Public Health Officer (PHO) First And Second Paper Questions For Loksewa Aayog With Answers (2024)

लोक सेवा आयोग

नेपाल स्वास्थ्य सेवा,हेल्थ इन्सपेक्सन समूह, सातौं तह

जनस्वास्थ्य अधिकृत पदको प्रतियोगितात्मक लिखित परीक्षा

समयः१ घण्टा १५ मिनेट

विषयः हेल्थ इन्स्पेक्सन सम्बन्धी ।

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First Paper (100 MCQs×1 = 100 Marks)

1. Regular follow-up of ongoing activities during the implementation phase is described best by:

A. Management

B. Monitoring

C. Budgeting

D. Evaluation

2. What is the most common cause of blindness in Nepal?

A. Trauma

B. Cataract

C. Glaucoma

D. Infection

3. Any numerical value computed from population is called:

A. Statistics

B. Sampling error

C. Error

D. Parameter

4. Epidemiological study does not consist of:

A. Case control study

B. Cohort study

C. Outbreak investigation

D. Immunological study

5. Prevalence is:

A. Rate

B. Ratio

C. Proportion

D. Average

6. DoHS (Department of Health Services) revealed that the sale of antihypertensive drugs was more in those states where death due to hypertension were more. This association may prove wrong when the individual based study designs are conducted. This association may prove wrong when the individual based study designs are conducted. This association is an example of:

A. Atomistic fallacy

B. Ecological fallacy

C. Indirect association

D. Specific association

7. In an outbreak of COVID-19 in a village of 20000 populations 200 cases have occurred and 50 die. Case fatality rate is:

A. 0.25%

B. 1%

C. 25%

D. 50%

Explanation: Case fatality rate represents the killing power of a disease. It is simply the ratio of deaths to cases.

CFR = no.ofdeathsduetoadiseaseno.ofcasesofthesamedisease×100

8. Which of the following method is used project district population?

A. Component method

B. Mathematical method

C. Ratio method

D. Regression method

9. In which of the following circ*mstances will the prevalence of a disease in the population increase, all else being constant?

A. If the incidence rate of disease falls.

B. If survival time with the disease increases

C. If recovery of the disease is faster

D. If the population in which the disease is measured increases.

10. Among 182751 deaths are estimated in Nepal for the year 2017, which is the leading cause of death?


B. Diarrhoea

C. Lower respiratory illness

D. Intracerebral hemorrhage

Explanation: A total of 182,751 deaths are estimated in Nepal for the year 2017. Non-communicable diseases (NCDs) are the leading causes of death – two thirds (66%) of deaths are due to NCDs, with an additional 9% due to injuries. The remaining 25% are due to communicable, maternal, neonatal, and nutritional (CMNN) diseases. Ischemic heart disease (16.4% of total deaths), chronic obstructive pulmonary disease (COPD) (9.8% of total deaths), diarrheal diseases (5.6% of total deaths), lower respiratory infections (5.1% of total deaths), and intracerebral hemorrhage (3.8% of total deaths), were the top five causes of death in 2017.

11. Which of the following is determined by calculating deaths after 24 hours of hospital admission?

A. Gross death rate

B. Net death rate

C. On-the-spot death rate

D. Random death rate

12. The percent of the total variation of the dependent variable XX measured by:

A. Cofficient of correlation

B. Cofficient of determination

C. Coefficient of skewness

D. Standard error estimate

13. Best way to study the relationship between two variables is:

A. Bar chart

B. Scatter diagram

C. Histogram

D. Pie-chart

14. If 'time' is used as the independent variable in a simple linear regression analysis, then which of the following assumption could be violated?

A. Successive observations of the dependent variables are uncorrelated.

B. The residual variation is the same for all fitted values of Y.

C. The residuals are normally distributed.

D. There is a linear relationship between the independent and dependent variables.

15. Constant presence of disease in an area during a period of time is:

A. Endemic

B. Epidemic

C. Pandemic

D. Sporadic

16. The median of the following data is 2, 4, 6, 8, 10, 12, 14, 16:

A. 7

B. 8

C. 9

D. 10


Median (Md) = Size of n+12\frac{n + 1}{2}2n+1th item.If nnis even, take the arithmetic mean of the two middle values.

