सुदूरपश्चिम प्रदेश, जनस्वास्थ्य अधिकृत, सातौँ, २०८३/०५/२४

Ajnabee Khadka
September 09, 2026
48

सुदूरपश्चिम प्रदेश, जनस्वास्थ्य अधिकृत, सातौँ, २०८३/०५/२४

Far Western Province, Public Health Officer, Seventh, 2083/05/24

1. The subjective, human experience of feeling unwell. It represents a disruption in a person's physical, mental, or psychosocial well-being is known as.........

(A) Disease
(B) Sickness
(C) Illness ✓
(D) Disability

2. "Quality assurance" in health care refers to:

(A) An ongoing process to measure and improve services against set standards ✓
(B) An audit conducted after patient complaints
(C) The procurement of medical supplies and maintenance of equipment
(D) Staff attendance monitoring and timely payment of salary

3. The "spectrum of health" concept illustrates that:

(A) Health and disease are fixed, mutually exclusive states
B) Health exists only in the absence of any risk factors
(C) Health and disease exist along a continuum, ranging from positive health through various degrees of illness to death ✓
(D) Disease always precedes death without intermediate stages.

4. Which of the following is classified as a "non-modifiable" determinant of health?

(A) Diet and nutrition
(B) Age, sex, and hereditary factors ✓
(C) Housing and sanitation
(D) Access to healthcare services

5. Which one is not the core function of Public Health?

(A) Authority ✓
(B) Assurance
(C) Assessment
(D) Policy development

6. The process of getting good quality staff appointed to rural health posts is critical for addressing workforce shortages. This process is called:

(A) Outsourcing
(B) Task shifting
(C) Retention ✓
(D) Recruitment

7. Which of the following is a major limitation of the bottom-up approach to health planning?

(A) It is time-consuming and requires more effort ✓
(B) It overlooks community needs
(C) It lacks community participation
(D) It is inflexible

8. Which type of planning focuses on long-term goals, vision, and future direction of an organization?

(A) Operational planning
(B) Strategic planning ✓
(C) Budget planning
(D) Contingency planning

9. The demand curve shows the relationship between:

(A) Price and quantity demand ✓
(B) Consumer tastes and quality demand.
(C) Price and production costs.
(D) Money income and quantity demands.

10. Which of the following best distinguishes "disease" from "illness"?

(A) Disease refers to subjective symptoms, while illness refers to objective pathological changes.
(B) Disease is a medically diagnosed pathological condition, whereas illness is the individual's personal experience of feeling unwell ✓
(C) Disease and illness are synonymous terms with identical meanings.
(D) Disease refers only to communicable conditions, whereas illness also includes non-communicable conditions

11. Why is bottom-up planning given priority in the health system?

(A) It ensures plans are based on local health needs ✓
(B) It reduces the role of local health institutions.
(C) It focuses mainly on financial management.
(D) It replaces national health policies

12. Health economics is the study of:

(A) Health financing and budgeting
(B) Allocation of scarce resources for health ✓
(C) Cost of medical equipment
(D) Economic growth through healthcare

13. What system is in place in the government to account value for money to purchase goods and services?

(A) A good specification
(B) Competent authority only authorizes
(C) Tender and Quotation process ✓
(D) Having place of a purchase committee

14. The characteristics of the individual who should be hired for the job are indicated by?

(A) Job identification
(B) Job analysis
(C) Job specification ✓
(D) Job description

15. What is the fundamental function to be addressed for improvement of Management Information System?

(A) Reporting
(B) Compilation
(C) Aggregation
(D) Recording ✓

16. The correct sequence of the health planning cycle is:

(A) Implementation → Evaluation → Needs assessment → Planning
(B) Evaluation → Needs assessment → Planning → Implementation
(C) Needs assessment → Planning → Implementation → Evaluation ✓
(D) Planning → Implementation → Evaluation → Needs assessment

17. A Ministry of Health plans to expand primary healthcare services in underserved areas. Which human resource planning approach is most appropriate to determine the number and mix of health workers required based on actual service demand and workload?

(A) Disease berden analysis of the community
(B) Historical staffing trend analysis
(C) Population-to-provider ratio method
(D) Workload Indicators of Staffing Need (WISN) method ✓

18. Which of the following is considered the greatest potential advantage of decentralization in health management?

(A) Elimination of disparities in health resource allocation.
(B) Improved responsiveness of health services to local needs and priorities ✓
(C) Reduced need for monitoring and evaluation by the central government.
(D) Uniform implementation of health policies across all regions.

