Section 1: Emergency Room Clinical Knowledge

Trauma & Triage

1. Q: What is the primary goal of triage in the ER? A: To prioritize patients based on the
severity of their condition to ensure timely care.
2. Q: What does the “ABCDE” approach in trauma assessment stand for? A: Airway,
Breathing, Circulation, Disability, Exposure.
3. Q: What is the Glasgow Coma Scale used for? A: Assessing a patient’s level of
consciousness.
4. Q: What is the first-line treatment for hypovolemic shock? A: Rapid fluid resuscitation
with isotonic crystalloids.
5. Q: What are signs of internal bleeding in a trauma patient? A: Hypotension, tachycardia,
pallor, abdominal distension.

Infectious Diseases & Isolation

6. Q: What PPE is required for suspected tuberculosis cases? A: N95 mask, gloves, gown,
and eye protection.
7. Q: What is the protocol for a needle-stick injury in the ER? A: Wash the area, report
immediately, and initiate post-exposure prophylaxis if needed.
8. Q: What is the incubation period for hepatitis B? A: 45–160 days.
9. Q: What is the first step in managing a patient with suspected cholera? A: Oral or IV
rehydration therapy.
10. Q: What is the most effective method to prevent nosocomial infections? A: Hand
hygiene.

👩⚕️ Section 2: Nursing Supervision & Management

Leadership & Team Coordination

11. Q: What is the role of a Nursing Activity Manager in MSF? A: To oversee nursing
activities, ensure quality care, manage staff, and coordinate with other departments.
12. Q: How do you handle conflict between two nursing supervisors? A: Facilitate a private
discussion, mediate respectfully, and seek a collaborative resolution.
13. Q: What is the best way to motivate nursing staff during a crisis? A: Provide clear
communication, emotional support, and recognize their efforts.
14. Q: How do you ensure accountability in your team? A: Set clear expectations, monitor
performance, and provide regular feedback.
15. Q: What is a key trait of effective leadership in humanitarian settings? A: Adaptability
and empathy.

Staff Training & Evaluation

 16. Q: What should be included in a nurse’s orientation in the ER? A: Triage protocols,
infection control, emergency procedures, and documentation standards.
17. Q: How often should nursing competencies be evaluated? A: At least annually or after
major incidents.
18. Q: What is the purpose of clinical supervision? A: To support professional development
and ensure safe practice.
19. Q: How do you identify training needs in your team? A: Through performance reviews,
incident reports, and staff feedback.
20. Q: What is a good method for evaluating nursing performance? A: Use of KPIs, direct
observation, and peer reviews.

🌍 Section 3: MSF Humanitarian Principles & Ethics

MSF Core Values

21. Q: What are the core principles of MSF? A: Neutrality, impartiality, independence, and
medical ethics.
22. Q: How does MSF define “impartiality”? A: Providing care based on need, regardless of
race, religion, or politics.
23. Q: What should you do if a local authority pressures you to prioritize certain patients? A:
Refer to MSF’s impartiality principle and escalate to coordination.
24. Q: What is the ethical approach to treating a patient who refuses care? A: Respect
autonomy while ensuring they understand the risks.
25. Q: What is MSF’s stance on patient confidentiality? A: It must be strictly maintained
unless legally or ethically required to disclose.

📋 Section 4: Protocols, Documentation & Quality Assurance

Documentation & Reporting

26. Q: What is the importance of accurate documentation in the ER? A: Ensures continuity
of care, legal protection, and data for monitoring.
27. Q: What should be included in an incident report? A: Date/time, people involved,
description, actions taken, and follow-up.
28. Q: How do you monitor nursing quality in the ER? A: Through audits, patient feedback,
and clinical indicators.
29. Q: What is the role of SOPs in nursing practice? A: Standardize care and reduce errors.
30. Q: What is the best way to implement a new protocol? A: Train staff, provide written
guidelines, and monitor compliance.

🧠 Section 5: Critical Thinking & Scenario-Based Questions

Situational Judgment
 31. Q: A nurse reports feeling overwhelmed and unsafe. What do you do? A: Assess
workload, provide support, and adjust staffing if needed.
32. Q: A patient arrives with a gunshot wound and no ID. What’s your priority? A: Stabilize
the patient and ensure safety protocols are followed.
33. Q: A nursing supervisor is not following infection control protocols. What’s your
response? A: Address the issue directly, reinforce training, and document the incident.
34. Q: There’s a sudden influx of patients due to a mass casualty. What’s your first action?
A: Activate emergency response plan and triage immediately.
35. Q: A nurse makes a medication error. What steps do you take? A: Ensure patient safety,
report the error, and review procedures.

🧠 Section 6: Pharmacology & Medication Safety

36. Q: What is the antidote for opioid overdose? A: Naloxone.
37. Q: What is the maximum dose of paracetamol for adults per day? A: 4 grams.
38. Q: What are signs of anaphylaxis? A: Difficulty breathing, hypotension, rash, and
swelling.
39. Q: What is the protocol for administering IV antibiotics in sepsis? A: Administer within
the first hour of recognition.
40. Q: What is the risk of giving potassium chloride IV push? A: Cardiac arrest; it must be
diluted and infused slowly.

🧠 Section 7: Logistics, Coordination & Resource

Management
Supplies & Inventory

41. Q: How do you prevent stockouts of essential medications? A: Regular inventory checks
and forecasting based on patient load.
42. Q: What is the role of the Nursing Activity Manager in supply chain coordination? A:
Communicate needs, monitor usage, and report shortages.
43. Q: How do you manage limited resources during a surge? A: Prioritize critical cases and
redistribute supplies.
44. Q: What’s the best way to track PPE usage? A: Maintain daily logs and monitor
consumption trends.
45. Q: How do you ensure cold chain integrity for vaccines? A: Use temperature monitoring
and proper storage protocols.

Mental Health & Psychosocial Support

 Q: What are signs of secondary traumatic stress in nurses? A: Irritability, sleep
disturbances, emotional numbness, and difficulty concentrating.
  Q: How should a Nursing Activity Manager support staff after a traumatic event? A:
Organize debriefings, offer access to mental health professionals, and adjust workloads
temporarily.
 Q: What is psychological first aid? A: A humane, supportive response to someone
suffering from serious stress, focusing on safety, comfort, and connection.
 Q: What is the role of nurses in managing patients with acute stress reactions? A:
Provide reassurance, ensure safety, and refer to mental health services if needed.

👶 Pediatric & Maternal Emergencies

 Q: What is the first-line treatment for a child with severe dehydration? A: IV fluid
resuscitation with isotonic solutions.
 Q: What is the most common cause of neonatal sepsis in low-resource settings? A:
Bacterial infections due to poor hygiene during delivery.
 Q: What is the priority in managing postpartum hemorrhage? A: Administer uterotonics
and begin fluid resuscitation immediately.
 Q: How do you assess malnutrition in children under 5? A: Use MUAC (Mid-Upper Arm
Circumference) and weight-for-height z-scores.

🌍 Cultural Sensitivity & Community Engagement

 Q: Why is cultural sensitivity important in humanitarian nursing? A: It builds trust,
improves patient compliance, and ensures respectful care.
 Q: How should a nurse respond to a patient refusing care due to cultural beliefs? A:
Respect the decision, provide education, and explore acceptable alternatives.
 Q: What is the role of community health workers in MSF operations? A: Bridge
communication between medical teams and local populations, support outreach and
follow-up.
 Q: How can MSF nurses adapt care to local customs? A: Use interpreters, involve family
members when appropriate, and respect traditional healing practices.

🚨 Disaster Response & Mass Casualty Management

 Q: What is the first step in a mass casualty incident? A: Activate the emergency response
plan and begin triage.
 Q: What is the role of the Nursing Activity Manager during a disaster? A: Coordinate
nursing teams, manage resources, and ensure documentation.
 Q: What triage system is commonly used in mass casualty events? A: START (Simple
Triage and Rapid Treatment).
 Q: How do you manage limited resources during a disaster? A: Prioritize critical cases,
redistribute supplies, and communicate with logistics.

🧠 Burnout Prevention & Staff Wellness

  Q: What are early signs of burnout in nurses? A: Fatigue, detachment, reduced
performance, and emotional exhaustion.
 Q: How can a Nursing Activity Manager prevent burnout? A: Rotate shifts fairly, offer
mental health support, and encourage peer support.
 Q: What is the benefit of regular team debriefings? A: They help process stress, improve
communication, and strengthen team cohesion.
 Q: What should be included in a wellness plan for ER nurses? A: Rest breaks, mental
health access, workload monitoring, and recognition of effort.

📊 MSF-Specific Reporting & Coordination

 Q: What is the SitRep in MSF? A: A Situation Report summarizing operational
activities, challenges, and needs.
 Q: What is the Nursing Activity Manager’s role in coordination meetings? A: Represent
nursing operations, advocate for resources, and align with medical and logistics teams.
 Q: How does MSF monitor quality of care? A: Through audits, patient feedback,
morbidity/mortality reviews, and supervision reports.
 Q: What tool is used to track nursing indicators in MSF? A: Nursing dashboards or
monthly activity reports.

Infection Control & Prevention

 Q: What is the most effective method to prevent hospital-acquired infections? A:
Consistent hand hygiene using soap or alcohol-based hand rubs.
 Q: How often should reusable medical equipment be disinfected in the ER? A: After
each patient use, following standard disinfection protocols.
 Q: What is the protocol for managing a suspected outbreak in the ER? A: Isolate cases,
notify coordination, initiate contact tracing, and reinforce IPC measures.
 Q: What PPE is required for managing a patient with suspected airborne disease? A: N95
respirator, gloves, gown, and eye protection.

🧠 Leadership Styles & Conflict Resolution

 Q: What leadership style is most effective in high-pressure humanitarian settings? A:
Transformational leadership—motivating, inspiring, and adapting to change.
 Q: How do you handle a nurse who consistently arrives late for shifts? A: Address the
issue privately, understand the cause, and set clear expectations.
 Q: What’s the best way to resolve tension between two nursing supervisors? A: Facilitate
open dialogue, mediate respectfully, and agree on shared goals.
 Q: How do you encourage initiative among your nursing team? A: Empower decision-
making, recognize contributions, and provide mentorship.

⚖️ Ethical Dilemmas in Humanitarian Nursing

  Q: A patient refuses life-saving treatment due to cultural beliefs. What do you do? A:
Respect their autonomy, provide education, and document the decision.
 Q: You witness a colleague breaching patient confidentiality. What’s your responsibility?
A: Report the incident to management and reinforce confidentiality protocols.
 Q: A local authority demands patient records. How do you respond? A: Refer to MSF’s
confidentiality policy and escalate to coordination.
 Q: A nurse is emotionally affected by a patient’s death. What support should you offer?
A: Provide emotional support, offer time off if needed, and refer to mental health
services.

🧠 Data Management & Monitoring

 Q: What indicators help monitor nursing performance in the ER? A: Patient outcomes,
documentation accuracy, infection rates, and staff punctuality.
 Q: How often should nursing activity data be reported to MSF coordination? A: Weekly
or monthly, depending on mission protocols.
 Q: What is the purpose of morbidity and mortality reviews? A: To analyze clinical
outcomes, identify gaps, and improve quality of care.
 Q: How do you ensure data accuracy in nursing reports? A: Train staff, use standardized
templates, and conduct regular audits.

🧠⚕️ Advanced Clinical Oversight

 Q: What is the role of the Nursing Activity Manager in clinical supervision? A: Ensure
adherence to protocols, mentor staff, and monitor patient care quality.
 Q: How do you manage a nurse who lacks competency in a critical procedure? A:
Provide targeted training, supervise closely, and reassess competency.
 Q: What is the protocol for managing a deteriorating patient in the ER? A: Activate rapid
response, reassess ABCs, and escalate to medical team.
 Q: How do you ensure continuity of care during shift handovers? A: Use structured
handover tools (e.g., SBAR), verify documentation, and encourage questions.

🩺 Emergency Obstetrics
 Q: What is the most urgent intervention for eclampsia in the ER? A: Administer
magnesium sulfate and manage airway and blood pressure.
 Q: What are signs of placental abruption? A: Vaginal bleeding, abdominal pain, uterine
tenderness, and fetal distress.
 Q: How do you manage shoulder dystocia during delivery? A: Perform McRoberts
maneuver and apply suprapubic pressure.
 Q: What is the priority in managing a retained placenta? A: Manual removal under sterile
conditions and monitor for hemorrhage.

🧠 Coordination with Logistics & Pharmacy

  Q: What is the Nursing Activity Manager’s role in pharmacy coordination? A:
Communicate medication needs, monitor usage, and report shortages.
 Q: How do you prevent medication stockouts in high-volume ERs? A: Forecast demand
based on patient trends and maintain buffer stock.
 Q: What is the protocol for expired medications found in stock? A: Remove
immediately, document, and report to logistics/pharmacy.
 Q: How do you ensure cold chain integrity for vaccines? A: Use temperature logs,
monitor daily, and store in approved refrigerators.

🗺️ MSF Mission Planning & Exit Strategies

 Q: What is the purpose of an MSF exit strategy? A: To ensure sustainable handover of
services to local health systems.
 Q: What should be included in a nursing handover plan during mission closure? A: Staff
training records, SOPs, patient follow-up plans, and inventory status.
 Q: How do you prepare local nurses for MSF departure? A: Provide mentorship,
reinforce protocols, and build leadership capacity.
 Q: What is the Nursing Activity Manager’s role in mission transition? A: Ensure
continuity of care, support staff adaptation, and document processes.

👥 Staff Recruitment & Onboarding

 Q: What criteria should be used when hiring ER nurses in MSF? A: Clinical competency,
adaptability, teamwork, and commitment to humanitarian principles.
 Q: What should be included in a nurse’s onboarding package? A: Job description,
protocols, safety guidelines, and MSF values.
 Q: How do you assess a new nurse’s readiness for ER work? A: Observe clinical skills,
review documentation, and evaluate decision-making.
 Q: What is the role of peer mentorship in onboarding? A: It helps new staff integrate,
learn protocols, and build confidence.

🛡️ Risk Management & Security Protocols

 Q: What is the Nursing Activity Manager’s role in security planning? A: Ensure staff are
briefed on risks, follow protocols, and report incidents.
 Q: What should nurses do during a security lockdown? A: Follow shelter-in-place
procedures, secure patients, and await instructions.
 Q: How do you manage patient care during curfews or movement restrictions? A: Adjust
staffing schedules, prioritize emergencies, and coordinate with logistics.
 Q: What is the protocol for evacuating the ER during a security threat? A: Activate
emergency evacuation plan, secure patient records, and coordinate with field
coordination.
📋 Clinical Audit & Quality Improvement
 Q: What is the purpose of a clinical audit in MSF operations? A: To evaluate current
practices against standards and identify areas for improvement.
 Q: How do you involve nursing staff in quality improvement? A: Encourage feedback,
share audit results, and engage them in developing action plans.
 Q: What is a key performance indicator (KPI) for ER nursing care? A: Time to triage,
medication error rates, infection control compliance.
 Q: How often should clinical audits be conducted in high-volume ERs? A: Monthly or
quarterly, depending on patient load and incident trends.

🗣️ Communication & Reporting to Headquarters

 Q: What should be included in a monthly nursing activity report? A: Staffing levels,
patient statistics, incidents, training updates, and supply needs.
 Q: How do you ensure timely reporting to MSF coordination? A: Set internal deadlines,
delegate tasks, and use standardized templates.
 Q: What is the role of the Nursing Activity Manager in donor reporting? A: Provide
accurate data on nursing activities and outcomes for transparency.
 Q: How do you communicate urgent needs to headquarters? A: Use priority channels
(email, radio, or satellite phone) and document requests clearly.

🧠 Gender-Based Violence (GBV) Response

 Q: What is the first step in managing a GBV survivor in the ER? A: Ensure privacy,
safety, and provide compassionate care.
 Q: What services should be offered to GBV survivors? A: Medical treatment,
psychosocial support, legal referral (if appropriate), and follow-up.
 Q: How do you train nurses to handle GBV cases sensitively? A: Provide trauma-
informed care training and reinforce confidentiality protocols.
 Q: What is MSF’s policy on mandatory reporting in GBV cases? A: It varies by country;
MSF prioritizes survivor consent and safety.

🧠 Pediatric Triage & Emergency Protocols

 Q: What is the most critical sign in pediatric triage? A: Altered consciousness,
respiratory distress, or poor perfusion.
 Q: How do you manage febrile seizures in children? A: Ensure airway safety, administer
antipyretics, and monitor for underlying infection.
 Q: What is the protocol for a child with suspected meningitis? A: Initiate IV antibiotics
immediately and monitor neurological status.
 Q: How do you assess pain in non-verbal pediatric patients? A: Use behavioral pain
scales like FLACC (Face, Legs, Activity, Cry, Consolability).
📑 Staff Disciplinary Procedures & Documentation
 Q: What is the first step in addressing a nurse’s repeated protocol violations? A: Conduct
a private meeting to understand the issue and document the discussion.
 Q: What should be included in a disciplinary report? A: Date, nature of violation, actions
taken, and follow-up plan.
 Q: How do you ensure fairness in disciplinary actions? A: Follow MSF HR guidelines,
involve coordination, and maintain transparency.
 Q: What is the role of progressive discipline in MSF? A: To correct behavior through
escalating interventions—verbal warning, written warning, suspension, or termination.

🚨 Emergency Preparedness Drills & Simulations

 Q: What is the purpose of emergency preparedness drills in MSF operations? A: To test
response protocols, identify gaps, and improve team coordination during real
emergencies.
 Q: How often should ER simulation exercises be conducted? A: At least quarterly or
after major changes in staff or protocols.
 Q: What should be evaluated during a mass casualty simulation? A: Triage accuracy,
communication flow, resource allocation, and documentation.
 Q: What is the Nursing Activity Manager’s role in preparedness planning? A: Lead
nursing input, coordinate training, and ensure SOPs are understood by all staff.

🧠 Coordination with Other Humanitarian Actors

 Q: Why is coordination with other NGOs important in emergency settings? A: To avoid
duplication, share resources, and ensure comprehensive care coverage.
 Q: What is the Nursing Activity Manager’s role in inter-agency coordination? A:
Represent nursing needs, share data, and align protocols with partners.
 Q: How do you manage conflicting protocols between MSF and another NGO? A:
Discuss collaboratively, prioritize patient safety, and escalate to coordination if needed.
 Q: What platform is commonly used for humanitarian coordination? A: Health Cluster
meetings or inter-agency coordination forums.

⚖️ Nursing Ethics & Patient Rights

 Q: What are the four pillars of medical ethics? A: Autonomy, beneficence, non-
maleficence, and justice.
 Q: How do you ensure informed consent in low-literacy populations? A: Use verbal
explanations, visual aids, and interpreters to ensure understanding.
 Q: What is the nurse’s responsibility when a patient refuses treatment? A: Respect the
decision, document it, and ensure the patient understands the risks.
 Q: How do you protect vulnerable patients from exploitation? A: Maintain
confidentiality, advocate for their rights, and report any abuse.
🧠 Chronic Disease Management in Emergency Settings
 Q: What is the priority in managing diabetic patients during displacement? A: Ensure
access to insulin or oral medications, monitor glucose, and provide dietary guidance.
 Q: How do you manage hypertension in a crisis zone with limited resources? A: Use
available antihypertensives, monitor BP regularly, and educate on lifestyle adjustments.
 Q: What challenges arise in managing chronic diseases in emergencies? A: Interrupted
supply chains, lack of follow-up, and limited diagnostics.
 Q: What is the role of nurses in continuity of care for chronic patients? A: Track patient
records, ensure medication adherence, and coordinate referrals.

