Nursing Practice II: Community Health Nursing and Care of the Mother and Child

Situation: You are the nurse assigned in the nursery unit and your patients are of various ages.

Assessment an infant, the nurse knows that a pincer grasp normally appear

A. At the same time as the palmar grasp

B. Between 9 & 12 month of age

C. Between 5 & 7 month of age

D. Along with the ability to "rake" objects toward themselves

B. Between 9 & 12 month of age

1 month - strong grasp reflex

2 months - begin to fade strong grasp

3 months - reach but still miss

4 months - thumb opposition, plays, rattle disappear plantar and palmar reflex

5 months - play and toes (-) fisting

7 months - transfer toys from 1 hand to another

8 months - effective graspoing, advanced eye-hand coordination

10 months - major milestone=pincer grasp

12 months - spoon, draw a straight line

In a child development, the period of negativism begins when the child

A. Can manipulate his or her parents

B. Copies negative behavior of sibling.

C. Is struggling between dependence and independence

D. Is learning manual skills

C. Is struggling between dependence and independence

Negativism - "no"

Autonomy vs SHame & Doubt - Erik Erickson

The nurse is caring for a hospitalized toddler who was toilet trained home. He wets his pants. The best response to this situation is to say

A. "It's okay, try not to wet your pants next time"

B. "That's okay. Now let's get you cleaned up"

C. "I know you understand how to use the toilet; what happened?"

D. "Your mom told me you don't wet anymore; what's wrong?"

B. "That's okay. Now let's get you cleaned up"

toilet training: 3 important development levels.

1 physiologic, 2 cognitive , control rectal and urethral spinchter, hold urine & stoo, desire to delay gratification

Which of the following behavior would a normal 18 months old be likely to exhibit during the first few hours of hospitalization?

A. Crying loudly when parents leave

B. Readily accepting the nurse caring for him

C. Showing considerable interest in new toy

D. Sitting quietly in the comer of the cab, showing little or no interest in his surrounding

A. Crying loudly when parents leave

greatest fear of infant and toddler = separation anxiety

6 months-6 years old = persists in preschool

8 months - heightened protest - despair - less active, cries monotonous

denial - silent, expression, repress care giver

problems in forming relationship if not resolved

Jason answers every question of his mother by saying "No!" How can she minimize this?

A. Tell Jayson she doesn't want him to say no anymore

B. Answer all Jayson's question by saying "No"

C. Reduce number of questions she asks Jason.

D. Explain hen is not using good communication skills.

C. Reduce number of questions she asks Jason.

Situation: Nurse Rose is the school nurse in Jose Reyes Elementary school. Her responsibility is to attend to the health needs of the students particularly nutrition.

Kwashiorkor is a condition usually seen among pre- school children. This is characterized by which of the following signs?

A. retarded growth and hairs

B. loss of appetite

C. edema

D. all these signs

D. all these signs

(-) CHON, 1-3 YO

edema, zebra sign ( brown and white, diarrhea )

Vitamin A deficiency will lead to which of the following conditions?

A. high blood pressure

B. swollen face, body and limb

C. inability to see in the dark

D. enlargement of the neck

C. inability to see in the dark

yellow vegetables S&S tender tongue, xeropthalmia - dryness , keratomalacia- corned necrosis

In the nutritional assessment of grade 6 pupils, which of the following nutritional assessment method is most appropriate?

A. Height for age

B. Weight for age

C. Body mass index

D. Mid upper arm circumference

C. Body mass index

Pupils with below normal nutritional status are candidates for a school feeding program. Which of the following is a prerequisite for a child to be included in a feeding program?

A. Deworming

B. Parental consent

C. Head to toe physical examination

D. Attendance in a nutritional class by a parent

A. Deworming

Situation: One of the trending news today is about the Reproductive health bill. The following questions are about the Philippine Reproductive Health.

