QUIZ 14 IMCI 9.

According to the IMCI guidelines, which of the

1. Which of the following is not included among following main symptoms should always be
the main causes of mortality in under-five assessed in every sick child age 2 months up to 5
children in the country? years?
a. Diarrheal diseases a. Cough
b. Pneumonia b. Abdominal pain
c. Road traffic injuries c. Fever
d. Malnutrition d. Skin infection
e. Diarrhea
2. For which of the following settings are the
IMCI guidelines suitable for use? 10. Which of the following signs are "general
a. Inpatient ward of a district hospital danger signs" that you should always check for in
b. Outpatient department of a hospital every sick child age 2 months up to 5 years,
c. Outpatient health facility according to the IMCI guidelines?
d. Inpatient ward of a specialized hospital a. Child is lethargic or unconscious
b. Child is not able to drink or breastfeed
3. Which of the following age groups do the IMCI c. Child vomits everything
clinical guidelines address? d. All of the above
a. Birth up to 5 years
b. 2 months up to 2 years 11. Which of the following signs is a "general
c. 1 week up to 5 years danger sign" in a sick child who is 3 months old?
d. 2 months up to 6 years a. Blood in the stool for 4 days
b. Pus with blood draining from the ear
4. Which of the following actions does a c. Convulsions since birth
pink-coded classification require? d. Axillary temperature ≥ 39.0°C
a. Give pre-referral treatment
b. Give medicines for home care 12. Which of the following signs are "general
c. Advise mother when to return danger signs" to be checked in any child 2
immediately months up to 5 years brought to the health
d. Refer urgently to hospital facility?
a. Irritability
5. Which of the following actions does a b. Axillary temperature ≥ 39.0°C
green-coded classification require? c. Severe wheezing
a. Give pre-referral treatment d. Not able to drink or breastfeed
b. Advise mother when to return
immediately 13. What is needed to be able to count the
c. Advise mother on antibiotic treatment respiratory rate correctly in an 11-month-old
d. Refer urgently to hospital child with cough?
a. Child should be calm
6. Which of the following color-coded b. Child should be alert
classification rows for fever of the IMCI chart c. A special timer is indispensable
booklet would apply to a 5-month-old child with d. The count should always be repeated
fever and stiff neck?
a. Pink color-coded row 14. To classify a child with some dehydration,
b. Yellow color-coded row the nurse must correctly identify which of the
c. Green color-coded row following signs and symptoms?
d. Orange color-coded row a. Sunken eyes, restless and
irritable
7. Which of the following color-coded rows of the b. Sunken eyes and difficult to
IMCI chart booklet applies to a awaken
42-month-old child with diarrhea who has sunken c. Sunken eyes and blood in
eyes, is thirsty and has no other the stool
problems? d. Sunken eyes and not able to
a. Pink color-coded row drink
b. Yellow color-coded row
c. Green color-coded row 15. What is the cut-off rate for "fast breathing" in
d. Orange color-coded row a child who is exactly 12 months old?
a. 60 breaths per minute
8. Which of the following are effective preventive b. 50 breaths per minute
interventions in children under-5? c. 40 breaths per minute
a. Antibiotics for pneumonia d. 30 breaths per minute
b. Immunization
c. Prompt treatment of malaria 16. What is "fast breathing" in a 3-month-old
d. Exclusive breastfeeding child?
a. 20 breaths per minute or more
b. 30 breaths per minute or more
c. 40 breaths per minute or more
d. 50 breaths per minute or more