📑 Documentation Standards & Legal Considerations

 Q: What is the legal importance of accurate patient documentation? A: It protects patient
rights, supports continuity of care, and provides evidence in case of disputes.
 Q: What should be included in a nursing progress note? A: Patient status, interventions,
response to treatment, and any changes in condition.
 Q: How do you document care for a patient with no formal ID? A: Use a unique
identifier, describe distinguishing features, and maintain confidentiality.
 Q: What is the protocol for documenting a critical incident? A: Record time, location,
people involved, actions taken, and follow-up recommendations.

🚦 Triage Systems & Decision-Making

 Q: What is the primary goal of triage in emergency settings? A: To prioritize patients
based on urgency and allocate resources effectively.
 Q: What does the “START” triage system stand for? A: Simple Triage and Rapid
Treatment.
 Q: How do you triage a patient with respiratory rate >30, capillary refill >2 seconds, and
unable to follow commands? A: Tag as “Immediate” (Red) in mass casualty triage.
 Q: What is the role of the Nursing Activity Manager in triage oversight? A: Ensure triage
protocols are followed, supervise staff, and adjust flow as needed.

🧠🔬 Staff Safety & Occupational Health

 Q: What is the first step when a nurse reports a needle-stick injury? A: Wash the area,
report immediately, and initiate post-exposure prophylaxis if indicated.
 Q: How do you prevent musculoskeletal injuries among ER nurses? A: Provide training
on safe patient handling and ensure access to lifting aids.
 Q: What is the protocol for managing heat stress among staff in field hospitals? A:
Encourage hydration, schedule rest breaks, and monitor for symptoms.
 Q: What should be included in a staff safety briefing? A: Security risks, IPC protocols,
emergency contacts, and evacuation plans.
🧠 Nursing Roles in Outbreak Response
 Q: What is the nurse’s role during a cholera outbreak? A: Triage patients, initiate
rehydration, monitor for complications, and support IPC measures.
 Q: How do you manage PPE shortages during an outbreak? A: Prioritize high-risk
procedures, reuse safely if protocols allow, and communicate needs to logistics.
 Q: What is the role of the Nursing Activity Manager in outbreak surveillance? A:
Monitor case trends, report to coordination, and adjust staffing and protocols.
 Q: How do you train nurses for outbreak response? A: Conduct drills, review SOPs, and
provide refresher training on IPC and case management.

🕊️ End-of-Life Care in Humanitarian Settings

 Q: What is the nurse’s role in palliative care in emergencies? A: Provide comfort,
manage symptoms, support family, and uphold dignity.
 Q: How do you approach pain management for terminal patients in low-resource
settings? A: Use available analgesics, assess regularly, and adjust doses based on
comfort.
 Q: What ethical principle guides end-of-life care? A: Respect for autonomy and dignity.
 Q: How do you support staff coping with frequent patient deaths? A: Offer debriefings,
peer support, and access to mental health services.

🧠⚕️ Delegation & Task-Shifting in Nursing Teams

 Q: What is task-shifting in humanitarian nursing? A: Delegating tasks to less specialized
staff to optimize resources and expand care.
 Q: What tasks can be safely delegated to nursing assistants? A: Vital signs monitoring,
hygiene care, and documentation under supervision.
 Q: How do you ensure safe delegation? A: Match tasks to competencies, provide
supervision, and clarify responsibilities.
 Q: What is the Nursing Activity Manager’s role in task-shifting? A: Identify
opportunities, train staff, and monitor outcomes.

Emergency Nutrition & Feeding Protocols

 Q: What is the first-line treatment for severe acute malnutrition with complications? A:
Therapeutic feeding with F-75 formula and medical stabilization.
 Q: How do you assess nutritional status in children under five? A: Use MUAC (Mid-
Upper Arm Circumference), weight-for-height, and presence of edema.
 Q: What is the nurse’s role in managing moderate malnutrition? A: Provide
supplementary feeding, monitor growth, and educate caregivers.
 Q: What is the protocol for refeeding in severely malnourished patients? A: Start with
low-calorie therapeutic feeds and gradually increase intake.
🧠 Coordination with Mental Health Teams
 Q: What is the Nursing Activity Manager’s role in mental health integration? A:
Coordinate referrals, support psychosocial interventions, and train nurses in basic mental
health care.
 Q: How do you identify patients needing mental health support in the ER? A: Look for
signs of distress, disorientation, withdrawal, or trauma-related symptoms.
 Q: What is the protocol for managing a patient with suicidal ideation? A: Ensure safety,
provide constant observation, and refer to mental health professionals.
 Q: How do nurses support patients with PTSD in humanitarian settings? A: Offer
reassurance, avoid triggering language, and refer for specialized care.

🚐 Nursing Roles in Mobile Clinics & Outreach

 Q: What is the purpose of mobile clinics in MSF operations? A: To reach underserved
populations with essential health services.
 Q: What should nurses carry during mobile outreach? A: Basic medications, PPE,
documentation tools, and emergency supplies.
 Q: How do you ensure continuity of care in mobile settings? A: Use patient tracking
systems, schedule follow-ups, and coordinate with fixed facilities.
 Q: What is the Nursing Activity Manager’s role in mobile clinic planning? A: Assess
needs, allocate staff, and ensure safety and logistics are in place.

🚰 Water, Sanitation & Hygiene (WASH) Integration

 Q: Why is WASH critical in emergency healthcare settings? A: It prevents disease
transmission and supports infection control.
 Q: What is the nurse’s role in promoting hygiene among patients? A: Educate on
handwashing, monitor sanitation practices, and distribute hygiene kits.
 Q: How do you manage waste disposal in a field hospital? A: Segregate waste, use
designated disposal areas, and follow MSF protocols.
 Q: What is the Nursing Activity Manager’s role in WASH coordination? A: Collaborate
with WASH teams to ensure clean water, sanitation, and hygiene supplies are available.

📈 Managing Nursing Data for Epidemiological Reporting

 Q: What types of data should nurses collect for epidemiological tracking? A: Patient
demographics, diagnoses, outcomes, and treatment details.
 Q: How do you ensure data quality in nursing reports? A: Train staff, use standardized
forms, and conduct regular reviews.
 Q: What is the purpose of line listing in outbreak response? A: To track individual cases
and identify transmission patterns.
 Q: How does nursing data contribute to public health decisions in MSF? A: It informs
resource allocation, outbreak control, and program evaluation.
🌪️ Emergency Preparedness for Natural Disasters
 Q: What is the first nursing priority during a natural disaster (e.g., earthquake)? A:
Ensure safety of staff and patients, assess injuries, and activate emergency protocols.
 Q: How do you prepare nursing teams for disaster scenarios? A: Conduct drills, review
SOPs, assign clear roles, and stock emergency supplies.
 Q: What is the role of the Nursing Activity Manager during a flood response? A:
Coordinate triage, manage displacement-related health issues, and liaise with logistics
and WASH teams.
 Q: What health risks increase after natural disasters? A: Trauma, waterborne diseases,
respiratory infections, and mental health issues.

🏥 Nursing Roles in Surgical Recovery Units

 Q: What is the nurse’s role in post-operative care? A: Monitor vitals, manage pain,
prevent infection, and assess for complications.
 Q: What are signs of post-op hemorrhage? A: Hypotension, tachycardia, pallor, and
increased drainage from surgical site.
 Q: How do you prevent surgical site infections? A: Maintain sterile technique, monitor
wounds, and ensure proper dressing changes.
 Q: What is the Nursing Activity Manager’s role in surgical recovery oversight? A:
Supervise nursing care, ensure protocol adherence, and coordinate with surgical teams.

🧠 Coordination with Maternity & Neonatal Care

 Q: What is the priority in managing neonatal sepsis? A: Start IV antibiotics immediately
and monitor for respiratory distress.
 Q: How do nurses support safe deliveries in low-resource settings? A: Use clean birth
kits, monitor labor, and identify complications early.
 Q: What is the protocol for managing pre-eclampsia? A: Monitor BP, administer
magnesium sulfate, and prepare for possible delivery.
 Q: How does the Nursing Activity Manager coordinate maternity care? A: Align ER and
maternity teams, ensure skilled staff availability, and monitor maternal outcomes.

⚖️ Ethical Dilemmas in Resource Scarcity

 Q: How do you prioritize care when resources are limited? A: Use triage principles,
focus on survivability, and communicate transparently.
 Q: What ethical principle guides decisions in scarcity? A: Justice—fair distribution of
limited resources.
 Q: How do you handle a situation where two patients need the same life-saving
intervention? A: Apply triage criteria, consult medical team, and document the decision-
making process.
  Q: What is MSF’s stance on equitable care? A: Care is provided based on need, without
discrimination, even in resource-constrained settings.

📈 Staff Mentoring & Career Development in Humanitarian

Missions
 Q: What is the benefit of mentoring junior nurses in MSF? A: Builds capacity, improves
retention, and strengthens team performance.
 Q: How do you identify potential leaders among nursing staff? A: Observe initiative,
communication skills, and clinical judgment.
 Q: What should be included in a professional development plan? A: Training goals,
mentorship opportunities, performance reviews, and feedback sessions.
 Q: How does the Nursing Activity Manager support career growth? A: Provide training,
delegate responsibilities, and advocate for advancement opportunities.

💉 Nursing Roles in Vaccination Campaigns

 Q: What is the nurse’s role in mass vaccination campaigns? A: Administer vaccines,
monitor for adverse reactions, maintain cold chain, and educate recipients.
 Q: How do you manage vaccine hesitancy in the community? A: Provide clear
information, address fears respectfully, and involve trusted local figures.
 Q: What is the protocol for reporting adverse events following immunization (AEFI)? A:
Document details, notify medical coordination, and follow MSF’s AEFI reporting
guidelines.
 Q: What is the Nursing Activity Manager’s role in campaign planning? A: Coordinate
staffing, logistics, training, and community engagement.

🧠 Managing Patient Flow & Overcrowding

 Q: What strategies help manage overcrowding in the ER? A: Streamlined triage, fast-
track for minor cases, and coordination with inpatient units.
 Q: How do you reduce bottlenecks at registration? A: Use clear signage, assign dedicated
staff, and implement pre-screening.
 Q: What is the role of the Nursing Activity Manager in patient flow optimization? A:
Monitor throughput, adjust staffing, and troubleshoot delays.
 Q: How do you prioritize care when the ER is overwhelmed? A: Apply triage protocols
strictly and communicate clearly with patients and families.

🧠🧠 Coordination with Rehabilitation & Physiotherapy

 Q: What is the nurse’s role in post-trauma rehabilitation? A: Support wound care,
encourage mobility, and coordinate with physiotherapists.
  Q: How do you identify patients needing rehab services? A: Assess functional
limitations, post-surgical recovery, and chronic conditions.
 Q: What is the Nursing Activity Manager’s role in rehab coordination? A: Ensure
referrals, track progress, and integrate rehab into discharge planning.
 Q: How do you support continuity of rehab in mobile or temporary clinics? A: Provide
home exercise plans, schedule follow-ups, and train caregivers.

📢 Handling Media & Public Relations in Crisis Zones

 Q: What is MSF’s policy on media engagement? A: Only designated spokespeople may
speak to media; all inquiries should be referred to coordination.
 Q: What should you do if a journalist asks for patient access? A: Deny access to protect
privacy and refer to MSF’s communications team.
 Q: How do you manage misinformation about MSF in the community? A: Engage local
leaders, clarify facts, and reinforce MSF’s principles.
 Q: What is the nurse’s role in maintaining MSF’s public image? A: Uphold
professionalism, respect patient dignity, and follow communication protocols.

🏘️ Integrating Community Health Education into ER

Operations
 Q: Why is community health education important in emergency care? A: It reduces
preventable visits, improves outcomes, and builds trust.
 Q: What topics should nurses prioritize in health education? A: Hygiene, nutrition,
chronic disease management, and when to seek emergency care.
 Q: How do you deliver health education in a busy ER? A: Use posters, brief counseling
during discharge, and involve community health workers.
 Q: What is the Nursing Activity Manager’s role in health promotion? A: Develop
materials, train staff, and coordinate outreach efforts.

🩺 Pediatric Emergency Nursing

 Q: What is the first priority in managing a child with respiratory distress? A: Assess
airway patency, provide oxygen, and monitor for signs of hypoxia.
 Q: What are signs of dehydration in infants? A: Sunken fontanelle, dry mucous
membranes, decreased urine output, lethargy.
 Q: How do you manage febrile seizures in children? A: Ensure airway safety, administer
antipyretics, and monitor for underlying infection.
 Q: What is the protocol for a child with suspected meningitis? A: Initiate IV antibiotics
immediately, monitor neurological status, and isolate if needed.
 Q: What is the nurse’s role in pediatric triage? A: Rapid assessment of consciousness,
breathing, circulation, and temperature.
🧠 Maternal Emergency Nursing
 Q: What is the first-line treatment for postpartum hemorrhage? A: Administer
uterotonics (e.g., oxytocin), initiate IV fluids, and monitor vitals.
 Q: What are signs of pre-eclampsia? A: High blood pressure, proteinuria, headache,
visual disturbances, and edema.
 Q: How do you manage eclampsia in the ER? A: Administer magnesium sulfate, control
blood pressure, and prepare for delivery.
 Q: What is the nurse’s role during emergency delivery? A: Support the mother, monitor
fetal heart rate, assist with delivery, and ensure sterile technique.
 Q: What is the protocol for retained placenta? A: Manual removal under sterile
conditions and monitor for hemorrhage and infection.

🧠 Psychosocial Support for Mothers & Children

 Q: How do you support a mother experiencing birth trauma? A: Provide emotional
support, ensure privacy, and refer to mental health services.
 Q: What is the nurse’s role in supporting grieving parents after neonatal loss? A: Offer
compassionate presence, allow time for mourning, and provide follow-up support.
 Q: How do you identify signs of postpartum depression? A: Persistent sadness,
withdrawal, sleep disturbances, and lack of interest in the baby.
 Q: What is the protocol for a child showing signs of abuse? A: Ensure safety, document
findings, and report to coordination per MSF guidelines.

🧠 Infection Control in Maternal & Pediatric ER

 Q: What is the most important IPC measure in neonatal care? A: Hand hygiene before
and after contact with the newborn.
 Q: How do you prevent neonatal sepsis in emergency deliveries? A: Use sterile
equipment, administer prophylactic antibiotics if indicated, and monitor closely.
 Q: What PPE is required when managing a mother with suspected COVID-19? A: N95
mask, gloves, gown, and eye protection.
 Q: How do you manage isolation for a child with suspected measles? A: Place in
airborne isolation, provide supportive care, and notify public health coordination.

📊 Monitoring & Evaluation in Maternal-Child ER

 Q: What indicators help monitor maternal care quality? A: Postpartum hemorrhage rates,
maternal mortality, and timely administration of uterotonics.
 Q: What pediatric indicators should be tracked in the ER? A: Admission rates,
malnutrition cases, vaccination status, and mortality under age 5.
 Q: What is the Nursing Activity Manager’s role in data reporting? A: Compile nursing
data, analyze trends, and submit reports to coordination.
  Q: How do you ensure accurate documentation in pediatric emergencies? A: Use age-
specific charts, verify medication doses, and record vital signs frequently.

👶 Neonatal Resuscitation & Emergency Protocols

 Q: What is the first step in neonatal resuscitation? A: Warm the baby, position the
airway, and stimulate breathing.
 Q: What is the APGAR score used for? A: To assess a newborn’s condition at 1 and 5
minutes after birth based on Appearance, Pulse, Grimace, Activity, and Respiration.
 Q: When should positive pressure ventilation be initiated in a newborn? A: If the baby is
apneic or has a heart rate below 100 bpm after initial stimulation.
 Q: What is the nurse’s role during neonatal resuscitation? A: Assist with airway
management, monitor vitals, prepare emergency medications, and document
interventions.

🍼 Breastfeeding Support & Maternal Nutrition

 Q: What is the nurse’s role in promoting breastfeeding in the ER? A: Educate mothers,
assist with latching, and address feeding concerns.
 Q: What are signs of poor breastfeeding technique? A: Nipple pain, poor weight gain,
prolonged feeding sessions, and infant fussiness.
 Q: How do you support a malnourished lactating mother? A: Provide nutritional
counseling, supplements if available, and monitor infant growth.
 Q: What is the protocol for a mother unable to breastfeed due to medical reasons? A:
Offer safe alternatives like formula or donor milk, and educate on preparation and
hygiene.

🏥 Coordination with Maternity & Pediatric Inpatient Units

 Q: What is the Nursing Activity Manager’s role in coordinating with maternity wards?
A: Ensure smooth patient transfers, align protocols, and monitor maternal outcomes.
 Q: How do you ensure continuity of care for pediatric patients admitted from the ER? A:
Use structured handovers, share documentation, and follow up on treatment plans.
 Q: What challenges arise in coordinating between ER and inpatient units? A:
Communication gaps, bed shortages, and inconsistent documentation.
 Q: How do you resolve delays in transferring critical maternal cases? A: Escalate to
coordination, prioritize based on severity, and ensure readiness in receiving unit.

⚠️ Managing High-Risk Pregnancies in Low-Resource

Settings
 Q: What are common high-risk pregnancy indicators? A: Hypertension, diabetes,
previous C-section, multiple gestation, and bleeding.
  Q: What is the protocol for managing antepartum hemorrhage? A: Monitor vitals, initiate
IV fluids, prepare for emergency delivery, and notify obstetric team.
 Q: How do you manage a pregnant woman with suspected malaria? A: Administer
antimalarials per protocol, monitor fetal well-being, and prevent complications.
 Q: What is the nurse’s role in monitoring high-risk pregnancies? A: Track vitals, fetal
heart rate, signs of labor, and educate on danger signs.

🎓 Staff Training for Maternal-Child Emergencies

 Q: What topics should be prioritized in ER nurse training for maternal-child care? A:
Neonatal resuscitation, postpartum hemorrhage, pediatric triage, and infection control.
 Q: How do you assess training effectiveness? A: Use pre/post tests, direct observation,
and feedback from staff.
 Q: What is the Nursing Activity Manager’s role in capacity building? A: Identify skill
gaps, organize training sessions, and mentor junior staff.
 Q: How do you maintain competency in emergency procedures? A: Conduct regular
drills, refreshers, and peer evaluations.

👶 Neonatal Resuscitation & Emergency Protocols

 Q: What is the first step in neonatal resuscitation? A: Warm the baby, position the
airway, and stimulate breathing.
 Q: What is the APGAR score used for? A: To assess a newborn’s condition at 1 and 5
minutes after birth based on Appearance, Pulse, Grimace, Activity, and Respiration.
 Q: When should positive pressure ventilation be initiated in a newborn? A: If the baby is
apneic or has a heart rate below 100 bpm after initial stimulation.
 Q: What is the nurse’s role during neonatal resuscitation? A: Assist with airway
management, monitor vitals, prepare emergency medications, and document
interventions.

🍼 Breastfeeding Support & Maternal Nutrition

 Q: What is the nurse’s role in promoting breastfeeding in the ER? A: Educate mothers,
assist with latching, and address feeding concerns.
 Q: What are signs of poor breastfeeding technique? A: Nipple pain, poor weight gain,
prolonged feeding sessions, and infant fussiness.
 Q: How do you support a malnourished lactating mother? A: Provide nutritional
counseling, supplements if available, and monitor infant growth.
 Q: What is the protocol for a mother unable to breastfeed due to medical reasons? A:
Offer safe alternatives like formula or donor milk, and educate on preparation and
hygiene.