The main objectives of Philippine Reproductive Health includes the following:

1. Reduce the maternal mortality rate

2. Reducing the child mortality

3. Halting and reversing the spread of HIV/AIDS

4. Increasing access to Reproductive health information services

5. Reduce paternal mortality to prostate cancer

A. All of the above

B. All except 5

C. All except 4

D. All except 3

A. All of the above

RH care according to DOH

> counseling education

>peri natal care

>nutri & HC for infants or children

> manageent & abortion complications

infertility

>humam sexuality

>male involvement

>Cancer reproduction

> Adolescent reproduction

According to this framework, the foremost intervention in attaining reproductive health is:

A. Family planning

B. Counselling

C. Safe Sex Campaign Drive

D. Maternal and Child Health and Nutrition

A. Family planning

Because of insufficient technical readiness and availability of resources, the DOH has focused in addressing the health concerns on the first four priority elements of the reproductive health namely:

1. Adolescent Reproductive health

2. Family Planning

3. Prevention and Management of Reproductive Tract Infection Including STIs and HIV/AIDS

4. Maternal and Child Health and Nutrition

5. Prevention of Infertility and sexual Dysfunction

A. All except 5

B. 1,3,4,5

C. 2,3,4,5

D. 1,2,4,5

C. 2,3,4,5

Situation: A pregnancy can be considered a high-risk pregnancy for a variety of reasons. It is one in which some condition puts the mother, the developing fetus, or both at higher-than-normal risk for complications during or after the pregnancy and birth.

Which of the following is the most likely effect on the fetus if the woman is severely anemic during pregnancy?

A. Large for gestational age (LGA) fetus

B. Hemorrhage

C. Small for gestational age (SGA) baby

D. Erythroblastosis

C. Small for gestational age (SGA) baby

Upon assessment the nurse found the following: fundus at 2 fingerbreadths above the umbilicus, last menstrual period (LMP) 5 months ago, fetal heart beat (FHB) not appreciated. Which of the following is the most possible diagnosis of this condition?

A. Hydatidiform mole

B. Missed abortion

C. Pelvic inflammatory disease

D. Ectopic pregnancy

A. Hydatidiform mole

bartolemue's rule - use landmarks

H mole- gestational tropoblastic disease- abnormal proliferation, begin degeneration

chorio carcinoma risk for protein deficiency , type A

When a pregnant woman goes into a convulsive seizure, the MOST immediate action of the nurse to ensure safety of the patient is:

A. Apply restraint so that the patient will not fall out of bed

B. Put a mouth gag so that the patient will not bite her tongue and the tongue will not fall back

C. Position the mother on her side to allow the secretions to drain from her mouth and prevent aspiration

D. Check if the woman is also having a precipitate labor

C. Position the mother on her side to allow the secretions to drain from her mouth and prevent aspiration

restrain for cheilloplasty - palate repair, elbow restraint

A gravido-cardiac mother is advised to observe bed rest primarily to

A. Allow the fetus to achieve normal intrauterine growth

B. Minimize oxygen consumption which can aggravate the condition of the compromised heart of the mother

C. Prevent perinatal infection

D. Reduce incidence of premature labor

B. Minimize oxygen consumption which can aggravate the condition of the compromised heart of the mother

A pregnant mother is admitted to the hospital with the chief complaint of profuse vaginal bleeding, AOG 36 wks, not in labor. The nurse must always consider which of the following precautions:

A. The internal exam is done only at the delivery under strict asepsis with a double set-up

B. The preferred manner of delivering the baby is vaginal

C. An emergency delivery set for vaginal delivery must be made ready before examining the patient

D. Internal exam must be done following routine procedure

A. The internal exam is done only at the delivery under strict asepsis with a double set-up

20 weeks - age of viability

38 to 42 weeks - Term

38 to 39 weeks - early term

39 to 40 weeks - term

41 - 42 weeks late term

above 42 - post term

Before giving a repeat dose of magnesium sulfate to a preeclamptic patient, the nurse should assess the patient's condition. Which of the following conditions will require the nurse to temporarily suspend a repeat dose of magnesium sulfate?

A. 100 cc urine output in 4 hours

B. Knee jerk reflex is (+) 2

C. Serum magnesium level is 10mEg/L.

D. Respiratory rate of 16/min

A. 100 cc urine output in 4 hours

Normal = 30ml/hr

Magnesium sulfate- muscle relaxant

- CNS depressant

- tocolytic

- decrease bp

- inhibit seizure

eclampsia

> proteinuria

> edema

> hypertension

Which of the following is TRUE in Rh incompatibility?

A. The condition can occur if the mother is Rh(+) and the fetus is Rh(-)

B. Every pregnancy of an Rh(-) mother will result to erythroblastosisfetalis

C. On the first pregnancy of the Rh(-) mother, the fetus will not be affected

D. RhoGam is given only during the first pregnancy to prevent incompatibility

C. On the first pregnancy of the Rh(-) mother, the fetus will not be affected

RHO GAM - within 72 hours after delivery

RHIG - 28 weeks of pregnancy

Situation: Promotion of a healthy growth and development as well as the prevention of diseases in pediatric clients is one of the vital roles of a nurse.

