Community Health Nursing MCQ Quiz - Objective Question with Answer for Community Health Nursing - Download Free PDF

• The Sustainable Development Goals (SDGs) are a collection of 17 global goals set by the United Nations, designed to achieve a better and more sustainable future by 2030. Each SDG has specific targets and measurable indicators to track progress.
• Indicator 3.8.1 is part of SDG 3, which aims to "Ensure healthy lives and promote well-being for all at all ages." This specific indicator tracks the "coverage of essential health services," including the proportion of the population covered by health insurance or public health schemes.
• The purpose of Indicator 3.8.1 is to measure progress toward achieving Universal Health Coverage (UHC), which ensures that all individuals and communities can access quality health services without suffering financial hardship.
• This indicator is critical because access to health insurance or public health schemes plays a significant role in reducing out-of-pocket expenditures, protecting individuals from catastrophic health costs, and ensuring equitable healthcare access.

• Rationale: Indicator 1.1.1 is part of SDG 1, which focuses on ending poverty in all its forms everywhere. This indicator tracks the "proportion of the population living below the international poverty line," which is unrelated to health insurance or public health schemes.

• Rationale: Indicator 2.2.2 is part of SDG 2, which aims to end hunger and improve nutrition. This indicator measures the "prevalence of malnutrition (weight for height) among children under 5 years of age." It focuses on nutrition and child health, not health insurance or public health schemes.

• Rationale: Indicator 4.4.3 is part of SDG 4, which focuses on quality education. This indicator measures the "proportion of youth and adults with ICT (information and communications technology) skills," which is unrelated to healthcare coverage or public health schemes.

• Among the given options, Indicator 3.8.1 under SDG 3 is the correct choice as it specifically tracks the proportion of the population covered by health insurance or public health schemes. This indicator is a vital measure of progress toward achieving Universal Health Coverage and ensuring equitable access to healthcare services for all.

• The World Health Organization (WHO) is the specialized agency of the United Nations responsible for international public health. WHO is actively involved in supporting countries to achieve Universal Health Coverage (UHC), a key component of Sustainable Development Goal 3 (SDG 3).
• In India, WHO provides technical and policy support to programs like the National Health Mission (NHM) and Ayushman Bharat. These initiatives aim to strengthen the healthcare system, ensure equitable access to healthcare services, and reduce financial hardship due to medical expenses.
• Ayushman Bharat, launched in 2018, is a flagship scheme of the Government of India, comprising two components: Health and Wellness Centers (HWCs) and the Pradhan Mantri Jan Arogya Yojana (PM-JAY). WHO supports these initiatives by offering expertise in health system strengthening, monitoring, and evaluation.

• Rationale: The World Trade Organization (WTO) deals with the global rules of trade between nations. It focuses on ensuring smooth trade flows and resolving trade disputes. WTO does not have a mandate for health system support or Universal Health Coverage.

• Rationale: The International Monetary Fund (IMF) provides financial assistance and advice to member countries on economic stability and fiscal policies. While IMF addresses macroeconomic issues, it does not directly involve itself in health programs like NHM or Ayushman Bharat.

• Rationale: The United Nations High Commissioner for Refugees (UNHCR) is responsible for protecting refugees, stateless people, and displaced populations. While UNHCR may work on health issues for displaced persons, its focus is not on national-level health programs or Universal Health Coverage.

• The WHO is the global organization that supports the implementation of Universal Health Coverage and works closely with governments, including India, in strengthening healthcare systems and ensuring accessible health services for all. Its role in supporting NHM and Ayushman Bharat underscores its commitment to achieving equitable healthcare globally.