19. A Ministry of Health transfers responsibility for managing primary health care services, including planning, budgeting and personnel management, to elected local governments with legal authority. This is an example of:

(A) Deconcentration
(B) Delegation
(C) Devolution ✓
(D) Privatization

20. Which of the following activities is most appropriately classified as evaluation rather than monitoring?

(A) Measuring the percentage of health facilities submitting reports on time.
(B) Assessing whether a maternal health program reduced maternal mortality after five years ✓
(C) Recording the number of health workers trained each quarter
(D) Tracking the monthly stock status of essential medicines

21. All are the main objectives of public procurement except:

(A) Bid evaluation ✓
(B) Ensure fair competition among suppliers
(C) Promote transparency and reduce corruption
(D) Achieve broader public policy goal

22. Need assessment helps planners to:

(A) Avoid Data Collection
(B) Eliminate all diseases immediately
(C) Allocate resources based on priorities ✓
(D) Increase administrative burden

23. Ultimate result of planning:

(A) Goal ✓
(B) Objective
(C) Achievement
(D) Target

24. Emergency order point of Health post:

(A) 1 month ✓
(B) 3 months
(C) 5 months
(D) 10 months

25. All are the principles of Health Governance except:

(A) Developing health policies and strategic plans ✓
(B) Accountability
(C) Transparency
(D) Responsiveness

26. Which of the following best defines disease elimination?

(A) Zero disease worldwide
(B) Complete extinction of the pathogen
(C) Disease reduced to an acceptable level
(D) Zero disease in a specific area with continued control measures ✓

27. The primary mode of transmission for typhoid fever is:

(A) Direct skin contact
(B) Blood transfusion
(C) Airborne droplets
(D) Fecal-oral route through contaminated food or water ✓

28. Diphtheria is an acute bacterial disease caused by:

(A) Haemophilus influenzae
(B) Bordetella pertussis
(C) Corynebacterium diphtheriae ✓
(D) Streptococcus pneumoniae

29. The major modifiable risk factors for NCDs include all of the following except:

(A) Tobacco use
(B) Genetic predisposition ✓
(C) Unhealthy diet
(D) Physical inactivity

30. The primary objective of vaccine supply chain management is:

(A) To maximize vaccine wastage
(B) To reduce the number of immunization sessions
(C) To minimize the cost of vaccines
(D) To ensure the availability of potent vaccines at the right time, in the right quantity, at the right place, and at the right cost ✓

31. What is the clinical incubation period of the Lymphatic Filariasis?

(A) One to two months
(B) Three to four months
(C) Five to seven months
(D) Eight to sixteen months ✓

32. According to WHO, the leprosy elimination means;

(A) Less than one case per 1000 population
(B) Less than one case per 10,000 population ✓
(C) Less than one case per 100,000 population
(D) Less than one case per 100,0000 population

33. Leprosy and Tuberculosis can be best prevented in Nepal by:

(A) Health education
(B) Early diagnosis and treatment ✓
(C) Immunoprophylaxis
(D) Chemoprophylaxis

34. Lyssa virus type 1 causes the:

(A) Measles
(B) Yellow fever
(C) SARS
(D) Rabies ✓

35. Neonatal tetanus is said to be eliminated when the Rate is:

(A) <0.1 per 1000 live births
(B) <1 per 1000 live births ✓
(C) >1 per 1000 live births
(D) >10 per 1000 live births

36. The incubation period of dengue fever is:

(A) 4-10 days ✓
(B) 14-21 days
(C) 28-32 days
(D) 35-40 days

37. Which of the following is not a component of integrated Vector Management?

(A) Using chemical insecticides for vector control
(B) Using bed nets
(C) Making clean environment
(D) Taking prophylaxis medication ✓

38. A patient with cough for 3 weeks, weight loss, and night sweats has a negative sputum AFB smear. What is the next best diagnostic test?

(A) Repeat sputum AFB after 1 month
(B) Start broad-spectrum antibiotics
(C) GeneXpert MTB ✓
(D) Rule out tuberculosis

39. WHO certified Nepal as "Trachoma Elimination" on:

(A) $24^{\text{th}}$ April 2018 ✓
(B) $24^{\text{th}}$ April 2020
(C) $24^{\text{th}}$ April 2022
(D) $24^{\text{th}}$ April 2024

40. Which of the following best defines multidrug-resistant tuberculosis (MDR-TB)?

(A) Tuberculosis resistant to any one first-line anti-tuberculosis drug.
(B) Tuberculosis resistant to rifampicin only
(C) Tuberculosis caused by Mycobacterium tuberculosis resistant to at least both isoniazid and rifampicin ✓
(D) Tuberculosis resistant to all first-line and second-line anti-tuberculosis drugs

41. A 7-year-old unvaccinated child presents with fever, sore throat, cervical lymphadenopathy, and an adherent grayish-white membrane over the tonsils that bleeds on attempted removal. What is the most likely diagnosis?