🏥 Coordination with Maternity & Pediatric Inpatient Units

  Q: What is the Nursing Activity Manager’s role in coordinating with maternity wards?
A: Ensure smooth patient transfers, align protocols, and monitor maternal outcomes.
 Q: How do you ensure continuity of care for pediatric patients admitted from the ER? A:
Use structured handovers, share documentation, and follow up on treatment plans.
 Q: What challenges arise in coordinating between ER and inpatient units? A:
Communication gaps, bed shortages, and inconsistent documentation.
 Q: How do you resolve delays in transferring critical maternal cases? A: Escalate to
coordination, prioritize based on severity, and ensure readiness in receiving unit.

⚠️ Managing High-Risk Pregnancies in Low-Resource

Settings
 Q: What are common high-risk pregnancy indicators? A: Hypertension, diabetes,
previous C-section, multiple gestation, and bleeding.
 Q: What is the protocol for managing antepartum hemorrhage? A: Monitor vitals, initiate
IV fluids, prepare for emergency delivery, and notify obstetric team.
 Q: How do you manage a pregnant woman with suspected malaria? A: Administer
antimalarials per protocol, monitor fetal well-being, and prevent complications.
 Q: What is the nurse’s role in monitoring high-risk pregnancies? A: Track vitals, fetal
heart rate, signs of labor, and educate on danger signs.

🎓 Staff Training for Maternal-Child Emergencies

 Q: What topics should be prioritized in ER nurse training for maternal-child care? A:
Neonatal resuscitation, postpartum hemorrhage, pediatric triage, and infection control.
 Q: How do you assess training effectiveness? A: Use pre/post tests, direct observation,
and feedback from staff.
 Q: What is the Nursing Activity Manager’s role in capacity building? A: Identify skill
gaps, organize training sessions, and mentor junior staff.
 Q: How do you maintain competency in emergency procedures? A: Conduct regular
drills, refreshers, and peer evaluations.

🩺 Emergency Response to Gender-Based Violence (GBV)

 Q: What is the first nursing priority when a mother or child presents with signs of GBV?
A: Ensure safety, provide compassionate care, and maintain strict confidentiality.
 Q: What services should be offered to GBV survivors in the ER? A: Medical treatment,
psychosocial support, legal referral (if appropriate), and follow-up care.
 Q: How do you document a GBV case? A: Use nonjudgmental language, record physical
findings, and avoid assumptions.
 Q: What is the Nursing Activity Manager’s role in GBV response? A: Train staff, ensure
protocols are followed, and coordinate with protection services.
🧠 Coordination with Nutrition & WASH Teams for
Pediatric ER
 Q: Why is coordination with nutrition teams critical in pediatric emergencies? A: To
ensure early identification and treatment of malnutrition and support feeding protocols.
 Q: What is the nurse’s role in integrating WASH practices in pediatric care? A: Promote
hand hygiene, monitor sanitation, and educate caregivers.
 Q: How do you manage hygiene in overcrowded pediatric ERs? A: Implement
handwashing stations, disinfect surfaces regularly, and enforce PPE use.
 Q: What is the Nursing Activity Manager’s role in cross-sector coordination? A:
Facilitate communication, align priorities, and ensure shared protocols are implemented.

🧠 Managing Infectious Disease Outbreaks in Maternal-

Child Settings
 Q: What are key signs of measles in children? A: Fever, cough, conjunctivitis, and a
characteristic rash.
 Q: How do you isolate a mother with suspected cholera while caring for her newborn? A:
Use barrier nursing, provide separate hygiene supplies, and monitor both patients closely.
 Q: What is the nurse’s role in outbreak surveillance? A: Identify cases, report trends, and
support contact tracing.
 Q: How do you prevent cross-contamination in a pediatric ER during an outbreak? A:
Cohort patients, enforce IPC protocols, and train staff in outbreak response.

🧠 Staff Wellness & Resilience in High-Volume Pediatric ERs

 Q: What are signs of compassion fatigue in maternal-child nurses? A: Emotional
exhaustion, detachment, and reduced empathy.
 Q: How do you support staff working long shifts in high-stress environments? A: Rotate
duties, provide rest breaks, offer mental health support, and recognize efforts.
 Q: What is the Nursing Activity Manager’s role in promoting resilience? A: Foster team
cohesion, encourage peer support, and model healthy coping strategies.
 Q: How do you address burnout proactively? A: Monitor workload, conduct regular
check-ins, and adjust staffing as needed.

🧠 Leadership & Decision-Making in Maternal-Child

Emergencies
 Q: What leadership style is most effective in pediatric ER crises? A: Adaptive
leadership—responsive, collaborative, and calm under pressure.
 Q: How do you make decisions when resources are limited and multiple critical cases
arrive? A: Apply triage principles, consult medical leads, and document rationale clearly.
  Q: What is the Nursing Activity Manager’s role in emergency decision-making? A: Lead
nursing response, coordinate with medical and logistics teams, and ensure ethical care.
 Q: How do you empower nurses to take initiative during emergencies? A: Provide clear
protocols, encourage autonomy, and offer real-time support.

👧 Emergency Obstetric Complications in Adolescents

 Q: What are common obstetric risks in adolescent pregnancies? A: Preterm labor,
obstructed labor, anemia, and hypertensive disorders.
 Q: How do you manage an adolescent in labor with no antenatal care history? A:
Conduct full assessment, monitor closely, prepare for complications, and provide
emotional support.
 Q: What is the nurse’s role in supporting adolescent mothers post-delivery? A: Offer
counseling, educate on newborn care, and connect with psychosocial services.
 Q: What is the Nursing Activity Manager’s role in adolescent maternal care? A: Ensure
staff are trained in youth-sensitive care and coordinate with protection services if needed.

💊 Pediatric Medication Safety & Dosing

 Q: What is the most common cause of medication errors in children? A: Incorrect
weight-based dosing.
 Q: How do you calculate pediatric medication doses? A: Use mg/kg formulas based on
accurate weight and age-specific guidelines.
 Q: What is the nurse’s role in preventing pediatric dosing errors? A: Double-check
calculations, verify prescriptions, and monitor for adverse reactions.
 Q: How do you store pediatric medications safely in the ER? A: Label clearly, separate
by age group, and monitor expiration dates.

🏛️ Coordination with Local Health Authorities

 Q: Why is coordination with local health authorities important in maternal-child
emergencies? A: It ensures continuity of care, supports outbreak response, and aligns
with national protocols.
 Q: What is the Nursing Activity Manager’s role in local coordination? A: Attend health
cluster meetings, share data, and advocate for nursing needs.
 Q: How do you handle conflicting protocols between MSF and local health systems? A:
Discuss collaboratively, prioritize patient safety, and escalate to MSF coordination if
needed.
 Q: What should be included in reports shared with local health authorities? A: Patient
statistics, outbreak alerts, maternal and child health indicators, and service gaps.

🌊 Managing ER Care During Natural Disasters Affecting

Mothers & Children
  Q: What are key maternal-child health risks during floods or earthquakes? A: Trauma,
infections, disrupted antenatal care, and malnutrition.
 Q: How do you adapt ER services for displaced mothers and children? A: Set up mobile
units, prioritize triage, and ensure safe delivery environments.
 Q: What is the nurse’s role in disaster triage for children? A: Rapid assessment,
stabilization, and referral based on severity.
 Q: What is the Nursing Activity Manager’s role in disaster preparedness? A: Develop
contingency plans, train staff, and coordinate with logistics and protection teams.

📈 Evaluating Nursing Impact in Maternal-Child

Humanitarian Missions
 Q: What indicators help evaluate nursing impact in maternal-child ERs? A: Maternal and
neonatal mortality rates, successful resuscitations, breastfeeding initiation, and infection
control compliance.
 Q: How do you collect meaningful nursing data in emergencies? A: Use standardized
forms, train staff in documentation, and conduct regular reviews.
 Q: What is the Nursing Activity Manager’s role in quality improvement? A: Analyze
trends, implement corrective actions, and engage staff in continuous learning.
 Q: How do you share nursing impact with MSF coordination and donors? A: Compile
reports with clear metrics, case studies, and recommendations.

🩺 Emergency Mental Health Care for Mothers and Children

 Q: What are signs of acute psychological distress in a mother post-delivery? A:
Disorientation, crying spells, withdrawal, and expressions of hopelessness.
 Q: How do you manage a child presenting with trauma-related symptoms? A: Provide a
calm environment, avoid re-traumatization, and refer to mental health services.
 Q: What is the nurse’s role in psychological first aid? A: Offer safety, listen actively,
provide practical support, and connect to further care.
 Q: What is the Nursing Activity Manager’s role in mental health integration? A:
Coordinate with mental health teams, train staff in basic psychosocial support, and
monitor referrals.

👶 Managing Congenital Anomalies and Birth Defects in the

ER
 Q: What is the first step in managing a newborn with a visible congenital anomaly? A:
Stabilize the baby, assess for life-threatening conditions, and document findings.
 Q: How do you support parents of a child born with a birth defect? A: Provide clear
information, emotional support, and coordinate follow-up care.
 Q: What is the nurse’s role in identifying congenital anomalies? A: Conduct thorough
newborn assessments and report abnormalities promptly.
  Q: How do you manage a cleft palate in a newborn in a low-resource ER? A: Ensure
feeding support, prevent aspiration, and refer for surgical evaluation.

🏥 Coordination with Surgical and Anesthesia Teams for

Obstetric Emergencies
 Q: What is the protocol for emergency C-section coordination? A: Alert surgical and
anesthesia teams, prepare the patient, ensure consent, and monitor vitals.
 Q: What is the nurse’s role during obstetric surgery? A: Assist with preparation, maintain
sterile field, monitor patient, and support post-op recovery.
 Q: How do you manage anesthesia-related complications in maternal patients? A:
Monitor airway, vitals, and consciousness; report immediately to anesthesia team.
 Q: What is the Nursing Activity Manager’s role in surgical coordination? A: Ensure
nursing readiness, align protocols, and facilitate communication between departments.

🧠 Integrating Family Planning into Maternal ER Services

 Q: Why is family planning important in postnatal care? A: It helps prevent unintended
pregnancies, supports maternal health, and promotes birth spacing.
 Q: What is the nurse’s role in family planning counseling? A: Provide information on
methods, assess eligibility, and respect patient autonomy.
 Q: How do you offer family planning in emergency settings? A: Integrate into discharge
planning, use visual aids, and ensure privacy.
 Q: What is the Nursing Activity Manager’s role in family planning integration? A: Train
staff, ensure supply availability, and monitor uptake and feedback.

🌸 Training Nurses in Respectful Maternity Care and Child

Safeguarding
 Q: What are principles of respectful maternity care? A: Dignity, privacy, informed
consent, and non-discrimination.
 Q: How do you train nurses to safeguard children in the ER? A: Teach recognition of
abuse signs, reporting protocols, and trauma-informed care.
 Q: What is the nurse’s role in preventing mistreatment during labor? A: Provide
continuous support, communicate clearly, and avoid coercive practices.
 Q: What is the Nursing Activity Manager’s role in promoting respectful care? A:

🩺 Emergency Care for Survivors of Sexual Violence

 Q: What is the first nursing priority when a survivor of sexual violence arrives at the ER?
A: Ensure privacy and safety, provide immediate medical care, and offer psychosocial
support.
  Q: What medical interventions may be required for survivors? A: STI prophylaxis,
emergency contraception, wound care, and post-exposure prophylaxis (PEP) for HIV.
 Q: How do you document a sexual violence case? A: Use objective language, record
physical findings, and avoid assumptions or judgment.
 Q: What is the Nursing Activity Manager’s role in sexual violence response? A: Ensure
staff are trained, protocols are followed, and survivors are treated with dignity and
confidentiality.

🧠 Managing Pediatric Chronic Conditions in Emergencies

 Q: What are common pediatric chronic conditions encountered in humanitarian settings?
A: Asthma, epilepsy, diabetes, and congenital heart disease.
 Q: How do you manage a child with asthma during an acute attack? A: Administer
bronchodilators, provide oxygen, and monitor respiratory status.
 Q: What is the nurse’s role in supporting children with epilepsy? A: Ensure medication
adherence, educate caregivers, and manage seizures safely.
 Q: How do you maintain continuity of care for chronic pediatric patients in
displacement? A: Use patient tracking systems, coordinate with outreach teams, and
ensure medication supply.

💉 Coordination with Immunization Campaigns

 Q: What is the nurse’s role in supporting immunization efforts in the ER? A: Identify
unvaccinated children, provide catch-up vaccinations, and educate caregivers.
 Q: How do you manage vaccine cold chain in a mobile ER setting? A: Use portable
coolers with temperature monitoring and follow MSF cold chain protocols.
 Q: What is the Nursing Activity Manager’s role in immunization coordination? A: Liaise
with public health teams, allocate nursing staff, and monitor coverage rates.
 Q: How do you address vaccine hesitancy among caregivers? A: Provide clear, culturally
sensitive information and involve trusted community figures.

👩⚕️ Staff Supervision & Performance Evaluation

 Q: What is the purpose of regular staff supervision in the ER? A: To ensure quality care,
support professional development, and address challenges early.
 Q: How do you evaluate nursing performance fairly? A: Use objective indicators, direct
observation, peer feedback, and self-assessment.
 Q: What is the Nursing Activity Manager’s role in staff development? A: Identify
training needs, mentor staff, and create growth opportunities.
 Q: How do you handle underperformance in a nurse? A: Provide constructive feedback,
set improvement goals, and offer support or retraining.

📋 Developing SOPs for Maternal-Child ER Operations

  Q: What is the purpose of Standard Operating Procedures (SOPs) in the ER? A: To
standardize care, reduce errors, and ensure consistency across shifts and teams.
 Q: What should be included in an SOP for neonatal resuscitation? A: Step-by-step
actions, equipment checklist, roles, and documentation requirements.
 Q: How do you ensure staff compliance with SOPs? A: Provide training, post SOPs
visibly, and monitor adherence through supervision.
 Q: What is the Nursing Activity Manager’s role in SOP development? A: Draft protocols
with input from staff, align with MSF guidelines, and update regularly.

🩺 Emergency Care for Survivors of Sexual Violence

 Q: What is the first nursing priority when a survivor of sexual violence arrives at the ER?
A: Ensure privacy and safety, provide immediate medical care, and offer psychosocial
support.
 Q: What medical interventions may be required for survivors? A: STI prophylaxis,
emergency contraception, wound care, and post-exposure prophylaxis (PEP) for HIV.
 Q: How do you document a sexual violence case? A: Use objective language, record
physical findings, and avoid assumptions or judgment.
 Q: What is the Nursing Activity Manager’s role in sexual violence response? A: Ensure
staff are trained, protocols are followed, and survivors are treated with dignity and
confidentiality.

🧠 Managing Pediatric Chronic Conditions in Emergencies

 Q: What are common pediatric chronic conditions encountered in humanitarian settings?
A: Asthma, epilepsy, diabetes, and congenital heart disease.
 Q: How do you manage a child with asthma during an acute attack? A: Administer
bronchodilators, provide oxygen, and monitor respiratory status.
 Q: What is the nurse’s role in supporting children with epilepsy? A: Ensure medication
adherence, educate caregivers, and manage seizures safely.
 Q: How do you maintain continuity of care for chronic pediatric patients in
displacement? A: Use patient tracking systems, coordinate with outreach teams, and
ensure medication supply.

💉 Coordination with Immunization Campaigns

 Q: What is the nurse’s role in supporting immunization efforts in the ER? A: Identify
unvaccinated children, provide catch-up vaccinations, and educate caregivers.
 Q: How do you manage vaccine cold chain in a mobile ER setting? A: Use portable
coolers with temperature monitoring and follow MSF cold chain protocols.
 Q: What is the Nursing Activity Manager’s role in immunization coordination? A: Liaise
with public health teams, allocate nursing staff, and monitor coverage rates.
 Q: How do you address vaccine hesitancy among caregivers? A: Provide clear, culturally
sensitive information and involve trusted community figures.
👩⚕️ Staff Supervision & Performance Evaluation
 Q: What is the purpose of regular staff supervision in the ER? A: To ensure quality care,
support professional development, and address challenges early.
 Q: How do you evaluate nursing performance fairly? A: Use objective indicators, direct
observation, peer feedback, and self-assessment.
 Q: What is the Nursing Activity Manager’s role in staff development? A: Identify
training needs, mentor staff, and create growth opportunities.
 Q: How do you handle underperformance in a nurse? A: Provide constructive feedback,
set improvement goals, and offer support or retraining.

📋 Developing SOPs for Maternal-Child ER Operations

 Q: What is the purpose of Standard Operating Procedures (SOPs) in the ER? A: To
standardize care, reduce errors, and ensure consistency across shifts and teams.
 Q: What should be included in an SOP for neonatal resuscitation? A: Step-by-step
actions, equipment checklist, roles, and documentation requirements.
 Q: How do you ensure staff compliance with SOPs? A: Provide training, post SOPs
visibly, and monitor adherence through supervision.
 Q: What is the Nursing Activity Manager’s role in SOP development? A: Draft protocols
with input from staff, align with MSF guidelines, and update regularly.

Emergency Preparedness for Maternal-Child Mass Casualty

Events
 Q: What is the first priority in a mass casualty event involving children and pregnant
women? A: Activate triage protocols and prioritize life-saving interventions based on
severity.
 Q: What triage system is suitable for pediatric mass casualty incidents? A: JumpSTART,
a modified version of START adapted for children.
 Q: What is the Nursing Activity Manager’s role in mass casualty preparedness? A:
Develop response plans, train staff, coordinate with logistics and medical teams, and lead
simulations.
 Q: How do you ensure maternal safety during chaotic emergency influxes? A: Assign
dedicated maternity responders, secure delivery areas, and maintain privacy.

☠️ Managing Pediatric Poisoning and Toxic Exposures

 Q: What are common causes of pediatric poisoning in humanitarian settings? A:
Ingestion of medications, household chemicals, contaminated water, and traditional
remedies.
 Q: What is the first step in managing a child with suspected poisoning? A: Assess
airway, breathing, and circulation; identify the substance if possible.
  Q: What is the nurse’s role in preventing poisoning? A: Educate caregivers, store
medications safely, and monitor high-risk children.
 Q: How do you document a toxic exposure case? A: Record time, substance, symptoms,
interventions, and outcome.

🏘️ Coordination with Maternity Shelters and Safe Spaces

 Q: What is the purpose of maternity shelters in humanitarian contexts? A: To provide
safe lodging for pregnant women near health facilities before delivery.
 Q: How do you coordinate ER referrals from maternity shelters? A: Establish
communication protocols, assign liaisons, and ensure transport readiness.
 Q: What is the Nursing Activity Manager’s role in shelter coordination? A: Monitor
shelter conditions, support health education, and ensure timely referrals.
 Q: How do shelters support maternal outcomes? A: Reduce delays in accessing care,
improve antenatal follow-up, and enhance birth preparedness.

👩⚕️ Integrating Adolescent Reproductive Health into ER

Services
 Q: What are key reproductive health concerns for adolescent girls in emergencies? A:
Early pregnancy, STIs, sexual violence, and lack of contraception access.
 Q: How do you provide youth-friendly care in the ER? A: Ensure privacy, use
nonjudgmental communication, and offer tailored counseling.
 Q: What is the nurse’s role in adolescent reproductive health? A: Educate on safe
practices, provide contraceptive options, and support emotional needs.
 Q: What is the Nursing Activity Manager’s role in adolescent care integration? A: Train
staff in youth-sensitive approaches and coordinate with protection and outreach teams.