• The National Health Mission (NHM) and Ayushman Bharat (AB) are two key healthcare initiatives in India aimed at improving health outcomes, but they differ significantly in their approach and objectives.
• NHM primarily focuses on strengthening healthcare service delivery, especially in rural and underserved areas. It includes programs for maternal and child health, disease control, and improving access to primary healthcare infrastructure.
• Ayushman Bharat, on the other hand, is a comprehensive scheme that includes two major components: the Pradhan Mantri Jan Arogya Yojana (PM-JAY), which provides health insurance coverage to economically weaker sections, and the establishment of Health and Wellness Centres (HWCs) for preventive and promotive healthcare.
• The key difference lies in NHM being service-delivery-oriented, while Ayushman Bharat incorporates an insurance-based model to provide financial protection against catastrophic health expenditures.

• Rationale: This statement is incorrect because both NHM and Ayushman Bharat utilize digital platforms to enhance healthcare delivery. For instance, NHM leverages data systems for monitoring programs, while Ayushman Bharat uses IT platforms for implementing PM-JAY, including beneficiary identification and hospital empanelment.

• Rationale: This is incorrect. NHM is not limited to any specific age group. It targets all sections of the population, with a special focus on vulnerable groups such as women, children, and marginalized communities. It aims to improve health outcomes across all demographics.

• Rationale: This statement is misleading. NHM is designed to address healthcare challenges in both rural and urban areas, though it has a significant focus on rural health. Similarly, Ayushman Bharat is not restricted to villages; it aims to provide healthcare access to all eligible citizens, regardless of their location.

• The main distinction between NHM and Ayushman Bharat lies in their core focus areas. NHM emphasizes strengthening healthcare service delivery, infrastructure, and public health systems, while Ayushman Bharat includes an insurance-based model to provide financial protection and access to secondary and tertiary healthcare services. Both programs complement each other to achieve universal health coverage in India.

• The Alma Ata Declaration was adopted in 1978 at the International Conference on Primary Health Care in Alma Ata (now Almaty, Kazakhstan). It is a landmark global declaration that emphasizes the need for universal access to primary health care and reaffirms health as a fundamental human right.
• The declaration defines health as "a state of complete physical, mental, and social well-being, and not merely the absence of disease or infirmity." It calls for governments, international organizations, and health sectors to prioritize primary health care to achieve "Health for All" by the year 2000.
• It also highlights the importance of community involvement, equity, and intersectoral collaboration in health care delivery.

• Rationale: The Geneva Protocol, signed in 1925, is focused on the prohibition of the use of chemical and biological weapons in warfare. While it is a significant document in international law, it does not address the right to health or health care frameworks.

• Rationale: The Kyoto Protocol, adopted in 1997, is an international treaty aimed at combating climate change by reducing greenhouse gas emissions. Although environmental factors can influence health, this treaty does not specifically address the right to health or health care frameworks.

• Rationale: While the New Delhi Declaration may refer to various agreements or statements made in international conferences held in New Delhi, none of them are globally recognized as directly affirming the right to health or addressing health care frameworks.

• The Alma Ata Declaration is the most relevant global document that reaffirms the right to health, emphasizing universal access to primary health care and the necessity of health equity. It remains a foundational statement in the global health community, guiding health policies and frameworks such as the National Health Mission (NHM).

• The Socio-Economic Caste Census (SECC) data is used as the population coverage criterion for launching PM-JAY (Pradhan Mantri Jan Arogya Yojana) in urban areas. SECC data is a comprehensive database that provides information on the socio-economic status of households across India, identifying beneficiaries based on their economic vulnerability.
• PM-JAY, also referred to as Ayushman Bharat, is a government initiative aimed at providing health insurance coverage to economically weaker sections of society. It ensures financial protection against catastrophic health expenditure and offers free medical treatment at empaneled hospitals.
• The SECC data includes parameters such as income levels, occupation, housing condition, and caste, which help in identifying the most disadvantaged households. It serves as the primary framework to determine eligibility for PM-JAY in both rural and urban areas.

• Rationale: Census income alone is not used for determining population coverage under PM-JAY because the Census primarily provides demographic data rather than detailed socio-economic indicators required to identify economically vulnerable households.
• While Census data can give an overall picture of income levels, it lacks the granularity and multifaceted socio-economic indicators that SECC data provides.