(A) Acute respiratory tract infections (ARI)
(B) Diphtheria ✓
(C) Pharangitis
(D) Tonsillitis

42. Prevalence of TB infection in a community is established by:

(A) Tuberculin test ✓
(B) Sputum microscope
(C) Chest x-ray
(D) Sputum culture

43. Rash of Rubella disappears by:

(A) $3^{\text{rd}}$ Day ✓
(B) $7^{\text{th}}$ Day ✓
(C) $10^{\text{th}}$ Day
(D) $15^{\text{th}}$ Day

44. Which of the following disease posing challenges for management due to drug resistant?

(A) Dengue
(B) Trachoma
(C) Japanese encephalitis
(D) Tuberculosis ✓

45. What is the causative agent of scabies?

(A) Sarcopptes scabie ✓
(B) Sarcoptes
(C) Scabie
(D) Sand fly

46. Which of the following health indicators is a composite measure that incorporates both premature mortality and years lived with disability, making it particularly useful for estimating the overall burden of disease?

(A) Infant Mortality Rate (IMR)
(B) Disability-Adjusted Life Year (DALY) ✓
(C) Crude Death Rate (CDR)
(D) Maternal Mortality Ratio (MMR)

47. According to the 2022 Nepal Demographic and Health Survey (NDHS), the prevalence of stunting in Sudurpashchim Province is approximately:

(A) 4.7%
(B) 13.5%
(C) 27.7% ✓
(D) 43%

48. A vector in the context of disease transmission is:

(A) The portal of exit from the host
(B) A non-living object that transmits infection
(C) A living organism that transmits pathogens between humans or from animals to humans ✓
(D) The environment where the agent lives

49. Epidemiology is best defined as the study of:

(A) The surgical management of chronic conditions
(B) The distribution, determinants, and control of health and disease in defined populations ✓
(C) The treatment of individual patients in a clinical setting
(D) The biochemical processes underlying disease

50. An epidemic reported that the epidemic curve which follows the classic log-normal pattern of sharp rise and more gradually decline from a food poisoning outbreak. Which type of source of agent is most consistent?

(A) Continuous source
(B) Intermittent source
(C) Point source ✓
(D) Propagated source

51. During an epidemic, if an infected person refuses isolation, what should the Public Health Officer do?

(A) Respect the person's decision
(B) Publicly disclose the person's identity
(C) Coordinate with authorities to enforce public health measures under the law ✓
(D) Personally impose a financial fine

52. If a province reports declining deaths from infectious diseases and rising illness and deaths from chronic diseases. This pattern is best described as:

(A) Double burden of disease
(B) Secular trend shift
(C) Demographic transition
(D) Epidemiological transition ✓

53. People searched for other's benefit, essential for disease control is called:

(A) Prospective Screening ✓
(B) Prescriptive Screening
(C) Multiphasic Screening
(D) Mass Screening

54. Which combination correctly represents the four essential components of epidemiology?

(A) Disease, diagnosis, drug and rehabilitation.
(B) Distribution, determinants, specified populations, and application of findings to health problems ✓
(C) Incidence, prevalence, mortality and palliation.
(D) Prevention, promotion, treatment and palliation.

55. Which one is the Tertiary prevention:

(A) Disability limitation ✓
(B) Early diagnosis
(C) Health promotion
(D) Specific protection

56. The simplest measure of variability, calculated as the difference between the maximum and minimum values, is the:

(A) Variance
(B) Range ✓
(C) Standard deviation
(D) Interquartile range

57. A researcher has a complete list of 12,000 households in a municipality and selects every $20^{\text{th}}$ household after randomly choosing the first household between 1 and 20. Which sampling technique is being used?

(A) Stratified random sampling
(B) Systematic random sampling ✓
(C) Cluster sampling
(D) Convenience sampling

58. Standard deviation of standard normal curve is:

(A) 0
(B) 1 ✓
(C) 2
(D) 3

59. Which of the following is not an inferential statistical method?

(A) ANOVA
(B) Standard deviation ✓
(C) Regression analysis
(D) Chi-square test

60. Determination of which statistical parameter requires quantities to be arranged in an ascending or descending order:

(A) Mean
(B) Median ✓
(C) Mode
(D) S.D.