Median (Md) = 8+12\frac{8 + 1}{2}28+1

= 4.5th item

= 8+102\frac{8 + 10}{2}28+10

= 9

17. Population pyramids are useful to:

A. Express the population growth rates

B. Express the age-sex distribution

C. Indicate the birth rates

D. Indicate the death rates

18. All of the following are an indicator of mortality EXCEPT:

A. Case fatality rate

B. Neonatal mortality rate

C. Doctor population ratio

D. Infant mortality rates

19. In fourth stage of the demographic cycle the population will be:

A. Declining

B. Low stationary

C. High stationary

D. Early expanding

20. Dependency ratio includes

A. 0-5 years age

B. 6-64 years age

C. 15-45 years age

D. >65 years


Total dependency ratio =


21. When total number of live births are expressed against the total population at a given place and during given period are referring to:

A. Crude birth rate

B. Specific birth rate

C. Total fertility rate

D. General fertility rate


CBR = No.oflivebirthsinayearMid-yearpopulationofthatyear×1000\frac{\text{No. of live births in a year}}{\text{Mid-year population of that year}} \times 1000

22. Treatment duration for Multi-bacillary Leprosy is:

A. 12 months

B. 18 months

C. 24 months

D. 5 years

23. Which one is not transmitted by droplet nuclei?

A. Measles

B. Chicken pox

C. Influenza

D. Anthrax

24. The 'MDA' terminology used in filariasis control means:

A. Minimum drug administration

B. Maximum drug acqustion

C. Mass delivery assessment

D. Mass drug administration

25. All of the following diseases are eliminated from Nepal EXCEPT:

A. Leprosy

B. Trachoma

C. Neonatal tetanus

D. Lymphatic filariasis

26. Which organ is involved by trochoma disease?

A. Brain

B. Eye

C. Heart

D. Stomach

27. The biggest single determinant of HIV transmission to the infant is:

A. Mother's age

B. Mother's viral load

C. Mother's immune status

D. Infant's CD4+ level

28. Which of the following infectious diseases is called elephantiasis?

A. Filariasis

B. Malaria

C. Schistosomiasis

D. Trichuriasis

29. Man is intermediate host for:

A. Malaria

B. Tuberculosis

C. Filariasis

D. Relapsing fever

Explanation: The malaria parasite undergoes 2 cycles of development - the human cycle (asexual cycle) and the mosquito cycle (sexual cycle). Man is the intermediate host and mosquito the definitive host.

30. The most common type of cancer in males is:

A. Lung

B. Stomach

C. Colon

D. Prostate

31. Best indicator for malaria in community is:

A. Infant parasite rate

B. Spleen rate

C. Annual parasite infestation

D. New cases in the community

Explanation: Infant Parasite Rate: Percentage of infants showing malarial parasite in their blood flims. It is the most sensitive index of recent transmission of malaria in a locality.

32. Incubation period of mumps is:

A. 14 days B. 18 days

C. 20 days D. 24 days

33. Government of Nepal has taken vision of making malaria free by:

A. 2020 AD

B. 2025 AD

C. 2030 AD

D. 2035 AD

34. Which of the following predisposes someone to developing an illness?

A. Fluoride

B. Genes

C. Mercury

D. Toxin

35. Which if the first illness that was attributed to an animal carrier?

A. Rabies

B. Malaria

C. Chicken pox


36. Typhoid Mary is classical example of a……….

A. Clinical case

B. Latent case

C. Healthy carrier

D. Incubatory carrier

37. A student of nursery class developed mild fever along with irritating cough and gradually becoming paroxysmal along with characteristic whoop. What you suggest how long the student should be isolated from class?

