SUCCEED REVIEW CENTER

CD – IMCI EXAM
By: Mark Joseph Magtanong, RN

1. Based on assessment, you classified a 3-month old infant with the chief complaint of diarrhea in the category of
SOME DEHYDRATION. Based on IMCI management guidelines, which of the following will you do?
A. Bring the infant to the nearest facility where IV fluids can be given.
B. Supervise the mother in giving 200 to 400 ml. of Oresol in 4 hours.
C. Give the infant’s mother instructions on home management.
D. Keep the infant in your health center for close observation.
Answer: (B) Supervise the mother in giving 200 to 400 ml. of Oresol in 4 hours.
In the IMCI management guidelines, SOME DEHYDRATION is treated with the administration of Oresol within a
period of 4 hours. The amount of Oresol is best computed on the basis of the child’s weight (75 ml/kg body weight). If
the weight is unknown, the amount of Oresol is based on the child’s age.

2. A mother is using Oresol in the management of diarrhea of her 3-year old child. She asked you what to do if her
child vomits. You will tell her to
A. Bring the child to the nearest hospital for further assessment.
B. Bring the child to the health center for intravenous fluid therapy.
C. Bring the child to the health center for assessment by the physician.
D. Let the child rest for 10 minutes then continue giving Oresol more slowly.

Answer: (D) Let the child rest for 10 minutes then continue giving Oresol more slowly.
If the child vomits persistently, that is, he vomits everything that he takes in, he has to be referred urgently to a
hospital. Otherwise, vomiting is managed by letting the child rest for 10 minutes and then continuing with Oresol
administration. Teach the mother to give Oresol more slowly.

3. A 1 ½ year old child was classified as having 3rd degree protein energy malnutrition, kwashiorkor. Which of the
following signs will be most apparent in this child?
A. Voracious appetite
B. Wasting
C. Apathy
D. Edema

Answer: (D) Edema

Edema, a major sign of kwashiorkor, is caused by decreased colloidal osmotic pressure of the blood brought about by
hypoalbuminemia. Decreased blood albumin level is due a protein-deficient diet.

4. Assessment of a 2-year old child revealed “baggy pants”. Using the IMCI guidelines, how will you manage this
child?
A. Refer the child urgently to a hospital for confinement.
B. Coordinate with the social worker to enroll the child in a feeding program.
C. Make a teaching plan for the mother, focusing on menu planning for her child.
D. Assess and treat the child for health problems like infections and intestinal parasitism.

Answer: (A) Refer the child urgently to a hospital for confinement.

“Baggy pants” is a sign of severe marasmus. The best management is urgent referral to a hospital.

5. During the physical examination of a young child, what is the earliest sign of xerophthalmia that you may observe?
A. Keratomalacia
B. Corneal opacity
C. Night blindness
D. Conjunctival xerosis

Answer: (D) Conjunctival xerosis

The earliest sign of Vitamin A deficiency (xerophthalmia) is night blindness. However, this is a functional change,
which is not observable during physical examination.The earliest visible lesion is conjunctival xerosis or dullness of
the conjunctiva due to inadequate tear production.

6. To prevent xerophthalmia, young children are given Retinol capsule every 6 months. What is the dose given to
preschoolers?
A. 10,000 IU
B. 20,000 IU
C. 100,000 IU
D. 200,000 IU

Answer: (D) 200,000 IU

Preschoolers are given Retinol 200,000 IU every 6 months. 100,000 IU is given once to infants aged 6 to 12 months.
The dose for pregnant women is 10,000 IU.

7. The major sign of iron deficiency anemia is pallor. What part is best examined for pallor?
A. Palms
B. Nailbeds
C. Around the lips
D. Lower conjunctival sac
Answer: (A) Palms
The anatomic characteristics of the palms allow a reliable and convenient basis for examination for pallor.
8. Food fortification is one of the strategies to prevent micronutrient deficiency conditions. R.A. 8976 mandates
fortification of certain food items. Which of the following is among these food items?
A. Sugar
B. Bread
C. Margarine
D. Filled milk

Answer: (A) Sugar

R.A. 8976 mandates fortification of rice, wheat flour, sugar and cooking oil with Vitamin A, iron and/or iodine.

9. What is the best course of action when there is a measles epidemic in a nearby municipality?
A. Give measles vaccine to babies aged 6 to 8 months.
B. Give babies aged 6 to 11 months one dose of 100,000 I.U. of Retinol
C. Instruct mothers to keep their babies at home to prevent disease transmission.
D. Instruct mothers to feed their babies adequately to enhance their babies’ resistance.

Answer: (A) Give measles vaccine to babies aged 6 to 8 months.

Ordinarily, measles vaccine is given at 9 months of age. During an impending epidemic, however, one dose may be
given to babies aged 6 to 8 months. The mother is instructed that the baby needs another dose when the baby is 9
months old.

