1.
In immunizing school entrants with BCG, you are not required to obtain parental consent. This is because of which legal document?
Correct Answer
A. P.D. 996
Explanation
Presidential Decree 996, enacted in 1976, made immunization in the EPI compulsory for children under eight years of age. Hepatitis B vaccination was made mandatory for the same age group by R.A. 7846.
2.
Which immunization produces a permanent scar?
Correct Answer
B. BCG
Explanation
BCG causes the formation of a superficial abscess, which begins two weeks after immunization. The abscess heals without treatment, with the formation of a permanent scar.
3.
A 4-week-old baby was brought to the health center for his first immunization. Which vaccine can be given to him?
Correct Answer
C. Infant BCG
Explanation
Infant BCG may be given at birth. All the other immunizations mentioned can be given at six weeks of age.
4.
You will not give DPT 2 if the mother says that the infant had:
Correct Answer
A. Seizures a day after DPT 1.
Explanation
Seizures within 3 days after administration of DPT is an indication of hypersensitivity to pertussis vaccine, a component of DPT. This is considered a specific contraindication to subsequent doses of DPT.
5.
A 2-month-old infant was brought to the health center for immunization. During the assessment, the infant’s temperature registered at 38.1°C. Which is the best course of action?
Correct Answer
A. Go on with the infant’s immunizations.
Explanation
In the EPI, a fever up to 38.5°C is not a contraindication to immunization. Mild acute respiratory tract infection, simple diarrhea, and malnutrition are not contraindications either.
6.
A pregnant woman had just received her 4th dose of tetanus toxoid. Subsequently, her baby will have protection against tetanus for how long?
Correct Answer
A. The baby will have protection against Tetanus at birth
Explanation
It is inferred, in accordance with WHO guidelines, that a newborn is considered protected against tetanus at birth if the cumulative doses received, including those administered during the last pregnancy, meet the recommended criteria.
7.
A 4-month-old infant was brought to the health center because of a cough. Her respiratory rate is 42 breaths per minute. Using the Integrated Management of Child Illness (IMCI) guidelines of assessment, her breathing is considered:
Correct Answer
C. Normal
Explanation
In IMCI, a respiratory rate of 50 breaths per minute or more is fast breathing for an infant aged 2 to 12 months.
8.
Which of the following signs will indicate that a young child is suffering from severe pneumonia?
Correct Answer
D. Chest indrawing
Explanation
In IMCI, chest indrawing is used as the positive sign of dyspnea, indicating severe pneumonia.
9.
Using IMCI guidelines, you classify a child as having severe pneumonia. What is the best management for the child?
Correct Answer
B. Refer urgently to the hospital.
Explanation
Severe pneumonia requires an urgent referral to a hospital. Answers A, C and D are done for a client classified as having pneumonia.
10.
A 5-month-old infant was brought by his mother to the health center because of diarrhea occurring 4 to 5 times a day. His skin goes back slowly after a skin pinch, and his eyes are sunken. Using the IMCI guidelines, which category will you classify this infant?
Correct Answer
B. Some dehydration
Explanation
Using the assessment guidelines of IMCI, a child (2 months to 5 years old) with diarrhea is classified as having SOME DEHYDRATION if he shows 2 or more of the following signs: restless or irritable, sunken eyes, the skin goes back slow after a skin pinch.
11.
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?
Correct Answer
B. Supervise the mother in giving 200 to 400 ml of Oresol in 4 hours.
Explanation
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.
12.
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:
Correct Answer
D. Let the child rest for 10 minutes then continue giving Oresol more slowly.
Explanation
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.
13.
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?
Correct Answer
D. Edema
Explanation
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 to a protein-deficient diet.
14.
Assessment of a 2-year-old child revealed “baggy pants.” Using the IMCI guidelines, how will you manage this child?
Correct Answer
A. Refer the child urgently to a hospital for confinement.
Explanation
“Baggy pants” is a sign of severe marasmus. The best management is an urgent referral to a hospital.
15.
During the physical examination of a young child, what is the earliest sign of xerophthalmia that you may observe?
Correct Answer
D. Conjunctival xerosis
Explanation
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.
16.
To prevent xerophthalmia, young children are given Retinol capsules every 6 months. What is the dose given to preschoolers?
Correct Answer
D. 200,000 IU
Explanation
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.
17.
The major sign of iron deficiency anemia is pallor. What part is best examined for pallor?
Correct Answer
A. Palms
Explanation
The anatomic characteristics of the palms allow a reliable and convenient basis for examination for pallor.
18.
Food fortification is one of the strategies to prevent micronutrient deficiency conditions. R.A. 8976 mandates the fortification of certain food items. Which of the following is among these food items?
Correct Answer
A. Sugar
Explanation
R.A. 8976 mandates fortification of rice, wheat flour, sugar, and cooking oil with Vitamin A, iron, and/or iodine.
19.
What is the best course of action when there is a measles epidemic in a nearby municipality?
Correct Answer
A. Give measles vaccine to babies aged 6 to 8 months.
Explanation
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.
20.
A mother brought her daughter, 4 years old, to the RHU because of cough and cold. Following the IMCI assessment guide, which of the following is a danger sign that indicates the need for urgent referral to a hospital?
Correct Answer
A. Inability to drink
Explanation
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.
21.
Management of a child with measles includes the administration of which of the following?
Correct Answer
D. Retinol capsule regardless of when the last dose was given
Explanation
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.
22.
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?
Correct Answer
B. Ask where the family resides.
Explanation
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.
23.
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?
Correct Answer
B. Destroying breeding places of mosquitoes
Explanation
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.
24.
Secondary prevention for malaria includes:
Correct Answer
C. Determining whether a place is endemic or not
Explanation
This is diagnostic and therefore secondary level prevention. The other choices are for primary prevention.
25.
Scotch tape swab is done to check for which intestinal parasite?
Correct Answer
B. Pinworm
Explanation
Pinworm ova are deposited around the anal orifice.
26.
Which of the following signs indicates the need for sputum examination for AFB?
Correct Answer
C. Cough for 3 weeks
Explanation
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.
27.
Which clients are considered targets for DOTS Category I?
Correct Answer
D. Clients diagnosed for the first time through a positive sputum exam
Explanation
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.
28.
To improve compliance with treatment, what innovation is being implemented in DOTS?
Correct Answer
B. Having the health worker or a responsible family member monitor drug intake
Explanation
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.
29.
Diagnosis of leprosy is highly dependent on the recognition of symptoms. Which of the following is an early sign of leprosy?
Correct Answer
C. Thickened painful nerves
Explanation
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. The inability to close the eyelids (lagophthalmos) and the sinking of the nose bridge are late symptoms.
30.
Which of the following clients should be classified as a case of multibacillary leprosy?
Correct Answer
D. 5 skin lesions, positive slit skin smear
Explanation
A multibacillary leprosy case is one who has a positive slit skin smear and at least 5 skin lesions.