Download - Chn Questions Imci

Transcript
Page 1: Chn Questions Imci

CHN QUESTIONS: lMClSITUATIONS: Sinie the 1970s, the estimated annual number of deaths among children less than 5 years old

has decreased by almost a third. Providing quality care to sick children in these conditions is aserious challenge. ln response to this challenge, WHO and UNICEF developed a strategy knownas Integrated Management of Childhood lllness (lMCl).

1. The core of the llt4Cl strategy is integrated case management of the most common childhood problems, witha focus on the most important causes of death. Which one is not a main component in lfvlol strategy?

A. lmprovements in the case-management skills of health staff through thb provision of locally adaptedguidelines on lMCl and through activities to promote their use

B. lmprovement of the public's acceptance ol lMCl.C. lmprovements in the health system requirad for effective management of childhood lllnessD. lmprovements in family and community practices

2. The clinical guidelines; which are based on expert clinical opinion and research results, are desiqned for themanagement of :

A. Sick children aged 1 week up to 5 yearsB. Sick children aged 1 month up to 5 yearsC. Sick children aged 1 year up to 5 yearsD. Sick children aged 1 day up to 5 years

3. Which of the following is wrong about iMCt?A. lntegrated case management relies on case detectionB. The t reatments are developed accord ing to act ion or iented c lass i f icat ions rather than exact

d iagnosis .C. The guidelines give instructions for how to routinely assess a child for general danger signsD. The treatments are developed according to diagnosis rather than action orienied classifications

4. ln the lMCl clinical guidelines, this measures the proportion or percentage of those with the disease who arecorrectly identified by the sign.

5 This measures the proportion of those without the disease who are correctly called free of the disease byusing the llvlcl sign guidelines.

A. SpecificityB. Sensitivily

A. SpecificityB. Sensitivity

C. True positivesD. False positives

C. True positivesD. False positives

SITUATION: When assessing a sick child, a combination of individual signs leads to one or more classifications,rather than to a diagnosis. lMCl classilications are action oriented and allow nurses and otherhealth care providers to determine if a child should be urgently referred to another healthtacility.

6. lMCl is a case management process for a first-level facility such as the following, except:A. A hsalth center C. Hospital pediatric wardB. An outpatient department of a hospital D. A clinic

7. The complete lMCl case management process involves the following elements:l. Assess a child by checking first for danger signsll. Classify a child's il lnesses using a colour-coded triage syslem.

lll. ldentify specific treatments for the child.lV. Provide practical treatment instructions

A . t , , l l lB. i r , l , t v

c. r, , lvD. l , , r , rv

8. FOR ALL SICK CHILDFIEN age I week up to 5 years who are brought to the clinic, what is the first informationthat you need to ask?

A. Ask why the child was brought to the clinicB. Ask for specific signs and symptoms

C. Counsel the motherD. Treat the child

C. Ask the child's ageD. Ask for danger signs

9 The case management process for sick children age 2 months up to 5 years is presented on three charts.Which chart title is not included?

A. Assess, classity and treat the sjck young infantS. Assess and classify the sick child

Page 2: Chn Questions Imci

10. The lMcl case management charts and recording forms guide you through the toflowing steps:A. Assess the sick child or sick young infant; Ctassid the iilnebs; tOlntify trealmen't; Treat the chitd oryoung infant; Counsel the mother; Give follow_up careB Assess the sick child or sick young infant; classify the illness; ldentify treatment; 'freat

the child oryoung infant; Give follow-up care Counsel the mother;c Assess the sick child or sick young infant; Classify the illness; Treat the child or young Inlant; tdentify

treatment; Give follow-up care ; Counsel the mother.D. Assess the sick child or sick young infant; Treat the child or young infant ; Classify the iltness; ldentifytreatment; Counsel the mother; Give follow-uo care

SITUATION: Slgns, classifications, treatments and counseling difter between sick young infants and sickchildren. lt is essential to start the case management process by selecting tie appropriate setof lMCl charts

1 l The ASSESS AND CLASSIFY chart describes how to assess the child, classify the child's il lnesses and identifytreatments. This column column on the Ieft side of the chart describes how totake a history ano do a physicalexamination.

. ri:,..-,

",_."r

12. This column means to make a decision about the severity of the illness.A. Treatment column C. Assess columnB. Classify column D. ldentjfy colLrmn

l3 This part bf the assess and classily chart helps you to quickly identify treatment for the classif ications writtenon your case recording form. Appropriate treatments are recommended for each classificatron.A. Treatment column C. tOentity freatmeni cotumn:B. Classify column . D. ldentify column

14' TREAT means giving treatment in clinic, preseribing drugs or other treatments to be gjven at home, and alsoteaching the caretaker how to carry out the treatments. What ttr,,tct chart shows trow tJ oo ttre treatment stepsidentified on the first chart?A Treat the child chart C. Treatment chartB: Assess and classify chart D. Intervention chart

l5 Recommendations on feeding, fluids and when to return are grven on the chart tifled:A. Assess and classify chart C. Counsel the mother chartB. Treat the child chart D. Follow_up care chart

slTUATloN: The nurse needs to understand the basic charts, tables and recording lorms for the sick childin tMCt.