A. 1 week

B. 2 week

C. 3 week

D. 4 week

38. Which of the following is true about influenza?

A. Affects all ages and sexes

B. Incubation period is 18-72 hours

C. Pandemic rare

D. No animal reservoir


  • It may occur in pandemics every 10- 40 years due to major antigenic changes, as occurred in 1918 (Spanish influenza), 1957 (Asian influenza) and 1968 (Hong Kong influenza). So pandemic common.
  • Incubation period: 18 to 72 hours.
  • Influenza affects all ages and both sexes. In general, the attack rate is lower among adults.
  • Children constitute an important link in the transmission chain. The highest mortality rate during an epidemic occurs among certain high-risk groups in the population such as old people (generally over 65 years of age), children under 18 months, and persons with diabetes or chronic heart disease, kidney and respiratory ailments
  • It has become increasingly evident that a major reservoir of influenza virus exists in animals and birds. Many influenza viruses have been isolated from a wide variety of animals and birds (e.g., swine, horses, dogs, cats, domestic poultry, wild birds, etc).
  • Both A and B are correct. We go with B as it is one liner. Readers are advised to go more through literature.

39. Japanese encephalitis is transmitted by

A. Culex

B. Aedes

C. Mansonia

D. Anopheles

40. Leprosy can be transmitted through all EXCEPT:

A. Mother to child

B. Breast milk

C. Insect vector

D. None of the above

41. Three doses of tetanus vaccine provides immunity for:

A. 1 year

B. 4 years

C. 10 years

D. 16 years

Explanation: Tetanus toxoid immunization schedule for routine immunization of pregnant women.

Dose of TT or TD

When to give

Expected duration of protection


At first contact or as early as possible in pregnancy



At least 4 weeks after TT 1

1 to 3 years


At least 6 months after TT 2 or during subsequent pregnancy

At least 5 years


At least 1 year after TT 3 or during subsequent pregnancy

At least 10 years


At least 1 year after TT 4 or during subsequent pregnancy

For all childbearing years and possibly longer

42. A child is said to be wasted, if malnutrition is:

A. Acutely developed

B. Developed as chronic malnutrition

C. Developed due to low birth weight

D. Associated with maternal malnutrition

Explanation: If chronically then stunted and if acutely then wasted.

43. Iodine deficiency:

A. Is unlikely to be seen in mountainous area

B. Can result in permanent mental retardation

C. Occurs especially in areas close to sea

D. Only results from the lack of iodine in drinking water.

44. Which of the following has the highest caloric value?

A. Carbohydrates

B. Fats

C. Proteins

D. Vitamins

45. Which of these is not considered nutrient?

A. Fats

B. Fibers

C. Minerals

D. Vitamins

46. Foods from meat, poultry, fish dry beans, eggs and nuts group are an important source of:

A. Beta carotene

B. Calcium

C. Fiber

D. Iron

47. Major source of air pollution in Nepal is:

A. Burning wood

B. Industries

C. Automobiles

D. Gas stove

48. In a rural community, there is high prevalence of typhoid cases. The best method of preventing this health problem in long run is:

A. Immunization against typhoid

B. Living in fly proof home

C. Provision of sanitary latrine

D. Use of boiled water

49. Which type of mosquito breed on dirty water collection?

A. Anopheles

B. Culex

C. Aedes

D. Mansoni

50. All are examples of water borne diseases EXCEPT:

A. Leptospirosis

B. Fish Tapeworm

C. Schistosomiasis

D. Brucellosis

51. Following are the waterborne diseases EXCEPT:

A. Poliomyelitis

B. Giardiasis

C. Kala azar

D. Round worm

52. Egronomics is:

A. Study of human behaviour

B. Study of social mobility

C. Study of health of female workers

D. Adjusting the workers to his/her job

53. All of the following are associated with Asbestosis EXCEPT:

A. Mesothelioma of pleura

B. Cancer of urinary bladder

C. Cancer of lungs

D. Cancer of gastrointestinal tact

54. The most common source of radiation hazard is:

A. X-ray

B. Cosmic ray

C. Thorium

D. Uranium

55. Which of the following color is used for radiation hazard?

A. Orange

B. Red

C. Purple

D. Green

56. Which of the following is associated with bladder cancer?

A. Mushroom poisoning

B. Polyvinyl chloride

C. Naphthalamine dye

D. None of the above

57. The most common manifestation of occupational disease is:

A. Cancer

B. Bronchitis

C. Abdominal pain

D. Dermatitis

58. Suppose a group of 6 experts discussing and interacting about a topic in front of large audience. Then it is known as:

