Saudi Prometric Nursing Community and Public Health Nursing 3 — Questions and Answers
Question 1: A community nurse is using the PRECEDE-PROCEED model for health program planning. What does the PRECEDE phase involve?
- Assessing needs — identifying factors predisposing, enabling, and reinforcing health behaviors (Correct answer)
- Implementing the intervention
- Evaluating outcomes after implementation
- Allocating resources and training staff
Correct answer: Assessing needs — identifying factors predisposing, enabling, and reinforcing health behaviors
PRECEDE (Predisposing, Reinforcing, Enabling Constructs in Educational/Ecological Diagnosis and Evaluation) is the assessment phase that identifies why people behave as they do, including predisposing factors (knowledge, beliefs), enabling factors (resources, skills), and reinforcing factors (social support).
Question 2: The nurse is following up on a patient with latent tuberculosis infection (LTBI) who has a positive tuberculin skin test but no symptoms. What treatment is typically recommended?
- Isoniazid for 9 months (or rifampin for 4 months) (Correct answer)
- Combination therapy with 4 drugs for 6 months
- No treatment, monitoring only
- Rifampin, isoniazid, pyrazinamide, ethambutol for 2 months
Correct answer: Isoniazid for 9 months (or rifampin for 4 months)
LTBI treatment prevents progression to active TB. Standard regimens include isoniazid (INH) for 9 months, or rifampin for 4 months (shorter, better tolerated). Active TB requires the full 4-drug regimen for 6 months.
Question 3: The nurse is implementing a cervical cancer screening program in Saudi Arabia. According to WHO guidelines, at what age should regular Pap smear screening begin?
- Age 25 (Correct answer)
- Age 18
- Age 30
- Age 21
Correct answer: Age 25
WHO guidelines recommend cervical cancer screening (Pap smear or HPV test) beginning at age 25–30, depending on the country's protocol. Screening before this age is not recommended because of high false-positive rates and overtreatment of lesions that would resolve naturally in younger women.
Question 4: A community health nurse is implementing a needle exchange program for people who inject drugs. This is an example of which public health approach?
- Harm reduction (Correct answer)
- Primary prevention
- Tertiary prevention
- Health promotion
Correct answer: Harm reduction
Harm reduction minimizes the negative health consequences of risky behaviors without requiring abstinence. Needle exchange programs reduce HIV and hepatitis transmission among people who inject drugs without requiring them to stop using. It is pragmatic and evidence-based.
Question 5: A nurse is caring for a patient with active pulmonary tuberculosis in the community. How long after initiating effective antibiotic therapy is the patient generally considered non-infectious?
- 2–3 weeks (Correct answer)
- 24–48 hours
- 6 weeks
- 3 months
Correct answer: 2–3 weeks
After 2–3 weeks of effective anti-TB therapy, sputum smears usually become negative and the patient is considered non-infectious. Clinical improvement typically occurs within the first 2 weeks. This guideline governs return to school or work decisions.
Question 6: A public health nurse is reviewing data showing that cardiovascular disease rates are disproportionately higher in lower-income neighborhoods. This difference is an example of:
- A health disparity related to social determinants of health (Correct answer)
- Random variation in disease distribution
- Expected biological variation across populations
- A genetic difference in disease susceptibility
Correct answer: A health disparity related to social determinants of health
Health disparities are preventable differences in disease burden linked to social, economic, and environmental disadvantage. Income, education, neighborhood environment, and access to care are social determinants that drive disparities in cardiovascular disease and other conditions.
Saudi Prometric Nursing Community and Public Health Nursing 3
A community nurse is using the PRECEDE-PROCEED model for health program planning.
What does the PRECEDE phase involve?