Community Health Nursing
Long Quiz
IMCI
1. The world health organization is concerned of the unnecessary deaths of children below
5 years old in the developing countries. Integrated management for childhood illness is
trying to fight these unnecessary deaths. according to WHO, the most common cause of
death among these under 5 children is:
a. Diarrhea c. Malaria
b. Pneumonia D. Malnutrition
2. If the child has only one of the danger sign implicitly stated in the IMCI guideline, this child
will be classified under what color?
a. Pink c. Yellow
b. Blue d. Green
3. Which vital sign is important in classifying a child with pneumonia from those who do not
have?
a. Temperature c. Chest in-drawing
b. Respiratory rate d. Stridor
4. Which of the following is not a danger sign?
a. Convulsion c. Lethargy/ unconsciousness
b. Inability to drink or breastfeed d. Difficulty of breathing
5. In home management of a child with pneumonia, caretaker is counseled on how not to:
a. Give oral drugs c. When to return
b. Treat local infection at home d. Discontinue feeding
6. If pneumonia is present with major signs and symptoms, treatment will include:
a. Cotrimoxazole P.O. BID c. ORS 240cc/ loose stool
b. Amoxicyllin P.O. BID d. Procaine Penicillin IM OD
7. What is the dose and schedule of amoxicillin (250 mg tablet) for a 5-week-old infant who
weighs 3.5 kilograms and has local bacterial infection:
a. ¼ tablet – 2 times a day – for 5 days
b. ½ tablet – 3 times a day – for 5 days
c. 1 teaspoon of syrup – 5 times a day – for 2 days
d. 5 ml of syrup – 3 times a day – for 3 days
8. What is a child’s classification if he is 10 months old, has had a cough that lasted two
days, has a breathing rate of 46 breaths per minute and chest in-drawing?
a. no pneumonia: cough or cold
b. pneumonia
c. severe pneumonia or very severe disease
d. very severe febrile disease
9. What are the four main symptoms for which every sick child should be checked?:
a.
b. anaemia
c. Cough, diarrhoea, malnutrition, ear problem
d. cough, diarrhea, fever, ear problem
10. Approximately 70% of all childhood deaths are associated with one or more of 5
conditions. Three of these conditions are diarrhea, measles and malnutrition. The other
two are: (2pts)
a. Acute respiratory infections, primarily pneumonia
b. malaria
c. Tuberculosis
d. HIV&AIDS
e. diabetes
11. A 3-year-old child has fever and diarrhea. He has no danger signs and he does not have
a cough or difficult breathing. The child has had diarrhea for 2 weeks and there is no blood
in stool. The child is restless and irritable, but is not drinking eagerly. His eyes are not
sunken. A skin pinch goes back slowly. He does not have an ear problem. The child’s
diarrhea should be classified as: (2pts)
a. no dehydration
b. some dehydration
c. severe dehydration
d. severe persistent diarrhea
e. persistent diarrhoea
f. dysentery
12. The IMCI clinical guidelines are designed for use with certain age groups. One group is 2
months up to 5 years. What is the other age group?
a. birth up to 5 years d. 2 months up to 9 years
b. birth up to 2 months e. 6 months up to 10 years
c. 2 months up to 1 year
13. A 2-year-old child has had diarrhea for several days. He is not dehydrated, but the mother
is alarmed because she saw blood in his stool this morning. Your treatment includes:
a. start antibiotic for dysentery and ORS in the clinic, re-assess in 4 hours, give the
mother ORS to continue at home, advise on feeding and fluids, zinc supplement
and tell her to return in 5 days
b. start antibiotic for cholera , advise on feeding and fluids and send home
c. start antibiotic for dysentery, give antibiotic to take home, advise on feeding and
fluids, zinc supplement, and tell her to return in 2 days
d. start antibiotic for cholera, give vitamin A, give antibiotic to take home, advise on
feeding and fluids and tell her to return in 3 days
14. 8) Feeding should be assessed in a child who: (3pts)
a. need urgent referral
b. is less than 2 years old
c. is classified as having anemia, very low weight and or growth faltering
d. is classified as having persistent diarrhea
15. 9) When a mother is advised to return to a health worker for her child, it is necessary to
tell her when to return for a follow-up visit and when to return immediately. When to return
for a follow-up visit depends on the child’s classification; for example, in case of acute ear
infection child needs to return in 5 days. The mother needs to return to the clinic
immediately if her child: (3pts)
a. is drinking eagerly d. is coughing often
b. is not able to drink or breastfeed e. has blood in stool
c. develops fever f. becomes sicker
16. For each of the following cases, select Yes, if urgent referral is needed or select No, if
urgent referral is not needed. (4pts)
a. A 6-month-old boy does not have general danger signs. He is classified with:
MASTOIDITIS, NO ANEMIA, NOT VERY LOW WEIGHT.