A. Seminar

B. Symposium

C. Panel discussion

D. Workshop

59. All of the following should be the effective communication through lecture method EXCEPT:

A. Group size should be less than 30

B. Talk duration should be less than 15-30 minutes

C. Combine with demonstration

D. Control the listener strictly

60. All of the following are objective of health promotion EXCEPT:

A. To enable people to gain greater control over the determinants of their health

B. To advocate people for their health as major resource for their all round development

C. To encourage people for their positive health

D. To medicate non concerned health sector for raising health status of people.

61. All of the following is the key strategy of Ottawa charter for health promotion EXCEPT:

A. Building healthy public policy

B. Promote social responsibility

C. Strengthen community action

D. Create supportive environment

62. The process of preparing message for health education communication by the health educator is called:

A. Sending

B. Receiving

C. Encoding

D. Decoding

63. Diarrhea among children is more common in urban slum where almost all mothers are illiterate and belong to lower socio economic class. It seems difficult to make them understand that use of ORS (Oral Rehydration Solution). What method can provide the best solution in that scenario?

A. Lectures

B. Poster competition

C. Radio program

D. Role play

64. All health education medias are mass or group medias EXCEPT:

A. Pamplet

B. Radio

C. Poster

D. Television

65. Distortion of message means

A. Twisting of message

B. Loss of clarity

C. Loss of certainty

D. All of the above

66. Which is not projected aids of health education?

A. Transparencies

B. Epidiascope

C. Picture

D. Silhoutte slide

67. To teach preparation of Oral Rehydration Solution (ORS) to the family, which is the most suitable method?

A. Lecture

B. Exhibition

C. Role playing

D. Demonstration

68. All of the following are the Millennium Development Goals EXCEPT:

A. Achieve universal primary education

B. Promote gender equality and empower women

C. Eradicate extreme poverty and hunger

D. Combat the con communicable disease like cancer

69. All of the following are the objectives fixed in the result frame work regarding to the EHCS, EXCEPT:

A. To increase access to and utilization of quality of EHCS

B. To improve the health system to achieve universal coverage of EHCS.

C. To reduce cultural and economic barrriers to access health care services.

D. To manage PHC services to urban people.

70. To improve the health condition of nation "The Millennium Development Goals" (MDGs) are mainly focused on:

A. Involvement of men in RH

B. Women education

C. Health system research

D. Fertility regulation

71. "Reduce the burden of tuberculosis, malaria and HIV" is stated in the Millennium Development Goals (MDGs) as goal number

A. 2

B. 4

C. 6

D. 8

72. Free health care program was launched in the year:

A. 1991 AD

B. 2002 AD

C. 2009 AD

D. 2015 AD

73. USAID is helping in all of the following area EXCEPT:

A. Family planning


C. Infectious disease control

D. Non infectious disease

74. The total number of members represented in UN General Assembly is:

A. 190

B. 193

C. 196

D. 199

75. Which of the following agency is bilateral?





Explanation: WHO, UNICEF and UNDP are multilateral organizations.

76. Burden of disease is best detected by:


B. Sullivan's index


D. Survival index

Explanation: Disability-adjusted life years (DALY): DALY is a measure of overall disease burden, expressed as a number of years lost due to ill-health, disability or early death.

