population.
53. Primary health care is a total approach to community development. Which of the following is an
indicator of success in the use of the primary health care approach?
A. Health services are provided free of charge to individuals and families.
B. Local officials are empowered as the major decision makers in matters of health.
C. Health workers are able to provide care based on identified health needs of the people.
D. Health programs are sustained according to the level of development of the community.
Answer: (D) Health programs are sustained according to the level of development of the community.
Primary health care is essential health care that can be sustained in all stages of development of the
community.
54. Sputum examination is the major screening tool for pulmonary tuberculosis. Clients would
sometimes get false negative results in this exam. This means that the test is not perfect in terms of
which characteristic of a diagnostic examination?
A. Effectiveness
B. Efficacy
C. Specificity
D. Sensitivity
Answer: (D) Sensitivity
Sensitivity is the capacity of a diagnostic examination to detect cases of the disease. If a test is 100%
sensitive, all the cases tested will have a positive result, i.e., there will be no false negative results.
55. Use of appropriate technology requires knowledge of indigenous technology. Which medicinal
herb is given for fever, headache and cough?
A. Sambong
B. Tsaang gubat
C. Akapulko
D. Lagundi
Answer: (D) Lagundi

28. Sambong is used as a diuretic. Tsaang gubat is used to relieve diarrhea. Akapulko is used for its
antifungal property.
56. What law created the Philippine Institute of Traditional and Alternative Health Care?
A. R.A. 8423
B. R.A. 4823
C. R.A. 2483
D. R.A. 3482
Answer: (A) R.A. 8423
(none)
57. In traditional Chinese medicine, the yielding, negative and feminine force is termed
A. Yin
B. Yang
C. Qi
D. Chai
Answer: (A) Yin
Yang is the male dominating, positive and masculine force.
58. What is the legal basis for Primary Health Care approach in the Philippines?
A. Alma Ata Declaration on PHC
B. Letter of Instruction No. 949
C. Presidential Decree No. 147
D. Presidential Decree 996
Answer: (B) Letter of Instruction No. 949
Letter of Instruction 949 was issued by then President Ferdinand Marcos, directing the formerly
called Ministry of Health, now the Department of Health, to utilize Primary Health Care approach in
planning and implementing health programs.
59. Which of the following demonstrates intersectoral linkages?
A. Two-way referral system
B. Team approach
C. Endorsement done by a midwife to another midwife
D. Cooperation between the PHN and public school teacher
Answer: (D) Cooperation between the PHN and public school teacher
Intersectoral linkages refer to working relationships between the health sector and other sectors
involved in community development.
60. The municipality assigned to you has a population of about 20,000. Estimate the number of 1-4
year old children who will be given Retinol capsule 200,000 I.U. every 6 months.
A. 1,500
B. 1,800
C. 2,000
D. 2,300
Answer: (D) 2,300
Based on the Philippine population composition, to estimate the number of 1-4 year old children,
multiply total population by 11.5%.
61. Estimate the number of pregnant women who will be given tetanus toxoid during an
immunization outreach activity in a barangay with a population of about 1,500.
A. 265
B. 300
C. 375
D. 400
Answer: (A) 265
To estimate the number of pregnant women, multiply the total population by 3.5%.
62. To describe the sex composition of the population, which demographic tool may be used?
A. Sex ratio
B. Sex proportion
C. Population pyramid
D. Any of these may be used.
Answer: (D) Any of these may be used.
Sex ratio and sex proportion are used to determine the sex composition of a population. A population