10. A mother brought her daughter, 4 years old, to the RHU because of cough and colds. Following the IMCI
assessment guide, which of the following is a danger sign that indicates the need for urgent referral to a hospital?
A. Inability to drink
B. High grade fever
C. Signs of severe dehydration
D. Cough for more than 30 days

Answer: (A) Inability to drink

A sick child aged 2 months to 5 years must be referred urgently to a hospital if he/she has one or more of the
following signs: not able to feed or drink, vomits everything, convulsions, abnormally sleepy or difficult to awaken.

11. Management of a child with measles includes the administration of which of the following?
A. Gentian violet on mouth lesions
B. Antibiotics to prevent pneumonia
C. Tetracycline eye ointment for corneal opacity
D. Retinol capsule regardless of when the last dose was given

Answer: (D) Retinol capsule regardless of when the last dose was given
An infant 6 to 12 months classified as a case of measles is given Retinol 100,000 IU; a child is given 200,000 IU
regardless of when the last dose was given.

12. A mother brought her 10 month old infant for consultation because of fever, which started 4 days prior to
consultation. To determine malaria risk, what will you do?
A. Do a tourniquet test.
B. Ask where the family resides.
C. Get a specimen for blood smear.
D. Ask if the fever is present everyday.

Answer: (B) Ask where the family resides.

Because malaria is endemic, the first question to determine malaria risk is where the client’s family resides. If the area
of residence is not a known endemic area, ask if the child had traveled within the past 6 months, where he/she was
brought and whether he/she stayed overnight in that area.

13. The following are strategies implemented by the Department of Health to prevent mosquito-borne diseases. Which
of these is most effective in the control of Dengue fever?
A. Stream seeding with larva-eating fish
B. Destroying breeding places of mosquitoes
C. Chemoprophylaxis of non-immune persons going to endemic areas
D. Teaching people in endemic areas to use chemically treated mosquito nets

Answer: (B) Destroying breeding places of mosquitoes

Aedes aegypti, the vector of Dengue fever, breeds in stagnant, clear water. Its feeding time is usually during the
daytime. It has a cyclical pattern of occurrence, unlike malaria which is endemic in certain parts of the country.

14. Secondary prevention for malaria includes

A. Planting of neem or eucalyptus trees
B. Residual spraying of insecticides at night
C. Determining whether a place is endemic or not
D. Growing larva-eating fish in mosquito breeding places
Answer: (C) Determining whether a place is endemic or not
This is diagnostic and therefore secondary level prevention. The other choices are for primary prevention.

15. Scotch tape swab is done to check for which intestinal parasite?
A. Ascaris
B. Pinworm
C. Hookworm
D. Schistosoma

Answer: (B) Pinworm

Pinworm ova are deposited around the anal orifice.

16. Which of the following signs indicates the need for sputum examination for AFB?
A. Hematemesis
B. Fever for 1 week
C. Cough for 3 weeks
D. Chest pain for 1 week

Answer: (C) Cough for 3 weeks

A client is considered a PTB suspect when he has cough for 2 weeks or more, plus one or more of the following signs:
fever for 1 month or more; chest pain lasting for 2 weeks or more not attributed to other conditions; progressive,
unexplained weight loss; night sweats; and hemoptysis.

17. Which clients are considered targets for DOTS Category I?

A. Sputum negative cavitary cases
B. Clients returning after a default
C. Relapses and failures of previous PTB treatment regimens
D. Clients diagnosed for the first time through a positive sputum exam

Answer: (D) Clients diagnosed for the first time through a positive sputum exam
Category I is for new clients diagnosed by sputum examination and clients diagnosed to have a serious form of
extrapulmonary tuberculosis, such as TB osteomyelitis.

18. To improve compliance to treatment, what innovation is being implemented in DOTS?

A. Having the health worker follow up the client at home
B. Having the health worker or a responsible family member monitor drug intake
C. Having the patient come to the health center every month to get his medications
D. Having a target list to check on whether the patient has collected his monthly supply of drugs

Answer: (B) Having the health worker or a responsible family member monitor drug intake
Directly Observed Treatment Short Course is so-called because a treatment partner, preferably a health worker
accessible to the client, monitors the client’s compliance to the treatment.

19. Diagnosis of leprosy is highly dependent on recognition of symptoms. Which of the following is an early sign of
leprosy?
A. Macular lesions
B. Inability to close eyelids
C. Thickened painful nerves
D. Sinking of the nosebridge

Answer: (C) Thickened painful nerves

The lesion of leprosy is not macular. It is characterized by a change in skin color (either reddish or whitish) and loss of
sensation, sweating and hair growth over the lesion. Inability to close the eyelids (lagophthalmos) and sinking of the
nosebridge are late symptoms.

