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CHN QUESTIONS: lMClSITUATIONS: Sinie the 1970s,the estimatedannual number of deaths among children less than 5 years old has decreasedby almost a third. Providingquality care to sick children in these conditions is a serious challenge.ln responseto this challenge,WHO and UNICEF developeda strategy known as IntegratedManagement Childhood lllness (lMCl). of 1. The core of the llt4Cl strategy integrated is case management the mostcommonchildhood of problems, with a focuson the most important causesof death.Whichone is not a maincomponent lfvlolstrategy? in A. lmprovements the case-management in skillsof healthstaffthroughthb provision locallyadapted of guidelines lMCl and throughactivities promote on to their use B. lmprovement the public's of acceptance lMCl. ol C. lmprovements the healthsystemrequirad effective in for management childhood of lllness D. lmprovements familyand community in practices guidelines; The clinical whichare basedon expertclinical opinionand research results, desiqned the are for management : of A. Sickchildren aged 1 week up to 5 years B. Sickchildren aged 1 monthup to 5 years C. Sickchildren aged 1 year up to 5 years D. Sickchildren aged 1 day up to 5 years Whichof the following wrongaboutiMCt? is A. lntegrated case management relieson casedetection B . T h e t r e a t m e n t s r e d e v e l o p e da c c o r d i n gt o a c t i o n o r i e n t e dc l a s s i f i c a t i o nr a t h e rt h a n e x a c t a s diagnosis. C. The guidelines give instructions how to routinely for assessa childfor general dangersigns D. The treatments developed are according diagnosis to ratherthan actionorienied classifications ln the lMCl clinical guidelines, measures proportion percentage thosewiththe disease this the or of who are correctly identified the sign. by A. Specificity C. True positives B. Sensitivily D. Falsepositives This measures the proportion those withoutthe diseasewho are correctly of calledfree of the diseaseby usingthe llvlcl sign guidelines. A. Specificity C. True positives B. Sensitivity D. Falsepositives





SITUATION: Whenassessinga sick child,a combination individual of signs leadsto one or moreclassifications, rather than to a diagnosis. lMCl classilicationsare action orientedand allow nurses and other health care providers to determine if a child should be urgently referred to another health tacility. 6. lMCl is a case management process a first-level for facility suchas the following, except: A. A hsalthcenter pediatric C. Hospital ward B. An outpatient department a hospital of D. A clinic The complete lMCl case management processinvolves following the elements: l. Assessa childby checking firstfor dangersigns ll. Classify child'sillnesses a usinga colour-coded triagesyslem. lll. ldentify specific treatments the child. for lV. Providepractical treatment instructions A.


B . i r , l ,t vthat you needto ask? A. Ask why the childwas brought the clinic to B. Ask for specific signsand symptoms

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8. FORALLSICK CHILDFIEN I week to 5 years age up whoarebrought theclinic, to whatisthefirstinformationC. Ask the child'sage D. Ask for dangersigns


The case management processfor sick children age 2 monthsup to 5 years is presented threecharts. on Whichcharttitleis not included? A. Assess,classity and treatthe sjckyounginfant C. Counsel mother the S. Assessand classify sickchild the D. Treatthe child


The lMcl case management chartsand recording formsguideyou throughthe toflowing steps: A. Assessthe sick child or sick younginfant; Ctassidthe iilnebs;tOlntify trealmen't; Treatthe chitdor younginfant; Counsel mother; Givefollow_up the care 'freat B Assessthe sick child or sick young infant; classifythe illness; ldentify treatment; the child or younginfant; Give follow-up care Counsel mother; the c Assessthe sick childor sickyounginfant; Classify illness;Treatthe childor youngInlant; tdentify the treatment; Give follow-up care ; Counsel mother. the D. Assessthe sickchildor sickyounginfant;Treatthe childor younginfant the ; Classify iltness;ldentify treatment; Counsel mother; Givefollow-uo the care