A. Assess and classify columnB. Classify column

A. Give follow-up care sectionB. l\4other's counseling section

C. Assess columnD. ldentify column

see if the child is improving on the drug or other treatment that was prescribed

C. Clinic visitD. RHU visit

16. ln l.MCl protocol, you can bestthrough this activity:

A. Home visitB. Follow-up visit

17 ' What section of the chart in lMcl describes the steps for conducting each type of visit to follow-up the child,scondition?

C. Assess and classify sectionD. Treat the child section

.lS According to this chart, you should ask the mother about the child's problem and check the chjld for generaldanger s igns.

A. Assess and classify the sick child chartB. Case recording formC. Assessment chartD. Classify and treat the child chart

19' Check the child for general oanger signs, common symptoms of the sick child and the main problem. Whichof the following is a not included in the lMCl four main symptoms of a sick child?

A. cough or difficult breathing C. feverB. diarrhea D. easy bruising

20 which of the lofiowing is not routinely checked in a sick child using the lMCr charts?A. malnutrition C. lmmunization statusB, anemia D nr r r rqac

Page 3: Chn Questions Imci

slTUATloN: A child who has one or mote of the maln symptoms could have a serious illness, The seriousdiseases can cause death or disabillty in young children il they are not treated.

21 . In assessing the child, the nurse observes. good communication skills. One of these siatements viotated theguidelines in the use of therapeutic communication:A. Listen carefully to what the mother tells youB. Use words the mother understandsC. Give the mother time to answer the questionsD. Do not ask additional qusstions when the mother is not sure about her answer

. ,,. -..,

22. A mother brings her child to the clinic. The nurse determines if this is an initial visit or a follow-up visit. lf it is '. .I

an initial visit for an identifled problem:

4 Give follow-up care C. Assess and classify the chiloB. Assess and treat the child D. Assess and give health teachrngs

23. lf thls is a follow-up visit for the problem:A. Give follow-up careB. Assess and treat the child

?4. This column on the left side of the chart describes how to take a history and do a physical examination. Theinstructions in this column begin with ask the mother what the chird,s piobrems are

A. Assess column C. Mother,s interview columnB. Classify column D. Ask column

25. When you see the mother, or the child,s caretaker, with the sick child, you first:A. Ask the mother about the child

. B. Greet the mother appropriatelyC. Check if the child's weight and temperature were recordedD. Assess the child

SITUATIoN: when patients arrive at most cllnics, ctinic staff identity the reason for the child's visit. Individualrecord is made for each patient.

26' Mrs Tamia brought her two-year-old son to the clinic. You noticed that the child's weight and ternperaturehave not been measured and r'corded. what wourd be the next best acflon to take?

A. Weigh the child and take the temoeratureB. Ask the BHW to take the child's wejght and temperatureC. Assess and classify the child's main symptoms.D. Ask the mother's particjpation in weighing the child

27' You ask Mrs. Tamia what the child's problems are. The main reason for asking a mother the chitd,s problemat the start of the visit is:

A. To open good communication with the mother.B. To come up with standard baseline dataC. To have an overview of the child's statusD. To be able to classify the child's condition

slTUATloN: Fatima is 18 months_old. She wejghs 11,5 kg, Hertemperature is 37.5"C. The health worker 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 il lness.

28. t\4oving down the left side of the ASSESS AND CLASSIFy chart, you find a box ti ed CHECK FOR GENERALDANGER SIGNS. Ask the questions and look for the clinical signs described jn thjs box, which one is notincludsd?

A. ts the child abte to drink or breastfeed?B. Does the chlld vomit everything?C. Has the child had convulsions?D. ls the child able to breath with ease?

29. Mrs' Tamia tells you that the child falls asleep often lately and seldom drinks from a cup when offered withfluids. The next nursing action is to:

A. Ask more about diarrhea, lever and possible.ear problemsB. Complete the assessment and any pre-referral keatment immediatelyC. Check for malnutrition and anemiaD. Give the child fluids and antibiotics

C. Assess and classify the chjldD. Assess and give health teachings

Page 4: Chn Questions Imci

t 30. A child who is breastfed may have dilficulty sucking when his nose is blocked. lf the child can breastfeed after

Fleassess the child's sucking on the next feedingOffer f luids f rom a cup

Nilrs. Tamia claims that her child vomited several times but can hold down some fluids. This is consioereotA. A danger s ignB. Not a danger signC. More data neededD. A possible danger sign so try offering some food to further assess the child.