📊 Evaluating Nursing-Led Interventions in Maternal-Child

Care
 Q: What are examples of nursing-led interventions in maternal-child ERs? A:
Breastfeeding support, neonatal resuscitation, infection control, and psychosocial care.
 Q: How do you measure the impact of nursing interventions? A: Track outcomes like
reduced complications, improved patient satisfaction, and increased service uptake.
 Q: What is the Nursing Activity Manager’s role in evaluation? A: Design monitoring
tools, analyze data, and share findings with coordination and donors.
 Q: How do you use evaluation results to improve care? A: Identify gaps, adjust
protocols, and implement targeted training.

🩺 Managing Maternal and Pediatric Care During Epidemics

  Q: What are key maternal-child risks during an epidemic (e.g., cholera, measles)? A:
Dehydration, miscarriage, neonatal infection, and increased mortality.
 Q: How do you adapt ER protocols during an epidemic? A: Implement isolation zones,
reinforce IPC measures, and prioritize high-risk patients.
 Q: What is the nurse’s role in epidemic surveillance? A: Identify cases, report trends, and
support contact tracing and community education.
 Q: What is the Nursing Activity Manager’s role in epidemic preparedness? A:
Coordinate training, ensure PPE availability, and align with MSF outbreak response
plans.

🧠 Coordination with Laboratory and Diagnostic Services

 Q: What is the nurse’s role in coordinating diagnostics for maternal-child emergencies?
A: Collect samples, ensure proper labeling, and communicate urgent results.
 Q: How do you prioritize lab tests in resource-limited ERs? A: Based on clinical
urgency—e.g., hemoglobin for hemorrhage, glucose for neonates, malaria tests for febrile
children.
 Q: What is the Nursing Activity Manager’s role in lab coordination? A: Monitor
turnaround times, troubleshoot delays, and ensure staff are trained in sample handling.
 Q: How do you ensure safe blood transfusion practices in pediatric ERs? A: Verify blood
type, monitor for reactions, and follow MSF transfusion protocols.

🧠 Emergency Contraception and Post-Rape Care Protocols

 Q: What is the time window for administering emergency contraception? A: Within 72
hours of unprotected intercourse or sexual assault.
 Q: What is the protocol for post-exposure prophylaxis (PEP) for HIV? A: Start within 72
hours, continue for 28 days, and monitor for side effects.
 Q: What is the nurse’s role in post-rape care for adolescents? A: Provide medical
treatment, emotional support, ensure privacy, and refer to psychosocial services.
 Q: What is the Nursing Activity Manager’s role in ensuring quality post-rape care? A:
Train staff, monitor case handling, and coordinate with protection and legal services.

🍽️ Pediatric Triage for Malnutrition and Dehydration

 Q: What is the first step in triaging a child with suspected severe malnutrition? A:
Measure MUAC, assess for edema, and check for medical complications.
 Q: How do you triage dehydration in children? A: Assess skin turgor, mucous
membranes, capillary refill, and consciousness.
 Q: What is the nurse’s role in managing moderate malnutrition? A: Provide
supplementary feeding, monitor growth, and educate caregivers.
 Q: What is the Nursing Activity Manager’s role in nutrition triage coordination? A:
Align with nutrition teams, ensure staff training, and monitor referral pathways.
🏘️ Building Community Trust in Maternal-Child ER
Services
 Q: Why is community trust essential in maternal-child emergency care? A: It improves
service uptake, reduces stigma, and enhances health outcomes.
 Q: How do you address community rumors about ER care? A: Engage local leaders,
clarify facts, and reinforce MSF’s principles of impartiality and dignity.
 Q: What is the nurse’s role in community engagement? A: Provide respectful care,
educate patients, and listen to concerns.
 Q: What is the Nursing Activity Manager’s role in trust-building? A: Lead outreach
efforts, ensure culturally sensitive care, and respond to feedback.

🩺 Pediatric Emergency Care for Trauma and Burns

 Q: What is the first priority in managing a child with trauma? A: Apply the ABC
approach—Airway, Breathing, Circulation—and stabilize vitals.
 Q: How do you assess burn severity in children? A: Use the Rule of Nines adjusted for
pediatric body proportions and assess depth.
 Q: What is the nurse’s role in pediatric burn care? A: Provide pain relief, prevent
infection, monitor fluid balance, and support wound care.
 Q: What is the Nursing Activity Manager’s role in trauma preparedness? A: Ensure staff
are trained in pediatric trauma protocols and coordinate with surgical teams.

🏕️ Managing Maternal Complications in Remote Areas

 Q: What are common maternal emergencies in remote settings? A: Postpartum
hemorrhage, obstructed labor, eclampsia, and sepsis.
 Q: How do you manage a maternal emergency with delayed referral access? A: Stabilize
the patient, initiate life-saving interventions, and coordinate urgent transport.
 Q: What is the nurse’s role in antenatal care in remote clinics? A: Screen for risk factors,
provide education, and prepare for emergency referrals.
 Q: What is the Nursing Activity Manager’s role in remote maternal care? A: Support
mobile outreach, train staff in emergency protocols, and liaise with transport and
logistics.

🧠 Coordination with Mental Health and Protection Teams

 Q: Why is coordination with protection teams essential in maternal-child ERs? A: To
safeguard vulnerable patients, respond to abuse, and ensure psychosocial support.
 Q: What is the nurse’s role in identifying protection concerns? A: Recognize signs of
neglect, violence, or exploitation and report per protocol.
 Q: How do mental health teams support ER operations? A: Provide crisis counseling,
support staff resilience, and assist with trauma cases.
  Q: What is the Nursing Activity Manager’s role in protection coordination? A: Facilitate
referrals, ensure confidentiality, and train staff in safeguarding procedures.

🌡️ Evaluating ER Readiness for Seasonal Disease Surges

 Q: What diseases commonly surge seasonally in maternal-child populations? A: Malaria,
respiratory infections, diarrheal diseases, and measles.
 Q: How do you prepare the ER for seasonal surges? A: Stock essential supplies, adjust
staffing, and reinforce triage protocols.
 Q: What is the nurse’s role in early detection of seasonal outbreaks? A: Monitor case
trends, report unusual patterns, and support community education.
 Q: What is the Nursing Activity Manager’s role in surge planning? A: Coordinate with
medical and logistics teams, update SOPs, and lead preparedness drills.

🎓 Training Nurses in Emergency Obstetric and Neonatal

Care
 Q: What core skills should ER nurses have in maternal-child emergencies? A: Neonatal
resuscitation, management of hemorrhage, eclampsia treatment, and pediatric triage.
 Q: How do you assess nursing competency in emergency procedures? A: Use
simulations, direct observation, and post-training evaluations.
 Q: What is the Nursing Activity Manager’s role in clinical training? A: Identify gaps,
organize workshops, mentor staff, and evaluate outcomes.
 Q: How do you maintain emergency readiness among nursing staff? A: Conduct regular
refreshers, rotate roles, and encourage peer learning

🩺 Pediatric Emergency Care for Respiratory Distress and

Sepsis
 Q: What are signs of respiratory distress in infants? A: Nasal flaring, grunting, chest
retractions, cyanosis, and tachypnea.
 Q: What is the first-line intervention for a child with severe respiratory distress? A:
Administer oxygen, position upright, and monitor saturation and respiratory rate.
 Q: How do you recognize pediatric sepsis in the ER? A: Fever or hypothermia, lethargy,
poor perfusion, tachycardia, and altered mental status.
 Q: What is the nurse’s role in managing pediatric sepsis? A: Initiate IV fluids, administer
antibiotics promptly, and monitor for shock.

🧠 Managing Maternal Mental Health in Crisis Zones

 Q: What are common maternal mental health challenges in humanitarian settings? A:
Postpartum depression, anxiety, PTSD, and grief after loss.
  Q: How do you support a mother showing signs of depression? A: Provide a safe space
to talk, validate her feelings, and refer to mental health services.
 Q: What is the Nursing Activity Manager’s role in maternal mental health care? A: Train
staff in psychological first aid, coordinate with mental health teams, and ensure follow-
up.
 Q: How do you reduce stigma around mental health in maternal care? A: Normalize
emotional support, use culturally sensitive language, and involve community leaders.

🧠🍼 Coordination with Community Birth Attendants

 Q: What is the role of community birth attendants in maternal-child health? A: Provide
basic delivery care, identify complications, and refer to health facilities.
 Q: How do you train birth attendants to recognize danger signs? A: Use visual tools,
role-play scenarios, and reinforce referral protocols.
 Q: What is the Nursing Activity Manager’s role in birth attendant coordination? A: Build
relationships, offer supervision, and integrate them into emergency referral systems.
 Q: How do birth attendants improve maternal outcomes in remote areas? A: By reducing
delays in care, promoting safe practices, and linking communities to health services.

🧠 Emergency Preparedness for Disease Outbreaks in

Maternity Wards
 Q: What are key IPC measures in maternity wards during outbreaks? A: Hand hygiene,
PPE use, patient isolation, and environmental cleaning.
 Q: How do you manage a laboring mother with suspected infectious disease? A: Isolate
safely, assign dedicated staff, and follow outbreak-specific delivery protocols.
 Q: What is the nurse’s role in outbreak surveillance in maternity care? A: Monitor
symptoms, report clusters, and educate patients on prevention.
 Q: What is the Nursing Activity Manager’s role in outbreak readiness? A: Update SOPs,
ensure staff training, and coordinate with public health teams.

🧠⚕️ Developing Mentorship Programs for Junior Nurses in

Maternal-Child ERs
 Q: Why is mentorship important in humanitarian nursing? A: It builds confidence,
improves clinical skills, and strengthens team cohesion.
 Q: What should be included in a mentorship plan? A: Clear goals, regular check-ins, skill
assessments, and feedback sessions.
 Q: What is the Nursing Activity Manager’s role in mentorship? A: Pair mentors with
mentees, monitor progress, and foster a supportive learning environment.
 Q: How do you evaluate the success of a mentorship program? A: Track competency
improvements, retention rates, and mentee satisfaction.
🩺 Pediatric Emergency Care for Neurological Conditions
 Q: What are signs of increased intracranial pressure in children? A: Vomiting, altered
consciousness, bulging fontanelle (in infants), and bradycardia.
 Q: How do you manage a child presenting with seizures in the ER? A: Ensure airway
safety, administer anticonvulsants, monitor vitals, and identify underlying cause.
 Q: What is the nurse’s role in post-seizure care? A: Monitor for recurrence, document
seizure activity, and provide reassurance to caregivers.
 Q: What is the Nursing Activity Manager’s role in neurological emergency
preparedness? A: Ensure staff are trained in seizure protocols and coordinate with
pediatric specialists if available.

🏕️ Managing Maternal Complications During Humanitarian

Evacuations
 Q: What are risks for pregnant women during emergency evacuations? A: Preterm labor,
trauma, dehydration, and lack of access to skilled care.
 Q: How do you manage a laboring mother during transport? A: Monitor contractions,
ensure airway and circulation, prepare for delivery, and maintain privacy.
 Q: What is the nurse’s role in evacuation planning for maternal patients? A: Identify
high-risk cases, prepare emergency kits, and coordinate with transport teams.
 Q: What is the Nursing Activity Manager’s role in evacuation protocols? A: Develop
contingency plans, train staff, and liaise with logistics and protection teams.

🛡️ Coordination with Child Protection and Legal Services

 Q: What are signs that a child may be at risk of abuse or exploitation? A: Unexplained
injuries, fearfulness, inconsistent stories, and signs of neglect.
 Q: What is the nurse’s responsibility when child protection concerns arise? A: Document
findings, ensure safety, and report to designated protection focal points.
 Q: How do legal services support child protection in humanitarian settings? A: They help
navigate custody issues, ensure rights are upheld, and support justice processes.
 Q: What is the Nursing Activity Manager’s role in protection coordination? A: Ensure
protocols are followed, staff are trained, and cases are escalated appropriately.

📊 Evaluating Nursing Workload and Staffing Needs

 Q: What indicators help assess nursing workload in the ER? A: Patient-to-nurse ratio,
acuity levels, overtime hours, and incident reports.
 Q: How do you adjust staffing during peak patient influx? A: Reassign duties, extend
shifts if needed, and request surge support from coordination.
 Q: What is the nurse’s role in reporting workload challenges? A: Communicate concerns
clearly, document impact on care, and suggest solutions.
  Q: What is the Nursing Activity Manager’s role in staffing evaluation? A: Monitor
trends, advocate for resources, and balance quality care with staff well-being.

💻 Integrating Digital Tools for Maternal-Child ER

Documentation
 Q: What are benefits of digital documentation in emergency care? A: Improved
accuracy, faster data retrieval, and better coordination across departments.
 Q: What challenges arise when implementing digital tools in low-resource settings? A:
Limited connectivity, staff unfamiliarity, and data security concerns.
 Q: How do nurses ensure data confidentiality in digital systems? A: Use secure logins,
avoid sharing devices, and follow MSF data protection protocols.
 Q: What is the Nursing Activity Manager’s role in digital integration? A: Train staff,
troubleshoot issues, and ensure compliance with documentation standards.

Pediatric Emergency Care for Dehydration and Shock

 Q: What are signs of severe dehydration in children? A: Sunken eyes, lethargy, poor skin
turgor, dry mucous membranes, and weak pulse.
 Q: What is the first-line treatment for pediatric hypovolemic shock? A: Rapid IV fluid
resuscitation with isotonic crystalloids (e.g., normal saline or Ringer’s lactate).
 Q: How do you assess fluid status in infants? A: Monitor urine output, weight changes,
capillary refill, and fontanelle tension.
 Q: What is the Nursing Activity Manager’s role in managing dehydration protocols? A:
Ensure staff are trained, monitor treatment outcomes, and coordinate with nutrition and
pharmacy teams.

👩🍼 Managing Maternal Complications in Adolescent

Pregnancies
 Q: Why are adolescent pregnancies considered high-risk? A: Increased risk of preterm
labor, obstructed labor, anemia, and hypertensive disorders.
 Q: How do you support an adolescent mother experiencing complications? A: Provide
respectful care, ensure privacy, offer counseling, and involve psychosocial support.
 Q: What is the nurse’s role in antenatal care for adolescents? A: Screen for risk factors,
educate on nutrition and hygiene, and prepare for safe delivery.
 Q: What is the Nursing Activity Manager’s role in adolescent maternal care? A: Train
staff in youth-sensitive approaches and coordinate with protection and mental health
services.

🧠 Coordination with Nutrition and Feeding Programs

  Q: What is the nurse’s role in linking ER patients to nutrition programs? A: Identify
malnourished children and mothers, refer to feeding centers, and monitor follow-up.
 Q: How do nutrition programs support maternal-child health in emergencies? A: Provide
therapeutic and supplementary feeding, micronutrient support, and education.
 Q: What is the Nursing Activity Manager’s role in nutrition coordination? A: Align ER
triage with nutrition screening, ensure referral pathways, and monitor program impact.
 Q: How do you integrate nutrition education into ER discharge planning? A: Offer brief
counseling, distribute materials, and schedule follow-up with nutrition teams.

📈 Evaluating ER Impact on Maternal and Child Mortality

 Q: What indicators help assess ER impact on maternal mortality? A: Number of maternal
deaths, causes, time to intervention, and referral effectiveness.
 Q: What pediatric indicators reflect ER performance? A: Under-five mortality,
successful resuscitations, infection control compliance, and nutrition recovery rates.
 Q: What is the Nursing Activity Manager’s role in impact evaluation? A: Compile data,
analyze trends, lead quality improvement initiatives, and report to coordination.
 Q: How do you use mortality reviews to improve ER care? A: Identify gaps, revise
protocols, train staff, and implement corrective actions.

🌍 Training Nurses in Culturally Sensitive Care for

Displaced Populations
 Q: Why is cultural sensitivity critical in maternal-child ERs? A: It builds trust, improves
care uptake, and ensures respectful treatment.
 Q: How do you train nurses in culturally sensitive care? A: Use case studies, role-play,
involve community leaders, and reinforce MSF principles.
 Q: What is the nurse’s role in adapting care to cultural norms? A: Respect beliefs, use
interpreters, involve family when appropriate, and avoid judgment.
 Q: What is the Nursing Activity Manager’s role in promoting cultural competence? A:
Lead training, monitor staff behavior, and respond to community feedback.

Pediatric Emergency Care for Infectious Diseases

 Q: What are common infectious diseases in children in humanitarian settings? A:
Measles, pneumonia, malaria, cholera, and tuberculosis.
 Q: What is the first step in managing a child with suspected measles? A: Isolate the
patient, provide supportive care, and notify outbreak surveillance teams.
 Q: How do you manage pediatric pneumonia in the ER? A: Administer oxygen, start
antibiotics, and monitor respiratory status.
 Q: What is the Nursing Activity Manager’s role in infectious disease response? A:
Ensure staff training, coordinate IPC measures, and monitor case trends.
🧠 Managing Maternal Complications During Prolonged
Labor
 Q: What are risks associated with prolonged labor? A: Fetal distress, uterine rupture,
infection, and postpartum hemorrhage.
 Q: How do you manage a mother in prolonged labor without access to surgical care? A:
Monitor closely, provide hydration and pain relief, and prepare for emergency referral.
 Q: What is the nurse’s role in identifying obstructed labor? A: Assess cervical dilation,
fetal position, and contraction patterns.
 Q: What is the Nursing Activity Manager’s role in managing prolonged labor cases? A:
Ensure timely escalation, coordinate with obstetric teams, and monitor maternal
outcomes.

🚑 Coordination with Emergency Transport and Referral

Systems
 Q: What is the nurse’s role in preparing a maternal or pediatric patient for referral? A:
Stabilize the patient, prepare documentation, and communicate with receiving facility.
 Q: How do you prioritize transport during multiple emergencies? A: Use triage criteria,
assess severity, and coordinate with logistics.
 Q: What challenges affect emergency transport in humanitarian settings? A: Poor roads,
security risks, fuel shortages, and limited vehicles.
 Q: What is the Nursing Activity Manager’s role in referral coordination? A: Maintain
referral protocols, liaise with transport teams, and track outcomes.

🧠 Staff Wellness Strategies in Maternal-Child ERs

 Q: What are signs of burnout in ER nurses? A: Fatigue, emotional withdrawal,
irritability, and decreased performance.
 Q: How do you promote wellness among ER staff? A: Provide rest breaks, mental health
support, peer debriefings, and recognition.
 Q: What is the nurse’s role in supporting team morale? A: Encourage teamwork, listen to
concerns, and model positive behavior.
 Q: What is the Nursing Activity Manager’s role in staff wellness? A: Monitor stress
levels, adjust workloads, and foster a supportive environment.

🧠⚕️ Designing Orientation Programs for New ER Nurses in

Humanitarian Settings
 Q: What should be included in a maternal-child ER orientation? A: Triage protocols,
emergency procedures, IPC standards, and MSF principles.
  Q: How do you assess readiness of new nurses? A: Observe clinical skills, review
documentation, and conduct competency tests.
 Q: What is the nurse’s role in onboarding peers? A: Share practical tips, offer
mentorship, and reinforce protocols.
 Q: What is the Nursing Activity Manager’s role in orientation? A: Design training plans,
assign mentors, and evaluate progress.