20. Which of the following clients should be classified as a case of multibacillary leprosy?
A. 3 skin lesions, negative slit skin smear
B. 3 skin lesions, positive slit skin smear
C. 5 skin lesions, negative slit skin smear
D. 5 skin lesions, positive slit skin smear

Answer: (D) 5 skin lesions, positive slit skin smear

A multibacillary leprosy case is one who has a positive slit skin smear and at least 5 skin lesions.

21. In the Philippines, which condition is the most frequent cause of death associated with schistosomiasis?
A. Liver cancer
B. Liver cirrhosis
C. Bladder cancer
D. Intestinal perforation

Answer: (B) Liver cirrhosis

The etiologic agent of schistosomiasis in the Philippines is Schistosoma japonicum, which affects the small intestine
and the liver. Liver damage is a consequence of fibrotic reactions to schistosoma eggs in the liver.
22. What is the most effective way of controlling schistosomiasis in an endemic area?
A. Use of molluscicides
B. Building of foot bridges
C. Proper use of sanitary toilets
D. Use of protective footwear, such as rubber boots

Answer: (C) Proper use of sanitary toilets

The ova of the parasite get out of the human body together with feces. Cutting the cycle at this stage is the most
effective way of preventing the spread of the disease to susceptible hosts.

23. When residents obtain water from an artesian well in the neighborhood, the level of this approved type of water
facility is
A. I
B. II
C. III
D. IV

Answer: (B) II
A communal faucet or water standpost is classified as Level II.

24. For prevention of hepatitis A, you decided to conduct health education activities. Which of the following is
IRRELEVANT?
A. Use of sterile syringes and needles
B. Safe food preparation and food handling by vendors
C. Proper disposal of human excreta and personal hygiene
D. Immediate reporting of water pipe leaks and illegal water connections

Answer: (A) Use of sterile syringes and needles

Hepatitis A is transmitted through the fecal oral route. Hepatitis B is transmitted through infected body secretions like
blood and semen.

26. Which biological used in Expanded Program on Immunization (EPI) should NOT be stored in the freezer?
A. DPT
B. Oral polio vaccine
C. Measles vaccine
D. MMR

Answer: (A) DPT

DPT is sensitive to freezing. The appropriate storage temperature of DPT is 2 to 8° C only. OPV and measles vaccine
are highly sensitive to heat and require freezing. MMR is not an immunization in the Expanded Program on
Immunization.

27. You will conduct outreach immunization in a barangay with a population of about 1500. Estimate the number of
infants in the barangay.
A. 45
B. 50
C. 55
D. 60

Answer: (A) 45
To estimate the number of infants, multiply total population by 3%.

28. In Integrated Management of Childhood Illness, severe conditions generally require urgent referral to a hospital.
Which of the following severe conditions DOES NOT always require urgent referral to a hospital?
A. Mastoiditis
B. Severe dehydration
C. Severe pneumonia
D. Severe febrile disease

Answer: (B) Severe dehydration

The order of priority in the management of severe dehydration is as follows: intravenous fluid therapy, referral to a
facility where IV fluids can be initiated within 30 minutes, Oresol/nasogastric tube, Oresol/orem. When the foregoing
measures are not possible or effective, tehn urgent referral to the hospital is done.

29. A client was diagnosed as having Dengue fever. You will say that there is slow capillary refill when the color of the
nailbed that you pressed does not return within how many seconds?
A. 3
B. 5
C. 8
D. 10

Answer: (A) 3
Adequate blood supply to the area allows the return of the color of the nailbed within 3 seconds.
30. A 3-year old child was brought by his mother to the health center because of fever of 4-day duration. The child
had a positive tourniquet test result. In the absence of other signs, which is the most appropriate measure that the
PHN may carry out to prevent Dengue shock syndrome?
A. Insert an NGT and give fluids per NGT.
B. Instruct the mother to give the child Oresol.
C. Start the patient on intravenous fluids STAT.
D. Refer the client to the physician for appropriate management.

Answer: (B) Instruct the mother to give the child Oresol.

Since the child does not manifest any other danger sign, maintenance of fluid balance and replacement of fluid loss
may be done by giving the client Oresol.

31. The pathognomonic sign of measles is Koplik’s spot. You may see Koplik’s spot by inspecting the _____.
A. Nasal mucosa
B. Buccal mucosa
C. Skin on the abdomen
D. Skin on the antecubital surface

Answer: (B) Buccal mucosa

Koplik’s spot may be seen on the mucosa of the mouth or the throat.

32. Among the following diseases, which is airborne?

A. Viral conjunctivitis
B. Acute poliomyelitis
C. Diphtheria
D. Measles

Answer: (D) Measles

Viral conjunctivitis is transmitted by direct or indirect contact with discharges from infected eyes. Acute poliomyelitis is
spread through the fecal-oral route and contact with throat secretions, whereas diphtheria is through direct and
indirect contact with respiratory secretions.