32. The mother also mentioned that the last time the child sulfered from sejzure was one and half years ago Thisinformation can be classified as:

A. A danger sjgn C. A major symptom8.. Not a danger sign with the current problem D. A minor symptom

33. l t the chi ld is s leeping and has cough or d i f l icu l t breath ingA. count the number of breaths first before you try to wake the chjldB. count the number of breaths after waking the childC. Refer the child immsdiately to the district hospitalD. lmmediately wake or shake the child

SITUATION: Nurse Anita, a public health nurse, ia asse6sing 18-month-old Bonny with troubled breathing. Themother said thal Boony is able to drink. He has not been vomiting. He has not had convulsions duringthis il lness' Nurse Anita asked, "Does he seem unusually sleepy?" The mother said, ,,yes.',

34. Nurse Anita clapped his hands. She asked the mother to shake the child. Bonny opened his eyes, but did notlook around She talked to Bonny, but he did not watch her face. He stared blankly and appeared not to noticewhat was going on around him. Nurse Anita is aware that:

A. Bonny needs jmmediate referral' 8. Bonny needs more rest

C, Bonny is demonstraling a normal behavior of his ageD. Bonny can be treated within the health center

SITUATION: Gori, 3 years old is brought to the clinic due to fever, cough and difficulty of breathing. yousugpect that this is a case pneumonia

Your basic assessment of Gori should include:A. Looking for signs of ear infectionB. Looking signs of dehydratjonC. All of theseD. Looking for intercostals and subcostal retractions

Gori is diagnosed of having pneumonia. you expect his respiratory rate to be:A. 60 breaths per minute C. .40 breaths per minu,teB. 50 breaths per minute D. 20 breaths per minute

37. Gori is on antibiotic therapy which of the fotlowing statements indicales that tho mother needs further teaching?A. "l can slop giving the antibiotics when he seems better.,'B. "He needs to finish the 5 day treatment even if he seems better.,,C. "l ' l l contlnue feeding my son as usual or add more if needed during hrs trealment.,,D. "l ' l l bring back my son to the health center in 2 days or sooner if his condition worsens.,'

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

A. Ask the mother to demonstrate what she has heardB. Ask the mother to repeat the jnstructions correct anv misinformatjonC. Ask the mother what problems she might have in g iv ing the ant ib jo t icsD. Any o i these

SITUATION: A child with cough or difficult breathing may harve pneumonia or another severe respiratory infection.Pneumonia is the leading cause of death among Filipino children under tive years old.

39. What are the two most common clinical signs in classifying a child under pneumonia category?

the nos€ is cleared:A. The child does not have the danger sjgn C.B. The child sti l l has a danger sign D.

A. Fast breathing and stridorB. Fast breathing.and chest indrawing

C. Fast breathing and rusty sputumD. Chest indrawing and flaring of the nares

i ' " - - -)r

35.

36.

38.

Page 5: Chn Questions Imci

41. when a two-year child with last breathing develops chest indrawing, he is classif ied under:

40. Fast breathing in children wrth pneumonia can be attributed tojA. Stiff Iungs and hypoxiaB. Tsnacioussecretions

A. No pneumoniaB. Pneumonla

A. Simple cough and feverB. Fast breathing

45. Chest indrawing is also known as:A. Subcosta l ret ract ionsB. Intercostalsretractions

A. Pink or top rowB. Yellow or second row

A. No pneumonia categoryB. Pneumonia category

48. Considering lvlarikar's signs and symptoms and age, she is classjfied under:

C. Fluid accum ulationD, Lung collapse

C. Severs pneumoniaD. Very severe pneumonia

lnfluenzaAsthma or bronchitis

C. Fever and normal breathingD. No pneumonia

C. Diaphragm retractionsD . A o r B

C. Green or bottom rowD. More assessment data needed

C. Severe pneumonia categoryD. Very severe disease

C. No anemia and very low weightD. Severe anemia and not very low weight

42. A child who has had cough or dill icult breathing for more than 30 days has a chronic cough. This could beindicative ot:

A. PneumoniaB. Severe pneumonia

43. Mikha, 12 months old, 12lbs, with Temperature ol 37.7 oC, resplratory rate of 40 breaths per minute, with coughis presenting with

{-'' rC.D.

44. The nurse assesses Mikha for chest indrawing. The child has chest indrawing iiA. the lower chest wall goes lN when the child breathes lNB. the lower chest wall goes lN when the child exhalesC. the lower chest wall goes OUT when the child breathes lND. the whole chest wall (upper and lower) and the abdomen move OUT when the child breathes lN.

46- To accurately assess lor stridor, the nurse does all or any of the following, except:A. Put your ear near the child,s mouth because strjdor can be difficult to hearB. look to see when the child breathes lNC. Be sure to look and listen tor stridor when the child is calm.Dl Ljsten 10 wheezing noise when the child breathes OUT

SITUATION: There are three possible classifications for a child with cough or difficutt breathing;Severe pneumonia or very severe disease, pneumonia, and no pneumonia: coughor cotd

47. Marikar, 7 weeks old, was brought by her mother to the health center because of high fever, cough, frequentvomiting and one episode of convulsion. The nurse puts her chart or case record under:

49. Further assessment of Marikar revealed severe palmar pallor and noted a 15% weight loss. Aside t rom thepneumonia classifications, she is also classified under:

A. Anemia and low weightB, Severe anemia

50. Before referring Mikha to the hospital, the nurse administers:A. Vltamin A and one dose of lM procaine penicill in 200, O0O lUB. Vitamin A and flrst dose of oral CotrimoxazoleC. Vitamin A and one dose of IM procaine penici in 400,000 lUD. Vi tamin A and one dose of lM procaine penic i l l in 100,000 lU