Does he need an urgent referral? ____Yes _____No
b. A 7-month-old girl does not have general danger signs. She is classified with: NO
PNEUMONIA: COUGH OR COLD, NO DEHYDRATION, PERSISTENT
DIARRHOEA, NO ANEMIA, NOT VERY LOW WEIGHT.
Does she need an urgent referral? _____Yes_____ No
c. A 9-month-old boy is lethargic. He is classified with: SEVERE DEHYDRATION,
NO ANEMIA, NOT VERY LOW WEIGHT. Your clinic can give IV fluids.
Does he need an urgent referral? _____Yes_____ No
d. A 2-year-old girl does not have general danger signs. She is classified with:
SEVERE DEHYDRATION, SEVERE MALNUTRITION, and SEVERE ANEMIA
Your clinic can give IV fluids.
Does she need an urgent referral? _____Yes _____ No
17. If a child has had ear pain and pus draining from the ear for 10 days, and no tender swelling
behind the ear, you will classify this child as having:
a. acute ear infection c. mastoiditis
b. chronic ear infection d. not enough signs to classify this child
18. If a child has any of the five general danger signs, you should urgently refer him to hospital
for treatment, These signs are: (5pts)
a. not able to drink or breastfeed d. vomiting everything
b. severe cough e. lethargic or unconsciousness
c. convulsions during this illness f. convulsing now
19. If a child less than 5 years of age and did not receive immunization for DPT-HB as
recommended, it is necessary to:
a. increase the dose of the vaccine prescribed for that age
b. not immunize at all – because it is too late
c. immunize the child any time, and give the remaining doses 4 weeks apart
20. A follow-up visit in 5 days should take place if a child is classified as having which of the
following condition(s): (3pts)
a. pneumonia e. very low weight-for-age and or growth faltering
b. measles f. feeding problem
c. persistent diarrhea g. acute ear infection
d. pallor
21. To be classified as having MASTOIDITIS a child must have the following signs:
a. a) severe ear pain d. pus draining from both ears
b. b) redness behind the ear e. tender swelling behind the ear
c. c) pus draining from one of the ears
22. To be classified as having JAUNDICE a young infant must have the following signs:
a. yellow palms and soles if age is more than 24 hours
b. only yellow eyes and skin if age is more than 24 hours
c. Any jaundice if age less than 24 hours
d. pus draining from the eyes
e. no signs suggesting jaundice
23. What is the cut-off rate for fast breathing in a child who is 11 months old?
a. 60 breaths per minute or more c. 40 breaths per minute or more
b. 50 breaths per minute or more d. 30 breaths per minute or more
24. A 14-month-old child with cough is brought to an outpatient clinic. You will assess this
child for: ( 4pts)
a. general danger signs
b. common main symptoms such as cough or difficult breathing, diarrhoea, fever and
ear problems
c. trauma
d. malnutrition and anemia
e. immunization status
f. developmental milestones
25. Choose the three best questions for checking the mother’s understanding about how to
give an antibiotic: (2pts)
a. How will you give the antibiotic?
b. Will you give the antibiotic three times per day?
c. For how many days will you give antibiotic?
d. Do you understand how to give the antibiotic?