🩺 Pediatric Emergency Care for Anemia and Malnutrition

 Q: What are signs of severe anemia in children? A: Pallor, fatigue, tachycardia, shortness
of breath, and delayed capillary refill.
 Q: How do you manage a child with severe anemia in the ER? A: Stabilize, administer
oxygen, prepare for blood transfusion, and treat underlying cause (e.g., malaria,
malnutrition).
 Q: What is the nurse’s role in managing moderate malnutrition? A: Provide
supplementary feeding, monitor weight gain, and educate caregivers on nutrition.
 Q: What is the Nursing Activity Manager’s role in anemia and malnutrition care? A:
Coordinate with nutrition teams, ensure screening protocols, and monitor treatment
outcomes.

👶 Managing Maternal Complications in Twin Pregnancies

 Q: What are common complications in twin pregnancies? A: Preterm labor,
preeclampsia, postpartum hemorrhage, and fetal growth restriction.
 Q: How do you monitor a mother with a twin pregnancy in the ER? A: Track fetal heart
rates, assess uterine size, monitor blood pressure, and prepare for possible surgical
delivery.
 Q: What is the nurse’s role during twin delivery? A: Assist with positioning, monitor
both fetuses, and prepare for neonatal resuscitation.
 Q: What is the Nursing Activity Manager’s role in managing twin pregnancies? A:
Ensure staff readiness, coordinate with obstetric and neonatal teams, and monitor
maternal outcomes.

🏘️ Coordination with Community Health Education Teams

 Q: What is the purpose of community health education in maternal-child care? A: To
promote preventive practices, improve care-seeking behavior, and reduce ER burden.
 Q: What topics should be prioritized in community health sessions? A: Antenatal care,
breastfeeding, hygiene, nutrition, and recognizing danger signs.
 Q: What is the nurse’s role in supporting health education? A: Share clinical insights,
reinforce messages during discharge, and collaborate with outreach workers.
 Q: What is the Nursing Activity Manager’s role in education coordination? A: Align ER
priorities with outreach messaging, monitor impact, and support training of educators.
🧠 Emergency Response to Maternal-Child Gender-Based
Violence
 Q: What are signs of GBV in mothers or children presenting to the ER? A: Unexplained
injuries, fearfulness, inconsistent histories, and signs of psychological trauma.
 Q: What is the protocol for managing GBV survivors? A: Ensure safety, provide medical
and psychosocial care, document findings, and refer to protection services.
 Q: What is the nurse’s role in GBV response? A: Offer compassionate care, maintain
confidentiality, and support informed decision-making.
 Q: What is the Nursing Activity Manager’s role in GBV coordination? A: Train staff,
ensure protocol adherence, and liaise with legal and protection teams.

🧠 Building Leadership Capacity Among Nursing

Supervisors
 Q: Why is leadership development important in humanitarian nursing? A: It strengthens
team performance, improves decision-making, and ensures sustainability.
 Q: How do you identify leadership potential in nursing supervisors? A: Observe
initiative, communication skills, clinical judgment, and ability to mentor others.
 Q: What is the nurse’s role in supporting peer leadership? A: Share responsibilities,
provide feedback, and encourage collaboration.
 Q: What is the Nursing Activity Manager’s role in leadership development? A: Provide
mentorship, delegate strategic tasks, and support professional growth pathways.

❤️ Pediatric Emergency Care for Congenital Heart

Conditions
 Q: What are signs of congenital heart disease in infants? A: Cyanosis, poor feeding,
tachypnea, failure to thrive, and heart murmurs.
 Q: How do you manage a child with suspected congenital heart disease in the ER? A:
Stabilize with oxygen, monitor vitals, avoid fluid overload, and prepare for referral.
 Q: What is the nurse’s role in supporting cardiac care? A: Monitor for signs of
decompensation, administer medications, and educate caregivers.
 Q: What is the Nursing Activity Manager’s role in congenital heart care coordination? A:
Ensure staff are trained in early recognition and facilitate timely referrals to specialized
care.

🧠 Managing Maternal Complications During Infectious

Disease Outbreaks
 Q: What are risks for pregnant women during outbreaks like cholera or malaria? A:
Dehydration, miscarriage, anemia, and increased maternal mortality.
  Q: How do you manage a laboring mother with suspected infectious disease? A: Isolate
appropriately, monitor closely, and follow outbreak-specific delivery protocols.
 Q: What is the nurse’s role in outbreak response for maternal patients? A: Provide safe
care, reinforce IPC measures, and educate on prevention.
 Q: What is the Nursing Activity Manager’s role in outbreak coordination? A: Align
maternity protocols with outbreak response plans and ensure staff readiness.

🚐 Coordination with Mobile Clinics and Outreach Teams

 Q: What is the purpose of mobile clinics in maternal-child health? A: To reach
underserved populations with antenatal care, vaccinations, and basic pediatric services.
 Q: How do you ensure continuity of care between mobile clinics and the ER? A: Use
referral forms, track patient follow-up, and maintain communication between teams.
 Q: What is the nurse’s role in mobile outreach? A: Provide assessments, basic
treatments, and health education in the field.
 Q: What is the Nursing Activity Manager’s role in mobile clinic coordination? A: Plan
outreach schedules, allocate nursing staff, and monitor service impact.

📊 Evaluating ER Efficiency and Patient Flow

 Q: What metrics help evaluate ER efficiency? A: Time to triage, length of stay, patient
throughput, and re-admission rates.
 Q: How do you reduce bottlenecks in maternal-child ERs? A: Streamline triage, fast-
track minor cases, and improve handover systems.
 Q: What is the nurse’s role in improving patient flow? A: Prioritize care, communicate
delays, and support discharge planning.
 Q: What is the Nursing Activity Manager’s role in optimizing ER operations? A:
Analyze workflow, adjust staffing, and implement quality improvement strategies.

🎓 Designing Continuing Education Plans for Maternal-

Child Nurses
 Q: Why is continuing education critical in humanitarian nursing? A: It maintains clinical
competency, improves care quality, and boosts staff morale.
 Q: What topics should be prioritized in maternal-child ER training? A: Neonatal
resuscitation, obstetric emergencies, pediatric triage, and IPC protocols.
 Q: How do you assess training needs among nursing staff? A: Use performance reviews,
incident reports, and staff feedback.
 Q: What is the Nursing Activity Manager’s role in continuing education? A: Develop
training plans, organize sessions, and evaluate learning outcomes.

Pediatric Emergency Care for Burns and Trauma

  Q: What is the first priority in managing a child with burn injuries? A: Stop the burning
process, assess airway and breathing, and begin fluid resuscitation if indicated.
 Q: How do you estimate burn surface area in children? A: Use the Lund and Browder
chart, which adjusts for pediatric body proportions.
 Q: What is the nurse’s role in pediatric trauma care? A: Stabilize the patient, monitor
vitals, provide pain relief, and support emotional needs.
 Q: What is the Nursing Activity Manager’s role in trauma preparedness? A: Ensure staff
are trained in pediatric trauma protocols and coordinate with surgical and psychosocial
teams.

🏕️ Managing Maternal Complications in Displaced

Populations
 Q: What are common maternal health risks in displacement settings? A: Lack of
antenatal care, malnutrition, exposure to violence, and delayed access to emergency
services.
 Q: How do you support a pregnant woman in a temporary shelter with no medical
history? A: Conduct a full assessment, estimate gestational age, and initiate antenatal
protocols.
 Q: What is the nurse’s role in maternal care during displacement? A: Provide respectful
care, monitor for complications, and educate on danger signs.
 Q: What is the Nursing Activity Manager’s role in displaced maternal care coordination?
A: Liaise with shelter teams, ensure safe delivery environments, and support mobile
outreach.

🧠 Coordination with Mental Health and Psychosocial

Support Teams
 Q: Why is mental health integration essential in maternal-child ERs? A: It addresses
trauma, supports recovery, and improves overall health outcomes.
 Q: What is the nurse’s role in identifying psychosocial needs? A: Observe behavior,
listen actively, and refer to mental health professionals.
 Q: How do psychosocial teams support ER operations? A: Provide crisis counseling,
assist with GBV cases, and support staff resilience.
 Q: What is the Nursing Activity Manager’s role in mental health coordination? A:
Facilitate referrals, ensure staff training, and monitor integration of services.

🌪️ Emergency Planning for Maternal-Child Care During

Natural Disasters
 Q: What are key maternal-child risks during natural disasters? A: Trauma, premature
labor, disrupted care access, and increased infection risk.
  Q: How do you prepare the ER for disaster scenarios? A: Conduct drills, stock
emergency supplies, assign roles, and secure safe spaces for delivery and pediatric care.
 Q: What is the nurse’s role during disaster response? A: Triage patients, stabilize critical
cases, and support family reunification.
 Q: What is the Nursing Activity Manager’s role in disaster planning? A: Lead
preparedness efforts, coordinate with logistics and protection teams, and ensure
continuity of maternal-child services.

🧠 Building Peer Support Networks Among ER Nursing

Staff
 Q: Why is peer support important in high-stress ER environments? A: It reduces burnout,
fosters resilience, and strengthens team cohesion.
 Q: How do you establish a peer support system? A: Identify peer leaders, schedule
regular debriefings, and create safe spaces for sharing.
 Q: What is the nurse’s role in peer support? A: Offer empathy, share experiences, and
encourage open communication.
 Q: What is the Nursing Activity Manager’s role in sustaining peer support? A: Promote a
culture of care, monitor staff well-being, and integrate support into daily routines.

🩺 Pediatric Emergency Care for Neurological Disorders and

Developmental Delays
 Q: What are signs of cerebral palsy in infants? A: Delayed milestones, muscle stiffness
or floppiness, poor coordination, and abnormal reflexes.
 Q: How do you manage a child with a known seizure disorder presenting with
convulsions? A: Ensure airway safety, administer prescribed anticonvulsants, and
monitor for postictal symptoms.
 Q: What is the nurse’s role in supporting children with developmental delays? A:
Provide tailored care, involve caregivers, and refer to rehabilitation or specialist services.
 Q: What is the Nursing Activity Manager’s role in neurological care coordination? A:
Ensure staff are trained in early recognition and support integration with mental health
and rehab teams.

🏔️ Managing Maternal Complications in High-Altitude or

Extreme Environments
 Q: What are risks for pregnant women at high altitudes? A: Hypoxia, preeclampsia, fetal
growth restriction, and preterm labor.
 Q: How do you adapt maternal care in extreme heat or cold? A: Ensure hydration,
temperature regulation, and monitor for environmental stress symptoms.
 Q: What is the nurse’s role in managing altitude-related complications? A: Monitor
oxygen saturation, assess for headache or dizziness, and escalate if needed.
  Q: What is the Nursing Activity Manager’s role in adapting care to extreme
environments? A: Modify protocols, ensure equipment readiness, and train staff in
environmental risk management.

🧠 Coordination with Local Midwives and Traditional Birth

Attendants
 Q: Why is collaboration with traditional birth attendants important in humanitarian
settings? A: They are trusted by communities and can facilitate early referrals and health
education.
 Q: How do you train birth attendants to recognize emergency signs? A: Use visual tools,
role-play scenarios, and reinforce referral pathways.
 Q: What is the nurse’s role in supporting traditional practices safely? A: Respect cultural
norms while promoting evidence-based care and hygiene standards.
 Q: What is the Nursing Activity Manager’s role in midwife coordination? A: Build
partnerships, offer supervision, and integrate them into maternal health strategies.

🏚️ Evaluating ER Preparedness for Mass Displacement

Events
 Q: What are key maternal-child health risks during mass displacement? A: Malnutrition,
trauma, infectious disease, disrupted antenatal care, and GBV.
 Q: How do you prepare the ER for sudden influxes of displaced families? A: Expand
triage capacity, stock emergency kits, and coordinate with shelter and protection teams.
 Q: What is the nurse’s role during mass displacement emergencies? A: Triage efficiently,
provide compassionate care, and support family reunification.
 Q: What is the Nursing Activity Manager’s role in displacement response? A: Lead
preparedness planning, monitor service strain, and advocate for additional resources.

🧠 Designing Leadership Workshops for Nursing

Supervisors in Humanitarian Missions
 Q: What topics should be included in a leadership workshop for nursing supervisors? A:
Conflict resolution, team motivation, ethical decision-making, and crisis communication.
 Q: How do you assess leadership growth among supervisors? A: Use feedback tools,
observe team dynamics, and track performance indicators.
 Q: What is the nurse’s role in peer leadership development? A: Share experiences,
mentor others, and model professional behavior.
 Q: What is the Nursing Activity Manager’s role in leadership capacity building? A:
Facilitate workshops, provide coaching, and create opportunities for advancement.
🩺 Pediatric Emergency Care for Neurological Disorders and
Developmental Delays
 Q: What are signs of cerebral palsy in infants? A: Delayed milestones, muscle stiffness
or floppiness, poor coordination, and abnormal reflexes.
 Q: How do you manage a child with a known seizure disorder presenting with
convulsions? A: Ensure airway safety, administer prescribed anticonvulsants, and
monitor for postictal symptoms.
 Q: What is the nurse’s role in supporting children with developmental delays? A:
Provide tailored care, involve caregivers, and refer to rehabilitation or specialist services.
 Q: What is the Nursing Activity Manager’s role in neurological care coordination? A:
Ensure staff are trained in early recognition and support integration with mental health
and rehab teams.

🏔️ Managing Maternal Complications in High-Altitude or

Extreme Environments
 Q: What are risks for pregnant women at high altitudes? A: Hypoxia, preeclampsia, fetal
growth restriction, and preterm labor.
 Q: How do you adapt maternal care in extreme heat or cold? A: Ensure hydration,
temperature regulation, and monitor for environmental stress symptoms.
 Q: What is the nurse’s role in managing altitude-related complications? A: Monitor
oxygen saturation, assess for headache or dizziness, and escalate if needed.
 Q: What is the Nursing Activity Manager’s role in adapting care to extreme
environments? A: Modify protocols, ensure equipment readiness, and train staff in
environmental risk management.

🧠 Coordination with Local Midwives and Traditional Birth

Attendants
 Q: Why is collaboration with traditional birth attendants important in humanitarian
settings? A: They are trusted by communities and can facilitate early referrals and health
education.
 Q: How do you train birth attendants to recognize emergency signs? A: Use visual tools,
role-play scenarios, and reinforce referral pathways.
 Q: What is the nurse’s role in supporting traditional practices safely? A: Respect cultural
norms while promoting evidence-based care and hygiene standards.
 Q: What is the Nursing Activity Manager’s role in midwife coordination? A: Build
partnerships, offer supervision, and integrate them into maternal health strategies.

🏚️ Evaluating ER Preparedness for Mass Displacement

Events
  Q: What are key maternal-child health risks during mass displacement? A: Malnutrition,
trauma, infectious disease, disrupted antenatal care, and GBV.
 Q: How do you prepare the ER for sudden influxes of displaced families? A: Expand
triage capacity, stock emergency kits, and coordinate with shelter and protection teams.
 Q: What is the nurse’s role during mass displacement emergencies? A: Triage efficiently,
provide compassionate care, and support family reunification.
 Q: What is the Nursing Activity Manager’s role in displacement response? A: Lead
preparedness planning, monitor service strain, and advocate for additional resources.

🧠 Designing Leadership Workshops for Nursing

Supervisors in Humanitarian Missions
 Q: What topics should be included in a leadership workshop for nursing supervisors? A:
Conflict resolution, team motivation, ethical decision-making, and crisis communication.
 Q: How do you assess leadership growth among supervisors? A: Use feedback tools,
observe team dynamics, and track performance indicators.
 Q: What is the nurse’s role in peer leadership development? A: Share experiences,
mentor others, and model professional behavior.
 Q: What is the Nursing Activity Manager’s role in leadership capacity building? A:
Facilitate workshops, provide coaching, and create opportunities for advancement.

🩺 Pediatric Emergency Care for Acute Respiratory

Infections
 Q: What are common respiratory infections in children in humanitarian settings? A:
Pneumonia, bronchiolitis, tuberculosis, and upper respiratory tract infections.
 Q: What are signs of severe pneumonia in children? A: Chest indrawing, fast breathing,
cyanosis, and inability to feed.
 Q: What is the nurse’s role in managing respiratory infections? A: Administer antibiotics
and oxygen, monitor respiratory rate and saturation, and educate caregivers.
 Q: What is the Nursing Activity Manager’s role in respiratory care coordination? A:
Ensure triage protocols are followed, staff are trained, and oxygen supply is maintained.

🧠 Managing Maternal Complications in the Postpartum

Period
 Q: What are common postpartum complications? A: Hemorrhage, infection
(endometritis), retained placenta, and postpartum depression.
 Q: How do you manage postpartum hemorrhage in the ER? A: Administer uterotonics,
initiate IV fluids, monitor vitals, and prepare for surgical intervention if needed.
 Q: What is the nurse’s role in postpartum monitoring? A: Check uterine tone, bleeding,
temperature, and emotional well-being.
  Q: What is the Nursing Activity Manager’s role in postpartum care oversight? A: Ensure
protocols are followed, staff are trained in early detection, and follow-up systems are in
place.

🏕️ Coordination with Shelter and Sanitation Teams

 Q: Why is shelter and sanitation coordination critical in maternal-child ERs? A: It
prevents disease, supports hygiene, and ensures safe spaces for care.
 Q: What is the nurse’s role in identifying sanitation risks? A: Report poor hygiene
conditions, educate patients, and support WASH interventions.
 Q: How do shelter conditions affect maternal-child health outcomes? A: Overcrowding
and poor ventilation increase infection risk and reduce access to care.
 Q: What is the Nursing Activity Manager’s role in shelter coordination? A: Liaise with
WASH teams, advocate for improvements, and monitor health impacts.

📋 Evaluating Nursing Documentation Standards

 Q: Why is accurate documentation essential in emergency care? A: It ensures continuity,
supports legal protection, and informs clinical decisions.
 Q: What should be included in a pediatric ER chart? A: Vital signs, symptoms,
interventions, medications, and response to treatment.
 Q: What is the nurse’s role in maintaining documentation quality? A: Record promptly,
use clear language, and follow standardized formats.
 Q: What is the Nursing Activity Manager’s role in documentation oversight? A: Conduct
audits, train staff, and ensure compliance with MSF standards.

🚨 Building Emergency Response Teams for Maternal-Child

Crises
 Q: What roles should be included in a maternal-child emergency response team? A:
Triage nurse, midwife, pediatric nurse, logistician, and psychosocial support staff.
 Q: How do you train ER teams for rapid response? A: Conduct simulations, assign clear
roles, and review protocols regularly.
 Q: What is the nurse’s role in team-based emergency care? A: Communicate clearly, act
swiftly, and support coordination across disciplines.
 Q: What is the Nursing Activity Manager’s role in team building? A: Identify strengths,
foster collaboration, and lead preparedness planning.

💩 Pediatric Emergency Care for Diarrhea and Electrolyte

Imbalance
  Q: What are signs of severe dehydration due to diarrhea in children? A: Sunken eyes,
lethargy, dry mucous membranes, poor skin turgor, and weak pulse.
 Q: How do you manage a child with acute watery diarrhea and signs of shock? A: Initiate
rapid IV fluid resuscitation, monitor electrolytes, and begin zinc supplementation.
 Q: What is the nurse’s role in preventing diarrhea-related complications? A: Educate
caregivers on hygiene, oral rehydration, and early care-seeking.
 Q: What is the Nursing Activity Manager’s role in diarrhea case management? A: Ensure
triage protocols, monitor treatment outcomes, and coordinate with WASH and nutrition
teams.

