# Situation: The public health nurse of a Rural Health Unit (RHU) holds a Philippine Package of Essential NCD Interventions (PhilPEN) screening day for noncommunicable diseases (NCDs) at the barangay hall. Barangay health workers (BHWs) help register the residents. The nurse sets up the stations for the screening day. In what order should each resident go through these steps? 1. Measure blood pressure, weight, height, and waist circumference 2. Enter the resident in the NCD registry and set a follow-up date 3. Register the resident and obtain consent 4. Interpret the results and counsel the resident

> source: MyMerci (mymerci.kr)  
> url: https://mymerci.kr/pages/nclex_q.php?qn_id=627019  
> language: ko  
> subject: Nursing Practice I — Community Health Nursing

## 문제

Situation: The public health nurse of a Rural Health Unit (RHU) holds a Philippine Package of Essential NCD Interventions (PhilPEN) screening day for noncommunicable diseases (NCDs) at the barangay hall. Barangay health workers (BHWs) help register the residents.

The nurse sets up the stations for the screening day. In what order should each resident go through these steps?
1. Measure blood pressure, weight, height, and waist circumference
2. Enter the resident in the NCD registry and set a follow-up date
3. Register the resident and obtain consent
4. Interpret the results and counsel the resident

## 보기

1. 1, 3, 4, 2
2. 3, 4, 1, 2
3. 3, 1, 4, 2 **✔ 정답**
4. 3, 1, 2, 4

**정답: 3**

## 해설

A PhilPEN screening follows the flow of the NCD risk assessment: registration and consent, then measurements, then interpretation of the results with counseling for every participant. Clients are then entered in the registry with a follow-up schedule so that those who miss visits can be recalled.

## 심화 해설

The flow of a PhilPEN screening station
A PhilPEN screening day is organized as a sequence of stations that mirrors the NCD risk assessment itself. Each resident should move through four steps in this order: registration and consent, measurements, interpretation of results with counseling, and finally entry in the NCD registry with a follow-up date. The correct sequence is therefore 3, 1, 4, 2. Each step produces what the next step needs, so the order is fixed by logic rather than by convenience.

Why each step depends on the one before
Registration comes first because the nurse must identify the resident, record basic data, and obtain consent before any measurement is taken. Measurements come next: blood pressure, weight, height, and waist circumference, plus blood glucose or cholesterol where available. Only once these values exist can the nurse interpret them, for example by computing body mass index, judging the blood pressure, and estimating total cardiovascular risk, and then counsel the resident on what the results mean. Registry entry closes the flow: the resident's risk level and plan are recorded and a follow-up date is set, so that residents who miss their visit can be traced and recalled.

| Step | Station | What it produces |
| --- | --- | --- |
| 1st | Register and obtain consent | Identity, basic data, permission to assess |
| 2nd | Measure BP, weight, height, waist | Raw values for risk assessment |
| 3rd | Interpret and counsel | Risk level, advice, plan of care |
| 4th | Registry entry and follow-up date | A record that allows recall and tracking |

Where the wrong sequences break
Starting with measurement skips consent and registration, so values would be collected from someone who has not agreed and is not yet recorded. Placing interpretation before measurement asks the nurse to interpret results that do not exist. Placing registry entry before interpretation is the subtler error: the registry entry and follow-up interval depend on the interpreted risk level, so the nurse cannot record a meaningful plan until counseling based on the results has been done. Watch out! Two options begin correctly with registration; the deciding point is whether interpretation and counseling come before the registry entry.

Exam takeaway
Every participant, whatever the result, receives interpretation and counseling before leaving, and every participant is entered in the registry with a follow-up date. The registry is not paperwork for its own sake; it is the tool that turns a single screening day into continuing care, because it lets the RHU and the barangay health workers find and recall clients who default. In sequencing items, ask what each step needs as input; the step that needs nothing comes first, and the step that needs everything comes last.

## 임상 시나리오

PhilPEN Screening Day FlowOrder of stations for each resident
Arrange the stations in the order of the NCD risk assessment: register and obtain consent, take measurements, interpret and counsel, then make the registry entry with a follow-up date.

Measurements include blood pressure, weight, height, and waist circumference. Interpretation turns these values into a risk level, and counseling is given to every participant, not only to those with abnormal results.

The registry entry records the risk level and next visit so that barangay health workers can trace and recall clients who miss follow-up.

CautionDo not enter a resident in the registry before the results are interpreted; the follow-up plan depends on the risk level.

## 핵심 개념

- **NCD risk assessment** — A structured check of blood pressure, body measurements, and lifestyle factors used to estimate a person's risk of noncommunicable disease.
- **Informed consent** — A person's voluntary agreement to a procedure after being told its purpose, steps, and possible results.
- **NCD registry** — A list of clients with or at risk of noncommunicable disease used to schedule follow-up and recall defaulters.
- **Defaulter tracing** — The process of finding and recalling clients who missed scheduled follow-up visits.

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