61. The annual population growth rate of Nepal from 2011 to 2021 was:

(A) 2.10%
(B) 1.35%
(C) 1.16%
(D) 0.92% ✓

62. Life expectancy is the indicator of:

(A) Mortality ✓
(B) Morbidity
(C) Fertility
(D) Mobility

63. Among all provinces of Nepal, Sudurpashchim Province ranks..... in terms of infant mortality rate (highest = 1)

(A) $1^{\text{st}}$ (highest) ✓
(B) $2^{\text{nd}}$
(C) $4^{\text{th}}$
(D) $7^{\text{th}}$ (lowest)

64. Data found that there was no gap on birth rate and death rate in a country. Which of the following best describes it?

(A) Demographic dividend
(B) Demographic window
(C) Demographic trap ✓
(D) Demographic transition

65. The three main components of population dynamics are:

(A) Urbanization, industrialization and globalization
(B) Morbidity, disability and mortality
(C) Education, income and occupation
(D) Fertility, mortality and migration ✓

66. Food adulteration is defined as:

(A) The intentional addition of nutrients to food to improve its nutritional value
(B) The process of adding or removing substances to food to increase profit, thereby reducing its quality ✓
(C) The process of heating food to kill pathogenic microorganisms
(D) The process of adding preservatives to extend shelf life

67. What is the purpose of fortifying flour with folic acid?

(A) To prevent Neural tube defects in newborns ✓
(B) To reduce gluten content.
(C) To prevent rancidity ✓
(D) To enhance its color.

68. According to NDHS 2022, what is the percentage of exclusive breast fed?

(A) 56% ✓
(B) 66%
(C) 76%
(D) 86%

69. Which disease is transmitted from unpasteurized milk?

(A) Cysticercosis
(B) Bovin tuberculosis ✓
(C) Pulmonary tuberculosis
(D) Hookworm

70. A district nutritional profile shows the following among children under five years:

Stunting: 32%, Wasting : 9%, Underweight: 21% and Overweight: 3%. Which statement is the most appropriate interpretation?

(A) Acute malnutrition is the predominant nutritional problem.
(B) Chronic undernutrition is the major nutritional concern in the district ✓
(C) Childhood obesity has become the principal nutritional challenge.
(D) The district has achieved the national targets of nutrition program.

71. Recommended minimum amount of residual chlorine in drinking water is:

(A) 0.55 ppm ✓
(B) 1.5 ppm
(C) 2.0 ppm
(D) 2.5 ppm

72. Which of the following represents the correct order of priority for waste management according to international healthcare waste management principles?

(A) Collection → Transportation → Segregation → Disposal
(B) Collection → Segregation → Treatment → Disposal
(C) Segregation → Collection → Treatment → Disposal ✓
(D) Segregation → Transportation → Incineration → Landfilling

73. Where is Biological Oxygen Demand test done?

(A) Air
(B) Water
(C) Soil
(D) Sewage ✓

74. The "3R" principle of solid waste management stands for:

(A) Reuse, Recycle, and Recover
(B) Reduce, Reuse, and Recycle ✓
(C) Reduce, Recycle, and Remove
(D) Reuse, Refuse, and Recycle

75. According to the WHO toxicity classification, Class Ia insecticides are:

(A) Slightly hazardous
(B) Moderately hazardous
(C) Highly hazardous
(D) Extremely hazardous ✓

76. Ergonomics is concern with:

(A) Improving the agricultural production
(B) Environmental manipulation according to human needs.
(C) Fitting the job to the workers ✓
(D) Improving the Genetic endowment of the human population.

77. Which hazard control measure is the most effective in occupational health and safety?

(A) Engineering controls
(B) Administrative controls
(C) Personal protective equipment (PPE)
(D) Elimination ✓

78. Which of the following is an example of a physical hazard in the workplace?

(A) Workplace stress and harassment
(B) Exposure to toxic fumes
(C) Exposure to bacteria and viruses
(D) Excessive noise and vibration ✓

79. Pre-placement examination has an important role to play in:

(A) Mental health
(B) Genetic counselling
(C) Occupational Health ✓
(D) Energy conservation

80. What is the most common occupational injury among rice paddy field workers?

(A) Back pain
(B) Cut injury
(C) Eye injury
(D) Foot injury ✓

81. Which group teaching method is most effective for demonstrating ORS preparation in a low-literacy community?

(A) Panel discussion
(B) Symposium
(C) Group lecture
(D) Demonstration ✓

82. Which rapid assessment method uses mapping and seasonal calendars to identify community health issues?

(A) Focus Group Discussion
(B) Participatory Rural Appraisal (PRA) ✓
(C) Rapid Rural Appraisal (RRA) ✓
(D) Case-control study

