QUIZ

INTEGRATED MANAGEMENT OF CHILDHOOD ILLNESS

Name: Date:
Year & Section: Score:

Fill in the blanks: 8. Tick (✔) your answer.

Is this a general danger sign? YES NO
1. If a child arrives at your clinic with a sign of serious
The child is vomiting frequently. When you give milk, he
illness, they should be immediately referred. What
holds it down.
are these signs?
The child will not take the mother’s breast.
a.
The child lies in his caregiver’s arms. When you clap he
b. follows you.
The child had convulsions last night and today. The child
c. has been ill for 4 days.
d. The child’s eyes are open, but he is limp and will not
respond to you.
Circle one answer for each question:
The child will not move, but after efforts to wake him,
2. When is a child lethargic? he walks around.

a. The child will not wake, even after shaking

b. The child is sleeping more often than usual, but
will wake up if you set them down to walk
c. The child is drowsy and will not follow movement
or noise in the room
3. When is a child unconscious?
a. The child will not wake, even after shaking.
However, his eyes might be open.
b. The child is drowsy and will not follow movement
9. What will you do for the children who have general
danger signs? Which statements below are true, and
which are false? Tick (✔) your answer.
TRUE FALSE
1 Stop immediately and send the child
to the hospital
2 Continue the assessment, determine
pre-referral treatment, treat, and
refer.

or noise in the room 3 Continue to assess the child and send

c. The child is sleeping very deeply child to hospital with referral note
about all of the treatments you
4. If you identify a child with serious illness that requires identified.

referral, your course of action is: 4 If referral is not possible, there is

nothing you can do. Send the child
a. Stop your assessment of the child, and tell the home.
caregiver they must hurry to the hospital Circle the best answer for each question.
b. Provide urgent treatments, prepare the caregiver
for travel to the hospital, and prepare supplies and 10. What clinical signs can help you identify if a child has
a referral note pneumonia?
c. Keep the child at your clinic to monitor them and a. Wet cough
see if they will improve during the course of the b. Fast breathing
day, and then refer only when necessary c. Chest indrawing
11. If a child has pneumonia, how will you treat?
5. Why do some children require urgent referral?
a. Oral antibiotics
a. The parents do not want to receive care in the b. Honey
clinic c. Paracetamol
b. It is quickest if the child receives important care at 12. Why is it important to correctly identify and manage
a different facility pneumonia?
c. They show signs of serious illness that require a. Pneumonia is very common, but it is not so serious
advanced care that is usually available at a referral for children
facility, like a hospital. b. Pneumonia is a major killer of children under 5
6. What charts will you use for this child? Tick (✔) your around the world, and it requires early
answer. management
Sick Child Sick young infant c. Children with pneumonia need to be isolated from
Sam is 6 weeks old all other family members
Mari is 2 months old
Jera is 4 years, 10 months
13. Chest indrawing is when:
Thabo is 7 weeks old a. The lower ribs move in when the child breathes
Paulo is 3 years old out
b. The lower ribs move in when the child breathes in
c. The lower ribs are always pushed in, no matter if
7. List the important pieces of information you gather the child is breathing in or out
during a greeting:
14. Children who have a cough, but do not show signs of
a.
pneumonia, should immediately receive an antibiotic:
b.
a. TRUE
c.
b. FALSE
d.
e.
15. The following is a good checking question: “how will
you prepare a safe home remedy for cough?”
f
a. TRUE
b. FALSE
16. What are two clinical signs that help you identify b. Children lose valuable nutrients because they