33. Among children aged 2 months to 3 years, the most prevalent form of meningitis is caused by which
microorganism?
A. Hemophilus influenzae
B. Morbillivirus
C. Steptococcus pneumoniae
D. Neisseria meningitidis

Answer: (A) Hemophilus influenzae

Hemophilus meningitis is unusual over the age of 5 years. In developing countries, the peak incidence is in children
less than 6 months of age. Morbillivirus is the etiology of measles. Streptococcus pneumoniae and Neisseria
meningitidis may cause meningitis, but age distribution is not specific in young children.

34. Human beings are the major reservoir of malaria. Which of the following strategies in malaria control is based on
this fact?
A. Stream seeding
B. Stream clearing
C. Destruction of breeding places
D. Zooprophylaxis

Answer: (D) Zooprophylaxis

Zooprophylaxis is done by putting animals like cattle or dogs close to windows or doorways just before nightfall. The
Anopheles mosquito takes his blood meal from the animal and goes back to its breeding place, thereby preventing
infection of humans.

35. The use of larvivorous fish in malaria control is the basis for which strategy of malaria control?
A. Stream seeding
B. Stream clearing
C. Destruction of breeding places
D. Zooprophylaxis

Answer: (A) Stream seeding

Stream seeding is done by putting tilapia fry in streams or other bodies of water identified as breeding places of the
Anopheles mosquito

36. Mosquito-borne diseases are prevented mostly with the use of mosquito control measures. Which of the following
is NOT appropriate for malaria control?
A. Use of chemically treated mosquito nets
B. Seeding of breeding places with larva-eating fish
C. Destruction of breeding places of the mosquito vector
D. Use of mosquito-repelling soaps, such as those with basil or citronella

Answer: (C) Destruction of breeding places of the mosquito vector

Anopheles mosquitoes breed in slow-moving, clear water, such as mountain streams.
37. A 4-year old client was brought to the health center with the chief complaint of severe diarrhea and the passage of
“rice water” stools. The client is most probably suffering from which condition?
A. Giardiasis
B. Cholera
C. Amebiasis
D. Dysentery

Answer: (B) Cholera

Passage of profuse watery stools is the major symptom of cholera. Both amebic and bacillary dysentery are
characterized by the presence of blood and/or mucus in the stools. Giardiasis is characterized by fat malabsorption
and, therefore, steatorrhea.

38. In the Philippines, which specie of schistosoma is endemic in certain regions?

A. S. mansoni
B. S. japonicum
C. S. malayensis
D. S. haematobium

Answer: (B) S. japonicum

S. mansoni is found mostly in Africa and South America; S. haematobium in Africa and the Middle East; and S.
malayensis only in peninsular Malaysia.

39. A 32-year old client came for consultation at the health center with the chief complaint of fever for a week.
Accompanying symptoms were muscle pains and body malaise. A week after the start of fever, the client noted
yellowish discoloration of his sclera. History showed that he waded in flood waters about 2 weeks before the onset of
symptoms. Based on his history, which disease condition will you suspect?
A. Hepatitis A
B. Hepatitis B
C. Tetanus
D. Leptospirosis

Answer: (D) Leptospirosis

Leptospirosis is transmitted through contact with the skin or mucous membrane with water or moist soil contaminated
with urine of infected animals, like rats.

40. MWSS provides water to Manila and other cities in Metro Manila. This is an example of which level of water
facility?
A. I
B. II
C. III
D. IV

Answer: (C) III

Waterworks systems, such as MWSS, are classified as level III.

41. You are the PHN in the city health center. A client underwent screening for AIDS using ELISA. His result was
positive. What is the best course of action that you may take?
A. Get a thorough history of the client, focusing on the practice of high risk behaviors.
B. Ask the client to be accompanied by a significant person before revealing the result.
C. Refer the client to the physician since he is the best person to reveal the result to the client.
D. Refer the client for a supplementary test, such as Western blot, since the ELISA result may be false.

Answer: (D) Refer the client for a supplementary test, such as Western blot, since the ELISA result may be
false.
A client having a reactive ELISA result must undergo a more specific test, such as Western blot. A negative
supplementary test result means that the ELISA result was false and that, most probably, the client is not infected.

42. Which is the BEST control measure for AIDS?

A. Being faithful to a single sexual partner
B. Using a condom during each sexual contact
C. Avoiding sexual contact with commercial sex workers
D. Making sure that one’s sexual partner does not have signs of AIDS

Answer: (A) Being faithful to a single sexual partner

Sexual fidelity rules out the possibility of getting the disease by sexual contact with another infected person.
Transmission occurs mostly through sexual intercourse and exposure to blood or tissues.

