सुदूरपश्चिम प्रदेश, सातौँ, स्वास्थ्य शिक्षा अधिकृत, २०८३/०५/२०

1. The Sudurpashchim Public Procurement Regulation, 2078 regulates that public procurement of health commodities or services must follow principles of: (A) Secretive, closes-door negotiations without bids (B) Giving contracts exclusively to international companies without competition (C) Transparency, competition, fairness and value for money (D) Avoiding any formal written documentation or contracts

2. What is the purpose of maintaining a standing list as per the Procurement Regulation? (A) To blacklist non-compliant suppliers (B) To register & update qualified suppliers, consultants and contractors for procurement opportunities (C) To record procurement grievances (D) To list international procurement agencies

3. Which of the following Act or Regulation must be followed for the acquisition of materials and services at Sudurpashchim Province? (A) Public Procurement Act, 2063 (B) Sudurpashchim Public Procurement Regulation, 2078 (C) Civil Service Act, 2079 (D) Financial Administrative Rules, 2056

4. According to the Local Government Operation Act 2074, how many tiers of local government are defined? (A) Two tiers (B) Three tiers (C) Four tiers (D) Five tiers

5. Which of the following is a respiratory occupational disease caused by inhaling hazardous dusts? (A) Asbestosis (B) Dermatitis (C) Tuberculosis (D) Encephalitis

6. What does the acronym "SWOT" analysis stand for in strategic health planning? (A) System, Worker, Organization, Treatment (B) Strengths, Weaknesses, Opportunities, Threats (C) Sanitation, Water, Order, Technology (D) Strategy, Welfare, Operation, Training

7. The role of Health Education Officer is: (A) Health Promotion and Education (B) Program Planning and Management (C) Community Engagement (D) All of the above

8. What is the correct sequence of the health planning cycle? (A) Implementation – Situation Analysis – Evaluation – Planning (B) Situation Analysis – Planning – Implementation – Monitoring & Evaluation (C) Evaluation – Planning – Implementation - Analysis (D) Planning – Evaluation – Implementation - Analysis

9. Local Governments are primarily responsible for: (A) Basic health service delivery (B) Secondary level care (C) Tertiary level care (D) Both (B) and (C)

10. The primary goal of Nepal's health care delivery system is: (A) To promote private health services (B) To provide free health care to all (C) To ensure equitable access to basic health services (D) To prioritize urban over rural health

11. Who is the head of the Department of Health Services (DoHS) in Nepal? (A) Secretary, Ministry of Health and Population (B) Director General (DG) (C) Health Coordinator (D) Mayor

12. The Female Community Health Volunteer (FCHV) program was launched by the Government of Nepal in: (A) 2045 BS (B) 2040 BS (C) 2030 BS (D) 2050 BS

13. Which of the following is NOT a responsibility of FCHVs? (A) Promoting immunization programs (B) Providing maternal and child health education (C) Prescribing medicines (D) Distributing contraceptives

14. The final step in the planning process is: (A) Setting objectives (B) Evaluating performance (C) Identifying alternatives (D) Implementing the plan

15. What is the full form of HMIS? (A) Health Monitoring and Information System (B) Health Management and Information System (C) Hospital Management and Information System (D) Health Model for Integrated Services

16. Nepal has set a goal to end TB by: (A) 2020 AD (B) 2035 AD (C) 2025 AD (D) 2040 AD

17. What is the vision of the National HIV Strategic Plan (NHSP) 2021-2026? (A) Reducing HIV prevalence by 50% (B) Ending the AIDS epidemic in Nepal by 2030 (C) Achieving universal health coverage for HIV infected persons (D) Virtual elimination of HIV infection by 2040

18. Which of the following approaches is conceptualized as a key strategy of the National Health Education, Information and Communication Centre (NHEICC) in Nepal? (A) Advocacy and Persuasive Communication (B) Social Mobilization and Community Participation (C) Social and Behaviour Change Communication (SBCC) (D) Mass Media Campaigns Only