• Rationale: UIDAI (Unique Identification Authority of India) database is primarily used for Aadhaar authentication and identification. It does not provide detailed socio-economic information required to determine eligibility for PM-JAY.
• The UIDAI database is critical for verifying identity but not sufficient for identifying economically vulnerable households.

• Rationale: State income tax records are applicable only to individuals who fall under the taxable income bracket. Economically weaker sections of society, who are the primary beneficiaries of PM-JAY, do not generally file income tax returns and hence cannot be identified using this criterion.
• This option is not suitable for identifying eligible households under PM-JAY as it excludes a large portion of the population living below the poverty line.

• The SECC data is the most appropriate and comprehensive criterion for launching PM-JAY in urban areas. It ensures that the scheme reaches the intended beneficiaries by using detailed socio-economic parameters. Other options, while useful for specific purposes, do not provide the necessary data to effectively identify economically vulnerable households.

The correct answer is option 3.

Concept:

• Oral contraceptive pills or birth control pills are a type of contraception that contains hormones that prevent pregnancy. It is also known as “the pill” because it comes in pill form. 

Oral contraceptive pills are of two types:

• Combination pills contain estrogen and progestin.
• Progestin-only pills are also known as “the minipill.”
• This is administered in women who are breastfeeding or have a history of blood clots and strokes and shouldn’t take estrogen.

Explanation:

Mechanism of action:

• Birth control pills prevent follicular development and hence, prevent ovulation. To understand this, let us look at a negative feedback loop involved in this process:
  • The hypothalamus secretes a hormone human gonadotropin-releasing hormone (GnRH).
  • GnRH signals the pituitary gland to release gonadotropins like stimulating follicle hormone (FSH) and luteinizing hormone (LH).
  • In females, FSH and LH cause the ovaries to secrete estrogen and progesterone.
  • Progesterone supplied in the oral contraceptive pills initiates a negative feedback loop by signaling the hypothalamus to reduce the production of GnRH.
  • Thus, FSH and LH production is reduced. 
  • Since follicles are not developing, there is no secretion of estrogen by follicles.
  • The progesterone negative feedback loop prevents an increase in LH levels in mid-cycle.
  • In normal conditions, LH in midcycle causes rupturing of Graffian follicle and ovulation.
  • But ovulation is prevented because of the negative feedback loop and low levels of LH in the midcycle.

​​

• Thus, hormones in birth control pills prevent pregnancy by:
  • By stopping or reducing ovulation 
  • Thickening cervical mucus to keep sperm from entering the uterus.
  • Thinning the lining of the uterus so that a fertilized egg is less likely to attach.

Confusion Points

• Option 1 is the combination of Both Hormones 
• Option 2 Is Only Progestin
• Option 3 is both 1 and 2
• Therefore the given solution is correct

Kindly note there are pills with 1 hormone and combination pills also.

So Option 3 is correct.

Additional Information Advantages of birth control pills:

• Regulate menstruation.
• Reduces the dysmenorrhea symptoms.
• Helps to manage premenstrual syndrome
• Treat polycystic ovary syndrome.
• Treat endometriosis or uterine fibroids.
• Lower the risk of ovarian cancer, uterine cancer, and colon cancer.

Side effects:

• Breast tenderness or swelling.
• Headaches.
• Irritability or moodiness.
• Nausea.
• Spotting between periods (abnormal menstruation).

Mistake Points The Question asks about Pills and Not Hormones

The correct answer is Typhoid.