43. The most frequent causes of death among clients with AIDS are opportunistic diseases. Which of the following
opportunistic infections is characterized by tonsillopharyngitis?
A. Respiratory candidiasis
B. Infectious mononucleosis
C. Cytomegalovirus disease
D. Pneumocystis carinii pneumonia
 Answer: (B) Infectious mononucleosis
Cytomegalovirus disease is an acute viral disease characterized by fever, sore throat and lymphadenopathy.

44. To determine possible sources of sexually transmitted infections, which is the BEST method that may be
undertaken by the public health nurse?
A. Contact tracing
B. Community survey
C. Mass screening tests
D. Interview of suspects

Answer: (A) Contact tracing

Contact tracing is the most practical and reliable method of finding possible sources of person-to-person transmitted
infections, such as sexually transmitted diseases.

45. Antiretroviral agents, such as AZT, are used in the management of AIDS. Which of the following is NOT an action
expected of these drugs.
A. They prolong the life of the client with AIDS.
B. They reduce the risk of opportunistic infections
C. They shorten the period of communicability of the disease.
D. They are able to bring about a cure of the disease condition.

Answer: (D) They are able to bring about a cure of the disease condition.
There is no known treatment for AIDS. Antiretroviral agents reduce the risk of opportunistic infections and prolong life,
but does not cure the underlying immunodeficiency.

46. A barangay had an outbreak of German measles. To prevent congenital rubella, what is the BEST advice that you
can give to women in the first trimester of pregnancy in the barangay?
A. Advice them on the signs of German measles.
B. Avoid crowded places, such as markets and moviehouses.
C. Consult at the health center where rubella vaccine may be given.
D. Consult a physician who may give them rubella immunoglobulin.

Answer: (D) Consult a physician who may give them rubella immunoglobulin.
Rubella vaccine is made up of attenuated German measles viruses. This is contraindicated in pregnancy. Immune
globulin, a specific prophylactic against German measles, may be given to pregnant women.

47. You were invited to be the resource person in a training class for food handlers. Which of the following would you
emphasize regarding prevention of staphylococcal food poisoning?
A. All cooking and eating utensils must be thoroughly washed.
B. Food must be cooked properly to destroy staphylococcal microorganisms.
C. Food handlers and food servers must have a negative stool examination result.
D. Proper handwashing during food preparation is the best way of preventing the condition.

Answer: (D) Proper handwashing during food preparation is the best way of preventing the condition.
Symptoms of this food poisoning are due to staphylococcal enterotoxin, not the microorganisms themselves.
Contamination is by food handling by persons with staphylococcal skin or eye infections.

48. In a mothers’ class, you discussed childhood diseases such as chicken pox. Which of the following statements
about chicken pox is correct?
A. The older one gets, the more susceptible he becomes to the complications of chicken pox.
B. A single attack of chicken pox will prevent future episodes, including conditions such as shingles.
C. To prevent an outbreak in the community, quarantine may be imposed by health authorities.
D. Chicken pox vaccine is best given when there is an impending outbreak in the community.

Answer: (A) The older one gets, the more susceptible he becomes to the complications of chicken pox.
Chicken pox is usually more severe in adults than in children. Complications, such as pneumonia, are higher in
incidence in adults.

49. Complications to infectious parotitis (mumps) may be serious in which type of clients?
A. Pregnant women
B. Elderly clients
C. Young adult males
D. Young infants

Answer: (C) Young adult males

Epididymitis and orchitis are possible complications of mumps. In post-adolescent males, bilateral inflammation of the
testes and epididymis may cause sterility.

50. A child is aged from 2 months to 5 years. Which of the following is NOT included in checking for danger signs?
a. If the child is not able to drink or breastfeed.
b. If the child is not abnormally sleepy or difficult to awaken
c. If the child has had convulsions.
d. If the child vomits everything he or she takes in.
Answer: B – a, c & d are all danger signs that should be checked always. Another danger sign is when child is
abnormally sleepy or difficult to awaken
 51. During a home visit, the nurse treats a local infection, gives oral drugs advices, and teaches the caregiver. She
performed interventions under what category?
a. Pink c. Green
b. Yellow d. Red
Answer: B – Yellow – specific medical treatment and advice is usually done at the clinic and it is under Yellow category.

52. Under what classification are you going to teach the mother or other caregivers on how to give oral drugs and treat
local infections at home.
c. Pink c. Green
d. Yellow d. Red
Answer: C – Green – simple advice on home management
53. In preparing a primigravida for breastfeeding, which of the following will you do?
A. Tell her that lactation begins within a day after delivery.
B. Teach her nipple stretching exercises if her nipples are everted.
C. Instruct her to wash her nipples before and after each breastfeeding.
D. Explain to her that putting the baby to breast will lessen blood loss after delivery.

