Student’s No:__________________________

Examiners
→ Name____________________
→Signature__________________
→Date______________________
Time allowed: 8 minutes
TAKING TEMPERATURE, PULSE Marks Marks Remarks
AND RESPIRATION Obtainable Scored

1 Hand washing with soap and water and 1

proper drying.

2 Explanation of purpose and procedure. 2

3 Preparation of thermometer and insertion 2

4 Counting and recording of pulse. 3

5 Counting and recording of respiration. 3

6 Remove and clean thermometer with wet 2

swab

7 Reading and recording of temperature. 3

8 Shake down thermometer and replace in 2

container
9 Interpretation and follow-up instruction. 2

Total 20
 Student’s No:__________________________
Examiners
→ Name____________________
→Signature__________________
→Date______________________
Time allowed: 10 minutes
IX USE OF STETHOSCOPE FOR Marks Marks Remarks
CHEST EXAMINATION Obtainable Score
d
1. Approach: explanation of purpose 2
and procedure to the client giving
clear instruction, establish
rapport.
Hand washing with soap and water
2. and proper drying. 1

3. Exposing parts of the chest and back 1

appropriately.
4. Check stethoscope for proper 2
functioning.
5. Place the ear piece of stethoscope 2
correctly in the ear.
6. Choose the correct side of the 2
stethoscope (bell or diaphragm)
depending on the sound to be
heard.
7. Listen to the appropriate parts of the 4
chest in a logical sequence (e.g.
comparing sides of chest
appropriately).
(a) Respiratory rate
(b) Breaths sound
(c) Heart sound
8. Interpret sound and explain findings. 3

9. Record findings and give appropriate 3

follow-up.
Sub-Total 20

-
 -
- Student’s No:__________________________
- Examiners
- → Name____________________
- →Signature__________________
- →Date______________________
II Marks Marks Remarks
BLOOD PRESSURE ESTIMATION Obtainable Scored
1. Explanation of purpose and procedure. 1

2. Testing of Sphygmomanometer and 3

Stethoscope.

3. Connect the tube to the measuring part 1

of the apparatus.

4. Proper positioning of the client and the 3

instrument.

5. Using appropriate side of the 2

stethoscope.

6. Taking of blood pressure reading and 6

recording.

7. Interpretation and appropriate 4

instruction on follow-up action.

Sub-Total 20

- Time allowed: 8 minutes

-
-
-

Student’s No:__________________________
 Examiners
→ Name____________________
→Signature__________________
Date___________________
Time allowed: 9 minute
Marks Marks Remarks
XV. PERFORMANCE OF TEPID Obtainable Scored
SPONGING
1. Assemble the equipment’s for tepid
sponging which include:
- Lukewarm water in a bowl
- Towel 3
- Mackintosh
- Cloth/sponge

2. Explanation of purpose and procedure to 2

patient/patient’s mother

3. Spread the mackintosh on the bed to

prevent the bed from getting wet 1

4. Spread the towel over the mackintosh 1

5. Position the patient comfortably on the bed

i.e. lying down 1

6. Soak the cloth/sponge in the bowl of

lukewarm water 1
7. Apply the wet towel sponge to the child’s
body from head to toe 2
8. Continue the process until the child’s
temperature goes down 1
Do not mop the child with the towel –
9. keep the child exposed for some time 1
to allow evaporation of water
10. Reassure the mother 1
11. Clean and replace the equipment’s in their 2
proper place
12. Observe and treat fever according to
standing orders 4

Sub-Total 20

Immunization schedule
 Minimum target Type of vaccine Dosage Route of Site
Age of child Administration
At birth BCG 0.05ml Intra Dermal Left upper arm
OPV 0 2 Drops Oral Mouth
Hep B 0.5ml Intra muscular Antero-lateral aspect of right thigh
6 weeks Pantervallent 1 0.5ml Intra muscular Antero-lateral aspect of Left thigh
PCV 1 0.5ml Intra muscular Antero-lateral aspect of right thigh
OPV 1 2 Drops Oral Mouth
Rota 1 1 ml Oral Mouth
10 weeks Pantervallent 2 0.5ml Intra muscular Antero-lateral aspect of Left thigh
PCV 2 0.5ml Intra muscular Antero-lateral aspect of right thigh
OPV 2 2 Drops Oral Mouth
Rota 2 1 ml Oral Mouth
14 Weeks Pantervallent 3 0.5ml Intra muscular Antero-lateral aspect of Left thigh
PCV 3 0.5ml Intra muscular Antero-lateral aspect of right thigh
OPV 3 2 Drops Oral Mouth
IPV 0.5ml Intra muscular Antero-lateral aspect of right thigh
(2.5cm apart from PCV)
6 months Vit A 1st dose 100,000iu Oral Mouth
9 weeks Measles 1st dose 0.5ml Subcutaneous Left upper arm
Yellow fever 0.5ml Subcutaneous Right upper arm
Meningitis 0.5ml Intra muscular Antero-lateral aspect of Left thigh
12 months Vit A 1nd dose 200,000iu Oral Mouth

15 weeks Measles 2nd dose 0.5ml Subcutaneous Left upper arm

NOTE-OPV must be given before the age of two weeks. Hep B at birth should be given
preferably within 24 hours of birth but can be given up to 14 days of birth. BCG should be given
within two weeks of birth and can be given up until 11 months.
Side effect of immunization
1. Rashes 3.Abscess etc
2. Slide body temperature

Tetanus Diphtheria Immunization schedule (For women of child bearing age)