19. The most common causes of Unintentional Injury death in Nepal: (A) Burns (B) Fire (C) Poisoning (D) Road Traffic Accident

20. At present Five year plan is functional in Nepal: (A) $13^{\text{th}}$ (B) $15^{\text{th}}$ (C) $16^{\text{th}}$ (D) $17^{\text{th}}$

21. Building Healthy Public Policy was one of the key action area: (A) Jakarta Declaration (B) Ottawa Charter (C) Helsinki Declaration (D) Nairobi Declaration

22. A Flip Chart is an example of: (A) Mass Approach (B) Group Approach (C) Individual Approach (D) All of the above

23. Which of the following is an effective medium for mass health education? (A) Pamphlet (B) Flannel Graph (C) Flash Card (D) Flip Chart

24. The most deadly species of malaria parasites is: (A) Plasmodium Vivax (B) Plasmodium Falciparum (C) Plasmodium Malariae (D) Plasmodium Ovale

25. Two way communication is the best achieved through: (A) Radio Broadcast (B) News Paper Articles (C) One-to-One Counseling (D) TV Advertising

26. Fruits are a rich sources of: (A) Glucose (B) Galactose (C) Fructose (D) Sucrose

27. As per School Health & Nursing Service Guideline 2081, which is the criteria for Health Promoting School? (A) School health services (B) National policies & resource allocation (C) Curriculum (D) All of the above

28. Communication skills include all of the following EXCEPT: (A) Active listening (B) Aggressive behaviour (C) Verbal expression (D) Non-verbal cues

29. In which era of modern school health, medical inspection program was launched in schools. (A) Period of recognition (B) Period of integration (C) Period of exploration (D) Period of synthesis

30. Which of the following best describes the concept of essential nutrients? (A) Nutrients that are always required in large amounts (B) Nutrients that the body can not synthesize in sufficient amounts & must obtain from the diet (C) Nutrients that are found exclusively in animal-based foods (D) Nutrients that do not perform essential physiological functions

31. Which is the most appropriate method for analyzing chronic malnutrition among children? (A) Body Mass Index (B) Waist Circumference Test (C) Weight for Height Test (D) Height for Age Test

32. Which of the following is the main source of energy for humans? (A) Carbohydrates (B) Fats (C) Proteins (D) Minerals

33. Which of the following is the first behavioural practice of a school health program in the world? (A) Free tiffin distribution (B) Health check-up by a physician (C) Hygiene education to students (D) Making school gardens for a pleasurable environment

34. The most common micronutrient deficiency in Nepal: (A) Iodine deficiency (B) Iron deficiency (C) Folic acid deficiency (D) Riboflavin deficiency

35. Which of the following is related to teaching health related knowledge, attitudes and practices through the curriculum in a school health program? (A) Health instruction (B) School community cooperation (C) School-site health promotion of teachers (D) Mental health promotion

36. Which of the following is NOT a principle of health promotion? (A) Involvement of multiple sectors (B) Individual behavior changes only (C) Community participation (D) Equity and social justice

37. Which of the following is NOT a core life skill as per WHO? (A) Memorizing and comprehending (B) Decision making and problem solving (C) Communicating and refusal (D) Critical thinking and self-reflecting

38. According to the NDHS 2022, what was the national prevalence of underweight (low weight for age) among children under five years in Nepal? (A) 8% (B) 19% (C) 25% (D) 35%

39. Which component of a school health program primarily aims to improve students' health and nutrition by promoting positive changes in their knowledge, attitudes and behaviors? (A) School health services (B) Health instruction (C) Healthy school environment (D) School community cooperation

40. In nutritional assessment, a child with low weight-for-height is clinically classified as suffering from: (A) Stunting (B) Kwashiorkor (C) Wasting (D) Marasmus

41. The primary mode of transmission for measles is: (A) Direct contact with infected fluid (B) Contaminated food and water (C) Airborne droplets from cough or sneeze (D) Vector borne transmission