Answer: (D) Explain to her that putting the baby to breast will lessen blood loss after delivery.
Suckling of the nipple stimulates the release of oxytocin by the posterior pituitary gland, which causes uterine
contraction. Lactation begins 1 to 3 days after delivery. Nipple stretching exercises are done when the nipples are flat
or inverted. Frequent washing dries up the nipples, making them prone to the formation of fissures.

54. A primigravida is instructed to offer her breast to the baby for the first time within 30 minutes after delivery. What
is the purpose of offering the breast this early?
A. To initiate the occurrence of milk letdown
B. To stimulate milk production by the mammary acini
C. To make sure that the baby is able to get the colostrum
D. To allow the woman to practice breastfeeding in the presence of the health worker

Answer: (B) To stimulate milk production by the mammary acini

Suckling of the nipple stimulates prolactin reflex (the release of prolactin by the anterior pituitary gland), which initiates
lactation.

55. In a mothers’ class, you discuss proper breastfeeding technique. Which is of these is a sign that the baby has
“latched on” to the breast properly?
A. The baby takes shallow, rapid sucks.
B. The mother does not feel nipple pain.
C. The baby’s mouth is only partly open.
D. Only the mother’s nipple is inside the baby’s mouth.

Answer: (B) The mother does not feel nipple pain.

When the baby has properly latched on to the breast, he takes deep, slow sucks; his mouth is wide open; and much
of the areola is inside his mouth. And, you’re right! The mother does not feel nipple pain.

56. You explain to a breastfeeding mother that breast milk is sufficient for all of the baby’s nutrient needs only up to
____.
A. 3 months
B. 6 months
C. 1 year
D. 2 years

Answer: (B) 6 months

After 6 months, the baby’s nutrient needs, especially the baby’s iron requirement, can no longer be provided by
mother’s milk alone.

57. What is given to a woman within a month after the delivery of a baby?
A. Malunggay capsule
B. Ferrous sulfate 100 mg. OD
C. Retinol 200,000 I.U., 1 capsule
D. Potassium iodate 200 mg, 1 capsule

Answer: (C) Retinol 200,000 I.U., 1 capsule

A capsule of Retinol 200,000 IU is given within 1 month after delivery. Potassium iodate is given during pregnancy;
malunggay capsule is not routinely administered after delivery; and ferrous sulfate is taken for two months after
delivery.

