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

• The National Immunization Schedule (NIS) of India is a program designed by the government to ensure that children and adults receive vaccines to prevent specific diseases. It includes vaccines that target diseases causing significant morbidity and mortality.
• The NIS currently covers 12 vaccine-preventable diseases, making this the correct answer. The diseases included under the schedule are tuberculosis, diphtheria, pertussis (whooping cough), tetanus, polio, hepatitis B, measles, rubella, rotavirus diarrhea, Japanese encephalitis (JE), Haemophilus influenzae type B (Hib), and pneumococcal pneumonia.
• These vaccines are provided free of cost under the Universal Immunization Program (UIP) to ensure equitable access to health services.

• Rationale: While the number of vaccine-preventable diseases covered under the NIS was lower in the past, advancements in immunization programs have increased the coverage to 12 diseases. Hence, 8 is incorrect and outdated.

• Rationale: Although the NIS has expanded over time, 10 vaccine-preventable diseases were covered in earlier versions of the schedule. However, newer vaccines like pneumococcal conjugate vaccine (PCV) have been added, raising the total to 12. Therefore, 10 is incorrect.

• Rationale: While 14 diseases might be a future goal for expanded immunization coverage, the current NIS covers 12 diseases. Hence, 14 is not correct at present.

• The National Immunization Schedule is a critical component of India's public health policy, aiming to reduce child mortality and prevent outbreaks of vaccine-preventable diseases.
• Vaccines under the schedule are provided at different stages of life, starting from birth, infancy, childhood, and into adulthood as needed.
• India has made significant progress in immunization coverage, with initiatives like Mission Indradhanush aiming to reach every child and pregnant woman who has been left out of routine immunization programs.
• Continuous monitoring and periodic updates to the NIS ensure alignment with global health standards and address emerging public health challenges.

• The National Immunization Schedule of India currently covers 12 vaccine-preventable diseases. This reflects the government's commitment to improving the health of its population through comprehensive immunization programs.

• Awareness campaigns about HIV/AIDS aim to educate individuals and communities on critical aspects of the disease. The primary focus is to empower people with accurate information about how HIV is transmitted, how it can be prevented, and the availability of treatment options like antiretroviral therapy (ART).
• Such campaigns also work toward reducing the stigma and discrimination faced by people living with HIV/AIDS, encouraging them to seek timely testing and treatment without fear of judgment.
• The ultimate goal of these campaigns is to control the spread of HIV, reduce the number of new infections, and improve the quality of life for those already living with the virus.
• By promoting prevention strategies (e.g., safe sex practices, use of condoms, regular HIV testing), treatment adherence, and societal acceptance, these campaigns contribute significantly to the global effort to achieve an AIDS-free world.

• Rationale: This is incorrect because awareness campaigns aim to reduce risky behaviors rather than encourage them. The emphasis is on promoting safe practices, such as using protection during sexual activities and avoiding needle sharing.

• Rationale: This is incorrect because antiretroviral therapy is a cornerstone of HIV treatment. Awareness campaigns actively promote the use of ART as it helps suppress the viral load, improves the health of individuals living with HIV, and reduces the chances of transmission.

• Rationale: This is incorrect and contrary to the purpose of awareness campaigns. The intent is to prevent the spread of HIV by educating at-risk populations on how to protect themselves and others.

• Rationale: No information is given for this option, so it is not applicable to the explanation.

• Awareness campaigns about HIV/AIDS play a vital role in global public health by focusing on prevention, treatment, and stigma reduction. They aim to reduce new infections and improve the lives of those living with HIV while fostering a more informed and accepting society. The other options provided are either incorrect or misrepresent the goals of these campaigns.

• Depo-Provera (DMPA) is a form of contraception that primarily works by inhibiting ovulation. It is a progestin-only injectable contraceptive administered every three months.
• Ovulation inhibition occurs as Depo-Provera suppresses the secretion of gonadotropins, specifically luteinizing hormone (LH) and follicle-stimulating hormone (FSH). These hormones are essential for the maturation and release of eggs from the ovaries. Without their activity, ovulation does not take place, preventing the possibility of fertilization.
• By keeping the ovaries in a state where egg development and release are suppressed, Depo-Provera is considered highly effective as a contraceptive method.

• Rationale: While Depo-Provera does thicken cervical mucus, making it more difficult for sperm to reach the egg, this is considered a secondary mechanism of action rather than its primary method of action. The thickened mucus creates a physical barrier that reduces sperm motility and access to the uterus.