Nurse Rolen is teaching parents about the nutritional needs of their 2 month old infant who is breastfeeding. Which response shows that the parent understands their infant's dietary needs?

A. "We wont start any new foods now"

B. " We'll start the bay on skim milk"

C. "We'll introduce cereal into her diet now"

D. "We should add new fruits to the diet at a time"

A. "We wont start any new foods now"

2 month kay hindi pa mature immune system

2 - 3 months if sleep disorder is present

6 months of age - introduces with gradual

1st cereal

2nd egg

3rd vegetables

4th fruits

A mother is concerned that she might be spoiling her 2 month old daughter by picking her up each time she cries. Which suggestion should the nurse offer?

A. "If the baby's diaper is dry when she is crying, leave her alone and she'll fall asleep"

B. "Continue to pick her up when she cries because young infants needs cuddling and holding to meet their needs"

C. "Leave your baby alone for 10 minutes. If she hasn't stopped crying by then; pick her up"

D. "Crying at their age indicates hunger. Try feeding her when she cries"

B. "Continue to pick her up when she cries because young infants needs cuddling and holding to meet their needs"

The nurse observes an infant in a playpen sitting up without support. He is playing with a plastic blocks and large plastic beads, bending over to pick them up, and changing them from one hand to the other. When another child hides a toy behind the infants back, he does not attempt to look for it. The nurse would be most correct in estimating the infant's age to be:

A. 4 months

B. 6 months

C. 8 months

D. 10 months

C. 8 months

In assessing an infant, the nurse should be aware that the birth weight of infant triples by:

A. 5-6 months

B. 12 months

C. 30 months

D. 3 years

B. 12 months

At 6 months, the following are expected to be observed from the baby except:

A. She can sit without support

B. Teething

C. She starts eating solid foods

D. None of the above

A. She can sit without support

Situation: In the light of the changing national and global health situation and the acknowledgement that nursing is a significant contributor to health the PHN strategically positioned to make a difference in health outcome of communities cared for.

Public Health Systems are operating within a context of ongoing changes, which exert a number of pressures on the public health system. These changes include the following except:

A. Health reforms

B. Emerging and existing environmental hazards

C. Shifting in the demographic and epidemiologic trends in disease

D. Increasing population within below poverty line

D. Increasing population within below poverty line

In response to above changes, the local and global community adopts a common vision of poverty reduction and sustainable development. This vision is exemplified by:

A. Universal Health Care

B. Primary Health Care

C. Millenium Development Goals

D. Health Sector Reform Agenda

C. Millenium Development Goals

Millenium Development Goals are based on the fundamental values of freedom, equality and solidarity, health, respect for nature and shared responsibility. How many goals does this exemplify?

A. Six

B. Seven

C. Eight

D. Nine

C. Eight

SDG = 17

Among the following Millenium Development Goals (MDG) which of the following is not health related?

1. Reduce child mortality

2. Improve maternal health

3. Achieve universal primary education

4. Combat HIV/AIDS, malaria and other diseases

5. Promote gender equality and empower women

A. 2 and 5

B. 3 and 5

C. 1 and 4

D. 4 and 5

A. 2 and 5

Which of the following Millennium Developmental Goals is the considered the most priority and is the first goal among the eight which is considered the root of all cause:

A. Achieve the universal primary education

B. Eradicate extreme poverty and hunger

C. Develop a global partnership for development

D. Ensure environmental sustainability

B. Eradicate extreme poverty and hunger

Situation: A pregnancy can be considered a high-risk pregnancy for a variety of reasons. It is one in which some condition puts the mother, the developing fetus, or both at higher-than-normal risk for complications during or after the pregnancy and birth.

Which of the following is the most likely effect on the fetus if the woman is severely anemic during pregnancy?

A. Large for gestational age (LGA) fetus

B. Hemorrhage

C. Small for gestational age (SGA) baby

D. Erythroblastosis

C. Small for gestational age (SGA) baby

AGA= 10 to 90th percentile

SGA= below 10th percentile

LGA= higher 90th percentile

a

a

a

a

a

a

a

a

a

a

a

a

a

a

a

a

a

a

a

When developing the plan of care for an infant with cleft lip before corrective surgery is performed, which of the following would be a priority? A. Maintaining skin integrity in the oral cavity.

