ST.

ANTHONY’S COLLEGE
San Jose Antique 1st Semester, SY 2019-2020
Nursing Department Prepared by: Sandra T. Gruy RN, MAN

COMPETENCY APPRAISAL (IMCI SET-A)

SITUATION: There are certain conditions that child is brought to a clinic without specific complaints
that point to malnutrition or anemia. Most of the time, a sick child can be malnourished without
being noticed by the members of the family. A child with problems on his/her nutrition has a higher
risk of many types of disease and death. The following questions relate to a child with malnutrition
and anemia.

1. A child with Severe wasting (very thin, has no fat and looks as if he is made up of only skin and
bones) probably has:
A. Anemia C. Kwashiorkor
B. Marasmus D. Slightly under weight
2. Edema of both feet may signal that a child has:
A. Anemia C. Kwashiorkor
B. Marasmus D. Slightly under weight
3. A child with anemia has reduced number of red blood cells or a reduced amount of hemoglobin
in each red blood cell. A child can also develop anemia as a result of:
A. Infections B. Parasites C. Malaria D. All of the above
4. A child with pallor may have anemia. Which of the following is INCORRECT in assessing pallor?
A. To check for pallor, look at the skin of the child’s palm
B. To check for pallor, compare the cold of the child’s palm with your palm and with those of
other children
C. To check for pallor stretch the fingers backwards
D. If the skin of the palm is very pale, the child has severe palmar pallor
5. You know that a child with malnutrition has the following classifications, EXCEPT:
A. Severe malnutrition C. Very low weight
B. Severe anemia D. Some palmar pallor
6. A child with SEVERE MALNUTRITION has which of the following signs:
A. Very low weight for age C. Visible severe wasting
B. Severe palmar pallor D. Some palmar pallor
7. You know that the right amount of iron (syrup) to be given to 12 months old child is:
A. 1 tsp B. 2 tsp C. 3 tsp D. 4 tsp

SITUATION: Observing adequate feeding is important for growth and development especially during
infancy. Poor feeding practices can lead to unwanted lifelong effects. Growth should be routinely
assessed by determining weight for age. It is essential to assess a young infant’s feeding and weight so
that feeding can be improved if necessary. The following questions relate to young infants with
feeding problems or low weight for age.

8. When will you assess a young infant’s breastfeeding?

A. If the infant has no feeding difficulty
B. If the infant breastfeeding less than 8 times in 24 hours
C. If the infant is not taking any other food or drink except breast milk
D. If the infant has a serious problem requiring urgent referral
 9. It is important to assess if the infant is sucking effectively. Which of the following assessment
requires further investigation?
A. The infant is suckling effectively if he suckles with slow deep sucks and sometimes pauses.
B. The infant releases the breast spontaneously
C. The infant appears relaxed, sleepy, and loses interest in the breast
D. You saw indrawing of the infant’s cheeks

SITUATION: The World Health Organization (WHO), together with UNICEF and other agencies,
developed a strategy known as an Integrated Management of Childhood Illness (IMCI). Although the
major purpose of developing the IMCI is to address the needs of curative care, the strategy also
answers aspects of nutrition, immunization, and other important elements of disease prevention and
health promotion.