SITUATION: Slgns, classifications,treatmentsand counseling difter between sick young infants and sick children. lt is essentialto start the case managementprocess by selecting tie appropriateset of lMCl charts 1l The ASSESSAND CLASSIFY chartdescribes howto assess child, the classify child's the illnesses identify and treatments. This columncolumnon the Ieftside of the chartdescribes how totake a history ano do a physical examination. A. Assessand classify column C. Assess column B. Classify column D. ldentify column This columnmeansto make a decision aboutthe severity the illness. of A. Treatment column C. Assesscolumn B. Classify column D. ldentjfy colLrmn This partbf the assessand classily chart helpsyou to quicklyidentify treatment the classif for ications written on your case recording form.Appropriate treatments recommended eachclassificatron. are for A. Treatment column C. tOentity freatmeni cotumn: B. Classify column . D. ldentify column TREAT meansgivingtreatment clinic,preseribing in drugsor othertreatments be gjvenat home,and also to teaching caretaker the how to carryout the treatments. What ttr,,tct chartshowstrowtJ oo ttretreatment steps identified the firstchart? on A Treatthe childchart C. Treatment chart B: Assessand classify chart D. Intervention chart Recommendations feeding, on fluidsand when to returnare grvenon the charttifled: A. Assessand classify chart C. Counsel motherchart the B. Treatthe childchart D. Follow_up carechart

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slTUATloN: The nurse needs to understandthe basic charts, tables and recording lorms for the sick child in tMCt. 16. ln l.MCl protocol, can best see if the childis improving the drugor othertreatment you on thatwas prescribed throughthis activity: A. Homevisit C. Clinicvisit B. Follow-up visit D. RHUvisit What sectionof the chartin lMcl describes stepsfor conducting the eachtypeof visitto follow-up child,s the condition? A. Give follow-up care section C. Assess classify and section B. l\4other's counseling section D. Treat childsection the According thischart,you shouldask the motheraboutthe child'sproblem to and checkthe chjldfor general danger igns. s A. Assessand classify sick childchart the B. Case recording form C. Assessment chart D. Classify and treatthe childchart Checkthe childfor general oangersigns,commonsymptoms the sick childand the mainproblem. of Which of the following a not included the lMCl four mainsymptoms a sick child? is in of A. coughor difficult breathing C. fever B. diarrhea D. easybruising





whichof thelofiowing notroutinely is checked a sickchildusing lMCr in the charts? A. malnutrition C. lmmunization statusB, anemia

slTUATloN: A child who has one or mote of the maln symptoms could have a serious illness, The serious diseasescan cause death or disabillty in young children il they are not treated. 21. In assessing child,the nurseobserves. the good communication skills.One of thesesiatements viotated the guidelines the use of therapeutic in communication: A. Listencarefully whatthe mothertellsyou to B. Use wordsthe motherunderstands C. Give the mothertime to answerthe questions D. Do not ask additional qusstions whenthe motheris not sure abouther answer A motherbringsher childto the clinic. The nursedetermines this is an initial if visitor a follow-up visit. lf it is an initialvisitfor an identifled problem: Give follow-up care C. Assessand classify chilo the 4 B. Assessand treatthe child D. Assessand give healthteachrngs lf thls is a follow-up visitfor the problem: A. Give follow-up care B. Assessand treatthe child C. Assessand classify chjld the D. Assessand give health teachings


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This columnon the left side of the chartdescribes how to take a historyand do a physical examination. The instructions thiscolumnbeginwith ask the motherwhatthe chird,s in piobrems are A. Assesscolumn C. Mother,s interview column B. Classify column D. Ask column When you see the mother, the child,s or caretaker, withthe sick child,you first: A. Ask the motheraboutthe child B. Greetthe motherappropriately C. Checkif the child'sweightand temperature were recorded D. Assessthe child

25. .

SITUATIoN: when patientsarriveat most cllnics,ctinic staff identitythe reasonfor the child's visit. Individual record is made for each patient. 26' Mrs Tamia broughther two-year-old to the clinic.You noticedthat the child'sweight son and ternperature have not been measured and r'corded.what wourdbe the nextbestacflonto take? A. Weighthe childand take the temoerature B. Ask the BHW to take the child'swejghtand temperature C. Assessand classify child'smainsymptoms. the D. Ask the mother's particjpation weighing child in the You ask Mrs.Tamiawhatthe child'sproblems are. The mainreasonfor askinga motherthe chitd,s problem at the start of the visit is: A. To open good communication the mother. with B. To come up withstandard baseline data C. To havean overview the child'sstatus of D. To be able to classify child'scondition the


slTUATloN: Fatimais 18 months_old. wejghs 11,5kg, Hertemperature 37.5"C. She is The healthworker asked, "What are the child's problems?" The mother said';Fatima has been coughing for 6 days, and 6he is having trouble breathing."This is ttle initial vislt for thls illness. . 28. t\4oving downthe leftsideof the ASSESS AND CLASSIFychart,you finda boxti ed CHECKFORGENERAL DANGERSIGNS.Ask the questions jn and look for the clinicalsigns described thjs box, which one is not includsd? A. ts the childabteto drinkor breastfeed? B. Doesthe chlldvomiteverything? C