B. Using techniques to minimize crying.

C. Altering the usual method of feeding.

D. Preventing the infant from putting fingers in the mouth.

C. Altering the usual method of feeding

Nurse Dianne needs to schedule a first home visit to postpartum client Mariz: A. Within one week after discharge

B. Within 24 hours after discharge

C. Within 1 hour after discharge

D. Within 4 days after discharge

A. Within one week after discharge

If you were Dianne, which one of the following actions would alert you that a new mother is entering a postpartal taking-hold phase?

A. She sleeps as if exhausted from the effort of labor.

B. She urges the baby to stay awake so that she can breast feed him or her.

C. She say that she has no selected name for the baby as yet.

D. She tells you she was in a lot of pain all during labor.

B. She urges the baby to stay awake so that she can breast feed him or her.

Mariz is developing constipation from being on bed rest. What measures would you suggest that she takes to help prevent this?

A. Drink 8 full glasses of fluid such as water daily.

B. Walk for at least half an hour daily to stimulate peristalsis.

C. Drink more milk, increased calcium intake prevents constipation

D. Eat more frequent, small meals instead of three large ones.

B. Walk for at least half an hour daily to stimulate peristalsis

The postpartal mother wants to lose the extra weight she gained in pregnancy, so she is reluctant to increase her caloric intake for breastfeeding. By how much should a lactating mother increase her caloric intake during the first 6 months after birth?

A. 500 kcal / day

C. 350 kcal / day

B. 1,000 kcal / day

D. 200 kcal / da

A. 500 kcal / day

preggy - 300 kcal

lactating - 500 kcal

One of Nurse Dianne's focus of health teaching to the mother is the advantage of breastfeeding. However, the newly delivered mother is concerned if she may be able to continue breastfeeding her baby when she returns to work as a bank teller. The nurse instructed the mother to do all of the following to be able to continue breastfeeding her baby except:

A. Milk the breast by hand before going to work and when the breast is full. B. Place the milk in a sterilized container.

C. Store milk inside a tightly sealed bottle placed inside a coleman filled with ice.

D. Give breastmilk within 24 hours.

C. Store milk inside a tightly sealed bottle placed inside a coleman filled with ice.

The new mother is curious when she can feed her baby other food than breastmilk. The nurse teaches her that:

A. The baby is ready to eat solid food at 3-4 months.

B. She should wait until the baby is about 6 months before giving other food. C. She can start giving her baby drops of clear broth and juice when the baby is two months.

D. She should concentrate on how to breastfeed before thinking of other ways of feeding her child.

B. She should wait until the baby is about 6 months before giving other food.

At 6-week post-partum visit, what should this postpartal mother's fundic height be?

A. Inverted and palpated at the cervix.

B. No longer palpable on her abdomen.

C. Six finger breadths below the umbilicus.

D. One centimeter above the symphysis pubis.

B. No longer palpable on her abdomen.

The negativistic behavior of Jay is noted by nurse Benedict when Jay responds with "NO" whenever she is asked a question. Mrs. Diego confirms that she acts this way at home too. The nurse should suggest that Mrs. Corazon handle this problem by:

A. Pretending not to hear Jay's "NO" response

B. Trying to avoid asking questions

C. Explaining to Jay why saying "NO" is inappropriate

D. Giving Jay choices and limiting the number of questions

D. Giving Jay choices and limiting the number of questions

Jay asked for chocolate after lunch. Her mother, Corazon, refused for she has a cough. Jay lied down and did not stop crying. Which of the following would help Corazon deal with Jay's outburst?

A. Tell her to leave the dining table

B. Withhold her playtime privileges

C. Let her express her frustrations

D. Spank her for misbehaving

C. Let her express her frustrations

Temper tantrums is common at this stage because

A. Jay lacks verbal skills in expressing her emotions

B. Jay normally exaggerates

C. Jay is stupid

D. All of the above

A. Jay lacks verbal skills in expressing her emotions

Which situation best demonstrates the parallel play typical of toddlers?