10. Josie brought her 3 months old child to your clinic because of cough and colds. Which of the
following is the primary action?
A. Give cotrimoxazole tablet or syrup
B. Assess the patient using the chart on management of children with cough
C. Refer to the doctor
D. Teach the mother how to count her child’s breathing
11. A child with ear problem should be assessed for the following EXCEPT:
A. Ear pain C. Ear discharge
B. Is there any fever D. If discharge is present for how long?
12. If the child does not have ear problem, using IMCI, what should you as the nurse do
A. Check for tender swellings, behind the ear C. Check for the ear discharge
B. Go the next question, check for malnutrition D. Check for ear pain
13. An ear discharge that has been present for more than 14 days can be classified as:
A. Chronic ear infection C. Complicated ear infection
B. Acute ear infection D. Mastoiditis
14. An ear discharge that has been present for less than 14 days can be classified as:
A. Complicate ear infection C. Chronic ear infection
B. Acute ear infection D. Mastoiditis
15. If the child has severe classification because of ear problem, what would be the best thing that
you as the nurse can do?
A. Dry the ear by wicking C. Give an antibiotic for 5 days
B. Refer urgently D. Instruct mother when to return immediately
16. If a child with diarrhea registers one sign in the pink row and one in the yellow row of the IMCI
chart, we can classify the patient as:
A. Moderate dehydration C. Severe dehydration
B. No dehydration D. Some dehydration
17. A child with NO DEHYDRATION needs home treatment. Which of the following is not included as
rules for home treatment in this case:
A. Know when to return to the health center C. Give oresol every 4 hours
B. Give the child extras fluids D. Continue feeding the child
18. A child who has had diarrhea for 14 days but has no sign of dehydration is classified as:
A. Severe dysentery C. Dysentery
B. Some dehydration D. Persistent diarrhea
19. If the child has sunken eyes, drinking eagerly, thirsty and skin does back slowly the classification
with be:
 A. Moderate dehydration C. No dehydration
B. Some dehydration D. Severe dehydration
20. Carlo has had diarrhea for 5 days. There is no blood in the stool, he is irritable. His eyes are
sunken. The nurse offers fluid to Carlo and he drinks eagerly. When the nurse pinched the
abdomen, it goes back slowly. How will you classify Carlo’s illness?
A. No dehydration C. Severe dehydration
B. Moderate dehydration D. Some dehydration
21. At the core of IMCI strategy is an integrated case management of the most common childhood
problems. Which is NOT a main component of this strategy:
A. Improvements in the case management skills of health staff through the provision of locally-
adapted guidelines on integrated management of childhood illness and activities to promote
their use
B. Improvements in the overall health system required for effective management of childhood
illness
C. Improvements in family and community health care practices.
D. All of the given options are component of the strategy