🧠 Managing Maternal Complications in Late Pregnancy

 Q: What are common complications in the third trimester? A: Pre-eclampsia, placental
abruption, preterm labor, and gestational diabetes.
 Q: How do you manage a mother presenting with high blood pressure and headache? A:
Assess for pre-eclampsia, monitor fetal status, administer antihypertensives, and prepare
for possible delivery.
 Q: What is the nurse’s role in late pregnancy monitoring? A: Track vitals, fetal
movement, signs of labor, and educate on danger signs.
 Q: What is the Nursing Activity Manager’s role in managing third-trimester
complications? A: Ensure staff readiness, align with obstetric protocols, and coordinate
emergency referrals.

🕵️ Coordination with Community-Based Surveillance

Systems
 Q: What is the purpose of community-based surveillance in maternal-child health? A: To
detect outbreaks, monitor health trends, and identify vulnerable populations early.
 Q: How do nurses contribute to surveillance efforts? A: Report cases, share data with
outreach teams, and support follow-up visits.
 Q: What is the Nursing Activity Manager’s role in surveillance coordination? A: Liaise
with public health teams, ensure timely reporting, and integrate ER data into community
systems.
 Q: How does surveillance improve ER response? A: It enables early preparation, targeted
interventions, and better resource allocation.

📚 Designing Patient Education Materials for Maternal-

Child ERs
 Q: What makes patient education materials effective in low-literacy settings? A: Use of
visuals, simple language, culturally relevant examples, and verbal reinforcement.
 Q: What topics should be prioritized in ER discharge education? A: Postpartum care,
newborn danger signs, breastfeeding, hygiene, and follow-up instructions.
  Q: What is the nurse’s role in delivering education? A: Explain clearly, answer
questions, and ensure understanding before discharge.
 Q: What is the Nursing Activity Manager’s role in education material development? A:
Oversee content creation, test materials with patients, and train staff in delivery.

⚖️ Evaluating Nursing Impact on Health Equity in Crisis

Settings
 Q: What does health equity mean in humanitarian nursing? A: Providing care based on
need, without discrimination, and addressing barriers to access.
 Q: How do nurses promote equity in maternal-child ERs? A: Prioritize vulnerable
patients, adapt care to cultural contexts, and advocate for underserved groups.
 Q: What indicators help measure nursing impact on equity? A: Service uptake among
marginalized groups, patient satisfaction, and reduced disparities in outcomes.
 Q: What is the Nursing Activity Manager’s role in advancing health equity? A: Monitor
access trends, train staff in inclusive care, and collaborate with community leaders.

🩺 Understanding Pediatric Malnutrition

Types of Malnutrition:

 Severe Acute Malnutrition (SAM):

o MUAC < 115 mm (6–59 months)
o Weight-for-height Z-score < -3
o Bilateral pitting edema
 Moderate Acute Malnutrition (MAM):
o MUAC 115–125 mm
o Weight-for-height Z-score between -2 and -3
 Chronic Malnutrition (Stunting):
o Height-for-age Z-score < -2
 Micronutrient Deficiencies:
o Common: Iron, Vitamin A, Zinc

🧠 Diagnosing Malnutrition in Children

Key Assessment Tools:

 MUAC (Mid-Upper Arm Circumference):

o Fast, field-friendly, and reliable for 6–59 months
 Weight-for-Height Z-score:
o Requires accurate scales and height boards
 Edema Check:
o Press on tops of feet for 3 seconds; if pitting remains, it’s a sign of kwashiorkor
 Clinical Signs:
 o Lethargy, wasting, skin changes, hair discoloration, recurrent infections
 Appetite Test (for outpatient eligibility):
o Offer RUTF (Ready-to-Use Therapeutic Food); refusal may indicate need for
inpatient care

🏥 Management of Malnourished Children

Inpatient Management (Complicated SAM):

 Indications:
o Medical complications, poor appetite, severe edema, under 6 months
 Treatment Protocols:
o Phase 1 (Stabilization):
 F-75 therapeutic milk
 Treat infections empirically
 Monitor vitals and glucose
o Phase 2 (Transition):
 Switch to F-100 or RUTF
 Begin catch-up growth
o Phase 3 (Rehabilitation):
 Nutritional recovery and psychosocial stimulation

Outpatient Management (Uncomplicated SAM):

 RUTF (e.g., Plumpy’Nut)

 Weekly follow-up for weight gain, appetite, and clinical signs
 Deworming, Vitamin A, and immunizations as needed

🧠⚕️ Nursing Roles in Malnutrition Management

 Screening:
o Integrate MUAC and edema checks into triage
o Train staff and CHWs for early detection
 Monitoring:
o Daily weight, temperature, hydration status
o Track progress and flag deterioration
 Caregiver Education:
o Feeding techniques, hygiene, danger signs
o Encourage continued breastfeeding
 Documentation:
o Use standardized nutrition registers
o Record anthropometric data and treatment outcomes

🧠 Nursing Activity Manager Responsibilities

  Protocol Oversight:
o Ensure MSF malnutrition protocols are followed
o Supervise staff adherence and update SOPs
 Coordination:
o Liaise with nutrition teams, pharmacy, and outreach services
o Ensure supply of RUTF, F-75, F-100, and micronutrients
 Quality Improvement:
o Audit nutrition outcomes
o Identify gaps in screening and follow-up
 Community Linkage:
o Support CHW training
o Strengthen referral pathways from shelters and mobile clinics

🚦 Emergency Triage for Malnourished Children

Priority Assessment:

 Red (Immediate):
o Lethargy or unconsciousness
o Severe dehydration with shock
o Severe edema with respiratory distress
o Hypoglycemia or hypothermia
 Yellow (Urgent):
o Moderate dehydration
o Fever with signs of infection
o Poor appetite but stable vitals
 Green (Stable):
o Mild malnutrition, good appetite, no complications

Nursing Actions:

 Rapid MUAC and edema check at triage

 Immediate glucose test if lethargic
 Prioritize stabilization before transfer to nutrition unit

⚠️ Managing Refeeding Syndrome and Medical

Complications
What is Refeeding Syndrome?

 A potentially fatal shift in fluids and electrolytes when nutrition is reintroduced too
quickly in severely malnourished children.

Signs to Watch For:

  Hypophosphatemia, hypokalemia, hypomagnesemia
 Edema, arrhythmias, confusion, seizures

Prevention:

 Start with F-75 (low-protein, low-sodium)

 Monitor electrolytes daily
 Gradually increase caloric intake

Other Common Complications:

 Hypoglycemia: Treat with glucose immediately

 Hypothermia: Use skin-to-skin contact or warming blankets
 Infections: Empirical antibiotics often required
 Anemia: Monitor hemoglobin and consider transfusion if severe

🧠 Integrating Psychosocial Support into Nutrition Care

Why It Matters:

 Malnutrition is often linked to neglect, displacement, or trauma. Recovery depends on

emotional and social support.

Nursing Interventions:

 Create a calm, child-friendly environment

 Encourage caregiver involvement in feeding
 Refer to mental health or protection teams if needed

Nursing Activity Manager Role:

 Train staff in trauma-informed care

 Coordinate with psychosocial teams
 Monitor emotional well-being as part of recovery

📚 Designing Nurse-Led Nutrition Education Sessions

Key Topics:

 Breastfeeding techniques and benefits

 Safe preparation of complementary foods
 Hygiene and handwashing
 Recognizing early signs of malnutrition
Delivery Methods:

 Visual posters and flipcharts

 Group sessions in waiting areas
 One-on-one counseling at discharge

Nursing Activity Manager Role:

 Develop culturally appropriate materials

 Schedule regular education sessions
 Evaluate caregiver understanding and retention

📈 Evaluating Program Impact on Child Survival Rates

Indicators to Track:

 Recovery rate (weight gain, MUAC improvement)

 Default rate (children who drop out of treatment)
 Mortality rate among admitted SAM cases
 Referral success and follow-up compliance

Nursing Activity Manager Responsibilities:

 Maintain accurate nutrition registers

 Analyze trends and report to coordination
 Implement corrective actions for poor outcomes

🩺 Diagnosing Dehydration in Children

Step 1: Clinical Assessment

Sign Mild Moderate Severe

General condition Alert Irritable Lethargic or unconscious
Eyes Normal Sunken Very sunken
Tears Present Reduced Absent
Mouth & tongue Moist Dry Very dry
Skin turgor (pinch test) Normal Slow return Very slow return
Thirst Drinks normally Thirsty, eager to drink Unable to drink or drinks poorly
Urine output Normal Reduced Minimal or none

💡 Use WHO’s Integrated Management of Childhood Illness (IMCI) guidelines for standardized
classification.
🧠 Supporting Diagnosis with Vital Signs
 Heart rate: Elevated in moderate/severe dehydration
 Respiratory rate: May increase due to acidosis
 Capillary refill time: >2 seconds suggests poor perfusion
 Blood pressure: May drop in late-stage dehydration
 Weight loss: Compare with previous records if available

🧠 Management of Dehydration in Children

1. Mild to Moderate Dehydration

 Treatment:
o Oral Rehydration Solution (ORS)
o Give small sips frequently (5–10 ml every few minutes)
o Continue breastfeeding
 Monitoring:
o Reassess hydration status every 2–4 hours
o Watch for vomiting or worsening signs

2. Severe Dehydration

 Treatment:
o Immediate IV fluid resuscitation
o Use isotonic solutions (e.g., Ringer’s lactate or normal saline)
o Initial bolus: 20 ml/kg over 30–60 minutes
o Reassess and repeat if needed
 Follow-up:
o Switch to ORS once stable
o Treat underlying cause (e.g., diarrhea, infection)

3. Special Considerations

 Infants <6 months:

o Use breast milk and age-appropriate fluids
o Avoid excessive sodium
 Malnourished children:
o Use ReSoMal (Rehydration Solution for Malnutrition)
o Avoid rapid IV fluids unless in shock

🧠⚕️ Nursing Roles in Dehydration Management

 Triage:
o Rapid assessment using clinical signs
 o Prioritize based on severity
 Fluid Administration:
o Calculate correct volumes
o Monitor for signs of fluid overload (especially in infants)
 Caregiver Education:
o Teach signs of dehydration
o Demonstrate ORS preparation and administration
 Documentation:
o Record fluid intake/output
o Track weight and vital signs

🧠 Nursing Activity Manager Responsibilities

 Protocol Oversight:
o Ensure adherence to WHO/MSF guidelines
o Train staff in dehydration recognition and treatment
 Supply Coordination:
o Maintain stock of ORS, IV fluids, and equipment
o Monitor cold chain for rehydration solutions if needed
 Quality Assurance:
o Audit case outcomes
o Identify gaps in triage or treatment
 Community Linkage:
o Support CHW training in dehydration screening
o Strengthen referral pathways from shelters and mobile clinics

Your Role as Nursing Activity Manager: The Big Picture

You’re not just overseeing care—you’re shaping outcomes. Your responsibilities span:

 Clinical Oversight: Ensure accurate diagnosis and safe treatment protocols

 Team Leadership: Train, supervise, and support nursing staff
 Coordination: Link ER with nutrition, WASH, pharmacy, and outreach teams
 Quality Assurance: Monitor indicators, audit care, and improve systems
 Community Interface: Strengthen referral pathways and caregiver education

🚦 Triage & Initial Assessment

What Nurses Must Screen Immediately:

 MUAC (Mid-Upper Arm Circumference): <115 mm = Severe Acute Malnutrition

 Edema Check: Bilateral pitting = Kwashiorkor
 Hydration Status: Skin turgor, sunken eyes, capillary refill, consciousness
 Appetite Test: Refusal of RUTF = inpatient care needed
  Vital Signs: HR, RR, temp, glucose, weight

Your Role:

 Ensure triage nurses are trained in malnutrition and dehydration screening

 Implement fast-track protocols for high-risk children
 Monitor triage flow and adjust staffing during surges

🧠 Diagnosis & Classification

Malnutrition Categories:

Type Criteria Management

SAM (Severe Acute MUAC <115 mm, WHZ < Inpatient or outpatient depending on
Malnutrition) -3, edema complications
MAM (Moderate Acute MUAC 115–125 mm, Outpatient with supplementary
Malnutrition) WHZ -2 to -3 feeding
Height-for-age Z-score < -
Chronic (Stunting) Long-term follow-up
2

Dehydration Categories:

Type Signs Treatment

Mild Thirst, dry mouth ORS at home or outpatient
Moderate Sunken eyes, irritability ORS under observation
Severe Lethargy, poor perfusion IV fluids urgently (20 ml/kg bolus)

Your Role:

 Ensure diagnostic tools (MUAC tapes, scales, ORS kits) are available and calibrated
 Supervise accurate classification and documentation
 Support nurses in complex cases (e.g., SAM with diarrhea or shock)

🏥 Treatment Protocols
For Malnutrition:

 Inpatient (Complicated SAM):

o F-75 → F-100 → RUTF
o Empirical antibiotics, deworming, Vitamin A
o Monitor weight, edema, appetite, and vitals daily
 Outpatient (Uncomplicated SAM/MAM):
 o RUTF or supplementary feeding
o Weekly follow-up and caregiver education

For Dehydration:

 Mild/Moderate:
o ORS every 5–10 minutes, continue breastfeeding
 Severe:
o IV fluids (Ringer’s lactate or normal saline)
o Monitor for rehydration and signs of overload

Your Role:

 Ensure staff follow MSF protocols precisely

 Monitor stock levels of F-75, F-100, RUTF, ORS, IV fluids
 Coordinate with pharmacy and nutrition teams for supply chain

📚 Education & Psychosocial Support

For Caregivers:

 How to prepare and give ORS

 Importance of continued feeding and hygiene
 Recognizing danger signs (lethargy, refusal to eat, persistent diarrhea)

For Children:

 Safe, calm environment

 Psychosocial stimulation during recovery
 Referral to mental health if trauma suspected

Your Role:

 Develop and distribute visual education materials

 Train nurses in trauma-informed care
 Monitor caregiver understanding and satisfaction

📊 Monitoring & Evaluation

Key Indicators:

 Recovery rate
 Default rate
 Mortality rate
  Weight gain and MUAC improvement
 Rehydration success

Your Role:

 Conduct regular chart audits

 Lead case reviews for deaths or complications
 Report trends to coordination and propose improvements

🧠 Coordination & Community Linkage

 With Nutrition Teams: Align ER screening with feeding programs
 With WASH Teams: Ensure hygiene practices in ER and shelters
 With Outreach Teams: Strengthen early detection and follow-up
 With CHWs: Train in MUAC and dehydration recognition

Your Role:

 Build referral systems that work

 Advocate for mobile nutrition units in underserved areas
 Ensure ER data feeds into community surveillance

🧠⚕️ Staff Training & Support

 Train nurses in:
o MUAC and edema assessment
o Therapeutic feeding protocols
o IV fluid calculation and administration
o Psychosocial care for malnourished children
 Support staff with:
o Peer mentoring
o Debriefing after critical cases
o Recognition and feedback

👶 Neonatal Malnutrition: Diagnosis & Management

🔍 Diagnosis

Neonatal malnutrition is often subtle and linked to:

 Low birth weight (<2.5 kg)

 Failure to gain weight postnatally
 Poor feeding or weak suck
 Signs of micronutrient deficiency (e.g., pallor, lethargy)
Key Assessment Tools:

 Weight-for-age tracking
 Breastfeeding observation
 Temperature regulation (hypothermia is common)
 Skin condition (dry, peeling, or thin skin)
 Activity level (lethargy, poor cry)

🧠 Important: MUAC is not reliable in neonates—use weight and clinical signs instead.

🧠 Management

1. Breastfeeding Support

 Immediate skin-to-skin contact

 Frequent feeding (every 2–3 hours)
 Positioning and latch correction
 Use of expressed breast milk if direct feeding fails

2. Supplementation (if needed)

 Cup or spoon feeding with expressed milk

 Therapeutic milk (e.g., diluted F-100) only under strict protocols
 Micronutrients: Vitamin D, iron, and zinc as per guidelines

3. Monitoring

 Daily weight checks

 Temperature and glucose monitoring
 Urine/stool output tracking
 Signs of feeding intolerance or aspiration

💧 Neonatal Dehydration: Diagnosis & Management

🔍 Diagnosis

Neonates dehydrate rapidly and subtly. Key signs:

 Sunken fontanelle
 Dry mucous membranes
 Reduced urine output (<6 wet diapers/day)
 Poor skin turgor (tenting)
 Lethargy or irritability
 Weight loss >10% of birth weight in first week
⚠️ Fever and diarrhea are less common in neonates—look for feeding issues and environmental
factors (e.g., heat exposure).

🧠 Management

1. Mild to Moderate Dehydration

 Increase breastfeeding frequency

 Supplement with expressed breast milk
 Monitor closely for improvement

2. Severe Dehydration

 IV fluids (e.g., 10% dextrose or isotonic saline)

o Administer cautiously to avoid fluid overload
o Use neonatal infusion pumps if available
 Treat underlying cause: infection, feeding failure, heat exposure

3. Special Considerations

 Avoid ORS unless guided by pediatric protocols

 Monitor for electrolyte imbalance and hypoglycemia

🧠⚕️ Nursing Roles in Neonatal Nutrition & Hydration

 Early identification of feeding problems
 Support for mothers in lactation and bonding
 Safe administration of fluids and feeds
 Education on thermal care and hygiene
 Documentation of feeding patterns and weight trends

🧠 Nursing Activity Manager Responsibilities

🧠 Clinical Oversight

 Ensure neonatal protocols are followed

 Supervise breastfeeding support and feeding assessments
 Monitor high-risk neonates (e.g., preterm, LBW)

🧠 Coordination

 Link ER with maternity, nutrition, and neonatal units

 Ensure supply of feeding tools (cups, syringes, breast pumps)
 Coordinate with mental health and protection teams for vulnerable mothers
📊 Quality Assurance

 Track neonatal weight gain and hydration outcomes

 Audit feeding support effectiveness
 Review neonatal mortality and morbidity data

📚 Staff Training

 Train nurses in neonatal feeding techniques

 Educate on dehydration signs and safe fluid management
 Reinforce respectful care and communication with mothers

Neonatal Malnutrition: Questions & Answers

Q1: What are key indicators of malnutrition in neonates?

A: Low birth weight (<2.5 kg), poor weight gain, weak suck, lethargy, and signs of micronutrient
deficiency (e.g., pallor, dry skin).

Q2: Why is MUAC not used for neonates?

A: MUAC is not validated for infants under 6 months due to body proportion differences;
weight-for-age and clinical signs are preferred.

Q3: What is the first-line nutritional intervention for a neonate with poor
feeding?

A: Support breastfeeding with skin-to-skin contact, correct positioning, and expressed breast
milk if needed.

Q4: When is therapeutic feeding (e.g., diluted F-100) appropriate for neonates?

A: Only under strict protocols for complicated SAM cases when breastfeeding fails and the
infant is medically stable.

Q5: What is the nurse’s role in monitoring neonatal nutrition?

A: Daily weight checks, feeding observation, temperature and glucose monitoring, and caregiver
education.

💧 Neonatal Dehydration: Questions & Answers

Q6: What are clinical signs of dehydration in neonates?
A: Sunken fontanelle, dry mucous membranes, reduced urine output, poor skin turgor, lethargy,
and weight loss >10% of birth weight.

Q7: What is the safest way to rehydrate a mildly dehydrated neonate?

