QUESTIONNAIRE FOR M.SC NURSING STUDENTS
SECTION – I
SOCIO-DEMOGRAPHIC DATA
- Age
a) 21
– 25 years ( )
b) 26
– 30 years ( )
c) 31
– 35 years ( )
d) 36
-40 years and above ( )
- Religion
a) Hindu
( )
b) Muslim ( )
c) Christian
( )
d) Others
( )
- Occupation
a) Technical
( )
b) Non
Technical ( )
c) Govt.
Employee ( )
d) Daily
Wages ( )
- Educational Qualification
a) Primary
( )
b) Secondary
( )
c) Intermediate ( )
d) Degree ( )
- Family Type
a) Nuclear
Family ( )
b) Extended
Family ( )
c) Joint
Family ( )
d) Others
( )
- Family Income / Month
a) 1000
– 2000/- ( )
b) 2001
– 3000/- ( )
c) 3001
– 4000/- ( )
d) 4001
– 5000/- and above ( )
- Source of Knowledge
a) Television
( )
b) News
paper ( )
c) Computer ( )
d) Magazines ( )
SECTION – II
QUESTIONNAIRE REGARDING KNOWLEDGE ON TOBACCO CHEWING
- What is Tobacco
a) Tobacco
is fresh moist leaf ( )
b) Tobacco
is dried leaf ( )
c) Tobacco
is ripen flavour leaf ( )
d) Tobacco
of perfumed leaf ( )
- Which chemical substance present in Tobacco?
a) Alcohol
( )
b) Nicotin
( )
c) Caffiene
( )
d) Nitrogen
( )
- What is the meaning of Tobacco chewing addiction?
a) State
of being depended on Tobacco chewing ( )
b) State
of being depended on alcohol ( )
c) State
of being depended on drugs ( )
d) State
of being depended on injection ( )
- How many types of Tobacco chewing you know?
a) Smoking
and Tobacco chewing ( )
b) Smokeless
and Tobacco chewing ( )
c) Smokeless
and chewing tobacco ( )
d) Consumption
of alcohol ( )
- How many types of smokeless tobacco you know?
a) Moist
snuff, chewing tobacco ( )
b) Cigarattes
and moist snuff ( )
c) Beedies
and moist snuff ( )
d) Ripe
cigar and moist snuff ( )
- Commonly where the tobacco is available?
a) Medical
shops ( )
b) General
stores ( )
c) Fancy
stores ( )
d) Kirana
shop ( )
- What are the ill effects of tobacco chewing?
a) Increases
health problems ( )
b) Prevention
of disease ( )
c) Development
of immunity ( )
d) Promotes
good health ( )
- What are the body parts mainly effect due to tobacco chewing?
a) Eyes
( )
b) Hair
( )
c) Oral
Cavity ( )
d) Nail
( )
- Which part effect commonly due to tobacco chewing?
a) Skin
Cancer ( )
b) Renal
Cancer ( )
c) Breast
Cancer ( )
d) Oral
Cancer ( )
- What is the commonest site of oral cancer?
a) Mouth
( )
b) Gums ( )
c) Lips
( )
d) Tongue ( )
- What is the risk for oral cancer?
a) Consumption
of Tobacco chewing ( )
b) Alcohol
consumption ( )
c) Drug
abuse ( )
d) Carticosteroids
( )
- Which is the common effect of Tobacco chewing on heart?
a) Prevent
cardiac fortune ( )
b) Maintain
normal heart rate ( )
c) Heart
attack ( )
d) Improve
circulation ( )
- What is the effect of Tobacco chewing on blood vessels?
a) Increase
elasticity of blood vessels ( )
b) Altered
structured of blood vessels ( )
c) Increase
damage of blood vessels ( )
d) Increase
thinness of blood vessels ( )
- What is the effect of Tobacco chewing on GI system?
a) Peptic
ulcer ( )
b) Healthy
peritoneal cavity ( )
c) Improve
digestion ability ( )
d) Increase
digestive enzymes ( )
- What is the withdrawal symptoms of Tobacco chewing?