29. pyramid is used to present the composition of a population by age and sex.
63. Which of the following is a natality rate?
A. Crude birth rate
B. Neonatal mortality rate
C. Infant mortality rate
D. General fertility rate
Answer: (A) Crude birth rate
Natality means birth. A natality rate is a birth rate.
64. You are computing the crude death rate of your municipality, with a total population of about
18,000, for last year. There were 94 deaths. Among those who died, 20 died because of diseases of
the heart and 32 were aged 50 years or older. What is the crude death rate?
A. 4.2/1,000
B. 5.2/1,000
C. 6.3/1,000
D. 7.3/1,000
Answer: (B) 5.2/1,000
To compute crude death rate divide total number of deaths (94) by total population (18,000) and
multiply by 1,000.
65. Knowing that malnutrition is a frequent community health problem, you decided to conduct
nutritional assessment. What population is particularly susceptible to protein energy malnutrition
(PEM)?
A. Pregnant women and the elderly
B. Under-5 year old children
C. 1-4 year old children
D. School age children
Answer: (C) 1-4 year old children
Preschoolers are the most susceptible to PEM because they have generally been weaned. Also, this is
the population who, unable to feed themselves, are often the victims of poor intrafamilial food
distribution.
66. Which statistic can give the most accurate reflection of the health status of a community?
A. 1-4 year old age-specific mortality rate
B. Infant mortality rate
C. Swaroop’s index
D. Crude death rate
Answer: (C) Swaroop’s index
Swaroop’s index is the proportion of deaths aged 50 years and above. The higher the Swaroop’s
index of a population, the greater the proportion of the deaths who were able to reach the age of at
least 50 years, i.e., more people grew old before they died.
67. In the past year, Barangay A had an average population of 1655. 46 babies were born in that year,
2 of whom died less than 4 weeks after they were born. There were 4 recorded stillbirths. What is the
neonatal mortality rate?
A. 27.8/1,000
B. 43.5/1,000
C. 86.9/1,000
D. 130.4/1,000
Answer: (B) 43.5/1,000
To compute for neonatal mortality rate, divide the number of babies who died before reaching the age
of 28 days by the total number of live births, then multiply by 1,000.
68. Which statistic best reflects the nutritional status of a population?
A. 1-4 year old age-specific mortality rate
B. Proportionate mortality rate
C. Infant mortality rate
D. Swaroop’s index
Answer: (A) 1-4 year old age-specific mortality rate
Since preschoolers are the most susceptible to the effects of malnutrition, a population with poor
nutritional status will most likely have a high 1-4 year old age-specific mortality rate, also known as
child mortality rate.

30. 69. What numerator is used in computing general fertility rate?
A. Estimated midyear population
B. Number of registered live births
C. Number of pregnancies in the year
D. Number of females of reproductive age
Answer: (B) Number of registered live births
To compute for general or total fertility rate, divide the number of registered live births by the
number of females of reproductive age (15-45 years), then multiply by 1,000.
70. You will gather data for nutritional assessment of a purok. You will gather information only from
families with members who belong to the target population for PEM. What method of data gathering
is best for this purpose?
A. Census
B. Survey
C. Record review
D. Review of civil registry
Answer: (B) Survey
A survey, also called sample survey, is data gathering about a sample of the population.
71. In the conduct of a census, the method of population assignment based on the actual physical
location of the people is termed
A. De jure
B. De locus
C. De facto
D. De novo
Answer: (C) De facto
The other method of population assignment, de jure, is based on the usual place of residence of the
people.
72. The Field Health Services and Information System (FHSIS) is the recording and reporting system
in public health care in the Philippines. The Monthly Field Health Service Activity Report is a form
used in which of the components of the FHSIS?
A. Tally report
B. Output report
C. Target/client list
D. Individual health record
Answer: (A) Tally report
A tally report is prepared monthly or quarterly by the RHU personnel and transmitted to the
Provincial Health Office.
73. To monitor clients registered in long-term regimens, such as the Multi-Drug Therapy, which
component will be most useful?
A. Tally report
B. Output report
C. Target/client list
D. Individual health record
Answer: (C) Target/client list
The MDT Client List is a record of clients enrolled in MDT and other relevant data, such as dates
when clients collected their monthly supply of drugs.
74. Civil registries are important sources of data. Which law requires registration of births within 30
days from the occurrence of the birth?
A. P.D. 651
B. Act 3573
C. R.A. 3753
D. R.A. 3375
Answer: (A) P.D. 651
P.D. 651 amended R.A. 3753, requiring the registry of births within 30 days from their occurrence.
75. Which of the following professionals can sign the birth certificate?
A. Public health nurse
B. Rural health midwife
C. Municipal health officer
D. Any of these health professionals