b.
Integrated Management of Childhood Illnesses November 2015 LOCAL MIDWIFERY LICENSURE EXAM
Salbutamol
d. =rythromycin
%/. In the ARI ARI #rogram! #rogram! a child child $ho has only only one of the danger danger signs is classified as ha"ing: a. Se"ere Se"ere #neumo #neumonia nia c. 1ery se"ere se"ere #neumo #neumonia nia b. No #neumonia d. 2neumonia
Prepared b! "o#a$ Marv%# M& A#a'(e RM) RN
SITUATION: SITUATION: Cristina Cristina brought her one month month old baby Chris Chris to the RHU because of cough and colds . On eamination! the child is noted to ha"e fast breathing. There is no stridor or con"ulsion noted u#on the assessment but there is a #resence of intercostals retraction or chest indra$ing $hen the baby is calm.
%.
As a #rudent #rudent mid$ife mid$ife utili& utili&ing ing the the I'CI I'CI #rocess( #rocess( )ast breathing breathing in this #articular child has a res#iratory rate of: a. *+ and and abo" abo"ee c. ,+ and and abo" abo"ee b. -+ and abo"e d. + and abo"e
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Under the ARI 'anageme 'anagement nt Chart Chart!! 'id$ife 'id$ife 0ebbie 0ebbie $ill $ill classify this child is as a case of: a. 1ery Se"ere Se"ere diseas diseasee c. 2neumo 2neumonia nia b. Se"ere 2neumonia d. No 2neumonia
%. An a##ro#riate a##ro#riate source source of informat information ion about the the family family is>are is>are the follo$ing: a. Inter" Inter"ie$ ie$ result resultss $ith $ith the the membe members rs of the the fami family ly b. )amily folder c. Actual Actual obser" obser"ati ation on of of fami family ly sit situat uation ion d. All of thes thesee are are sourc sources es of of inform informati ation on %,. An im#ortant im#ortant factor factor $hich $hich should ser"e ser"e as basis in #re#arin #re#aring g the family health care #lan is: a. 0ata 0ata gath gathere ered d from from the the healt health h cent center er b. Needs and #roblem as seen and acce#ted acce#ted by the family c. Needs and #roblems #roblems gathe gathered red and and recogni recogni&ed &ed by the the mid$if mid$ifee herself d. Needs are e#ressed e#ressed by the the mid$ife mid$ife assigned assigned in the the area area $here $here the family resides.
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After certain certain assessment assessment and eami eaminati nation on follo$i follo$ing ng the I'CI #rotocol the management management for this child $ould $ould be: a. Urge Urgent nt ref refer erra rall to the the hos# hos#it ital al b. Antibiotics to be ta3en at home c. Close Close obser" obser"at ation ion at the healt health h cente center r d. Home care
SITUATION: SITUATION: As frontline health $or3er! the mid$ife must be 3no$ledgeable about the first aid measures %-. =ternal =ternal chest chest com#ressi com#ression on is done as an emergency emergency measur measures es $hen: a. Ther Theree is is a res# res#ir irat atory ory arre arrest st b. There is a heartbeat heartbeat but not breathing breathing c. There here is no #ul #ulse d. A and C only
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Counting Counting the the res#ira res#iratory tory rate rate of the the child! child! the the mid$ife mid$ife should should remember the follo$ing ece#t for $hich4 a. Coun Countt the the RR for for one one ful fulll min minut utee b. Count the RR $hen $hen the child is restless restless or crying c. Coun Countt the the RR RR $he $hen n the the chi child ld is is cal calm m d. None None of the abo"e bo"e
%*. If a #atient #atient to commit commit suicide suicide by ta3ing an an o"erdose of slee#ing slee#ing #ills! the first first aid measure that that the mid$ife can can do is: a. 0on? 0on?tt ind induc ucee "om "omit itin ing g b. @i"e stimulant li3e coffee if still a$a3e c. 0o gastri stricc la" la"age age d. Inec nectt a st stimul imulaant
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Under Under the ARI ARI 2rogram 2rogram!! chest chest indra$ indra$ing ing $ould $ould mean mean:: a. Noisy Noisy ins#ir ins#irati ation on c interc intercost ostal al retrac retractio tion n b. Noisy e#iration d. subcostal retraction retraction
%5. There is is bleeding bleeding in the forearm forearm of your #atient. #atient. Bour Bour first first aid measure $ould be: a. =le"at =le"atee the the #art #art high higher er than than the heart heart le"e le"ell b. A##ly direct #ressure on the the bleeding site c. A##ly A##ly #ress #ressure ure at the the site site of the brachi brachial al #ulse #ulse d. Any of th the abo abo" "e
SITUATION: A three year old child came to the Health Center because of 0iarrhea. 0iarrhea. At #resent! the child child is un$ell and irritable. irritable. His eyes are sun3en although his mouth and tongue are moist. *.