Key Points

• Typhoid is a bacterial infection that can lead to a high fever, diarrhea, and vomiting and can be fatal.
  • It is caused by the bacteria Salmonella typhi.
  • Typhoid fever is a type of enteric fever, along with paratyphoid fever
• The infection is often passed on through contaminated food and drinking water.
  • It is more prevalent in places where handwashing is less frequent.
• Typhoid fever is uncommon in the UK, with an estimated 500 cases occurring each year.
• Two typhoid vaccines are licensed for use for the prevention of typhoid: 
  • Oral Ty21a vaccine  and the injectable typhoid polysaccharide vaccine

​ Additional Information

• Bacteria are found even inside the human body, on our skin, in our hairs, and on all other surfaces.
  • Bacteria inside our gut or stomach are good bacteria and we must have them to lead a healthy life. 

List of Bacterial Diseases in Humans

• Hepatitis A : 
  • Hepatitis A is an inflammation of the liver caused by the hepatitis A virus (HAV).
  • The virus is primarily spread when an uninfected person ingests food or water that is contaminated with the feces of an infected person.
• Measles :
  •  Measles is caused by morbillivirus, which is mostly seen in the winter and spring.
    • It is a highly contagious illness caused by a virus that replicates in the nose and throat of an infected child or adult.
    • it is spread through airborne droplets from an infected child.
• Polio :
  • Polio is a disease caused by the poliovirus.
  • ​The virus enters the body through the mouth or nose, getting into the digestive and respiratory systems.
    • It multiplies in the throat and intestines. 
    • It can also attack the nervous system, the nerve network that helps the brain communicate with the rest of the body.
    • It happens mostly in children younger than 5.
  • The World Health Organization (WHO) continues to work to eliminate polio.

Concept-

• The Bacille Calmette Guerin vaccine was developed by French bacteriologists Albert Calmette and Camille Guerin.
• The BCG vaccine is a vaccine generally used to prevent tuberculosis.
• In countries where tuberculosis or leprosy is common, one dose of the BCG vaccine is recommended for newborn babies as soon as they are born.
• BCG vaccine is a live attenuated vaccine designed to help people become immune from TB.

Important Points

• The BCG vaccine route is different from all other vaccines. The BCG vaccine route requires an intradermal (ID) injection.
• ID BCG injection administers the vaccine into the top layer of the skin. Intradermal BCG injection reduces the risk of neurovascular injury but may leave scarring of the BCG vaccine.
• The BCG vaccine is the most difficult vaccine to administer due to the small size of the newborn's arms.
• A small narrow needle (15 mm, 26 gauge) is used to administer the BCG vaccine. The standard dose for BCG vaccination is 0.1 g in 1 mL.
• The dose of BCG vaccine for children under 1 year of age is 0.05 mL. Children above 1 year have to take the standard dosage.

Explanation

• Humans have 22 pairs of autosomes and one pair of sex chromosomes (the X and Y).
• Humans have 23 pairs of chromosomes – 22 pairs of numbered chromosomes, called autosomes, and one pair of sex chromosomes, X and Y.
• Autosomes control the inheritance of characteristics of all organisms except sex-linked ones, which are controlled by sex chromosomes.

Additional Information

• Chromosome- A structure is found inside the nucleus of a cell. a chromosome is made up of proteins and DNA which are organized into genes. 
• An autosome, unlike a sex chromosome, can contain any of the numbered chromosomes.

Concept:

• Lyme is a vector-borne disease.
• It is caused by Borrelia burgdorferi.
• It is transmitted through the bite of black-legged ticks.

Explanation:

• Symptoms of Lyme disease:
  • fever
  • headache
  • fatigue
  • erythema migrans (rashes)
• Prevention of Lyme disease:
  • insect repellent
  • removing ticks promptly
  • applying pesticides
  • reducing tick habitat.
• Treatment:
  • Doxycycline or Amoxicillin or Cefuroxime for 14 days.
• Complication:
  • Neurologic Lyme disease
  • Lyme arthritis
  • Lyme carditis.

Concept-

• ELISA means Enzyme-Linked Immuno-sorbent Assay.
• ELISA techniques serve the purpose of early diagnosis.
• ELISA is based on the principle of antigen-antibody interaction.
• Infection by a pathogen can be detected by the presence of antigens (proteins, glycoproteins, etc.) or by detecting the antibodies synthesized against the pathogen.