SITUATION: Baby Glenn, a 3 year old child, weighs 15 kg. The child is being brought to the health center because of
cough and diarrhea. There was no General Danger Sign (GDS),no chest indrawing ,no stridor or fastbreathing.
Upon the assessment for diarrhea , the health worker decides that the patient has a sunken eyes and a skin
pinch that goes back very slowly.
58. What is Baby Glenn’s classification for cough or difficult breathing?
a. Severe Pneumonia or Very severe Disease
b. Pneumonia
c. No pneumonia; cough or cold
d. None of the above
 59. What is the best treatment of the above identified classification?
a. First dose of antibiotic then refer
b. Give antibiotic for 5 days
c. Counsel on how to soothe the throat and relieve the cough with a safe remedy
d. None of the above
60. What is Baby Glenn’s classification for diarrhea?
a. severe Dehydration
b. Some dehydration
c. No dehydration
d. None of the above
61. What is the best action of the nurse for the classification identified above?
a. Plan C
b. Plan B
c. Plan A
d. None of the above
62. Plan C means;
a. Giving oresol at home
b. Giving oresol at the health center
c. Giving intravenous therapy
d. None of the above
SITUATION: Mandy, a two year old,10 kg child is being brought by her mother to the health center because she had
diarrhea , this is her initial visit. The health worker checked for the child’s General Danger sign (GDS) . The health worker
ask if Mandy is able to drink or breastfeed , the mother said no . Mandy is too weak to lift her head let alone sip from a
cup. Next, the health worker asked the mother if the child had been vomiting , she said no . The health worker asked if
Mandy had convulsions, described to the mother what is convulsion , and asked the mother if Mandy experienced that ,
she said none. Mandy is awake and conscious.Her skin pinch goes back very slowly.
63. What is Mandy’s General Danger Sign?
a. Not able to drink or breastfed
b. Vomits everything
c. Convulsions
d. Abnormally sleepy or difficult to awaken
64. The health worker encircled the sign she previously identified and ticked yes. What will the health worker do next?
a. Rehydrate according to plan c
b. Finish the whole assessment quickly and refer the child urgently
c. Give first dose of appropriate antibiotic
d. Send a referral note with the patient
65. If the nurse is not trained to give intravenous fluid in cases of severe dehydration , what is her best alternative?
a. give oresol by mouth (NGT)
b. give oresol in a cup
c. Refer to the hospital without rehydration
d. none of the above
66. The IV fluid suggested for rehydration;
a. plain LR
b. D5 NaCl
c. D5 LR
d. none of the above
67. What is the likely cause of Mandy’s General Danger Sign (GDS) ?
a. infection
b. severe dehydration
c. influenza
d. none of the above
SITUATION: BABY CLARISSE 2 year old, 14 kg, was brought by her mother at the health center because she had cough,
fever, rash and red eyes. They live in a Malaria risk area. Upon assessment, the health worker finds a generalized rash all
over the child’s body and few mouth ulcers.
68. What is the classification for baby Clarisse in the fever box?
a. Very severe Febrile Disease/ Malaria
b. Malaria
c. Fever: Malaria unlikely
d. none of the above
69. What is the treatment for the classification identified above?
a. first dose of Quinine then refer
b. Oral antimalarial drug
c. Give Paracetamol for temperature 38.5 degree Celsius and above
d. none of the above
70. What is the classification for measles?
a. Severe Complicated Measles
b. measles with mouth or eyes complication
c. measles
d. none of the above
71. What is the treatment of measles with mouth complication?
a. salt water and gentian violet
b. betadine and gentian violet
c. gentian violet
d. none of the above
SITUATION:
Menchu is a 14 months old baby. She weighs 10 kg, her mother brought her to the hospital because she has diarrhea.
She does not have General Danger Sign (GDS) and does not have cough or difficult breathing. The mother said that the
diarrhea has been there for 21 days and there is blood in the stool. Menchu is not abnormally sleepy or difficult to
awaken , and she is not restless or irritable . Her eyes were sunken, when offered fluids Menchu drinks eagerly. The skin
pinch goes back immediately.
72. What is Menchu’s classification for dehydration?
a. Severe Dehydration
b. Some dehydration
c. No dehydration
73. How much oresol will the health worker give Menchu for the classification identified above?
a. 650cc
b. 750 cc
c. 50 to 100 cc after each loose stool
d. none of the above
74. What are the classification of Menchu for persistent diarrhea and bloody stool?
a. Severe Persistent Diarrhea and Dysentery
b. Persistent diarrhea and Dysentery
c. No dehydration and Dysentery
d. none of the above
75. What is the type of milk contraindicated for children with persistent diarrhea?
a. goat’s milk
b. cow’s milk
c. breastmilk
d. none of the above
76. What is the replacement of the abovementioned milk in the care of a child who has persistent diarrhea;
a. rice water
b. buko juice
c. nutrient rich semi solid foods
d. none of the above
Molly , is a 4 year old child. She was brought by her mother to the health center because of ear discharges on the left ear.
There was no ear pain and there is no swelling behind the ears;
77. The signs ear discharge for 25 days , without ear pain puts the child in what classification?
a. Mastoiditis
b. chronic ear infection
c. acute ear infection
d. none of the above
78. What is the best treatment for the classification identified above?
a. First dose of Antibiotic then refer
b. Give antibiotic for 5 days
c. Dry the ear by wicking and Quinolone otic drops
d. none of the above
79. What is used to wick the child’s ears?
a. clean cloth
b. cotton buds
c. gauze
d. none of the above
Molly then is assessed for malnutrition and anemia. The health worker find some palmar pallor for Molly, no visible severe
wasting and no edema of both feet.
80. What will be the health worker’s classification for malnutrition and anemia?
a. Severe Malnutrition
b. Severe anemia
c. anemia
d. none of the above
81. What is the best treatment for the classification identified above?
a. Vitamin A , treat to prevent low blood sugar then refer
b. iron and mebendazole
c. Counsel on feeding
d. none of the above
82. How much mebendazole will be given to a 4 year old child like Molly , suppose she has anemia.
a. ½ tablet
b. 1 tablet
c. ¼ tablet
d. none of the above
83. The interval of deworming for uderfive children is;
a. 3 months
b. 6 months
c. one year
d. none of the above
84. Ben was subjected for a PPD test. The nurse performs a PPD test on his right forearm today. When should he return
to have the test read?
a. right after performing the test
b. 24 hours after performing the test
c. 48 hours after performing the test
d. 1 week after performing the test
 Answer C – PPD tests should be read in 48 to 72 hours. If read too early or too late, the results won’t be
accurate.

85. Which of the following diagnostic tests is definitive for tuberculosis?

a. chest x-ray
b. mantoux test
c. sputum culture
d. tuberculin test

Answer C – The sputum culture for Mycobacterium tuberculosis is the only method of confirming the diagnosis.
Lesions in the lung may not be big enough to be seen on X-ray. Skin tests maybe falsely positive or falsely
negative.

86. A client with a positive Mantoux test result will be sent for a chest x – ray. For which of the following reasons is this
done?
a. to confirm the diagnosis
b. to determine if a repeat skin test is needed
c. to determine if this is a primary or secondary infection
d. to determine the extent of lesions

Answer C – If the lesions are large enough, the chest X-ray will show their presence in the lungs. Sputum culture
confirms the diagnosis. There can be false – positive and false negative skin test results. A chest x-ray can’t
determine if this is a primary or secondary infection.