A: Increase breastfeeding frequency and supplement with expressed breast milk.

Q8: What IV fluid is recommended for severely dehydrated neonates?

A: 10% dextrose or isotonic saline, administered cautiously with close monitoring to avoid fluid
overload.

Q9: Why is ORS generally avoided in neonates?

A: Neonates have immature kidneys and fluid balance systems; ORS may cause electrolyte
imbalance unless guided by pediatric protocols.

Q10: What is the Nursing Activity Manager’s role in dehydration management?

A: Ensure staff are trained in neonatal fluid protocols, monitor equipment availability, and
supervise high-risk cases.

🧠⚕️ Leadership & Coordination: Questions & Answers

Q11: How do you ensure accurate diagnosis of neonatal malnutrition in the ER?

A: Train staff in weight-for-age assessment, feeding observation, and early recognition of

clinical signs.

Q12: What teams should you coordinate with for neonatal nutrition and
hydration?

A: Maternity, nutrition, pharmacy, mental health, and WASH teams.

Q13: What indicators help evaluate neonatal nutrition program success?

A: Breastfeeding initiation rate, weight gain trends, feeding complication rates, and neonatal
mortality.

Q14: How do you support caregivers of malnourished or dehydrated neonates?

A: Provide emotional support, feeding education, hygiene guidance, and involve them in care
routines.
Q15: What is your role in quality assurance for neonatal care?

A: Conduct chart audits, lead case reviews, monitor outcomes, and implement corrective actions.

Neonatal Malnutrition: Advanced Q&A

Q16: What is the most reliable indicator of neonatal nutritional status in the first
week of life?

A: Weight change from birth—loss >10% of birth weight may indicate feeding failure or
dehydration.

Q17: What are signs of feeding failure in a neonate?

A: Weak or absent suck, prolonged feeding time, poor weight gain, and frequent vomiting.

Q18: How do you assess whether a neonate is receiving enough breast milk?

A: Monitor weight gain, urine output (≥6 wet diapers/day), stool frequency, and feeding
behavior.

Q19: What is the protocol if a neonate refuses to breastfeed and shows signs of
malnutrition?

A: Initiate expressed breast milk via cup or syringe, monitor closely, and assess for underlying
medical issues.

Q20: What micronutrient deficiencies are most concerning in neonates?

A: Iron, Vitamin D, and Zinc—especially in low birth weight or preterm infants.

💧 Neonatal Dehydration: Advanced Q&A

Q21: What is the most sensitive early sign of dehydration in neonates?

A: Reduced urine output and dry mucous membranes—often before other signs appear.

Q22: How do you differentiate between dehydration and sepsis in a neonate?

A: Both may present with lethargy and poor perfusion, but sepsis often includes temperature
instability and abnormal WBC count; dehydration typically follows feeding issues or diarrhea.
Q23: What is the safest IV fluid for a neonate with severe dehydration and
hypoglycemia?

A: 10% dextrose solution, administered slowly with close monitoring.

Q24: What are the risks of rapid fluid administration in neonates?

A: Fluid overload, heart failure, electrolyte imbalance, and intracranial hemorrhage—especially

in preterms.

Q25: What is the nurse’s role in preventing dehydration in neonates?

A: Promote frequent breastfeeding, monitor feeding effectiveness, educate caregivers, and

ensure thermal protection.

🧠⚕️ Nursing Leadership & Coordination: Advanced Q&A

Q26: How do you ensure continuity of care for neonates discharged from the
ER?

A: Establish follow-up appointments, link with community health workers, and provide
caregiver education.

Q27: What teams should be involved in managing neonatal malnutrition and

dehydration?

A: Maternity, nutrition, mental health, pharmacy, WASH, and community outreach.

Q28: How do you evaluate the effectiveness of neonatal feeding support in your
ER?

A: Track breastfeeding initiation rates, weight gain trends, feeding complication reports, and
caregiver feedback.

Q29: What is your role in training ER nurses for neonatal care?

A: Organize hands-on workshops, develop protocols, supervise clinical practice, and conduct
competency assessments.

Q30: How do you respond to a neonatal death related to malnutrition or

dehydration?

A: Lead a case review, identify system gaps, support staff emotionally, and implement corrective
actions.
Case-Based Scenario Questions (Neonatal Focus)
Q31: A 3-day-old neonate presents with poor feeding, lethargy, and weight loss of
12% since birth. What is your immediate nursing priority?

A: Assess for dehydration and hypoglycemia, initiate thermal protection, and begin feeding
support with expressed breast milk.

Q32: A low birth weight infant is not gaining weight despite frequent
breastfeeding. What steps should the nurse take?

A: Observe feeding technique, assess milk transfer, consider supplementation, and monitor
weight daily.

Q33: A neonate in a displacement camp shows signs of dehydration and

hypothermia. What environmental factors should be addressed?

A: Ensure warmth (skin-to-skin or blankets), protect from wind/dust, and provide clean water for
caregivers.

Q34: A mother reports her newborn hasn’t urinated in 24 hours. What should
the nurse assess?

A: Check hydration status, feeding adequacy, and signs of renal or systemic illness.

Q35: A neonate with severe dehydration is started on IV fluids. What

complications must the nurse monitor for?

A: Fluid overload, electrolyte imbalance, cardiac distress, and changes in consciousness.

🧠⚕️ Leadership & Protocol Questions

Q36: What protocol should be followed for neonates with feeding refusal and
weight loss >10%?

A: Initiate expressed breast milk feeding, monitor vitals and glucose, and escalate to medical
team for possible inpatient care.

Q37: How do you ensure neonatal dehydration protocols are followed in the ER?

A: Post clear SOPs, train staff regularly, and conduct spot checks during shift handovers.
Q38: What indicators should be tracked to evaluate neonatal nutrition care in
the ER?

A: Breastfeeding initiation rate, weight gain trends, feeding complication reports, and neonatal
readmission rates.

Q39: How do you support nurses emotionally after a neonatal death due to
malnutrition or dehydration?

A: Facilitate debriefing, offer mental health support, and create space for reflection and learning.

Q40: What is your role in coordinating neonatal care across departments?

A: Ensure smooth handovers between maternity, nutrition, and ER teams; align protocols; and
monitor continuity of care.

📚 Caregiver Education Questions

Q41: What should caregivers be taught about neonatal hydration?

A: Signs of dehydration, importance of frequent feeding, and when to seek help.

Q42: How do you explain feeding frequency to a mother of a newborn?

A: Feed every 2–3 hours, including at night; watch for hunger cues like rooting or sucking.

Q43: What hygiene practices should be emphasized to prevent neonatal illness?

A: Handwashing before feeding, clean feeding tools, and proper cord care.

Q44: How do you reassure a mother worried about her milk supply?

A: Observe feeding, explain normal newborn behavior, and offer support with expression and
positioning.

Q45: What visual tools help caregivers understand neonatal nutrition?

A: Illustrated feeding charts, hydration signs posters, and pictorial guides for breastfeeding
positions.

Emergency Response: Neonatal Sepsis, Shock &

Dehydration
Q46: A neonate presents with hypothermia, poor feeding, and lethargy. What
condition must be ruled out immediately?

A: Neonatal sepsis—initiate antibiotics, monitor vitals, and assess hydration and glucose.

Q47: What is the first nursing action for a neonate in shock due to dehydration?

A: Establish IV access, begin cautious fluid resuscitation (e.g., 10% dextrose), and monitor for
fluid overload.

Q48: How do you differentiate between hypoglycemia and dehydration in a

neonate?

A: Hypoglycemia presents with jitteriness, apnea, or seizures; dehydration shows sunken

fontanelle, dry mucosa, and poor perfusion. Both may coexist.

Q49: What is the nurse’s role during neonatal resuscitation in a malnourished

infant?

A: Maintain warmth, support airway and breathing, monitor glucose, and prepare for IV access
and fluid therapy.

Q50: What complications must be monitored after fluid resuscitation in a

neonate?

A: Pulmonary edema, electrolyte imbalance, cardiac overload, and altered consciousness.

🧠⚕️ Nurse Training Quiz: Neonatal Fluid & Feeding

Protocols
Q51: What is the maximum safe bolus volume for IV fluids in a neonate with
shock?

A: 10–20 ml/kg over 30–60 minutes, depending on clinical status and weight.

Q52: What feeding method is preferred if a neonate cannot breastfeed directly?

A: Cup or spoon feeding with expressed breast milk.

Q53: What fluid is recommended for neonates with hypoglycemia?

A: 10% dextrose IV, administered slowly with close monitoring.

Q54: What is the danger of using standard ORS in neonates?

A: Risk of sodium overload and renal stress—ORS is not recommended unless guided by
pediatric protocols.

Q55: What is the nurse’s role in preventing feeding-related aspiration?

A: Position the neonate upright, feed slowly, and monitor for coughing or cyanosis.

🧠 Leadership Scenario Questions: Managing Neonatal

Surge in ER
Q56: Your ER receives five neonates with suspected dehydration from a
displacement camp. What is your first leadership action?

A: Activate neonatal triage protocol, assign experienced staff, and ensure thermal and glucose
monitoring.

Q57: Supplies of F-75 and 10% dextrose are low. What do you do?

A: Alert pharmacy/logistics, prioritize critical cases, and coordinate with maternity and nutrition
units for shared resources.

Q58: A nurse is unsure how to assess feeding adequacy in a neonate. How do you
respond?

A: Provide bedside coaching, demonstrate latch and milk transfer assessment, and schedule a
refresher training.

Q59: Caregivers are anxious and confused during a neonatal surge. What is your
role?

A: Communicate calmly, assign staff to support families, and ensure clear updates on care plans.

Q60: How do you evaluate your team’s response after a neonatal emergency
influx?

A: Conduct a debrief, review case outcomes, gather staff feedback, and identify areas for
improvement.

🩺 SOP-Based Decision Tree Questions for Neonatal Triage

Q61: A neonate arrives with low temperature, poor feeding, and weak cry. What
is the first SOP-directed action?

A: Initiate thermal protection (skin-to-skin or warming), check glucose, and begin sepsis
protocol if indicated.

Q62: A newborn has lost 12% of birth weight by day 4 and is feeding poorly.
What does the SOP recommend?

A: Begin expressed breast milk feeding, monitor vitals, and escalate to medical team for possible
inpatient care.

Q63: A neonate presents with sunken fontanelle and dry mouth but is alert.
What is the SOP-based classification?

A: Moderate dehydration—initiate breastfeeding support and monitor hydration status closely.

Q64: A neonate is lethargic, not feeding, and has no urine output. What is the
SOP-based triage level?

A: Red (Emergency)—requires immediate IV access, fluid resuscitation, and full neonatal

emergency protocol.

Q65: A mother reports her baby is feeding well but has not gained weight in 7
days. What does the SOP advise?

A: Assess feeding technique, check for underlying illness, and consider nutritional
supplementation.

🧠⚕️ Advanced Clinical Scenario Questions

Q66: A neonate with low birth weight is admitted with hypothermia and
hypoglycemia. What is the nursing care plan?

A: Warm the infant, administer 10% dextrose IV, monitor glucose hourly, and support feeding
with expressed breast milk.

Q67: A 5-day-old infant has persistent vomiting and poor weight gain. What
complications should be considered?

A: Feeding intolerance, metabolic disorders, dehydration, and possible infection—initiate full

assessment.
Q68: A neonate with severe dehydration is started on IV fluids. What monitoring
is essential?

A: Respiratory rate, heart rate, urine output, fontanelle tension, and signs of fluid overload.

Q69: A mother is unable to breastfeed due to trauma. What is the nursing

strategy?

A: Provide psychosocial support, assist with milk expression, and initiate alternative feeding
methods (cup/spoon).

Q70: A neonate in a mobile clinic setting shows signs of malnutrition. What is the
referral protocol?

A: Stabilize, initiate feeding support, and refer to ER or inpatient nutrition unit with full
documentation.

🧠 Leadership-Focused Questions for Neonatal Care

Management
Q71: How do you prepare your ER team for a neonatal emergency influx?

A: Conduct drills, assign neonatal triage roles, stock emergency kits, and ensure clear SOPs are
posted.

Q72: What is your role in mentoring junior nurses in neonatal care?

A: Provide bedside coaching, organize training sessions, and offer feedback on clinical decision-
making.

Q73: How do you evaluate the effectiveness of neonatal care protocols?

A: Audit charts, track outcomes (e.g., weight gain, mortality), and gather staff feedback for
improvements.

Q74: What leadership actions support caregiver trust in neonatal ER care?

A: Ensure respectful communication, involve caregivers in care plans, and maintain transparency
during emergencies.

Q75: How do you manage staff stress after a critical neonatal case?

A: Facilitate debriefings, offer mental health support, and promote peer encouragement and
resilience.
Neonatal Infection Control & Antibiotic Protocols
Q76: What are key infection risks for neonates in ER settings?

A: Sepsis, pneumonia, umbilical infections, and nosocomial infections due to poor hygiene or
overcrowding.

Q77: What are early signs of neonatal sepsis?

A: Hypothermia or fever, poor feeding, lethargy, respiratory distress, and abnormal cry.

Q78: What is the first-line antibiotic protocol for suspected neonatal sepsis?

A: Ampicillin and gentamicin, adjusted based on weight and local resistance patterns.

Q79: What is the nurse’s role in preventing neonatal infections?

A: Hand hygiene, sterile technique during procedures, cord care, and environmental cleanliness.

Q80: What is the Nursing Activity Manager’s role in infection control?

A: Ensure IPC protocols are followed, monitor hygiene practices, and coordinate with WASH
and pharmacy teams.

🧠 Caregiver Group Education Questions

Q81: What should caregivers know about neonatal feeding?

A: Feed every 2–3 hours, watch for hunger cues, and ensure proper latch and milk transfer.

Q82: How do you explain dehydration signs to caregivers?

A: Dry mouth, sunken fontanelle, reduced urine, and lethargy—seek help immediately if
observed.

Q83: What hygiene practices should be taught to prevent neonatal illness?

A: Handwashing before feeding, clean utensils, safe cord care, and avoiding overcrowded
sleeping areas.

Q84: How do you support caregivers emotionally during neonatal care?

A: Listen actively, validate their concerns, offer reassurance, and involve them in care routines.
Q85: What tools help deliver effective group education?

A: Flipcharts, posters, role-play, and visual guides in local languages.

🧠⚕️ Nurse Competency Assessment Questions

Q86: How do you assess a nurse’s ability to manage neonatal dehydration?

A: Observe clinical assessment, fluid calculation accuracy, monitoring skills, and

documentation.

Q87: What skills are essential for neonatal feeding support?

A: Breastfeeding technique correction, cup feeding, milk expression guidance, and caregiver
coaching.

Q88: How do you evaluate neonatal triage competency?

A: Use case simulations, review triage decisions, and assess prioritization accuracy.

Q89: What is your role in building nurse confidence in neonatal care?

A: Provide mentorship, encourage peer learning, and offer constructive feedback.

Q90: How do you track nurse training outcomes?

A: Pre/post training evaluations, clinical audits, and patient outcome reviews.

🌪️ Emergency Preparedness for Neonatal Surge in Conflict

Zones
Q91: What are key risks for neonates in conflict settings?

A: Trauma, hypothermia, feeding disruption, infection, and separation from caregivers.

Q92: How do you prepare your ER for neonatal influx during displacement?

A: Stock neonatal kits, assign trained staff, secure warm spaces, and activate triage protocols.

Q93: What coordination is needed during neonatal emergencies in conflict

zones?

A: Link with maternity, protection, logistics, and outreach teams for rapid response.
Q94: How do you ensure safe transport of neonates during evacuation?

A: Use thermal protection, monitor vitals, assign skilled escorts, and prepare emergency
supplies.

Q95: What is your leadership role during neonatal crisis response?

A: Lead calmly, delegate clearly, support staff emotionally, and ensure protocol adherence.

Neonatal Care in Malnutrition Stabilization Centers

Q96: What neonates qualify for admission to a malnutrition stabilization center?

A: Low birth weight infants with feeding failure, neonates with complications (e.g.,
hypothermia, hypoglycemia), and those born to severely malnourished mothers.

Q97: What is the first-line nutritional support for neonates in stabilization

centers?

A: Expressed breast milk; if unavailable or insufficient, diluted F-100 or therapeutic milk under
strict supervision.

Q98: What is the nurse’s role in neonatal stabilization care?

A: Monitor feeding, temperature, glucose, and weight daily; support caregivers; and document
progress.

Q99: How do you prevent cross-infection in neonatal nutrition units?

A: Enforce hand hygiene, isolate sick neonates, sterilize feeding tools, and maintain clean
bedding.

Q100: What is the Nursing Activity Manager’s role in stabilization center

operations?

A: Ensure protocols are followed, coordinate with nutrition and maternity teams, and monitor
outcomes.

📋 SOP Development for Neonatal ER Care

Q101: What should be included in an SOP for neonatal dehydration
management?

A: Assessment criteria, fluid calculation guidelines, monitoring schedule, and escalation steps.
Q102: How do you ensure SOPs are used consistently by ER staff?

A: Train staff, post SOPs visibly, integrate into handovers, and audit compliance.

Q103: What is the process for updating neonatal care SOPs?

A: Review clinical data, consult with medical coordination, incorporate field feedback, and
retrain staff.

Q104: How do SOPs improve neonatal care quality?

A: They standardize treatment, reduce errors, and ensure timely, evidence-based interventions.

Q105: What is your role in SOP development as Nursing Activity Manager?

A: Lead drafting, gather input from frontline nurses, align with MSF protocols, and oversee
implementation.

💡 Nurse-Led Innovations in Neonatal Feeding & Hydration

Q106: What are examples of nurse-led innovations in neonatal care?

A: Cup feeding techniques, caregiver coaching models, thermal care bundles, and hydration
tracking charts.

Q107: How do you encourage innovation among ER nurses?

A: Create space for idea-sharing, recognize contributions, and pilot promising practices.

Q108: What is the impact of nurse-led feeding support programs?

A: Improved breastfeeding rates, reduced feeding complications, and stronger caregiver

engagement.

Q109: How do you document and share successful nursing innovations?

A: Use case studies, internal reports, and coordination meetings to disseminate best practices.

Q110: What is your role in scaling up effective nursing practices?

A: Evaluate outcomes, secure resources, train staff, and integrate into SOPs.
📊 Evaluating Neonatal Care Impact in Humanitarian
Missions
Q111: What indicators help measure neonatal care success?

A: Neonatal mortality rate, breastfeeding initiation rate, weight gain trends, and caregiver
satisfaction.

Q112: How do you collect reliable data in emergency settings?

A: Use standardized registers, train staff in documentation, and conduct regular audits.

Q113: What challenges affect neonatal care impact in crisis zones?

A: Resource shortages, staff turnover, caregiver displacement, and environmental stressors.

Q114: How do you use data to improve neonatal care?

A: Identify gaps, adjust protocols, retrain staff, and advocate for targeted support.

Q115: What is your role in reporting neonatal outcomes to coordination?

A: Compile data, analyze trends, present findings, and recommend strategic improvements.