a) Altered
speech ( )
b) Numbness
of mouth ( )
c) Blurred
speech ( )
d) Bleeding
mouth ( )
- When is withdrawal symptoms are appear?
a) 1-2
weeks after stoppage of chewing ( )
b) 4-5
weeks after stoppage of chewing ( )
c) 5-6
weeks after stoppage of chewing ( )
d) 3-4
weeks after stoppage of chewing ( )
- Which are the main symptoms of Tobacco chewing?
a) Redness
of oral cavity ( )
b) Redness
of nasal cavity ( )
c) Redness
of conjunctiva ( )
d) Redness
of the face ( )
- What is the subjective symptoms of Tobacco chewing?
a) Thickness
of tongue ( )
b) Tasteless
of substance ( )
c) Twitching
of oral cavity ( )
d) Itching
of oral cavity ( )
- What are the clinical manifestations oral cancer?
a) Soreness
in oral cavity ( )
b) Pain
in oral cavity ( )
c) Un
healthy mucous layer in oral cavity ( )
d) Pain
in the neck glands ( )
- How will you manage a case of Tobacco chewing?
a) Taking
a person to hospital ( )
b) By
taking history ( )
c) By
giving health education on oral cancer ( )
d) By
giving personal hygiene ( )
- Who develop more tobacco chewing?
a) Teenagers ( )
b) Young
adult ( )
c) Elderly
( )
d) All
age group ( )
- In which age person will start tobacco chewing?
a) Pre
school ( )
b) School
age ( )
c) Adolescent
( )
d) Old
age ( )
- What is common cause for tobacco chewing?
a) Easy
availability ( )
b) Family
pressure ( )
c) Friends
pressure ( )
d) Time
pass ( )
- What is the effect of tobacco chewing on teeth?
a) Dental
caries, peridental disease ( )
b) Healthy
teeth ( )
c) Shiny
teeth ( )
d) Cool
teeth ( )
- What are the types of smokeless tobacco?
a) Pan
( )
b) Gutka ( )
c) Cigarettes
& Beedies ( )
d) Plug
tobacco ( )
- Who was discoloured tobacco?
a) Madam
Curey ( )
b) Grahambel
( )
c) Christopher
Columbus ( )
d) Robert
Hook ( )
SECTION – Iii
KNOWLEDGE
QUESTIONNAIRE REGARDING PRACTICES OF TOBACCO CHEWING
- Which kind of practices is necessary to prevent tobacco chewing
a) Healthy
life style ( )
b) Unhealthy
life style ( )
c) Mal
practice ( )
d) All
the above ( )
- What are the preventive measures for tobacco chewing?
a) Elderly
males becoming addicted to tobacco chewing ( )
b) Protection
from voluntary exposure to tobacco chewing ( )
c) Health
education chewing cessation programmes ( )
d) Encourage
the tobacco chewing programme ( )
- Which is the best preventive practice of tobacco chewing?
a) Forcing
( )
b) Counselling
and health education ( )
c) Encouraging
( )
d) Discouraging ( )
- What kind of practice are you following while taking tobacco?
a) Chewing
in Pan ( )
b) Chewing
without Pan ( )
c) Chewing
with addition of other ( )
d) All
the above ( )
- When you taking tobacco did you?
a) Swallow
the content ( )
b) Spitting
the content ( )
c) Keep
for long time at check ( )
d) Keep
for long time below tongue ( )
- When will you take more tobacco for chewing?
a) During
morning ( )
b) During
afternoon ( )
c) During
evening ( )
d) Complete
day ( )
- Why will you take tobacco frequently?
a) Time
pass ( )
b) For
pleasure seeking ( )
c) To
enjoy redness of mouth ( )
d) All
the above ( )
- Where will you store tobacco?
a) In
Box ( )
b) In
Purse ( )
c) In
Bag at Hip ( )
d) In
Pocket ( )
- Tobacco consumption will cause off?
a) Increase
health problem ( )
b) Prevention
of disease ( )
c) Development
immunity ( )
d) Promote
of good health ( )
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