26. According to IMCI, a mother of a sick child should be counselled about what topics: (4pts)
a. importance of the fluids and feeding
b. why she needs to come to clinic
c. when to immediately return to clinic
d. food and feeding problems
e. her own health
f. immunization
g. when to return for a follow-up visit
27. Complimentary foods should be started if the child:
a. shows interest in semisolid foods
b. does not show interest in semisolid foods
c. appears hungry after breastfeeding
d. does not appear hungry after breastfeeding
e. is not gaining weight adequately
f. is six months old
28. If a child has measles now or has had it within the last three months, and has fever and
any general danger sign, he or she will be classified as having: (2pts)
a. Uncomplicated malaria
b. severe complicated measles
c. very severe febrile disease or severe malaria
d. measles with eye or mouth complication
29. What are two signs that are used to classify severe malnutrition? (2pts)
a. small arm circumference d. severe dehydration
b. visible severe wasting e. growth faltering
c. edema of both feet
30. To classify the dehydration status of young infant with diarrhea you will look: (3pts)
a. at the general condition of the child (does the infant move when stimulated or does
not move even when stimulated, restless and irritable)
b. for sunken eyes
c. for edema of both feet
d. if the young infant is drinking eagerly or poorly
e. for visible severe wasting
f. for a swollen abdomen
31. A boy is 13 months old. He weighs 8 kg. His temperature is 37ºC. His mother says he has
had a dry cough for the last 3 weeks. He does not have any general danger signs. The
breathing rate is 41 breaths per minute. There is no chest in-drawing. You can hear
wheezing noise when the child breathes out. There is no stridor when he is calm. The
breathing per minute remained 41 after 3 cycles trial of an inhaled bronchodilator. There
is no diarrhea, fever or ear problem. He does not have visible severe wasting, there is no
edema of both feet and no growth faltering. His palms are very pale and appear almost
white. The child should be classified as having: (2pts)
a. pneumonia with wheezing
b. severe anemia
c. no pneumonia: cough or cold and wheezing
d. severe pneumonia with wheezing or very severe disease
e. anemia, very low weight and or growth faltering
32. Where can the IMCI case management guidelines be used?
a. in the inpatient ward of a hospital
b. in a neonatal ward e) at the house hold level
c. in the outpatient ward of a hospital
d. at first-level health facilities
33. Which should be checked for malnutrition and anaemia?
a. only children with feeding problems
b. only children who are younger than 12 months old
c. all children brought to the clinic
d. only children who are not breastfed
e. only children with diarrhea
f. only children with malaria
34. What is the dose and schedule of cotrimoxazole for a 2-year-old child who weighs 12
kilograms and is classified as having pneumonia?
a. 1 adult tablet – 2 times a day – for 5 days
b. 1 paediatric tablet – 3 times a day– for 5 days
c. 4 paediatric tablets – 2 times a day– for 3 days
d. 1 teaspoon of syrup – 5 times a day – for 2 days
35. A child with fever plus any general danger sign should be classified as:
a. uncomplicated malaria
b. acute ear infection
c. measles
d. very severe febrile disease or severe malaria
e. mastoiditis
36. If a caretaker brings an 18-month-old child with a cough to a health facility, what do you
need to do? (8pts)
a. ask the duration of the cough
b. count the number of breaths in one minute
c. look for chest in-drawing
d. check for sore throat
e. look and listen for stridor and wheeze
f. take the child’s pulse rate
g. check for other main symptoms (e.g. fever, diarrhoea, ear problem)
h. h) check for malnutrition and anaemia
i. i) check the child’s immunization status
j. j) check for other problems
37. A boy is 20 months old. He has had fever for 5 days, cough for 3 days; he is able to drink,
does not have convulsions, and is not lethargic or unconscious. His breathing rate is 51
per minute, there is no chest indrawing or stridor or wheeze. The boy does not have
diarrhoea, but has generalized rash and a runny nose. There is no clouding of the cornea
or mouth ulcers. The boy should be classified as having: (2pts)
a. no pneumonia: cough or cold
b. pneumonia
c. severe pneumonia or very severe disease
d. very severe febrile disease
e. uncomplicated malaria
f. measles
g. measles with eye or mouth complications
38. A mother brought her 16-month-old child back to clinic after 2 days of ORS treatment for
diarrhea with no dehydration. The mother says that the child still has diarrhea and now is
coughing and has fever. What is the proper course of action?
a. immediately refer the child to hospital
b. reassess the child for diarrhea
c. continue current treatment and ask mother to return later
d. disregard diarrhea, treat cough
e. assess and classify child’s cough and fever as in initial visit
f. treat diarrhea, it’s more important than cough
g. assess and classify diarrhea as if it is initial visit
39. Which of the following statements are true?
a. a 3-month-old child should be exclusively breastfed
b. a 5-month-old child should be breastfed as often as s/he wants, day and night, at
least 10 times in 24 hours
c. children should be given fewer feedings during illness