• Rationale: Depo-Provera alters the endometrial lining of the uterus, making it less suitable for implantation of a fertilized egg. However, this is not its primary mode of action. Since Depo-Provera prevents ovulation, the likelihood of fertilization and subsequent implantation is already minimal.

• Rationale: Depo-Provera does not directly affect sperm count. Its contraceptive effects are focused on the female reproductive system, including ovulation suppression and cervical mucus thickening, rather than influencing male reproductive physiology.

• Depo-Provera’s primary mechanism of action is the inhibition of ovulation, which prevents the release of eggs from the ovaries. While it also thickens cervical mucus and alters the uterine lining as secondary mechanisms, these are supplementary to its main function. By effectively suppressing ovulation, Depo-Provera is a reliable and long-lasting contraceptive method used globally.

• Anemia Mukht Bharat (AMB) program is a government initiative in India aimed at reducing the prevalence of anemia, especially in vulnerable groups such as pregnant women, children, and adolescents.
• Pregnant women are one of the priority groups under the AMB program due to the increased risk of anemia during pregnancy and its potential adverse effects on maternal and fetal health.
• The hemoglobin level of 12.5 gm in the patient is within the normal range for pregnancy, as per standard guidelines. Pregnant women are classified as non-anemic if their hemoglobin levels are ≥11 gm/dL.
• The AMB program recommends prophylactic iron and folic acid supplementation for all pregnant women, regardless of their hemoglobin levels, to prevent anemia and support the increased iron and folic acid demands during pregnancy.
• The recommended dose is 60 mg elemental iron and 500 mcg folic acid daily for pregnant women to ensure adequate iron stores and prevent folic acid deficiency, which is crucial for fetal neural tube development.

• Rationale: Although the hemoglobin level is normal, it is incorrect to suggest no intervention. The AMB program mandates prophylactic iron and folic acid supplementation for all pregnant women, including those with normal hemoglobin levels, to prevent anemia and promote maternal and fetal health.

• Rationale: This dose is higher than the recommended prophylactic dose for non-anemic pregnant women. Such a higher dose is typically reserved for treating moderate to severe anemia rather than for prophylaxis.

• Rationale: This option suggests doubling the recommended prophylactic dose, which is unnecessary for a pregnant woman with normal hemoglobin levels. Over-supplementation can lead to gastrointestinal side effects such as constipation, nausea, and vomiting.

• The most appropriate nursing intervention for a 4-week pregnant woman with a hemoglobin level of 12.5 gm is to advise daily supplementation with 60 mg elemental iron and 500 mcg folic acid as per the Anemia Mukht Bharat program guidelines.
• This prophylactic supplementation prevents anemia and ensures adequate iron and folic acid levels to support the health of both the mother and the developing fetus.

• National Deworming Day (NDD) is a biannual initiative undertaken by the Ministry of Health and Family Welfare in India to combat parasitic worm infections in children and adolescents. It is observed on 10 February and 10 August every year.
• The objective of NDD is to improve the overall health, nutrition, and education of children by reducing the prevalence of Soil-Transmitted Helminths (STH), commonly known as parasitic intestinal worms, which are widely prevalent in India.
• Children aged 1 to 19 years are targeted under this program, as they are most vulnerable to STH infections due to poor hygiene and sanitation practices.
• Albendazole, a safe and effective deworming medicine, is administered free of cost to children in schools and Anganwadi centers across the country during these two days.
• The program also includes awareness campaigns to educate parents, teachers, and communities about the importance of deworming and maintaining hygiene to prevent reinfection.

• Rationale: This option is incorrect because National Deworming Day is not observed in July and January. These months do not align with the official schedule of the program as set by the Ministry of Health and Family Welfare.

• Rationale: This option is also incorrect. While May and December are not linked with National Deworming Day, they may correspond to other health initiatives but are not relevant to deworming campaigns.

• Rationale: This option is incorrect because April and November are not the designated months for National Deworming Day. These months do not coincide with the program's biannual schedule.

• Soil-Transmitted Helminths infections are caused by poor sanitation and hygiene practices, leading to malnutrition, anemia, and impaired mental and physical development in children.
• The World Health Organization (WHO) recommends periodic deworming as a cost-effective strategy to reduce the burden of STH infections in endemic areas.
• India's National Deworming Day is one of the largest public health programs globally, targeting over 270 million children and adolescents annually.

• The correct observation of National Deworming Day on 10 February and 10 August ensures a coordinated effort to control STH infections and improve the health and well-being of children in India. The other options do not align with the official schedule of the program.

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.