A. Two toddlers sharing a toy car with her brother

B. Two toddlers playing a board game with her older sister

C. Two toddlers seated next to each other playing with separate dolls

D. A toddler seated on the play therapist's lap playing with a music box.

C. Two toddlers seated next to each other playing with separate dolls

On the 4th day of hospitalization, a 3 year-old who had been inconsolably crying and screaming begins to regress and is now lying quietly in the crib with a blanket. The nurse recognizes that the child is in the stage of:

A. Denial

C. Mistrust

B. Despair

D. Protest

B. Despair

Nurse Rose intends to get the census of the population to obtain an accurate assessment of their health needs by collaborating with the community to do a situational analysis. This process entails the following, except:

A. Determine the health status of the population as well as the factors that directly or indirectly affecting the health condition of the people in the community

B. Provide clear picture of the health situation among all sectors in the community, allowing people to freely express what they consider as their health problem

C. Lay-out health plan and provide immediate solution to identified health problems

D. All of the above

C. Lay-out health plan and provide immediate solution to identified health problems

All of the following are possible ways of transmitting malaria except:

A. Sexual intercourse

C. Sharing of IV needles

B. Blood transfusion

D. Transplacental

A. Sexual intercourse

It is the goal of the DOH to reduce the incidence of rabies from 7/million to 1/million and eventually declare the country rabies free. The primary implementing agency on this program is:

A. Department of Health

B. Department of Agriculture

C. Department of Education

D. Department of Interior and Local Government

B. Department of Agriculture

The three major causes of intestinal parasitism in the Philippines are:

A. Paragonimiasis, capillariasis, echinostomiasis

B. Ascaris, trichuriasis, hookworm

C. Heterophysiasis, taeniasis, tapeworm infection

D. Ascariasis, capillariasis, tapeworm infection

B. Ascaris, trichuriasis, hookworm

The following are steps in processing the data. Choose the systematic arrangement: 1. Data utilization 2. Data collection 3. Data presentation 4. Data collation 5. Data analysis

A. 2, 4, 1, 5, 3

C. 2, 4, 3, 5, 1

B. 1, 2, 3, 4, 5

D. 2, 4, 5, 1 , 3

C. 2, 4, 3, 5, 1

A program of the government that is a hospital based information system that monitors infectious diseases with outbreak potential is the:

A. National Epidemic Sentinel Surveillance System (NESSS)

B. Proper Excreta and Sewage Disposal Program

C. Control of Communicable Diseases Program

D. Epidemiological Investigation

A. National Epidemic Sentinel Surveillance System (NESSS)

The most sensitive index of the general health conditions of a community which is influenced more by environmental rather than endogenous factor is the:

A. Crude Death Rate

C. Crude Birth Rate

B. Infant Mortality Rate

D. Maternal Mortality Rate

B. Infant Mortality Rate`

Provinces have been categorized according to the number and trend of reported malaria cases. Category A refers to:

A. Highly endemic provinces

B. Moderately endemic provinces

C. Low endemic provinces

D. Malaria-free provinces

A. Highly endemic provinces

Schistosomiasis resembles the following early signs and symptoms.

A. Enlargement of the abdomen,hematuria

B. Tenesmus and right upper quadrant pain

C. Bloody and mucoid stools

D. Swimmers itch , cough and fever

D. Swimmers itch , cough and fever

The patient asked of the confirmatory diagnosis of schistosomiasis, nurse Chona advised the patient that this could be:

A. Sputum test

C. Stool examination

B. Peripheral blood smear

D. Complete blood count

C. Stool examination

A plan for schistosomiasis eradication has been assigned to a community nurse, a health education class was done among farmers and as part of the lecture the mode of transmission of the disease is by

A. Contact with infected stray animals

B. Contact with contaminated water

C. Use of unsanitary toilet

`D. Vector borne from flies and rodents

B. Contact with contaminated water

0-28 weeks one vist per month

29-36 weeks every 2 weeks

36 up - every week visit

To encourage patients or families to go to the health center, you inform them of free service being provided which is all but one of the following

A. Creationof foot bridges

B. Detection and treatment

C. Snail control

D. Provision of sanitary toilets

A. Creationof foot bridges

Health education is a vital component in the control of diseases. The major aim is to

A. Modify risk behavior

B. Helps individual protects himself

C. Reduce risk of exposure

D. Avoid unnecessary stress

A. Modify risk behavior

The primary disorders detected in newborn screening are:

A. Metabolic disorders

C. Hereditary disorders

B. Respiratory disorders

D. Hematologic disorders

A. Metabolic disorders

Regine, a first time mother, asked the nurse why newborn screening is important. She tells the nurse that they do not have hereditary conditions in the family that her baby might inherit. The best response by the nurse is:

A. It is mandatory by law and she cannot be discharged if her baby is not screened.

B. Most babies with disorders that can be treated by newborn screening look normal at birth.

C. If her history reveals that she has no hereditary conditions in the family then her baby may no undergo newborn screening.