SITUATION: Dengue Hemorrhagic Fever (DHF) is caused by a virus that is spread by a vector mosquito.
When infected, a child can have a fever that lasts for 2-7 days. This disease can cause severe damage
to the blood and blood vessels, which may lead to bleeding. The following questions relate to DHF.
22. How many classifications are there for Dengue Hemorrhagic Fever?
A. 1 B. 2 C. 3 D. 4
23. Which among the following is NOT a classification of DHF?
A. SEVERE DENGUE HEMORRHAGIC FEVER
B. FEVER: DENGUE HEMORRHAGIC FEVER UNLIKELY
C. VERY SEVERE FEBRILE DISEASE: DHF
D. Options B and C
24. Which of the following signs you can NOT use in classifying a child with DHF?
A. Bleeding from the nose and gum C. Slow capillary refill
B. Cold and clammy extremities D. You can use all of the signs
25. What is the correct pre-referral treatment for child with DHF classified in pink row?
A. Give ORS according to PLAN B if the child has any of the following signs: skin petechiae,
persistent abdominal pain, persistent vomiting and positive tourniquet test
B. Give fluids immediately according to PLAN C if the child has any of the following signs: skin
petechiae, persistent abdominal pain, persistent vomiting and positive tourniquet test
C. Give ORS according to PLAN B if the child has any of the following signs: bleeding from nose
and gums, blood in stool or vomitus, cold and clammy skin, and slow capillary refill
D. Give ORS according to PLAN A if the child has any of the following signs: bleeding from nose
and gums, blood in stool or vomitus, cold and clammy skin, and slow capillary refill
26. Which of the following interventions is not included to any of the classification of DHF?
A. Give fluids according to PLAN A C. Give fluids according to PLAN C
B. Give fluids according to PLAN B D. Treat the child to prevent lowering of blood sugar
27. In checking bleeding a tourniquet test can be done. A pediatric cuff is inflated halfway between
the systolic and diastolic pressure and kept that pressure for 5 minutes. The pressure is releases
and a one-inch-size square is drawn below the cuff and on the front surface of the forearm. You
should count the number of petechiae inside the square. A positive tourniquet test would result
to how many petechiae?
A. 5 or more B. 10 or more C. 15 or more D. 20 or more
28. To prevent low blood sugar, you have to know PRIMARILY if:
A. If sugar water is available C. If there is stock of 50% dextrose solution
B. If 10% dextrose solution is available D. Mother can breastfeed
29. You would expect that which of the following should be given to a child with diarrhea?
A. Antibiotics B. Oxygen C. ORT D. Antimotility drugs
30. Assess a child with fever to see if there are signs suggesting measles. Look for a generalized rash
and for one of the following signs, EXCEPT:
A. Cough B. Itchiness C. Runny nose D. Red eyes
31. Which of the following signs indicates shock for a child with DHF?
A. Skin petechiae C. Slow capillary refill
B. Dried blood in nostrils D. Bleeding gums
32. While giving instructions to the mother you see that she was overwhelmed with the instructions
you are giving her. Which of the following instructions can you omit or delay?
A. How to give antibiotics C. Giving complete doses of paracetamol
B. When to give antimalarial drug D. How much fluid to give to child with diarrhea
33. Under PLAN A how much fluid should be given to a 3 year old child with 5 loose stool?
A. 500 ml-1000 ml B. 100 ml-200 ml C. 300 ml-400 ml D. 400 ml-500 ml
34. A possible feeding problem is present in which of the following?
A. A 3-month-old is given sugar water as well as breastmilk
B. A 2-year-old receiving 2 extra feedings between meals, as well as 3 meals a day
C. A breastfed 8 month-old should also be given adequate servings of a nutritious
complementary food 3 times a day
D. All are good feeding practices
35. A child with SOME DEHYDRATION is treated using PLAN B. For a child who weighs 12 kg., how
much ORS should be given?
A. 800 ml B. 900 ml C. 100 ml D. 1200 ml
36. Following the principles of IMCI, you can give albendazole as a single in the health center,
except:
A. The child is 2 years of age or older
B. The child had a dose of albendazole in the last 6 months
C. Hookworm/whipworm infections are a problem among children in your area
D. All of the above
37. In the health center, you are giving instructions to a mother on proper measurement of
medicine. You know that the mother doesn’t need additional teaching when she said that 15 ml
is also the same with:
A. 1 tsp B. 1 ½ tsp C. 2 tsp D. 3 tsp
38. In IMCI, which of the following is NOT included as a treatment for local infection?
A. Dry the ear by wicking C. Tetracycline to treat eye infection
B. Treat mouth ulcers with Genetian Violet D. Sugar water
39. What is the treatment for pain under IMCI protocols?
A. Paracetamol B. Aspirin C. Gentian Violet D. Tetracycline
40. An infant with jaundice should be referred urgently to hospital if:
A. Yellow discoloration is seen in less than 24 hours of life
B. Has yellow discoloration but palms and soles of feet not yellow
C. Infant’s color is pink
D. No jaundice
41. To look for severity of jaundice you should:
A. Check palms and soles of feet C. Checked forehead
 B. Check eyes D. Palpate liver
42. For CHRONIC EAR INFECTION, what is the appropriate treatment?
A. Instilling ear drops for two weeks C. Dry the ear by hair dryer
B. Paracetamol for ear pain D. Vitamine A
43. What is the first line antibiotic for acute ear infection?
A. Cotrimoxazole C. Tetracycline
B. Amoxycilline D. Nalidixic Acid
44. What should be given as a single dose if a child is infected with plasmodium falcificarum?
A. Primaquine B. Amoxycillin C. Chloroquine D. Cotrimoxazole
45. Which is the first line anti-malarial drug?
A. Chloroquine C. Primaquine
B. Artemether- Lumefantrine D. Sulfadoxine and Pyrimethamine
46. Which of the following steps is NOT included in the IMCI strategy?
A. Identify treatment C. Assess and classify
B. Counsel and follow-up D. Referral
47. Which of the following laboratory tests would classify the presence of fever as positive for
malaria?
A. Complete blood count C. Tourniquet test
B. Occult blood test D. Blood smear
48. The IMCI chart provides the necessary procedure when identifying the appropriate interventions
to be done. However, the CHN should be aware that the following factor should be considered
in utilizing the case management chart:
A. Problem of the child C. Danger signs
B. Age of the child D. Chief complaint
49. Wheezing is defined as a:
A. Harsh sound when breathing in C. Chest going in, when breathing in
B. Musical sound when breathing out D. Sounds like a bee
50. A child with wheezing should be given with?
A. Inhaled salbutamol with or without spacer C. Antibiotic
B. Vitamin A D. None of the above