77. One DALY signifies

A. One year of disease free life

B. One lost year of healthy life

C. One month of bedridden life

D. None of the above

78. Susceptibility of a host is ability to:

A. Fight against the agent before occurrence of disease

B. Fight against the disease after occurrence

C. Develop resistance against the disease

D. Develop the disease

79. Which United Nation body deals with population problem?





80. Which of the following is primary preventing obesity?

A. Low intake of salt

B. Low fiber diet

C. High fiber diet

D. High intake of protein

81. All of the following are the areas of quality services EXCEPT:

A. Effectiveness

B. Technical competence

C. Safety

D. Choice in illnesses

82. Audit of costs and services of all the bills of health care providers is classified on:

A. Wellness review

B. Utilization review

C. Profitability review

D. Productivity review

83. All of the following are quality characteristics of a leader EXCEPT:

A. Decisiveness

B. Self confidence

C. Problem solving skill

D. Legal advisor

84. Changes in demand for health care can be caused by changes in all EXCEPT:

A. Consumer income

B. The prices of services in hospital, clinic, nursing home

C. Consumer expectations

D. Degree of service providers

85. Most comprehensive indicator of cost effective analysis is:

A. No. of life gained

B. No. of attacks avoided

C. QALYs gained

D. Cost per life year gained

86. The benefits associated with the best alternatives use of resource is called:

A. Health economics B. Health resources

C. Opportunity cost D. Alternative activities

87. Which of the following is the process of developing and maintaining a strategic fit between the organization's goals and capabilities and its changing marketing opportunities?

A. Strategic control

B. Strategic networking

C. Strategic planning

D. Strategic development

88. All of the following are the strengths of the Logistic Management Information Systems (LMIS) EXCEPT:

A. Maintaining hardly the quality of drugs and commodities

B. A nationwide LMIS producing reliable logistic data for decision making at all levels

C. Improvement is storage practices, thus reducing the waste and expiry commidies

D. LMIS made possible and successful introduction of the pull system for essential drugs

89. Benefits associated with best alternative use of resources is defined as:

A. Opportunity cost

B. Alternative activities

C. Resource needs

D. Health economics

90. Strategic plan usually covers

A. Long term (5 years)

B. Midterm (2-3 years)

C. Short term (1-2 years)

D. None of the above

91. The PERT chart helps in which of the following?

A. Budgeting

B. Scheduling

C. Evaluating

D. None of the above

92. In the health planning cycle, which is not included?

A. Situation analysis

B. Problem identification

C. Distribution of resources

D. Priotization of problems

93. Latest National HIV strategic plan has been developed for a period of which year?

A. 2015-20 AD

B. 2016-21 AD

C. 2016-20 AD

D. 2017-21 AD

94. According to WHO, health sector budget must be at least what percentage of the country's total budget?

A. 3%

B. 5%

C. 6 %

D. 10%

95. Which of the following agencies focuses on poverty reduction and the improvement of living standard worldwide?

A. World Bank

B. International Labour Organization

C. World Health Organization

D. International Organization of Migration

96. Key characteristic of quality health care are:

A. Effectiveness, Efficiency, Acceptability and Equity

B. Acceptability, affordability, sensitivity and responsibility

C. Effectiveness, responsiveness, availability and responsibility

D. Effectiveness, validity, efficiency, availability

97. CIPP evaluation scheme stands for ………

A. Context-Input-Priority-Product

B. Context-Input-Process-product

C. Context-Input-Premises-Priority

D. Content-Input-Practicability-Premises

98. All are included in the planning spiral EXCEPT:

A. Need assessment

B. Implantation

C. Financing

D. Evaluation

99. What do you mean by inventory management?

A. General management

B. Personal management

C. Materials management

D. Financial Management

100. Cost of product failure, error prevention and appraisals are classified as:

A. Shrinkage cost

B. Stocking cost

C. Cost of quality

D. Stockout costs


1.B. Monitoring

2.B. Cataract

3.D. Parameter

4.D. Immunological study

5.C. Proportion

6.B.Ecological fallacy

7.C. 25%

8.A. Component method

9.B. If survival time with the disease increases


11.B. Net death rate

12.D. Standard error estimate

13.B. Scatter diagram

14.A. Successive observations of the dependent variables are uncorrelated.