D. It is free so she has to take advantage of it.

B. Most babies with disorders that can be treated by newborn screening look normal at birth.

Regine asked if newborn screening will take a while because she does not want her baby to be separated from her. Correct information that the nurse will provide Regine about newborn screening will include the following:

A. Blood sample will be collected from the baby by collecting blood from the umbilical cord.

B. Newborn screening is ideally done on the 48th hour after birth.

C. Only licensed medical technologists and physicians can collect blood samples to ensure the safety of the baby.

D. The results will be available within one week.

B. Newborn screening is ideally done on the 48th hour after birth.

All of the following statements are true except: 1. At least 40% of women experience complications during pregnancy, childbirth, or after childbirth, and about 15% develop potentially life-threatening conditions. 2. At least 30-40% of infant deaths is the result of the mother's poor health and poor care during pregnancy and childbirth. 3. Poor maternal health and nutrition contribute to low birth weight of about 20% of babies, who are at greater risk of infection, malnutrition, long-term disabilities, including visual and hearing impairments, learning disabilities, and mental retardation and death. 4. Pregnancy and childbirth are the leading cause of death, disease, and disability among women of reproductive age in developing countries. 5. Motherless children are 3-10 times more likely to die within 2 years or get less health care and education as they grow up.

A. 1, 2, 3, 4, 5

C. 1, 2, 3, 4

B. 2, 3, 4, 5

D. 1, 3, 4, 5

A. 1, 2, 3, 4, 5

When rendering prenatal care to a woman in the community. Bea does which of the following, except?

A. Refers Hayanna, who is 6 months pregnant, with fundic height 30 cms, to the physician.

B. Checks BP every clinic visit on the same arm always.

C. Tells Kendra, who is on her 36th week of gestation, and with normal findings to come back to the clinic two weeks after the examination.

D. Examines FHT beginning on the first trimester for early detection of abnormalities.

C. Tells Kendra, who is on her 36th week of gestation, and with normal

Tuberculosis is primarily a respiratory disease caused by tubercle bacilli. Which mode of transmission is extremely contagious?

A. Ingestion of food

C. Animal handling

B. Airborne

D. Skin control

B. Airborne

Which of the following is a priority objective in PTB control?

A. Sputum treatment

B. Reduction of risk

C. BCG immunization

D. Identification of positive cases

B. Reduction of risk

As a nurse, which of the following basic preventive actions is done to eradicate PTB control?

A. Sputum teachings

B. Improvement of social condition

C. Distribution of medicines

D. Referral to health centers

A. Sputum teachings

Case finding of TB by the DOH uses primarily which diagnostic tests:

A. Chest xray and sputum exam

B. Sputum exam and tuberculin test

C. Tuberculin test and Mantoux test

D. Tuberculin test and chest xray

A. Chest xray and sputum exam

Streptomycin should not be given to:

A. Pregnant women to prevent abortion

B. Pregnant women to prevent nerve deafness in their fetus

C. Children below six years old to prevent tooth staining.

D. Children below six years old to prevent growth stunting.

B. Pregnant women to prevent nerve deafness in their fetus

The core of the IMCI strategy is integrated case management of the most common childhood problems, with a focus on the important causes of death. Which one is not a main component in IMCI strategy?

A. Improvements in the case management skills of heath staff through the provision of locally adapted guidelines on IMCI and through activities to promote their use

B. Improvement of the public's acceptance of IMCI

C. Improvements in the health system required for effective management of childhood illness

D. Improvements in family and community practices

B. Improvement of the public's acceptance of IMCI

The clinical guidelines, which are based on expert clinical opinion and research result, are designed for the management of:

A. Sick children aged 1 week up to 5 years

B. Sick children aged 1 month up to 5 years

C. Sick children aged 1 year up to 5 years

D. Sick children aged 1 day up to 5 years

A. Sick children aged 1 week up to 5 years

Which of the following is wrong about IMCI?