Explanation-

• ELISA uses an enzyme to detect the binding of antigens and antibodies.
• The enzyme converts a colorless substrate to a colored product, indicating the presence of Ag: Ab binding.
• An ELISA can be used to detect either the presence of Antigens or antibodies in a sample depending on how the test is designed.
• ELISA was developed in 1970 and became rapidly accepted.
• ELISA is used for the diagnosis of AIDS.
• The working principle of ELISA is antigen-antibody interaction.

The correct answer is Earth Quake.

Key Points

• A seismograph records the waves reaching the surface during an earthquake.
• The sudden tremors or shaking of the earth's crust is called an earthquake.
• The earth’s crust is made up of different parts of various sizes. They are called plates.
• Most of the earthquakes in the world are caused by the movements of the plates.
• ‘Seismology’ deals with the study of the earthquake.
• ‘Richter scale’ and ‘Mercalli scale’ are the instruments to measure and record the magnitude and the intensity of an earthquake respectively.

Additional Information

Key Points

Explanation:

• Malaria is caused due to Protozoa Plasmodium vivax.
  • It is transmitted through the female anopheles mosquito.
  • The protozoan plasmodium mainly attacks red blood cells, liver, and spleen of the human body.
  • There is no effective vaccine available for the treatment of Malaria.
  • The only approved vaccine is RTS, S, known by the trade name of Mosquirix but it has very low efficacy.
  • Medicines used to treat Malaria are hydroxychloroquine and quinine.
  • Resistance to antimalarial medicines is a recurring problem.
  • Resistance of P. falciparum malaria parasites to previous generations of medicines, such as chloroquine and sulfadoxine-pyrimethamine (SP), became widespread in the 1950s and 1960s.
  • Anopheles is a genus of mosquito first described and named by J. W. Meigen in 1818.
  • Female Anopheles mosquito is the carrier of malaria which when sucked blood from the patient and bite to another person which getting infected.

Concept:-

• GOBI
  • Growth Monitoring,
  • Oral Rehydration,
  • Breastfeeding
  • Immunization
• GOBI is a select package of World Health Organization primary health care strategies recommended by UNICEF.

Additional Information

• Full form of UNICEF- United Nations International Children's Emergency Fund / United Nations Children's Fund.
• UNICEF was created by United Nations General Assembly on 11 Dec 1946.
• UNICEF is the successor of the International Children's Emergency Fund (ICEF) which was created in 1946 by the U.N. Relief Rehabilitation Administration with the prime objective of providing immediate relief to children and mothers affected by World War II.
• The primary objective of the agency is to provide humanitarian and development aid to children worldwide.
• UNICEF is having more than 150 country offices across the globe & has a presence in 192 countries & Territories.
• Via a specific partnership mechanism established with the host country, UNICEF depends on national offices to help carry out its mission.

The UNICEF Flag

Explanation:

• Crude Death Rate: indicates the number of death per 1000 mid-year population.
• CDR is calculated as:
• CDR =   D x K  divided by P

1. D=total number of deaths registered during the calendar year
2. P= total mid-year estimated population or the total population of the middle of the year 
3. K=a constant usually taken as1,000

Key Points

• Natural population growth happens because of the following
  1. Birth Rate
  2. Death Rate
• The natural increase in birth rate and death rate causes natural population growth.
• Basic components of population change-
  • The fertility rate in women
  • Mortality
  • Migration
• Natural increase is the difference between the no. of births and deaths in the population.
• Crude Birth Rate - It is the total number of live births per 1,000 population divided by the length of the period in years. 
  • current rate - 18.2births/1000
• Crude Death Rate - the ratio of deaths to the population of a particular area or during a particular period of time, usually calculated as the number of deaths per one thousand people per year.