🚦 Pediatric ER Triage (Under 12 Years)

Key Priorities:

 Airway, Breathing, Circulation (ABC)

 Level of consciousness
 Signs of shock or sepsis
 Malnutrition and dehydration screening
 Pain and distress assessment

Triage Categories:

Color Urgency Examples

Red Immediate Seizures, shock, severe trauma, unconsciousness
Yellow Urgent Moderate dehydration, fever with respiratory distress, fractures
Green Stable Minor wounds, mild fever, skin infections

🧠 Common Pediatric Emergencies & Management

1. Respiratory Distress

 Causes: Pneumonia, asthma, bronchiolitis, foreign body

 Signs: Tachypnea, nasal flaring, chest retractions, cyanosis
 Management: Oxygen, bronchodilators, antibiotics, suctioning

2. Seizures

 Causes: Epilepsy, fever, infection, trauma

 Management: Protect airway, administer anticonvulsants (e.g., diazepam), monitor
vitals, identify cause

3. Trauma & Burns

 Assessment: ABCs, Glasgow Coma Scale, burn surface area

 Management: Pain control, wound care, IV fluids, tetanus prophylaxis

4. Diarrhea & Dehydration

 Assessment: Skin turgor, mucous membranes, capillary refill

 Management: ORS for mild/moderate, IV fluids for severe, zinc supplementation

5. Malnutrition

 Screening: MUAC, weight-for-height, edema

 Management: RUTF, F-75/F-100, infection treatment, psychosocial support

6. Fever & Infection

 Causes: Malaria, typhoid, pneumonia, UTI

 Management: Antipyretics, antibiotics, malaria testing, blood cultures if available

7. Shock

 Signs: Cold extremities, weak pulse, delayed capillary refill

 Management: IV fluids, oxygen, treat underlying cause

8. Poisoning

 Common agents: Medications, household chemicals, traditional remedies

 Management: Stabilize ABCs, identify substance, administer antidote if available

9. Skin & Soft Tissue Infections

 Examples: Cellulitis, abscesses, impetigo

  Management: Drain abscesses, antibiotics, hygiene education

10. Psychosocial Emergencies

 Examples: Abuse, neglect, trauma

 Management: Ensure safety, provide emotional support, refer to protection teams

🧠⚕️ Nursing Roles in Pediatric ER

 Triage & Assessment: Rapid identification of life-threatening conditions
 Clinical Care: Administer medications, fluids, oxygen, wound care
 Monitoring: Vitals, consciousness, hydration, nutrition status
 Education: Teach caregivers about danger signs, hygiene, feeding
 Documentation: Accurate records of interventions and outcomes

🧠 Nursing Activity Manager Responsibilities

🧠 Clinical Oversight

 Ensure protocols are followed for all pediatric emergencies

 Supervise triage and critical care delivery
 Support decision-making in complex cases

🧠 Coordination

 Link ER with maternity, nutrition, lab, protection, and outreach teams

 Ensure referral pathways are functional
 Advocate for pediatric resources and staffing

📊 Quality Assurance

 Monitor key indicators: mortality, recovery, referral success

 Conduct chart audits and case reviews
 Implement improvements based on data

📚 Staff Training

 Organize workshops on pediatric emergency care

 Mentor junior nurses in clinical and communication skills
 Promote respectful, child-friendly care

🚦 Pediatric Triage & Initial Assessment

Q1: What is the first step in triaging a child under 12 in the ER?

A: Apply the ABC approach—assess Airway, Breathing, and Circulation immediately.

Q2: What signs indicate a child is in shock?

A: Cold extremities, weak pulse, delayed capillary refill, altered consciousness, and low blood
pressure.

Q3: How do you classify a child with fever, cough, and chest indrawing?

A: Yellow (urgent)—likely respiratory distress; requires oxygen and antibiotics.

Q4: What tool is used to assess nutritional status in children 6–59 months?

A: MUAC (Mid-Upper Arm Circumference); <115 mm indicates severe acute malnutrition.

Q5: What is the nurse’s role during pediatric triage?

A: Rapid assessment, prioritization, documentation, and initiation of life-saving interventions.

🧠 Common Pediatric Emergencies

Q6: What is the first-line treatment for a child having a seizure?

A: Protect the airway, administer diazepam or midazolam, and monitor vitals.

Q7: How do you manage a child with severe dehydration?

A: Administer IV fluids (20 ml/kg of isotonic solution), monitor vitals, and treat underlying
cause.

Q8: What are signs of pneumonia in children?

A: Fast breathing, chest indrawing, nasal flaring, and fever.

Q9: What is the treatment for uncomplicated malaria in children?

A: Administer artemisinin-based combination therapy (ACT) per weight-based dosing.

Q10: How do you manage a child with burns covering 15% of body surface?

A: Provide pain relief, fluid resuscitation, wound care, and monitor for infection.
💩 Diarrhea, Malnutrition & Dehydration
Q11: What is the best treatment for mild dehydration due to diarrhea?

A: Oral Rehydration Solution (ORS) and zinc supplementation.

Q12: What is the appetite test used for in malnutrition screening?

A: To determine if a child with SAM can be managed as an outpatient with RUTF.

Q13: What is the first-line nutritional therapy for a child with complicated
SAM?

A: F-75 therapeutic milk during stabilization phase.

Q14: What is the nurse’s role in managing diarrhea cases?

A: Assess hydration, administer ORS or IV fluids, educate caregivers, and monitor progress.

Q15: What complications must be monitored in severely malnourished children?

A: Hypoglycemia, hypothermia, infections, and refeeding syndrome.

🧠⚕️ Nursing Leadership & Coordination

Q16: How do you ensure ER staff follow pediatric emergency protocols?

A: Provide training, post SOPs visibly, conduct supervision, and lead case reviews.

Q17: What teams must be coordinated for pediatric care in the ER?

A: Nutrition, pharmacy, laboratory, mental health, protection, and outreach teams.

Q18: How do you evaluate the quality of pediatric care in your ER?

A: Monitor indicators like recovery rate, mortality, referral success, and caregiver satisfaction.

Q19: What is your role in mentoring junior nurses in pediatric care?

A: Offer bedside coaching, organize workshops, and provide constructive feedback.

Q20: How do you respond to a surge of pediatric patients during an outbreak?

A: Activate emergency protocols, reassign staff, ensure supply readiness, and coordinate with
public health teams.

Pediatric Trauma & Injury Management

Q21: What is the first nursing action for a child with suspected head trauma?

A: Stabilize the airway, assess consciousness using the Glasgow Coma Scale, and monitor for
signs of increased intracranial pressure.

Q22: How do you manage a child with a suspected fracture?

A: Immobilize the limb, control pain, assess circulation and sensation, and prepare for imaging
or referral.

Q23: What are signs of internal bleeding in pediatric trauma?

A: Pallor, tachycardia, hypotension, abdominal distension, and restlessness.

Q24: What is the nurse’s role in wound care for pediatric patients?

A: Clean the wound, apply sterile dressing, assess for infection, and provide tetanus prophylaxis
if needed.

Q25: How do you support a child emotionally during trauma care?

A: Use calm language, involve caregivers, explain procedures simply, and offer comfort items if
available.

☠️ Pediatric Poisoning & Toxic Exposure

Q26: What are common sources of poisoning in children under 12?

A: Medications, household cleaners, pesticides, and traditional remedies.

Q27: What is the first step in managing a child with suspected poisoning?

A: Stabilize ABCs, identify the substance, and consult poison control or medical coordination
for antidote guidance.

Q28: What signs suggest organophosphate poisoning?

A: Salivation, sweating, vomiting, muscle twitching, and respiratory distress.

Q29: What is the nurse’s role in preventing pediatric poisoning?

A: Educate caregivers on safe storage, recognize early signs, and document exposure details.

Q30: How do you manage a child who ingested a corrosive substance?

A: Do not induce vomiting; maintain airway, monitor vitals, and prepare for endoscopic
evaluation.

🌡️ Pediatric Fever & Infection

Q31: What temperature defines fever in children?

A: ≥38°C (100.4°F) measured orally or rectally.

Q32: What are red flags in a febrile child?

A: Altered consciousness, seizures, stiff neck, rash, and respiratory distress.

Q33: What is the nurse’s role in managing fever?

A: Administer antipyretics, monitor temperature, assess hydration, and identify potential sources
of infection.

Q34: How do you differentiate viral vs. bacterial fever?

A: Viral: gradual onset, mild symptoms; Bacterial: high fever, localized signs, rapid
deterioration.

Q35: What is the protocol for febrile seizures?

A: Protect airway, administer anticonvulsants if prolonged, and monitor for recurrence.

🧠 Caregiver Education & Discharge Planning

Q36: What should caregivers know before discharge?

A: Medication instructions, danger signs, follow-up schedule, and hygiene practices.

Q37: How do you explain dehydration signs to caregivers?

A: Dry mouth, sunken eyes, reduced urine, lethargy—seek care if observed.

Q38: What feeding advice is essential for sick children?

A: Continue breastfeeding or age-appropriate feeding, offer small frequent meals, and maintain
hydration.

Q39: How do you support caregivers emotionally during pediatric emergencies?

A: Listen actively, provide clear updates, involve them in care, and offer reassurance.

Q40: What tools help caregivers understand pediatric care?

A: Illustrated handouts, verbal instructions, visual posters, and demonstration sessions.

🧠⚕️ Nurse Leadership in Pediatric ER

Q41: How do you prepare your team for pediatric surge events?

A: Conduct drills, assign roles, stock supplies, and ensure triage protocols are ready.

Q42: What is your role in mentoring nurses in pediatric care?

A: Provide bedside coaching, organize training, and model compassionate care.

Q43: How do you evaluate nursing performance in pediatric emergencies?

A: Use case reviews, direct observation, feedback sessions, and outcome tracking.

Q44: How do you promote teamwork in high-stress pediatric ER settings?

A: Encourage communication, recognize contributions, and debrief after critical cases.

Q45: What indicators help assess pediatric ER quality?

A: Mortality rate, recovery rate, referral success, caregiver satisfaction, and protocol adherence.

Pediatric Emergencies in Displaced & Conflict-Affected

Populations
Q46: What are common health risks for displaced children under 12?

A: Malnutrition, respiratory infections, diarrhea, trauma, psychological distress, and vaccine-

preventable diseases.

Q47: How do you manage a child with fever and cough in an overcrowded
shelter?
A: Isolate if possible, provide antibiotics and oxygen, monitor for pneumonia, and educate
caregivers on hygiene.

Q48: What is the nurse’s role in supporting children exposed to violence or

trauma?

A: Provide emotional support, ensure safety, document concerns, and refer to mental health or
protection teams.

Q49: How do you prevent disease outbreaks among displaced children?

A: Enforce IPC measures, support vaccination campaigns, and coordinate with WASH and
public health teams.

Q50: What is the Nursing Activity Manager’s role in emergency response for
displaced children?

A: Coordinate multi-sectoral care, ensure triage readiness, monitor trends, and advocate for
pediatric resources.

💊 Pediatric Medication & Fluid Calculation Quiz

Q51: What is the correct dose of paracetamol for a child weighing 15 kg?

A: 10–15 mg/kg every 4–6 hours → 150–225 mg per dose.

Q52: How do you calculate IV fluid bolus for a child in shock?

A: 20 ml/kg of isotonic fluid → For 10 kg child, give 200 ml over 30–60 minutes.

Q53: What is the standard dose of amoxicillin for a child with pneumonia?

A: 40–50 mg/kg/day divided into 2–3 doses.

Q54: What is the maximum volume of ORS recommended per day for a child
with moderate dehydration?

A: Approximately 75 ml/kg over 4 hours, then maintenance fluids based on age and weight.

Q55: What is the nurse’s role in safe medication administration?

A: Verify weight, calculate dose, check for allergies, monitor for side effects, and document
accurately.
📋 SOP-Based Pediatric Triage & Referral
Q56: A child arrives with high fever, stiff neck, and altered consciousness. What
is the SOP-based triage level?

A: Red (Emergency)—suspected meningitis; initiate antibiotics and supportive care

immediately.

Q57: A child with diarrhea and sunken eyes is alert and drinking. What is the
SOP classification?

A: Yellow (Urgent)—moderate dehydration; begin ORS and monitor closely.

Q58: What SOP steps are required before referring a pediatric patient?

A: Stabilize, document vitals and treatment, prepare referral form, and communicate with
receiving facility.

Q59: How do you triage multiple pediatric patients during a mass casualty
event?

A: Use color-coded triage tags, prioritize ABCs, assign staff to zones, and activate surge
protocols.

Q60: What is your role in SOP compliance across pediatric ER teams?

A: Train staff, audit cases, reinforce protocols during handovers, and lead corrective actions.

🧠 Leadership Scenarios for Pediatric ER Coordination

Q61: Your ER receives 20 children with respiratory symptoms during a dust
storm. What’s your first move?

A: Activate respiratory triage protocol, assign oxygen stations, and coordinate with logistics for
supplies.

Q62: A nurse reports confusion about pediatric fluid calculation. How do you
respond?

A: Provide immediate guidance, share reference charts, and schedule a refresher training.

Q63: Supplies of antibiotics are running low during a pediatric surge. What do
you do?
A: Prioritize critical cases, alert pharmacy, coordinate with field logistics, and document usage
trends.

Q64: How do you ensure respectful care for children from diverse cultural
backgrounds?

A: Train staff in cultural sensitivity, use interpreters, involve caregivers, and adapt
communication styles.

Q65: What indicators help evaluate pediatric ER coordination success?

A: Timely triage, reduced wait times, protocol adherence, caregiver satisfaction, and improved
outcomes

Pediatric Emergencies During Epidemics & Outbreaks

Q66: What are common pediatric conditions during outbreaks?

A: Measles, cholera, malaria, respiratory infections, and malnutrition-related complications.

Q67: How do you manage a child with suspected measles in the ER?

A: Isolate immediately, provide Vitamin A, treat fever and dehydration, and notify outbreak
surveillance teams.

Q68: What is the nurse’s role during a pediatric cholera outbreak?

A: Rapid rehydration with ORS or IV fluids, monitor for shock, educate caregivers, and enforce
hygiene protocols.

Q69: How do you protect children from infection during an outbreak?

A: Enforce IPC measures, ensure vaccination, provide clean water, and reduce overcrowding.

Q70: What is the Nursing Activity Manager’s role in outbreak response?

A: Coordinate triage, ensure supply readiness, train staff in outbreak protocols, and monitor case
trends.

🧠⚕️ Mentorship Programs for Pediatric Nurses

Q71: Why is mentorship important in pediatric ER settings?

A: It builds clinical confidence, improves care quality, and strengthens teamwork under pressure.
Q72: What should be included in a pediatric nurse mentorship program?

A: Bedside coaching, case reviews, skills assessments, and emotional support.

Q73: How do you identify nurses ready to become mentors?

A: Look for clinical competence, communication skills, empathy, and leadership potential.

Q74: What is your role in sustaining mentorship programs?

A: Match mentors with mentees, monitor progress, provide feedback, and celebrate growth.

Q75: How do mentorship programs improve pediatric outcomes?

A: Faster triage, better decision-making, reduced errors, and more compassionate care.

📋 SOP-Based Pediatric Discharge Planning

Q76: What must be assessed before discharging a pediatric patient?

A: Clinical stability, caregiver understanding, medication access, and follow-up plan.

Q77: What instructions should be given to caregivers at discharge?

A: Medication dosing, danger signs, feeding advice, hygiene practices, and return schedule.

Q78: How do you ensure safe discharge of a malnourished child?

A: Confirm appetite, provide RUTF, schedule outpatient follow-up, and educate caregivers.

Q79: What is the nurse’s role in discharge planning?

A: Communicate clearly, verify understanding, document instructions, and coordinate referrals.

Q80: What is the Nursing Activity Manager’s role in discharge SOPs?

A: Standardize procedures, train staff, audit discharge quality, and improve caregiver education
tools.

🧠 Pediatric Mental Health & Psychosocial Support

Q81: What are signs of psychological distress in children under 12?
A: Withdrawal, aggression, nightmares, bedwetting, and somatic complaints (e.g., stomach
pain).

Q82: How do you support a child showing trauma symptoms in the ER?

A: Provide a calm environment, involve caregivers, use child-friendly communication, and refer
to MHPSS teams.

Q83: What is the nurse’s role in psychosocial care?

A: Recognize distress, offer comfort, document concerns, and facilitate referrals.

Q84: How do you integrate mental health into pediatric ER care?

A: Train staff in psychological first aid, create safe spaces, and coordinate with mental health
professionals.

Q85: What is your leadership role in pediatric psychosocial support?

A: Promote trauma-informed care, ensure referral pathways, and support staff dealing with
emotional cases.

Leadership & Strategic Oversight

Q1: What is your role in setting clinical priorities during a pediatric surge in the
ER?

A: Assess patient acuity, activate triage protocols, reassign staff based on skill level, and ensure
critical supplies are available.

Q2: How do you lead during a multi-casualty emergency involving children?

A: Delegate roles clearly, maintain calm communication, ensure SOPs are followed, and
coordinate with logistics and medical teams.

Q3: What leadership actions improve ER efficiency?

A: Streamline triage, reduce bottlenecks, monitor patient flow, and implement feedback from
frontline staff.

Q4: How do you advocate for nursing needs at coordination meetings?

A: Present data on workload, patient outcomes, and staffing gaps; propose realistic solutions and
highlight risks if unmet.
Q5: What is your role in aligning ER operations with MSF’s mission and values?

A: Ensure care is impartial, culturally sensitive, and prioritizes the most vulnerable; reinforce
ethical standards in daily practice.

👥 Team Management & Staff Development

Q6: How do you build a cohesive nursing team in a high-stress ER?

A: Promote open communication, recognize contributions, resolve conflicts quickly, and foster
mutual respect.

Q7: What strategies help prevent burnout among ER nurses?

A: Rotate shifts fairly, encourage rest breaks, provide emotional support, and organize peer
debriefings.

Q8: How do you mentor junior nurses in emergency care?

A: Pair them with experienced staff, offer bedside coaching, conduct case reviews, and provide
constructive feedback.

Q9: What is your role in evaluating nursing performance?

A: Use direct observation, review documentation, assess clinical decision-making, and hold
regular feedback sessions.

Q10: How do you manage staff shortages during peak ER demand?

A: Prioritize critical tasks, reassign roles temporarily, request surge support, and communicate
transparently with the team.

📦 Resource & Supply Management

Q11: How do you ensure essential supplies are available in the ER?

A: Monitor inventory daily, forecast needs based on patient trends, report shortages early, and
coordinate with logistics.

Q12: What is your role in managing medication safety?

A: Ensure proper storage, train staff in dosage calculation, monitor adverse reactions, and audit
administration records.
Q13: How do you handle equipment breakdowns in a resource-limited ER?

A: Report immediately, implement backup plans, and coordinate with technical/logistics teams
for urgent repairs.

Q14: What leadership actions reduce waste and misuse of resources?

A: Educate staff on rational use, track consumption patterns, and reinforce accountability in
supply handling.

Q15: How do you prepare the ER for seasonal or outbreak-related surges?

A: Stockpile key items, update protocols, train staff in outbreak response, and coordinate with
public health teams.

📊 Quality Assurance & Data-Driven Management

Q16: What indicators help you evaluate ER nursing quality?

A: Triage accuracy, documentation completeness, patient recovery rates, and caregiver

satisfaction.

Q17: How do you use data to improve ER operations?

A: Analyze trends, identify gaps, adjust staffing or protocols, and share findings with
coordination.

Q18: What is your role in incident reporting and follow-up?

A: Ensure timely reporting, lead root cause analysis, implement corrective actions, and support
staff involved.

Q19: How do you maintain high standards in documentation?

A: Train staff, conduct regular audits, provide feedback, and integrate documentation into
handovers.

Q20: How do you lead continuous improvement in ER nursing care?

A: Encourage innovation, review outcomes regularly, involve staff in problem-solving, and

celebrate progress.