children with pneumonia? cannot eat
a. c. Diarrhoea causes liver failure
b. 23. What are critical treatments for children with
17. Do the following children have fast breathing? diarrhoea and dehydration?
Tick(✔)your answers.
a. Oral antibiotics
YES NO b. Oral rehydration therapy and zinc
a 3 years, 36 breaths per minute c. Paracetamol for discomfort
b 12 months, 50 breaths per 24. What is persistent diarrhoea?
minute
a. When a child frequently has diarrhoea over a
c 6 months, 45 breaths per period of 1 month, and is ill as a result
minute b. When a child has several episodes of diarrhoea a
d 3 months, 57 breaths per day
minute c. When a child has an episode of diarrhoea lasting
14 days or more, which is particularly dangerous
18. Julie arrives at your clinic with her mother. You begin for dehydration and malnutrition
by gathering important information about the child. 25. Critical messages for caregivers about diarrhoea and
You check Julie for danger signs, and she has none. dehydration include:
What do you do next?
a. The child must receive increased fluids, ORS, zinc,
a. ASK: and regular feeding
b. LOOK: b. The child requires ORS, but should receive less
food in order to reduce the diarrhoea
19. When you ask Julie’s mother, she says Julie has no c. The child should immediately receive antibiotics to
cough or difficult breathing. You watch Julie, and she
stop the diarrhoea
seems to be breathing regularly. What do you do next?
26. Nidhi arrives at your clinic and is very lethargic. Her
20. Match the boxes below. Each “signs” box should be eyes are very sunken. She has diarrhoea. You observe
matched with one classification. a significant loss of skin elasticity. How will you
manage Nidhi?
SIGNS CLASSIFICATION
a. Nidhi requires ORS immediately, as she is
Sal is 9 months old and has a cough.
SEVERE PNEUMONIA or dehydrated.
You count 45 breaths per minute. No
VERY SEVERE DISEASE
chest indrawing or stridor. b. These are common signs of diarrhoea, as the
Linus is 3 months old, and you could 65 child’s body is exhausted.
breaths in one minute. When he c. Nidhi is severely dehydrated. She requires urgent
PNEUMONIA
breathes in, has had convulsions during rehydration therapy by IV or nasogastric tube.
current illness.
27. Which of the following children has a fever that
Jojo is 3 years old. You count 56 breaths requires further investigation?
COUGH OR COLD
in one minute. No indrawing or stridor.
a. Imrana has an axillary temperature of 37 °C
21. Are these statements true or false? Tick(✔)your b. Joy’s mother says she has been feeling very hot for
answers. the past three days
TRUE FALSE c. Samuel’s face is very flushed and red
You should look for chest indrawing when the child
breathes OUT.
28. What are common causes of fever that often kill
children?
Fast breathing in a child 12 months and older is 40 or
more a minute. a. Local infection and malaria
Chest indrawing is a sign of pneumonia.
b. Meningitis and influenza
If a child has a cough but no other signs, they probably
have pneumonia. c. Measles and malaria
A child with chest indrawing will always also have fast 29. What would you give to children with high fever?
breathing.
a. Paracetamol
Chest indrawing is when the lower ribs move IN
when the child breathes IN
a. Amoxicillin or another antibiotic
A child 2 up to 12 months has fast breathing if b. Fluids
more than 45 breaths a minute.
30. What is recommended treatment for malaria?
A child with chest indrawing has a higher risk of death
from pneumonia than a child with fast breathing and a. Chloroquine
no chest indrawing.
b. Artemisinin-based combination therapies
Difficult breathing can also be described as noisy,
interrupted, or fast. c. Paracetamol
If a child has cough, fast breathing, and vomits
everything, he is classified as PNEUMONIA (YELLOW) 31. Traci has a fever, generalized rash, runny nose, and
mouth ulcers. How you would you classify?