15A. Endemic

16.C. 9

17.B. Express the age-sex distribution

18.C. Doctor population ratio

19.B. Low stationary

20.D. >65 years

21.A. Crude birth rate

22.A. 12 months

23.D. Anthrax

24.D. Mass drug administration

25.D. Lymphatic filariasis

26.B. Eye

27.B. Mother's viral load

28.A. Filariasis

29.A. Malaria


31.A. Infant parasite rate

32.B. 18 days

33.B. 2025 AD

34.B. Genes

35.A. Rabies

36.C. Healthy carrier

37.C. 3 week

38.B. Incubation period is 18-72 hours


40.A. Mother to child

41.C. 10 years

42.A. Acutely developed

43.B. Can result in permanent mental retardation

44.B. Fats

45.B. Fibers

46.D. Iron

47.C. Automobiles

48.C. Provision of sanitary latrine

49.B. Culex

50.D. Brucellosis

51.C.Kala azar

52.D.Adjusting the workers to his/her job

53.B.Cancer of urinary bladder



56.C.Naphthalamine dye


58.C. Panel discussion

59.D. Control the listener strictly

60.D.To medicate non concerned health sector for raising health status of people.

61.B. Promote social responsibility

62.C. Encoding

63.D. Role play

64.C. Poster

65.D. All of the above

66.C. Picture

67.D. Demonstration

68.D. Combat the con communicable disease like cancer

69.D. To manage PHC services to urban people.

70.B. Women education

71.C. 6

72.C. 2009 AD

73.D. Non infectious disease

74.B. 193


76.A. DALYs

77.B. One lost year of healthy life

78.D. Develop the disease


80.C. High fiber diet

81.D. Choice in illnesses

82.B. Utilization review

83.D.Legal advisor

84.D. Degree of service providers

85.C. QALYs gained

86.C. Opportunity cost

87.C. Strategic planning

88.A.Maintaining hardly the quality of drugs and commodities

89.A. Opportunity cost

90.A. Long term (5 years)

91.B. Scheduling

92.C. Distribution of resources

93.B.2016-21 AD

94.D. 10%

95.A.World Bank

96.A.Effectiveness, Efficiency, Acceptibility and Equity

97.B. Context-Input-Process-product

98.C. Financing

99.C. Materials management

100. C. Cost of quality

Second Paper Subjective Questions

Section 'A'

  1. What do you mean by national health policy? Describe briefly the areas addressed by National Health Policy 1991 and the national policy 2015. (2+8=10)
  2. Explain in role of Nepal Health Professional Council (NHPC) in improving the quality of health services in Nepal. (10)
  3. What do you mean by decentralization? What is the role of local government's in effective health services delivery? Describe in the present context. (10)

    Section 'B'

  4. Critically analyze the performance and status of primary health care out-reach clinic (PHC- ORC) in remote rural setting of Nepal. What are the major challenges and how could they challenges be overcome? (5+5=10)
  5. What is a Logistic Management Information System (LMIS)? How this information system contributes to dynamics of overall health care system? Explain. (10)
  6. Describe the Tuberculosis National health program and critically review the current status of this program. (10)

    Section 'C'

  7. What are the major nutritional disorders among the under five children in Nepal? Describe in brief that the difference efforts being launched to correct those disorders by the Government of Nepal. How could the problem of overnutrition be overcome?(3+3+4-10)
  8. Explain the different types of training needed to organize in a district to manage the district health programs smoothly. (10)

    Section 'E'

  9. Critically analyze the existing HRH planning in the National Health System of Nepal. How could the restructuring of HRH be done to address the transit to federalism in Nepal? (5+5=10)
  10. What is supervision? how supervision can be differentiate with monitoring? Describe the role of supervision in improving health care system in a country? (2+4+4=10)

    (Source: Loksewa Aaayog Past Question 2077)

By Shisir Kumar Adhikari

Public Health Officer (PHO) First And Second Paper Questions For Loksewa Aayog With Answers (2024)
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