A. Integrated case management relies on case detection

B. The treatments are developed according to action oriented classification rather than exact diagnosis

C. The guidelines give instructions for how to routinely assess a child for general danger signs

D. The treatments are developed according to diagnosis rather than action oriented classifications

D. The treatments are developed according to diagnosis rather than action oriented classifications

The complete lMCl case management process involves the following elements: 1. Assess a child by checking first for danger signs 2. Classify a child's illnesses using a color-coded triage system. 3. Identify specific treatments for the child. 4. Provide practical treatment instructions

A. 1, 2, 3

C. 2, 3, 4

B. 1, 3, 4

D. All of these

D. All of these

In utilizing the IMCI protocol, the nurse should initially?

A. Observe the condition of the child

B. Ask the mother if what is the problem of the child

C. Look for danger signs

D. Identify main symptoms

B. Ask the mother if what is the problem of the child

Urgent referral should be suggested with the presence of danger signs. Which of the following are considered as general danger signs to a sick young child? I. Stridor, chest in-drawing and low fever with clouding of the cornea and deep extensive mouth ulcers II. High fever, lethargy and inability to drink III. Stiff neck with high fever and tender swelling behind the ear IV. Unable to breastfeed and difficulty to awaken V. Visible severe wasting, edema of both feet and severe palmar pallor with diarrhea

A. III, IV

C. II, IV

B. II, III, IV, V

D. II, III, IV

C. II, IV

Baby Xavier an 11 month old infant, has cough with wheezing and an RR of 57 per minute. The nurse gave him a trial of rapid-acting inhaled bronchodilators. After 3 cycles, the child has 53 breaths per minute. The nurse would:

A. Administer another bronchodilators and return in 25 days if cough is still present

B. Give an IM Benzyl Penicillin 10,000 units/lbs and Gentamicin 7.5 mg/lbs and refer right away.

C. Give amoxicillin 2 capsules three times daily for five days

D. Administer amoxicillin 15ml two times daily for three day

D. Administer amoxicillin 15ml two times daily for three day

If inhaler is not available, the nurse should do which of the following?

A. Refer the child for assessment for TB or asthma

B. Consider oral salbutamol as the second choice

C. Tell the mother to bring the child for a follow up check after 5 days

D. Soothe the throat and relieve cough with a safe remedy

B. Consider oral salbutamol as the second choice

Your basic assessment of Nikko should include:

A. Looking for signs of ear infection

B. Looking signs of dehydration

C. All of these

D. Looking for intercostals and subcostal retractions

D. Looking for intercostals and subcostal retractions

Nikko is diagnosed of having pneumonia you expect his respiratory rate to be:

A. 60 breaths per minute

B. 50 breathsper minute

C. 40 breaths per minute

D. 20 breathsper minute

C. 40 breaths per minute

Nikko is on antibiotic therapy which of the following statements indicates that the mother needs further teaching?

A. "l can slop giving the antibiotics he seems better."

B. "He needs to finish the 5 day treatment even if he seems better"

C. "l'll continue feeding my son as usual or add more if needed during the treatment"

D. "l'll bring back my son to the health center in 2 days or sooner if his condition worsens."

A. "l can slop giving the antibiotics he seems better."

In order to check whether the mother understands and will be able to carry out the instructions given her, which of the following will you do:

A. Ask the mother to demonstrate what she has heard

B. Ask the mother to repeat the instructions to correct any misinformation

C. Ask them other what problems she might have in giving the antibiotics

D. Any of these

D. Any of these

Andoy, has diarrhea for 5 days. Upon assessment, you noted that there is no blood in her stool and that she is irritable and her eyes are sunken. You offered her fluids and the child drank eagerly. How would you classify Andoy's illness?

A. Some dehydation

C. Severe dehydration

B. Dysentery

D. No dehydration

A. Some dehydation

You know that Andoy's treatment includes the following EXCEPT:

A. Reassess the child and classify him for dehydration

B. Give in the health center the recommended amount of ORS for 4 hours

C. Use the PLAN A: Treat Diarrhea at home

D. Use the PLAN B: Treat Some Dehydration with ORS

C. Use the PLAN A: Treat Diarrhea at home

Upon taking the informaton you find out that Andoy is 2 years old and weighed 16 kg. Based on the treatment plan for Andoy, how much amount of ORS must be given to him for the first 4 hours considering the following data?

A. 200-400 ml ORS

C. 900 ml ORS

B. 400-700 ml ORS

D. 900- 1400 ml ORS

D. 900- 1400 ml ORS