1
c. Restlessness
d. Respiratory rate of 56 breaths per
minute
17. When the nurse correctly identifies some
dehydration, she plans to intervene immediately 24. If a mother complains of diarrhea of her child
which of the following actions? with blood in the stool, the nurse should classify
a. Give ORS, zinc supplements and as which of the following?
food for some dehydration to the a. Persistent Diarrhea
child b. Severe Persistent Diarrhea
b. Give fluid and food to treat c. Dysentery
diarrhea of the child at home d. Dehydration
c. Give Vitamin A and Zinc
supplements 25. Which of the following signs would make you
d. Advise the mother to resume classify any child age 2 months up
breast feeding to 5 years presenting with cough as SEVERE
PNEUMONIA OR VERY SEVERE DISEASE?
18. If a mother complains of diarrhea of her child a. Stridor when agitated
for 14 days and more, the nurse should classify b. Respiratory rate of 65 breaths per
as which of the following? minute
a. Persistent Diarrhea c. Difficult breathing
b. Severe Persistent Diarrhea d. Vomiting everything
c. Dysentery
d. Dehydration 26. After health teaching of the nurse to the
mother of the child with malaria risk, the mother
19. Which of the following movements of the has concrete understanding of the signs and
lower chest describes chest indrawing? symptoms of the child if she states the following,
a. Inward movement during inspiration except:
b. Inward movement during expiration a. General rashes, stiff neck and
c. Outward movement during inspiration fever
d. Outward movement during expiration b. Runny nose, cough and red
eyes
20. Which of the following statements best c. Slow capillary refill and runny
describes chest indrawing? nose
a. Inward movement of the lower chest d. General rashes, cough and
wall during inspiration runny nose
b. Inward movement of the lower chest
wall during expiration 27. Which of the following signs in a 5-month-old
c. Any intercostal retractions during child with cough are an indication for
inspiration urgent referral?
d. Upper intercostal retractions during a. Respiratory rate of 60 breaths per
expiration minute
b. Stridor when agitated
21. Which of the following statements best c. Chest indrawing
describes wheezing? d. Axillary temperature ≥ 39.0°C
a. It is a harsh sound during inspiration
b. It is a soft musical sound during 28. Which of the following signs in a
expiration 12-month-old child with cough are an indication
c. It is accompanied by prolonged for
expiration urgent referral?
d. It is a soft musical sound during a. Severe palmar pallor
inspiration b. Respiratory rate of 65 per minute
c. Axillary temperature ≥ 39.0°C
22. Which of the following signs would make you d. Visible severe wasting
classify a 9-month-old child with
difficulty breathing as SEVERE PNEUMONIA OR 29. How do you classify a 3-year-old child with
VERY SEVERE DISEASE? cough who has a respiratory rate of 55
a. Not able to drink or breastfeed breaths/ minute and chest indrawing?
b. Chest indrawing a. SEVERE PEUMONIA OR VERY SEVERE
c. Audible wheeze DISEASE
d. Respiratory rate of 55 breaths per b. PNEUMONIA
minute c. NO PNEUMONIA: COUGH OR COLD
e. Both A & B d. None of the above

23. Which of the following signs would make you 30. How do you classify a 10-month-old child
classify a 4-month-old child with who has had cough for 4 days, has a
difficult breathing as PNEUMONIA ? respiratory rate of 52 breaths per minute, has
a. Stridor when calm fever and has no stridor?
b. Chest indrawing

2
a. SEVERE PNEUMONIA OR VERY SEVERE 37. Which of the following signs should you LOOK
DISEASE and FEEL for in an 8-month-old child with
b. PNEUMONIA diarrhea to classify his/her dehydration status?
c. NO PNEUMONIA: COUGH OR COLD a. Lethargic or unconscious
d. None of the above b. Skin turgor (skin pinch)
c. Unable to drink
d. Restless, irritable