Circle the best answer for each question. a. She shows signs local infections of the skin

22. How can diarrhoea kill children? b. She shows clinical signs of AIDS

a. Children lose valuable fluids, salts, and sugars, c. Measles with mouth complications
which can cause shock to vital organs
 32. When is it necessary to check a child for malnutrition
and anaemia?
a. Check if the child appears low weight for age
b. Check every child for malnutrition and anaemia, as
sometimes problems go unnoticed
c. Check if the caregiver tells you about a feeding
problem
Circle the best answer for each question.
40. What is mastoiditis?
a. Infection of the ear drum, which can cause
deafness
b. Infection that has spread from the ear to the brain
c. Infection of the bone behind the ear

33. Sami has a MUAC measurement of 112 mm. What 41. What is a clinical sign of mastoiditis?
does this tell you? a. A lot of pus is seen draining from the ear
a. Sami is healthy b. Tender swelling behind the ear
b. 112 mm is low weight, so you will advise on
c. The ear has a very terrible smell
feeding recommendations
c. Sami is showing a sign of severe acute malnutrition 42. Why are ear problems important in IMCI?
34. A child with anaemia needs: a. Ear problems are a common health issue in
children, and can cause deafness and serious
a. Vitamin A infection
b. Iron
b. Ear problems are a major killer of children
c. Glucose
c. Ear problems are sign of serious brain or bone
35. Traci shows oedema in her feet. What are your infections
actions?
43. What is an acute ear infection?
a. Sit Traci and elevate her legs, to drain the swelling
b. Advise Traci’s mother to cut down the salts and a. When one point of the ear (like the ear lobe) has a
fats in her child’s diet local infection
c. Urgently refer, as this is a sign of severe b. When the child is experiencing ear pain, and pus is
malnutrition draining from the ear
36. What is palmar pallor? c. When the child has had pus draining from the ear
for over a month
a. A sign of anaemia
b. A sign of local infection 44. What is an important care measure for ear infections?
c. A sign of severe wasting a. Regularly wicking the ear to keep it dry
37. What is marasmus? b. Rinsing out the ear with saline water
a. A common skin infection in malnourished children c. Antiseptic ointment
b. A type of malnutrition where the child is very thin 45. Why do young infants require different care than sick
and lacks fat children?
c. A type of malnutrition where the child has a puffy a. Young infants are much quicker to recover from
moon face and thin hair illness because they are young.
38. Which of the following in an important measurement b. Young infants show signs of illness differently.
of wasting? They can also become ill and die from an infection
very quickly.
a. Weight-for-age
b. Percentage weight gain since last visit c. Young infants very rarely get sick.
c. Weight-for-height (or length) 46. Which of the following is important care for a young
39. What is the child’s Z-score? Tick the correct box. infant?
Child is: Below Between Between Between Between
-3 and -2 -2 and -1 -1 and 0 0 and 3 a. Keeping the infant loosely bundled so he can begin
-3
to move his arms and legs
a. Boy, 18 months,
length 75 cm, b. Keeping the umbilical cord moist so that it falls off
weight 8.5 kg
b. Boy, 30 months,
quickly
height 118 cm, c. Keeping the infant warm through skin-to-skin care
weight 22 kg
c. Girl, 11 months, 47. What are the feeding recommendations for sick
length 70 cm,
weight 6 kg young infants?
d. Girl, 27 months,
weight 11 kg, a. Exclusive, on-demand breastfeeding for at least 6
height 95 cm months
e. Boy, 7 months,
length 60 cm, b. Breastfeeding and additional sources of fluid, like
weight 5 kg water, to hydrate
f. Girl 32 months,
length 111 cm, c. Soft complementary foods as soon as the child is
weight 14.5 kg
g. Boy, 26 months, ready
weight 14.5 kg,
height 113 cm 48. What are signs that a young infant is seriously ill and
h. Girl, 32 months, needs urgent referral and care?
height 111 cm,
weight 16.5 kg a. Breathing more than 60 breaths per minute
i. Girl, 20 months,
length 100 cm, b. Skin pustules
weight 14.5 kg
c. Some jaundice, where the eyes are yellow but not
the palms or soles
49. A young infant presents at your clinic, and his 62. Chin touching breast
caregiver says the infant has been feeding well, but in 63. Equal amount areola visible below/above mouth
the past 2 days is unable to breastfeed at all. What 64. Lower lip turned in
actions will you take? 65. Match signs with how well the infant is suckling.
a. Counsel the caregiver on positioning and a. Unable to suck breast milk. Nose is SUCKLING EFFECTIVELY
attachment so that the infant can breastfeed not blocked.
better. b. Suckles deeply, sometimes pausing. NOT SUCKLING EFFECTIVELY
Releases on own when satisfied.
b. The infant is seriously ill if they are unable to feed. c. Rapid, shallow sucks. Cannot hear NOT SUCKLING AT ALL
You must urgently refer. swallowing. Cheeks draw in.
Restless.
c. Recommend that the caregiver give other safe
fluids by cup.
50. Are these statements true or false? WRITE True or 66. Are the following statements TRUE or FALSE? Write
False. True or False.
a. Young infants are up to 2 months of age. a. Spoon feeding is not safe
b. Cup feeding is the preferred method of feeding
b. Young infants have a different section of charts
because they have a separate IMCI process that is
c. Bottle feeding is unsafe
entirely different from the process for the sick
d. Cup feeding is preferred over spoon feeding
child.
c. Severe infections are the most serious illness in the
e. Bottle feeding is most recommended for young
first two months of life.
infants to practice suckling
d. Young infants and children are very similar in how
they show signs of illness.
e. Sami is 2 months old. He is considered a sick young
infant.
51. How many breaths per minute is fast breathing in an
infant?
52. How do you decide if an infant has fast breathing?

53. How will you measure temperature in a young infant?

54. What temperature is a fever in a young infant?

54. What temperature is considered low body

temperature?
55. Which of the following statements about signs of
severe disease or bacterial infection are true? Which
are false? Write True of False.
a. Chest indrawing is identified when an infant is
breathing OUT.
b. A healthy umbilicus is often red, and sometimes
drains pus.
c. Any difficulty with feeding in an important issue
for young infants.
d. Only severe chest indrawing is a serious sign in
infants, as mild chest indrawing is normal in young
infants.
56. Practice charting weight for age in young infants:
WEIGHT AGE Is this infant low weight for age?
YES NO
a. 2.5 kg 1 month
b. 3 kg 2 weeks
c. 4 kg 8 weeks
d. 3.2 kg 4 weeks
e. 4.5 kg 3 weeks
f. 3.3 kg 2 weeks
g. 3.1 kg 7 weeks

Circle the number of the signs of good attachment. Cross-

out the number of the signs of poor attachment.
57. Chin away from breast
58. Mouth wide open
59. More areola visible above than below mouth
60. Lower lip turned outward
61. Narrow mouth with lips pushed forward