Using the C00 C00 Assess Assessment ment Chart! Chart! this this child child is ha"ing ha"ing diarrhea diarrhea $ith: a. No signs signs of dehydr dehydrati ation on c. Se"ere Se"ere dehydr dehydrat ation ion b. Some dehydration d. 1ery 1ery Se"ere 0ehydration
5. 'anage 'anagemen mentt to this this child child $ould $ould be: a. Clos Closee obse obser" r"at atio ion n at home home b. Oresol to be ta3en for for the first , hrs c. Refe Referr rral al to the the hos hos#i #ita tall d. I1 )lui )luid d thera hera#y #y 6. a. b. c. d. 9.
a. b. c. d.
Oral Rehydr Rehydratio ation n thera#y thera#y is im#ortant im#ortant in in the managemen managementt of this this child. Ho$ much Oresol should be gi"en to the child4 %++7 %++7/+ /++ + aft after 8' 6++7%/++ ml for the first ,hrs as much uch as as he he de desire siress %/++7//++ 0iarrhea 0iarrhea is is one of the leading leading causes causes of morbidi morbidity ty in the 2hili##ines. The most common cause of diarrhea among the older children is: Unsa Unsani nita tary ry sour source ce of $ate $ater r Im#ro#er human $aste dis#osal Unhyg Unhygie ieni nicc feed feedin ing g #racti #ractice ce Unco Uncoll llec ecte ted d refu refuse se
%+. 2re"ention 2re"ention is the best best care; for diarrhea diarrheall disease. disease.
%%. This is the drug drug of choice in in the treatment treatment of early early #neumonia: #neumonia: a. Co7t Co7tri rimo moa a&o &ole le c. 2eni 2enici cill llin in
%6. )irst )irst aid aid measur measures es are are done: done: a.
d.
/+ breaths #er minute
/,.
SITUATION: T$o children $ere brought to you. One $ith chest indra$ing andthe other had diarrhea. -.Using the integrated 'anagement of Childhood illness a##roach! ho$$ould you classify the %st child4 a.8roncho#neumonia b.No #neumonia cough or colds c.Se"er #neumonia d.2neumonia *.The %stchild $ho is % months has fast breathing. Using I'CI #arametershe has: a.,+ breaths #er minute or more b.-+ breaths #er minute or more c.+ breaths #er minute or more d.*+ breaths #er minute or more 5.Nene the second child has diarrhea for - days. There is no blood in thestool. She is irritable and her eyes are sun3en. The nurse offered fluidsand the child drin3s eagerly. Ho$ $ould you classify Nene?s illness4 a.Some dehydration b.0ysentery c.No dehydration d.Se"ere dehydration 6.Nene?s treatment should include the follo$ing =FC=2T: a.Reassess the child and classify him for dehydration b.)or infants under * months old $ho are not breastfed! gi"e %++7/++ ml of clean $ater as $ell during this #eriod c.@i"e in the health center the recommended amount of ORS for , hours. d.0o not gi"e any other foods to the child for home treatment 9.are im#ortant uestion?sthat you $ould as3 her mother4 a.Is 8aby @em feeding $ell4; b.Is 8aby @em able to drin34; c.0id 8aby @em had con"ulsions during the #resent illness4; d.A and C only ,%.It is im#ortant to assess 8aby @em breathing. Bou $ould 3no$ that shehas fast breathing if her RR is: a.,+ breaths>min b.*+ breaths>min c.*- breaths>min d.-+ breaths>min ,/. 8aby @em has fast breathing. The nurse 3no$s that this is a sign of a.No #neumonia b.2neumonia c.Se"ere 2neumonia d.1ery Se"ere 0isease ,.8ased on the I'CI #rotocol! 8aby @em belongs to $hat ro$4 a.2in3 b.Bello$ c.@reen d.Red%+. ,,. If b aby @em has stridor! $hat is the classification4 a.No 2neumonia: Cough and Cold b.2neumonia - 2 -
c.1ery Se"ere 0isease d.Se"ere 2neumonia
,-.