38. A "skin pinch goes back very slowly" if it

returns:
a. Immediately
31. If confirmed that the child has malaria risk b. In less than 1 seconds
and a positive blood smear which of the following c. In less than 2 seconds
actions would the nurse take first to treat the d. In more than 2 seconds
child with malaria?
a. Treat child with oral anti 39. What is the recommended procedure to take
malarial a skin pinch?
b. Give one dose of paracetamol a. Pinching the abdomen skin halfway
for fever of 38 degrees Celsius between the umbilicus and the side of
c. Treat other causes of malaria the abdomen
aside from fever b. Holding the skin firmly between the
d. Treat the child to prevent low thumb and the tip of the 1st finger
blood sugar c. Holding the skin across the child’s body
d. Holding the skin in line up and down
32. What is the earliest time that a mother of a the child’s body
3-month-old child with PNEUMONIA and
LOW WEIGHT FOR AGE should come for a 40. How do you classify a 6-month-old child
follow-up visit? living in a low malaria risk area who has a
a. 2 days history of fever for 2 days, is hot to the touch,
b. 5 days has no general danger signs, no stiff neck,
c. 7 days no generalized rash, no cough, no runny nose, no
d. 14 days red eyes and no other cause of fever?
a. VERY SEVERE FEBRILE DISEASE
33. How do you classify a 12-month-old child b. MALARIA
who has severe palmar pallor? c. FEVER – MALARIA UNLIKELY
a. SEVERE ANEMIA D. FEVER NO MALARIA
b. ANEMIA
c. NO ANEMIA 41. How do you classify a 22-month-old child
d. None of the above living in a no malaria risk area who has
a history of fever for 4 days, has an axillary
34 . How do you classify a 4-month-old child who temperature of 38.6°C, had an episode of
has some palmar pallor? convulsions three months ago and has no other
a. SEVERE ANEMIA signs?
b. ANEMIA a. VERY SEVERE FEBRILE DISEASE
c. NO ANEMIA b. FEVER NO MALARIA
d. None of the above c. FEVER MALARIA UNLIKELY
D. MEASLES
35. In a 12-month-old child with cough and
diarrhea, which of the following signs is an 42. Which of the following signs must a child
indication for urgent referral? have to be classified as having MASTOIDITIS?
a. Restless, irritable a. Redness behind the ear
b. Respiratory rate of 65 per minute b. Swelling behind the ear
c. Axillary temperature ≥ 39.0°C c. Pus draining from one of the ears
d. Child unable to breastfeed d. Tender swelling behind the ear

36. According to the IMCI guidelines, which of 43. How do you classify a 16-month-old child
the following key questions should be who has ear pain, no pus draining from the
asked to the mother of every child with diarrhea? ear and has a tender swelling behind the ear?
a. For how long has the child had a. MASTOIDITIS
diarrhea? b. ACUTE EAR INFECTION
b. Does the child have mucous in the c. CHRONIC EAR INFECTION
stools? d. NO EAR INFECTION
c. What did the child eat before the
diarrhea started? 45. How do you classify a two-year-old child with
d. Does the child have fever? an axillary temperature of 37.5°C, pus
seen coming from the ear and no tender swelling
behind the ear whose mother says that
pus has been coming for 5 days?

3
a. MASTOIDITIS
b. ACUTE EAR INFECTION
c. CHRONIC EAR INFECTION
d. NO EAR INFECTION

46. How do you classify a 20-month-old child

whose mother reports that her child has
been having ear pain for 5 days with discharge
for 3 days, and in whom you observe pus
draining from the right ear and find no tender
swelling behind the ear?
a. MASTOIDITIS
b. ACUTE EAR INFECTION
c. CHRONIC EAR INFECTION
d. NO EAR INFECTION

47. Which of the following children with diarrhea

are classified as having SOME
DEHYDRATION?
a. Drinks eagerly and skin pinch goes
back slowly
b. Has had convulsions during this illness
and drinks eagerly
c. Has blood in the stool and is irritable
d. Has sunken eyes and drinks normally

48. Which of the following children with diarrhea

are classified as having NO DEHYDRATION?
a. Thirsty and skin pinch goes back slowly
b. Restless
c. Thirsty and lethargic
d. Thirsty and skin pinch goes back very
slowly

49. Which children brought to an outpatient clinic

should be checked for malnutrition
and anemia?
a. Children with feeding problem(s) only
b. Children who are less than 12 months
of age only
c. All children from 2 months up to 5
years
d. Only children who are not breastfed

50. How do you classify a 25-month-old child

who has edema of both feet and is not
low weight for age?
a. SEVERE MALNUTRITION
b. LOW WEIGHT
c. NOT LOW WEIGHT
d. NOT VERY LOW WEIGHT