NLE Community Health Nursing Reviewer 2026

Answer: B. PD 856

Step 1 — Identify the question focus: which law governs environmental sanitation in the Philippines? Step 2 — Recall that PD 856 is the 'Code on Sanitation of the Philippines,' covering water supply, food establishments, sewage disposal, refuse management, and public places. It is enforced by the DOH and LGU sanitation inspectors. Step 3 — Eliminate distractors: RA 9003 is the Ecological Solid Waste Management Act; RA 9275 is the Clean Water Act; RA 8749 is the Clean Air Act. All are environmental laws but none carries the title 'Code on Sanitation.' Step 4 — Confirm: PD 856 is the correct and complete answer, and it is a high-yield NLE item you must memorize.

Answer: A. Level I — Point source

Step 1 — Key clues: 'protected spring,' 'no distribution system,' '15 households,' '250-meter radius.' Step 2 — Under PD 856, Level I (point source) is defined as a protected well or developed spring WITHOUT a piped distribution system, typically serving up to 15 households within 250 meters. Step 3 — Level II involves a communal faucet system where water is piped to a central faucet shared by households — there is a distribution system. Step 4 — Level III means individual piped connections directly into each household — an advanced waterworks system. Step 5 — Level IV is not an official category under PD 856 and is therefore a distractor. The description matches Level I exactly.

Answer: C. At least 2 minutes

Step 1 — The question asks for the minimum duration of a rolling boil to render water potable at the household level. Step 2 — A 'rolling boil' (vigorous bubbling throughout the water) maintained for at least 2 minutes is the standard recommendation because it destroys bacteria, viruses, and most parasites. Step 3 — 30 seconds and 1 minute are insufficient to guarantee the destruction of all waterborne pathogens, particularly cysts of some parasites. Step 4 — While boiling for 5 minutes is not harmful, it is not the minimum standard taught for the NLE. The correct answer is at least 2 minutes. Step 5 — Note: at altitudes above 2,000 meters, boiling time may be extended because water boils at a lower temperature; however, this detail is secondary for the NLE.

Answer: B. Level II

Step 1 — The question asks you to match 'septic tank connection' to its toilet facility level. Step 2 — Level I toilet facilities are non-water-carriage or minimal-water types: pit latrines, ventilated improved pit (VIP) latrines, pour-flush toilets — they do NOT connect to a septic tank. Step 3 — Level II toilet facilities are those connected to a SEPTIC TANK for primary treatment of sewage. This is the most common type in Philippine urban and peri-urban homes. Step 4 — Level III facilities are water-carriage toilets connected to a SEWERAGE SYSTEM with full treatment — this requires infrastructure beyond a septic tank. Step 5 — Level IV is not an official category. The answer is clearly Level II.

Answer: D. RA 9003 — Ecological Solid Waste Management Act

Step 1 — Identify key terms: 'segregation at source,' 'open dumpsites prohibited,' 'reduce-reuse-recycle' — these are hallmarks of solid waste legislation. Step 2 — RA 9003, the Ecological Solid Waste Management Act of 2000, specifically addresses solid waste: it mandates segregation into biodegradable, non-biodegradable/recyclable, and special/hazardous waste; bans open dumpsites; and promotes the reduce-reuse-recycle hierarchy. Step 3 — RA 8749 (Clean Air Act) addresses air pollution, not solid waste. Step 4 — RA 9275 (Clean Water Act) addresses water quality, not solid waste. Step 5 — PD 1152 is the Philippine Environment Code (general), not specific to solid waste management. RA 9003 is the definitive answer.

Answer: C. Ergonomic hazard

Step 1 — Note the key descriptors: 'back pain,' 'wrist strain,' 'repetitive movements,' 'poorly designed workstation.' Step 2 — Ergonomic hazards arise from the relationship between the worker and the work environment — poor posture, repetitive motion, heavy lifting, and ill-fitting workstations cause musculoskeletal strain. This matches the scenario exactly. Step 3 — Physical hazards involve noise, radiation, extreme temperatures, vibration — not workstation design. Step 4 — Chemical hazards involve exposure to dusts, fumes, solvents, or heavy metals — not physical strain from motion. Step 5 — Psychosocial hazards involve stress, harassment, and workload — they affect mental health, not musculoskeletal injuries. The correct classification is ergonomic hazard.