42. The commonest agent causing diarrheal disease in infant and children in Nepal: (A) Escherichia coli (B) Salmonella species (C) Shigella species (D) Rota virus

43. The incubation period of Hepatitis "A" Virus is: (A) 5-15 days (B) 15-25 Days (C) 15-50 days (D) 40-80 days

44. Which of the following is NOT a viral-borne disease? (A) Measles (B) AIDS (C) Cholera (D) COVID-19

45. Which of the following is a communicable disease? (A) Arthritis (B) Meningitis (C) Hypertension (D) Dental caries

46. What is the full form of PEN? (A) Personal Education about Nutrition (B) Palliative Effective Nursing care (C) Package of Essential Non-communicable disease (D) Primary Emergency Network

47. Which of the following organs is infected primarily in Amoebiasis or Amoebic dysentery? (A) Stomach (B) Small intestine (C) Large intestine (D) Liver

48. Following increase the risk for coronary heart disease EXCEPT: (A) Oral contraceptives (B) Alcohol abuse (C) High fiber diet (D) Type A personality

49. Which of the following is NOT a modifiable risk factor for Tpye 2 Diabetes? (A) Physical inactivity (B) Family history/genetics (C) Obesity (D) Unhealthy diet

50. Which of the following is a common bacterial cause of food poisoning? (A) Salmonella (B) Plasmodium (C) Mycobacterium tuberculosis (D) Treponema pallidum

51. At what age is the Typhoid Conjugate Vaccine (TCV) administered under Nepal's national immunization schedule? (A) At birth (B) 6 months (C) 9 months (D) 15 months

52. The mode of transmission of AIDS is: (A) Blood contact (B) Sexual contact (C) Mother to child transmission (D) All of the above

53. As a Health Education Officer, which of the following is the most important behavioral change message for preventing dengue in the community? (A) Use mosquito repellant when going outdoors during a dengue outbreak (B) Sleep under insecticide-treated bed nets at night (C) Eliminate stagnant water and adopt measures to prevent mosquito bites during the day and evening (D) Install screens on doors and windows to prevent mosquitoes from entering homes

54. Which vector is biologically responsible for transmitting Kala-azar (Visceral Leishmaniasis) in Nepal? (A) Anopheles mosquito (B) Phlebotomus argentipes (Sandfly) (C) Aedes aegypti mosquito (D) Culex tritaeniorhynchus mosquito

55. What is the most common route of transmission for Hepatitis B? (A) Sexual contact (B) Faecal-oral- route (C) Blood borne transmission (D) Mosquitoes bite

56. What is the fundamental mechanism of the "DOTS" strategy utilized in the National Tuberculosis Control Program? (A) Randomly distributing antibiotics to all citizens (B) Treating only severe cases in ICU settings (C) Relying entirely on surgical intervention (D) Standardized short-course chemotherapy under direct clinical observation to ensure adherence

57. When was the Nepal Health Professional Council (NHPC) established? (A) 1991 AD (B) 1997 AD (C) 2000 AD (D) 2005 AD

58. In the present context of Nepal's federal health structure, which level of government is primarily accountable for managing local EHCS delivery? (A) Federal Government (B) Local Government (C) Provincial Government (D) International Non-governmental Organizations

59. What is a key distinction between PHC and EHCS? (A) PHC is only for urban populations, while EHCS is rural (B) PHC does not include community participation, while EHCS does (C) PHC is a broad guiding philosophy/approach, while EHCS represents a defined operational package of basic services (D) EHCS excludes preventive measures entirely

60. The Health Education Association of Nepal (HEAN) functions primarily as a: (A) Statutory licensing body for Doctors (B) Professional association aimed at advancing health education practices (C) Trade union for government administrative staff (D) Sub-section of the World Health Organization