Communicable diseases are most prevalent in Brgy. Problemado. A group of PHN went to the area to disseminate
necessary information requiring early detection, control and cure of the different communicable diseases.

87. What is the host of Schistosoma Japonicum?

A. Mosquitoes
B. Rats
C. Snails
D. Dogs

ANSWER: C
Snails of species Oncomelia Quadrasi is the most common intermediate host for Schistosomiasis. Option A, B and D are
not the host for Schistosomiasis.

88. The drug of choice for Schistosomiasis is:

A. Metrofinate
B. Praziquantel
C. Hetrazan
D. Quinidine Sulfate
ANSWER: B
Praziquantel (Biltricide) is the Drug of choice for all species of Schistosoma parasite. Option A: This maybe used as an
alternative drug for schistosomiasis. Option C: This is the drug of choice for Filariasis. Option D: Quinidne S04 is used
for Malaria.

Influenza Virus is the etiologic agent of Influenza occuring in local and sporadic cases.
89. How is Influenza transmitted?
A. Airborne
B. Esophageal
C. Sexual Contact
D. Skin Contact

ANSWER: A
Possible mode of transmission for influenza are through direct contact e.g. droplet, indirect e.g. by articles contaminated
with discharges of nose and throat of infected person or it can also be transmitted AIRBORNE. Option B: This is not a
mode of transmission. Option C: Microorganism is not found in the reproductive area but in the nasopharyngeal
secretions. Option D: It is not transmitted through skin contact.

90. To educate the public the prevention of influenza, the nurse must teach to:
A. burn soiled clothes.
B. avoid spitting in public places.
C. isolate patient.
D. prevent cross infection.

ANSWER: B
Methods of Prevention and Control for influenza include 3 measures: 1.) Education of the public as to sanitary hazard
from spitting, sneezing and coughing. 2.) Avoid use of common towels, glasses and eating utensils. 3.) Active
Immunization with Influenza Vaccine. Option A: This is part of the nursing care for a patient with influenza to prevent its
spread. Option C: This is one of the PUBLIC health nursing responsibilities of the nurse.

91. If a student is sick, the school nurse should advise the student to:
 A. stay at home.
B. eat proper food.
C. attend school but not play.
D. have daily bath.

ANSWER: A
The nurse should advise the student to stay at home and rest to prevent the spread of infection and to promote recovery.
Option B: Although this is necessary but the important responsibilty here is to prevent the spread of infection. Option C:
The student is advise to rest. Option D: This is one of the hygenic measures but not related to the question.

92. When at home, the visiting nurse must contact patient to:
A. keep warm and free form drafts.
B. sleep, rest and eat often.
C. continue playing mahjong.
D. help prepare food in the kitchen.
ANSWER: A
One of the nursing care is to make sure that patient is kept warm and free from draft to prevent pneumonia complications
and hasten recovery. Option B: The patient is advised to rest but patient is put on diet as tolerated. Option C and D:
Patient is advise to rest.
93. The avian flu is caused by a;
a. Virus
b. Bacteria
c. Fungus
d. Protozoa

ANSWER: A

94. The classical signs of leprosy except:

a. Madarosis
b. Lagopthalmus
c. Katayama fever
d. Chronic ulcer

ANSWER: C – is for schistosomiasis

95. The causative agent for filariasis except:

a. Filariasis japonicum
b. Wuchereria bancrofti
c. Bruga malai
d. B. timori

ANSWER: A – no such thing as F. japonicum.

96. The classical sign of pertussis:

a. Paroxysmal cough beyond 2 weeks lasting for 2-3 months
b. Paroxysmal cough beyond 1 weeks lasting for 3-4 months
c. Paroxysmal cough beyond 3 weeks lasting for 2-4 months
d. Paroxysmal cough beyond 3 weeks lasting for 2-3 months

ANSWER: A

97. The classical sign of poliomyelitis:

a. High fever
b. Abdominal pain
c. Poker’s sign
d. Night sweats

ANSWER: C
A and B: is for dengue
D: for TB

98. Diagnostic exam for poliomyelitis:

a. Pandy’s test
b. Lumbar puncture
c. Stool exam
d. Wood’s light

ANSWER: A
B: is for meningitis and encephalitis
C: is for shistosomiasis, and all diarrheal diseases
D: for ringworm

99. The drug of choice for patients with thrush;

a. Doxycycline
b. Nystatine
 c. Penicillin
d. Mebendazole

ANSWER: B
A: for Chlamydia
C: for gonorrhea, syphilis, diphtheria, tetanus, rabies
D: for capilariasis

100.Anthrax is also known as;

a. Biological weapon
b. Western weapon
c. Powder weapon
d. Industrial weapon