A!8 A8C AC= AC0
,9. A 7year7old child has fe"er and diarrhoea. He has no danger signs and he does not ha"e a cough or difficult breathing. The child has had diarrhoea for / $ee3s and there is no blood in stool. The child is restless and irritable! but is not drin3ing eagerly. His eyes are not sun3en. A s3in #inch goes bac3 slo$ly. He does not ha"e an ear #roblem. The child?s diarrhoea should be classified as: a. no dehydration b. some dehydration c. se"ere dehydration d. se"ere #ersistent diarrhoea e. #ersistent diarrhea f. dysentery A. ADD =FC=2T A 8. A!8!C!= C. 8 M0 0. ) ONDB -+. The I'CI clinical guidelines are designed for use $ith certain age grou#s. One grou# is / months u# to - yeas.
-/. )eeding should be assessed in a child $ho: a. need urgent referral b. is less than / years old c. is classified as ha"ing anaemia! "ery lo$ $eight and or gro$th faltering d. is classified as ha"ing #ersistent diarrhoea A. A!8 MC 8. 8 M C ONDB C. A M 0 ONDB 0. A M 8 -.
A M 8 ONDB 8! C M ) ADD O) TH= CHOIC=S A ONDB
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If a child has had ear #ain and #us draining from the ear for %+ days! and no tender s$elling behind the ear! you $ill classify this child as ha"ing: a. acute ear infection b. chronic ear infection c. mastoiditis d. not enough signs to classify this child --. If a child has any of the fi"e general danger signs! you should urgently refer him to hos#ital for treatment! These signs are: a. not able to drin3 or breastfeed b. se"ere cough c. con"ulsions during this illness d. "omiting e"erything e. lethargic or unconsciousness f. con"ulsing no$ A. A! 8! C! = 8. ADD =FC=2T C C. ADD =FC=2T 8 0. ADD O) TH= A8O1= -*.
If a child less than - years of age and did not recei"e immuni&ation for 02T7H8 as recommended! it is necessary to: a. increase the dose of the "accine #rescribed for that age b. not immuni&e at all J because it is too late c. immuni&e the child any time! and gi"e the remaining doses , $ee3s a#art
-5. A follo$7u# "isit in - days should ta3e #lace if a child is classified as ha"ing $hich of the follo$ing conditionGs: a. #neumonia b. measles c. #ersistent diarrhoea d. #allor e. "ery lo$ $eight7for7age and or gro$th faltering f. feeding #roblem g. acute ear infection A. A! 8! 0! )! @ 8. C! )! @ C. ADD =FC=2T 0 M= 0. NON= O) TH= CHOIC=S
-6. To be classified as ha"ing 'ASTOI0ITIS a child must ha"e the follo$ing signs: a. se"ere ear #ain b. redness behind the ear c. #us draining from one of the ears d. tender s$elling behind the ear - 3 -
e.
#us draining from both ears
-9. To be classified as ha"ing EAUN0IC= a young infant must ha"e the follo$ing signs: a. yello$ #alms and soles if age is more than /, hours b. only yello$ eyes and s3in if age is more than /, hours c. Any aundice if age less than /, hours %5 d. #us draining from the eyes e. no signs suggesting aundice
a. b. c. d. e.
