Community Health Nursing Questions and Answers

Answer: C

The major role is played by genetic factors.

The wheel model of disease causation draws the host as a hub with a genetic core, surrounded by the biological, physical and social environment. The relative size of each part changes with the disease. In a hereditary condition such as phenylketonuria, an inborn error of metabolism caused by a recessive defect in the enzyme phenylalanine hydroxylase, the genetic core is the largest part of the wheel.

Diet matters only because phenylalanine in food accumulates when the enzyme is missing, which is why a low-phenylalanine diet controls the disease; but diet is not the cause. Environmental factors alone do not produce PKU, so the options naming them, or diet as a co-equal cause, are weaker than genetic factors.

Answer: D

The phase is pre-pathogenesis.

In the natural history of disease, the period of pre-pathogenesis is the time before the disease process has started in the person: the agent, host and environment are interacting and risk factors are present, but no pathological change has yet begun. Primary prevention, through health promotion and specific protection, acts in this phase.

Pathogenesis is the phase after the disease process starts in the host, ending in recovery, disability or death. 'Post pathogenesis' is not a phase of the natural history. Primordial prevention is a level of prevention, aimed at stopping risk factors from arising at all, not a phase of disease.

Answer: C

The correct match is a-III, b-I, c-IV, d-II.

• Diagnosis: determination of the nature and extent of disease.
• Etiology: the science of the cause of disease.
• Symptoms: subjective evidence of disease, what the patient feels and reports, such as pain or nausea (signs are the objective evidence).
• Prognosis: the chance of recovery, the likely outcome of the disease.

The other options pair diagnosis with the cause or the outcome, or etiology with the outcome, which mixes up these basic terms.

Answer: B

The one not necessary for good health is eating diet rich in only fats and proteins.

A healthy diet is balanced: it supplies carbohydrates, proteins, fats, vitamins, minerals, fibre and water in suitable proportions. A diet of only fats and proteins lacks fibre, vitamins and minerals from cereals, fruits and vegetables and can raise the risk of obesity and heart disease.

Vaccination prevents infectious diseases, control of vectors prevents diseases such as malaria and dengue, and hygienic food prevents food-borne infection. All three are necessary for good health.

Answer: A

The non-infectious diseases are 1, 3: diabetes and cancer.

Non-communicable diseases are not caused by an infectious agent and do not spread from person to person. They arise from genetic, lifestyle and environmental factors. Diabetes and cancer are covered under the National Programme for Prevention and Control of NCDs.

AIDS is caused by HIV, the common cold by viruses such as rhinoviruses, and COVID by the SARS-CoV-2 virus. All three are infectious, so any option including 2, 4 or 5 is wrong.

Answer: A

The genetic disorder is Thalassemia.

Thalassaemia is an inherited disorder of haemoglobin synthesis, passed on in an autosomal recessive pattern. A defect in the genes for the alpha or beta globin chains causes reduced production of haemoglobin and severe anaemia; thalassaemia major needs regular blood transfusions.

Cancer arises mainly from acquired mutations, with only some inherited predisposition. Marasmus is a nutritional disease. Anaemia is a condition with many causes, most often iron deficiency; it can be genetic, as in thalassaemia itself, but is not a genetic disorder as such.

Answer: B

These are examples of Quaternary prevention.

Quaternary prevention protects patients from overmedicalisation: unnecessary tests, screening, drugs and procedures that may cause harm without benefit. Avoiding needless antibiotics and needless screening fits this definition.

Primordial prevention stops risk factors from arising in a population, secondary prevention is early diagnosis and treatment, often through screening, and tertiary prevention limits disability and rehabilitates. None of them describes avoiding unnecessary intervention.

Answer: C

The important interventions are yoga, balanced diet, personal hygiene and vaccination.

Each of these supports health in a different way: a balanced diet meets nutritional needs, personal hygiene prevents infections, vaccination gives specific protection against disease, and yoga promotes physical fitness and mental well-being.

The other options leave out a key element such as balanced diet or vaccination, or include consuming high-energy foods, which encourages obesity rather than good health. 'Avoiding crowded places' is a situational measure, not a core health intervention.

Answer: D

Health means a state of complete physical, mental and social well being.

The WHO definition (1948) states that health is a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity.

'Absence of disease' is exactly what the definition says health is more than. The option with physical and mental well-being leaves out the social dimension, and longevity with low maternal mortality are indicators of a population's health, not a definition of health.

Answer: A

The paper's answer is 9 factors.

The BEINGS model, described in Park's textbook, explains disease as the result of an interplay of Biological and Behavioural factors, Environmental factors, Immunological factors, Nutritional factors, Genetic factors, Services (health care), Social factors and Spiritual factors. Counting the two B's separately gives nine factors.

Counting the letters of the word BEINGS, or merging the biological and behavioural factors, would give a smaller number such as 8 or 7, which is why those options are traps.