61. Who carries the ultimate responsibility for maintaining everyday health actions under the EHCS framework at the micro-level? (A) The individual, family and community (B) International donors exclusively (C) Central level hospital directors only (D) The District Coordination Committee members

62. Which historic international declaration formally defined the principles and components of Primary Health Care (PHC) in 1978? (A) Declaration of Geneva (B) Astana Declaration (C) Alma-Ata Declaration (D) Ottawa Charter

63. Universal Health Coverage (UHC) is closely linked with Primary Health Care because both emphasize: (A) Access to essential health services for all people (B) Promotion of curative services through hospitals (C) Promotion of inter-sector collaboration (D) Access to tertiary care services

64. Demographic processes dose not include : (A) Fertility (B) Morbidity (C) Mortality (D) Mobility

65. Which of the following is a major implementation gap frequently identified in analytical reviews of the Essential Health Care Services (EHCS) program in Nepal? (A) Excess availability of human resources at local health facilities (B) Weak referral linkages among community, primary and hospital level health services (C) Over supply of essential medicines across all levels of health facilities (D) Complete absence of a legal framework guaranteeing the right to health

66. Which of the following is considered a core element of the original Alma-Ata PHC framework? (A) Advanced neurosurgery access (B) Space medicine research (C) Robotic surgery training (D) Immunization against major infectious diseases

67. Which of the following best describes the goal of the Health Education Association of Nepal (HEAN)? (A) Improving the health of people through the expansion of primary health care services (B) Improving the health of people through community-based preventive and promotive health services (C) Improving the health and well-being of people through health education approach and behaviour change strategies (D) Improving the health of people through mass screening and active disease surveillance programs

68. Which of the following authorities is providing ethical approval for health research in Nepal? (A) DoHS (B) NHRC (C) NMC (D) TU ERB

69. Which of the following is a modern concept of health? (A) Free from non-communicable diseases (B) Absence of accident (C) Access to health services (D) Dynamic state of well-being

70. Which of the following methods of waste management is applicable the most in an epidemic? (A) Reuse (B) Composting (C) Reduce (D) Incineration

71. Which of the following is an example of vital statistics? (A) BMI (B) Birth rate (C) Blood glucose level (D) CPR

72. Immunization is an example of: (A) Primary prevention (B) Secondary prevention (C) Tertiary prevention (D) Screening

73. According to the traditional humoral theory, which of the following correctly describes the element and qualities associated with phlegm? (A) Fire, Hot & Dry (B) Air, Hot & Wet (C) Water, Cold & Wet (D) Earth, Cold & Dry

74. According to the Nepal Demographic and Health Survey (NDHS) 2022, what was the Total Fertility Rate (TFR) in Nepal? (A) 1.8 children per woman (B) 2.1 children per woman (C) 2.5 children per woman (D) 3.1 children per woman

75. Which of the following is a key characteristic of disease elimination? (A) Disease burden is reduced to zero globally (B) Disease no longer exist in any geographic region or human population (C) Disease transmission has been stopped in a specific region but continue to be monitored & controlled (D) The pathogens is eradicated from both human and animals globally

76. Meningococcal vaccine is not recommended for: (A) Pregnant women (B) Children below 2 years of age (C) Infants (D) All of the above

77. For scrub typhus, interruption of transmission is primarily achieved by controlling which vector? (A) Aedes mosquito (B) Anopheles mosquito (C) Trombiculid mites (D) Sandflyes

78. Which is not a primary air pollutant? (A) $\text{So}_2$ (B) $\text{No}_2$ (C) Ozone (D) Smoke and dust

79. Which of the following Ethical aspects is least possible to maintain while collecting data through interview? (A) Informed consent (B) Provacy (C) Confidentiality (D) Anonymity

80. If a disease is constantly present in a specific geographic population at a baseline level without external input, it is classified as: (A) Epidemic (B) Pandemic (C) Sporadic (D) Endemic

81. Case fatality rate indicates: (A) infectivity of disease (B) Herd immunity of disease in community (C) Killing power of disease (D) Relative importance of disease in community