*5.
*+.
*/. Choose the three best uestions for chec3ing the mother?s understanding about ho$ to gi"e an antibiotic: a. Ho$ $ill you gi"e the antibiotic4 b.
small arm circumference "isible se"ere $asting oedema of both feet se"ere dehydration gro$th faltering A. AM8 8. 8MC C. CM0 0. A ONDB
To classify the dehydration status of young infant $ith diarrhoea you $ill loo3: a. at the general condition of the child Gdoes the infant mo"e $hen stimulated or does not mo"e e"en $hen stimulated! restless and irritable b. for sun3en eyes c. for oedema of both feet d. if the young infant is drin3ing eagerly or #oorly e. for "isible se"ere $asting f. for a s$ollen abdomen A. A!C !0 8. A! 8! 0 C. C!=!) 0. ) ONDB
*6. A boy is % months old. He $eighs 6 3g. His tem#erature is 5C. His mother says he has had a dry cough for the last $ee3s. He does not ha"e any general danger signs. The breathing rate is ,% breaths #er minute. There is no chest indra$ing. Bou can hear $hee&ing noise $hen the child breathes out. There is no stridor $hen he is calm. The breathing #er minute remained ,% after cycles trial of an inhaled bronchodilator. There is no diarrhoea! fe"er or ear #roblem. He does not ha"e "isible se"ere $asting! there is no oedema of both feet and no gro$th faltering. His #alms are "ery #ale and a##ear almost $hite. The child should be classified as ha"ing: a. #neumonia $ith $hee&ing b. se"ere anaemia c. no #neumonia: cough or cold and $hee&ing d. se"ere #neumonia $ith $hee&ing or "ery se"ere disease e. anaemia! "ery lo$ $eight and or gro$th faltering A. A! 8 8. 8 !C C. C!0 0. NOTA *9.
5+.
5/.
A child $ith fe"er #lus any general danger sign should be classified as: a. uncom#licated malaria b. acute ear infection c. measles - 4 -
d. e.
"ery se"ere febrile disease or se"ere malaria mastoiditis
0. 5-.
5. If a careta3er brings an %67month7old child $ith a cough to a health facility! $hat do you need to do4 a. as3 the duration of the cough b. count the number of breaths in one minute c. loo3 for chest indra$ing d. chec3 for sore throat e. loo3 and listen for stridor and $hee&e f. ta3e the child?s #ulse rate g. chec3 for other main sym#toms Ge.g. fe"er! diarrhoea! ear #roblem h. chec3 for malnutrition and anaemia i. chec3 the child?s immuni&ation status . chec3 for other #roblems A. ADD =C=2T 0M ) 8. All ece#t A M = C. All ece#t H!I ME 5,. A boy is /+ months old. He has had fe"er for - days! cough for days( he is able to drin3! does not ha"e con"ulsions! and is not lethargic or unconscious. His breathing rate is -% #er minute! there is no chest indra$ing or stridor or $hee&e. The boy does not ha"e diarrhoea! but has generali&ed rash and a runny nose. There is no clouding o f the cornea or mouth ulcers. The boy should be classified as ha"ing: a. no #neumonia: cough or cold b. #neumonia c. se"ere #neumonia or "ery se"ere disease d. "ery se"ere febrile disease e. uncom#licated malaria f. measles g. measles $ith eye or mouth com#lications A. AM b 8. 8 M) C. @ ONDB
8 ONDB
A mother brought her %*7month7old child bac3 to clinic after / days of ORS treatment for diarrhoea $ith no dehydration. The mother says that the child still has diarrhoea and no$ is coughing and has fe"er.
5*. he $ants! day and night! at least %+ times in /, hours c. children should be gi"en fe$er feedings during illness A. A ONDB 8. 8! C C. A! 8 0. 8 ONDB
“Failure defeats losers, failure inspires winners.” - Robert T. Kiyosaki
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