Answer: C. Last line of defense

Step 1 — The hierarchy of occupational hazard controls lists interventions from MOST to LEAST preferred. Step 2 — The correct order is: (1) Elimination/Substitution — remove or replace the hazard entirely; (2) Engineering controls — ventilation, machine guards, enclosures; (3) Administrative controls — work procedures, job rotation, training, limiting exposure; (4) PPE — respirators, gloves, ear protection. Step 3 — PPE is at the bottom of the hierarchy because it does NOT eliminate or reduce the hazard — it only protects the worker IF worn correctly and consistently. Step 4 — Common misconception: many students think PPE is the first response because it is the most visible. The NLE specifically tests that PPE is the LAST resort. Step 5 — This concept is critical for practice: always try to eliminate or engineer out the hazard before relying on PPE.

Answer: D. Health insurance coverage

Step 1 — Recall the three official components of the school health program in the Philippines. Step 2 — The three components are: (1) Health Services — assessments, screenings, deworming, immunization, first aid, referral; (2) Healthful School Environment — safe water, sanitation, clean canteen, ventilation, safety; (3) Health Education — integration of health lessons, behavior reinforcement. Step 3 — 'Health insurance coverage' is NOT a component of the school health program. Health insurance (PhilHealth) is covered under UHC (RA 11223) and is separate from the school health program structure. Step 4 — This is a classic NLE distractor — it sounds plausible but does not belong. Step 5 — Memorize the three components as a triad: Services + Environment + Education.

Answer: B. Twice a year

Step 1 — The question asks about the frequency of school-based mass deworming under the DOH Integrated Helminth Control Program. Step 2 — Mass deworming of school children is conducted TWICE A YEAR (every 6 months) to control soil-transmitted helminth (STH) infections such as Ascaris, Trichuris, and hookworm. Step 3 — Twice-yearly deworming maintains helminth burden below clinically significant levels, improving nutritional status, cognitive development, and school attendance. Step 4 — Once a year is insufficient to control STH reinfection because eggs in the soil can reinfect children within months. Step 5 — Every three months would be excessive for a national program and is not the standard recommendation. The answer is twice a year.

Answer: C. RA 11058 — OSH Law

Step 1 — The question asks for the law governing Occupational Safety and Health. Step 2 — RA 11058, the Occupational Safety and Health Standards Law, signed in 2018, strengthens employer obligations to ensure a safe workplace, mandates reporting of work-related accidents and diseases, and reinforces worker rights to refuse unsafe work. Step 3 — RA 9173 is the Philippine Nursing Act — it governs nursing practice, not workplace safety. Step 4 — RA 10121 is the DRRM Act — it governs disaster risk reduction and management, not routine occupational health. Step 5 — RA 11223 is the Universal Health Care Act — it broadens health service coverage but is not specific to workplace OSH. RA 11058 is the correct answer.

Answer: C. Municipalities and cities

Step 1 — Understand devolution: RA 7160 transferred the delivery of basic health services from the national DOH to Local Government Units (LGUs). Step 2 — Identify which LGU handles which facility: Municipalities and cities operate RHUs and BHS (primary level), while provinces operate provincial and district hospitals (secondary/tertiary level). Step 3 — Eliminate wrong options: The DOH Central Office no longer directly operates frontline facilities after devolution; CHDs are DOH regional offices that coordinate but do not operate LGU facilities; provinces run hospitals, not RHUs. Step 4 — Conclusion: Municipalities and cities are the correct answer because RHUs and BHS are primary-care facilities, which fall under the jurisdiction of municipal and city LGUs.

Answer: B. USSR (present-day Kazakhstan)

Step 1 — Recall the landmark event: The International Conference on Primary Health Care was held in Alma-Ata (now Almaty), which was in the USSR and is now the city of Almaty in Kazakhstan. Step 2 — Remember the year: 1978. Step 3 — Remember the goal declared at Alma-Ata: 'Health for All by the Year 2000.' Step 4 — Eliminate distractors: The USA, Philippines, and Switzerland were not the venue. The WHO headquarters is in Geneva, Switzerland, which is why students sometimes confuse this. Step 5 — Conclusion: The correct answer is USSR (present-day Kazakhstan).