82. The health spectrum is best described as: (A) A flexible state of health (B) A system for classifying diseases according to their severity (C) A random classification in which a person is either healthy or ill (D) A dynamic continuum between wellness and illness

83. Which of the following is a social problem in Nepal? (A) Shortage of health service (B) Malnutrition (C) Menstrual taboo (D) Rise of non-communicable disease

84. Which of the following best defines "social determinants of health"? (A) Genetic and hereditary factors that predispose individuals to disease (B) The conditions in which people are born, grow, live, work and age shaped by the distribution of money, power and resources (C) Environmental pollution and poor solid waste management (D) Health and treatment services provided by health institutions

85. Which of the following is categorized as a "Biological Determinant" of health? (A) Education status (B) Cultural practices (C) Genetic makeup (D) Political system

86. Which of the following best describes droplet transmission as distinct from airborne transmission? (A) Transmission through pathogens that remain suspended in the air for prolonged periods and travel long distances (B) Transmission through larger respiratory droplets that travel short distances after coughing, sneezing or talking (C) Transmission through direct contact with infected blood or other bodily fluids (D) Transmission through the bite of infected insects or other vectors

87. Which of the following is a physical hazard commonly found in industries? (A) Acid vapors (B) Job stress (C) Viral and bacterial infections (D) Noise and vibration

88. What is the best way of rearing animals to maintain community hygiene? (A) Animals and humans should live together in the same area for the care of animals (B) Feeding animals near the household water resource (C) Allowing animals to roam freely for their health (D) Maintaining animal sheds at a safe distance from human residence

89. Which of the following is an example of a mechanical hazard in a factory? (A) Viral infection due to personal contact (B) Argument leading to violence among people (C) Loose clothing gets caught in the rotating part of a machine (D) Contact with an exposed electrical wire

90. Which of the following water purification methods at the household level is the best for practical measures? (A) Storing in large tanks (B) Chlorination of the water source (C) Solar water disinfection (D) Boiling

91. Which of the following is the First step for solid waste management at the household level? (A) Recycling the waste (B) Dumping the waste in nearby land or water (C) Burning the waste or burying it in the backyard (D) Segregation of waste at the source

92. What is the primary public health objective of excreta disposal management? (A) Interrupt the air borne transmission (B) Interrupt the faecal oral transmission (C) Reduce the noise induced health problems (D) Control the zoonotic transmission

93. Occupational hazards are broadly classified in to physical, chemical, biological, ergonomic and: (A) Psychosocial hazards (B) Financial hazards (C) Political hazards (D) Recreational hazards

94. Which behaviour change approach is most emphasized in community-led total sanitation (CLTS) programs? (A) Subsidy-driven latrine construction (B) Triggering collective disgust/shame to end open defecation (C) Mandatory fines (D) Water tariff increases

95. Which environmental problem contributes most directly to climate change? (A) Greenhouse gas emissions (B) Ozone layer depletion (C) Soil erosion (D) Noise pollution

96. The color code for radioactive waste is: (A) Red (B) Green (C) Black (D) Yellow

97. Which of the following is considered a common ergonomics hazards in work places? (A) Poor posture and repetitive movements (B) Noise exposure (C) Chemical spills (D) Excessive workload

98. Which principle is followed under the National Solid Waste Management Policy for waste disposal fees? (A) Free disposal for all citizens (B) The polluter pays principle (C) Government pays all disposal costs (D) Subsidized disposal for industries

99. In solid waste management, the principle of the "3 Rs" stands for: (A) Remove, Replace, Retain (B) Reduce, Reuse, Recycle (C) Recover, Reheat, Return (D) Regulate, Reconstruct, Remove

100. Which of the following is the main cause of land pollution in terms of biological hazards? (A) Excessive pesticide use in farming (B) Industrial waste (C) Unmanaged household sewage and solid wastes (D) All of the above