83. Which of the following is a basic principle of health education?

(A) Imposing the educator's views on the community
(B) Starting from the "known to the unknown" ✓
(C) Using complex medical jargon to show expertise
(D) Providing information only during emergencies

84. What is the most important point to remember to include in a Social and Behavioral Change Communication activity?

(A) Stakeholders ✓
(B) Leaders
(C) Target group members
(D) School teachers

85. According to the Health Belief Model, which factor reflects a person's perceived chance of getting a disease?

(A) Perceived Benefits
(B) Perceived Severity
(C) Perceived Susceptibility ✓
(D) Cues to Action

86. Health behavior change is better to be promoted by:

(A) Internalization ✓
(B) Identification
(C) Compliance
(D) Incentive

87. Health education methods are broadly classified into:

(A) Direct and indirect
(B) Printed and electronic
(C) Individual, group, and mass approaches ✓
(D) Formal and semi-formal

88. During an outbreak investigation, a health educator conducts a community meeting where participants ask questions, express concerns, and jointly develop preventive strategies. Which type of communication is best represented?

(A) One-way communication using mass media
(B) Two-way communication with active feedback and participation ✓
(C) Intrapersonal communication
(D) Mass communication

89. Main goal of community organization:

(A) Bring external support in community
(B) Ignoring community needs
(C) Empowering individuals and groups to address community issues ✓
(D) Forming group in community

90. Which of the following is the correct sequence of various stages of the Adoption process in Behavior change?

(A) Adoption stage, Trial stage, Evaluation stage, Interest stage and Awareness stage
(B) Trial stage, Evaluation stage, Interest stage, Awareness stage and Adoption stage
(C) Evaluation stage, Interest stage, Awareness stage, Adoption stage and Trial stage
(D) Awareness stage, Interest stage, Evaluation stage, Trial stage and Adoption stage ✓

91. Which service is not included in Nepal's free Basic Health Services (BHS)?

(A) Basic mental health care
(B) Skilled birth attendance
(C) Essential emergency surgery ✓
(D) Childhood immunization

92. Which principle of Primary Health Care (PHC) ensures fair access to health services for all, especially underserved populations?

(A) Community participation
(B) Equitable Distribution ✓
(C) Intersectoral Coordination
(D) Appropriate Technology

93. A country expands primary health care services, increases financial risk protection through national health insurance, and ensures access to essential medicines without causing catastrophic health expenditure. Which SDG 3 target is primarily being addressed?

(A) SDG Target 3.2 – End preventable deaths of newborns and children under five years.
(B) SDG Target 3.3 – End epidemics of AIDS, tuberculosis, malaria, and neglected tropical diseases.
(C) SDG Target 3.9 – Reduce deaths from hazardous chemicals and pollution.
(D) SDG Target 3.8 – Achieve Universal Health Coverage (UHC) ✓

94. Which pair of indicators is recommended by the World Health Organization (WHO) for monitoring progress toward Universal Health Coverage?

(A) Infant Mortality Rate and Crude Birth Rate
(B) Service Coverage Index (SCI) and incidence of catastrophic health expenditure ✓
(C) Life expectancy and literacy rate
(D) Hospital bed density and physician-to-population ratio

95. The second-long term Health Plan (SLTHP 1997-2017) has defined..... key service interventions under the Essential Health Care Services (EHCS):

(A) 10
(B) 15
(C) 20 ✓
(D) 25

96. UNICEF works for the improvement of:

(A) Elderly
(B) Sick people
(C) Women
(D) Children ✓

97. Which External development partner is supporting on Health system strengthening and social health protection in Sudurpashchim Province?

(A) USAID
(B) JICA
(C) GIZ
(D) SDC ✓

98. What is the core functional area of WHO?

(A) Technical function ✓
(B) Donor function
(C) Logistics function
(D) Monitoring function

99. External development partners in the context of Nepal's health sector refer to:

(A) International agencies, bilateral donors, and multilateral organizations that provide financial and technical support for development programs ✓
(B) Domestic non-governmental organizations working within Nepal
(C) Private hospitals and clinics operating in urban areas
(D) Local community-based organizations

100. Which of the following activities best reflects the principle of country ownership, a key priority emphasized by most international development partners?

(A) Aligning donor-funded interventions with national health policies, government systems, and local priorities ✓
(B) Implementing projects designed entirely by external consultants
(C) Funding vertical programs independently of national health plans to maximize visibility
(D) Requiring parallel procurement and reporting systems for all externally funded projects

सुदूरपश्चिम प्रदेश, जनस्वास्थ्य अधिकृत, सातौँ, २०८३/०५/२४

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