COMMUNITY HEALTH NURSING Midterm Examination
Summer Series June/July 2026 (QUESTIONS AND
ANSWERS)
1. Which level of prevention focuses primarily on reducing the
impact of established disease and restoring function?
A. Primary prevention
B. Secondary prevention
C. Tertiary prevention
D. Quaternary prevention
Correct Answer: C
Explanation: Tertiary prevention aims to reduce disability and
restore function after disease has occurred, while primary prevents
occurrence and secondary detects early disease; quaternary
prevents overmedicalization.
2. A community health nurse conducts a household survey and finds
clustering of diarrheal cases around a single water source. Which
epidemiologic concept best describes this observation?
A. Endemic
B. Common-source outbreak
C. Propagated outbreak
D. Sporadic occurrence
Correct Answer: B
Explanation: A common-source outbreak arises when many cases
are linked to the same contaminated source; propagated
, outbreaks spread person-to-person, and endemic/sporadic
describe baseline patterns.
3. During a home visit, a 70-year-old client reports no recent tetanus
booster and a puncture wound from metal. The nurse’s immediate
action should be:
A. Observe and advise home wound care only
B. Arrange tetanus booster and provide wound care guidance
C. Refer to physiotherapy for wound management
D. Administer antibiotics at home without referral
Correct Answer: B
Explanation: For high-risk puncture wounds in an older adult
without recent booster, arrange tetanus immunization and proper
wound care; antibiotics or physiotherapy alone are not first-line
community actions.
4. Which indicator is most appropriate for comparing child health
between two communities?
A. Crude birth rate
B. Infant mortality rate
C. Life expectancy at birth
D. Maternal mortality ratio
Correct Answer: B
Explanation: Infant mortality rate is sensitive to child health and
healthcare access; crude birth rate and life expectancy are broader
and maternal mortality focuses on maternal outcomes.
,5. A community health nurse plans a health education session on
malaria prevention for a rural village. Which teaching method best
fosters community ownership and sustained behaviour change?
A. Lecture with slides
B. Distribution of leaflets only
C. Participatory community dialogue and demonstration
D. Short radio announcement
Correct Answer: C
Explanation: Participatory dialogue engages community members,
builds ownership, and supports sustained behavior change;
lectures, leaflets, and radio are less interactive and less likely to
produce lasting local change.
6. In designing a cluster household survey, the nurse must minimize
selection bias. Which sampling approach best supports
representativeness?
A. Convenience sampling of households near the clinic
B. Random selection of clusters then random households within
clusters
C. Choosing households volunteering to participate
D. Selecting households with known cases only
Correct Answer: B
Explanation: Two-stage cluster sampling (random clusters, then
random households) improves representativeness; convenience or
volunteer sampling introduces bias, and selecting known cases
skews results.
, 7. A mother brings a 2-month-old infant with fever of 38.5°C for
vaccination day. Which is the correct action regarding routine
immunization?
A. Withhold all vaccines until fever subsides
B. Proceed with age-appropriate vaccines if fever is mild and child
otherwise well
C. Give only oral vaccines and delay injections
D. Refer to tertiary hospital for immunization
Correct Answer: B
Explanation: Mild fever alone is usually not a contraindication to
routine immunization; withholding unnecessarily delays
protection. Severe illness warrants delay and referral.
8. Which measure expresses the proportion of a population that has
a disease at a specific time?
A. Incidence rate
B. Prevalence proportion
C. Attack rate
D. Mortality rate
Correct Answer: B
Explanation: Prevalence is the proportion of existing cases at a
point in time; incidence measures new cases, attack rate is for an
outbreak, and mortality rate concerns deaths.
9. During a cholera outbreak, the priority immediate public health
intervention is:
A. Mass vaccination of the community immediately
Summer Series June/July 2026 (QUESTIONS AND
ANSWERS)
1. Which level of prevention focuses primarily on reducing the
impact of established disease and restoring function?
A. Primary prevention
B. Secondary prevention
C. Tertiary prevention
D. Quaternary prevention
Correct Answer: C
Explanation: Tertiary prevention aims to reduce disability and
restore function after disease has occurred, while primary prevents
occurrence and secondary detects early disease; quaternary
prevents overmedicalization.
2. A community health nurse conducts a household survey and finds
clustering of diarrheal cases around a single water source. Which
epidemiologic concept best describes this observation?
A. Endemic
B. Common-source outbreak
C. Propagated outbreak
D. Sporadic occurrence
Correct Answer: B
Explanation: A common-source outbreak arises when many cases
are linked to the same contaminated source; propagated
, outbreaks spread person-to-person, and endemic/sporadic
describe baseline patterns.
3. During a home visit, a 70-year-old client reports no recent tetanus
booster and a puncture wound from metal. The nurse’s immediate
action should be:
A. Observe and advise home wound care only
B. Arrange tetanus booster and provide wound care guidance
C. Refer to physiotherapy for wound management
D. Administer antibiotics at home without referral
Correct Answer: B
Explanation: For high-risk puncture wounds in an older adult
without recent booster, arrange tetanus immunization and proper
wound care; antibiotics or physiotherapy alone are not first-line
community actions.
4. Which indicator is most appropriate for comparing child health
between two communities?
A. Crude birth rate
B. Infant mortality rate
C. Life expectancy at birth
D. Maternal mortality ratio
Correct Answer: B
Explanation: Infant mortality rate is sensitive to child health and
healthcare access; crude birth rate and life expectancy are broader
and maternal mortality focuses on maternal outcomes.
,5. A community health nurse plans a health education session on
malaria prevention for a rural village. Which teaching method best
fosters community ownership and sustained behaviour change?
A. Lecture with slides
B. Distribution of leaflets only
C. Participatory community dialogue and demonstration
D. Short radio announcement
Correct Answer: C
Explanation: Participatory dialogue engages community members,
builds ownership, and supports sustained behavior change;
lectures, leaflets, and radio are less interactive and less likely to
produce lasting local change.
6. In designing a cluster household survey, the nurse must minimize
selection bias. Which sampling approach best supports
representativeness?
A. Convenience sampling of households near the clinic
B. Random selection of clusters then random households within
clusters
C. Choosing households volunteering to participate
D. Selecting households with known cases only
Correct Answer: B
Explanation: Two-stage cluster sampling (random clusters, then
random households) improves representativeness; convenience or
volunteer sampling introduces bias, and selecting known cases
skews results.
, 7. A mother brings a 2-month-old infant with fever of 38.5°C for
vaccination day. Which is the correct action regarding routine
immunization?
A. Withhold all vaccines until fever subsides
B. Proceed with age-appropriate vaccines if fever is mild and child
otherwise well
C. Give only oral vaccines and delay injections
D. Refer to tertiary hospital for immunization
Correct Answer: B
Explanation: Mild fever alone is usually not a contraindication to
routine immunization; withholding unnecessarily delays
protection. Severe illness warrants delay and referral.
8. Which measure expresses the proportion of a population that has
a disease at a specific time?
A. Incidence rate
B. Prevalence proportion
C. Attack rate
D. Mortality rate
Correct Answer: B
Explanation: Prevalence is the proportion of existing cases at a
point in time; incidence measures new cases, attack rate is for an
outbreak, and mortality rate concerns deaths.
9. During a cholera outbreak, the priority immediate public health
intervention is:
A. Mass vaccination of the community immediately