Vaccines Dosage Time of Administer Site Route of Administer Storage Dur
TD 1 0.5ml At first contract Deltoid Deep subcutaneous Refrigerator Note
+400C 800C
TD 2 0.5ml At least 4weeks after TD Deltoid Deep subcutaneous Refrigerator 3 ye
1. +400C 800C
TD – 3 0.5ml At least one year after TD Deltoid Deep subcutaneous Refrigerator 5 ye
2 or During Pregnancy +400C 800C
TD 4 0.5ml At least one year after TD Deltoid Deep substances Refrigerator 10 y
3 or During Pregnancy +400C 800C
TD 5 0.5ml At least one year after TD Deltoid Deep substance Refrigerator For life
4 or During Pregnancy +400C 800C

INJECTION TRAY
Before you start the procedure of injection, all the items needed should be assembled in a
tray or trolley and these should include:
1· Kidney dish with lid, containing sterile needle and syringes.
2· A Galli pot with swabs
3· Methylated spirit
4· Kidney dish for used swabs
5· Kidney dish with a pair of forceps
6· Container with drugs / injection vials and ampoules
PROCEDURES FOR INJECTION
These are steps you should follow in giving injection:
1· Explain procedure to the patient / client
2· Select and clean the site which can be the arm, thigh, buttock or vein
3· Read the label on the drugs for the expiry date before using it.
4· Use a syringe to draw drugs to the correct amount and expel the air bubbles
5· Insert the needle at an angle of 45 if its sub cut routes at angle 90 deeply into the muscle’s
intra muscular route.
6· Draw the plunger to make sure you are not in a blood vessel (artery or vein)
7· Insert your drug
8· Remove your needle and wipe the site with the swab.
9· for subcutaneous injection repeat the same procedure above except for intravenous
injection, then you do the following:
i- Pierce the skin obliquely until the needle has gone in about a half to one inch and blood
can be seen at the tip of the syringe
ii- draw blood a little and inject the prescribed drug
iii- apply puncture with little pressure to the site until bleeding stops.
PART OF NEEDLE
I-Hub Opening ii-Shaft of the needle iii-Bevel iv-Protective Cover.
PART OF SYRINGE
I-Plunger ii-Barrel iii-Needle Adapter.
TYPES OF SYRINGE
i. BCG syringe (0.05mls) and auto disables.
ii. 0.5mls syringe
iii.1ml
iv. 2mls syringe
v. 5mls, 10mls, 20mls and 30mls syringe.
TYPES OF NEEDLES
i. BCG needles ii. 23 gauge needles iii. 22 gauge needles iv. 21gauge needles
Reasons for injection
1. Some drugs cannot be taking orally.
2. Some do not work with hydrochloride acid in the stomach.
3. Injection works faster than oral drugs.
4. It can be given to an unconscious person as drugs.
5. You are sure that the patient has taken his or her drugs when you give injection.

Student’s No:__________________________
Examiners
 → Name____________________
→Signature__________________
→Date______________________
Marks Marks Remarks
VI. ADMINISTRATION OF Obtainabl Scored
INJECTION (VACCINE) e
1. Create rapport, explain purpose 2
and procedure.
Hand washing with soap and
2. water and proper drying. 1

3. Setting of tray with appropriate 3

requirements.

4. Checking the label and expiry 2

date of vaccine.

5. Drawing of correct dosage 3

(correct vaccine).

6. Preparation of clients, site and 4

administration of injection
for correct client.

7. Appropriate instructions and 3

follow-up.

8. Return of equipments used to 2

their places and proper
disposal of used materials.
Sub-Total 20

Time allowed: 10 minutes

Student’s No:__________________________
Examiners
→ Name____________________
 →Signature__________________
→Date______________________
Time allowed: 10 minutes
XII. URINE TEST FOR ALBUMIN Marks Marks Remarks
USING ALBUSTIX Obtainabl Scored
e
Required materials: (i )Albustix and 2
(ii) Albustix
chart
(iii) Bottles
Approach: Greet the patient and
1. introduce self and function. 1

2. Explain the procedure 1

3. Obtain freshly voided urine 2

specimen from the patient.
4. Dip the test end of the albustix strip 3
into the urine specimen and
remove immediately.
5. Matching result with the colour 4
chart on the albustix bottle and
record wether trace, +, ++. +++,
as the case may be.
6. Interpretation of result to the 4
patient:
(i) the strip does not change colour
if protein is negative.
(ii) the strip change colour if
protein is positive.
7. Washing hands with soap and water. 1

8. Correct recording. 2
9. Follow-up instruction to patient. 2
Sub-Total 20

ORAL HYGIENE (Oral Toileting)

Oral hygiene means cleanliness of oral cavity, its parts and organ which include teeth, tongue
and gums while, oral toilet means the procedures use in cleaning the mouth cavity
 Equipment for Oral Toilet
1. Tray
2. Small galipot
3. Kidney dish
4. Cotton gauze
5. Lint swab
6. A clean tooth brush
7. Spatula
8. Tooth paste
9. Chewing stick
10. Cup
11. Water
12. Container with Salt
13. Towel

Student’s No:__________________________
Examiners
→ Name____________________
→Signature__________________
→Date______________________
 Time allowed: 8 minutes
ORAL HEALTH Marks Marks Remarks
Obtainable Score
d
Assembling all the required items:
1. tooth paste, tooth brush, chewing 2
stick, cup, water, salt, towel etc.

2. Explain the purpose and procedure to 2

patient and thereafter
3. Press the tooth paste on the brush OR 1
give the patient chewing stick.
4. Wet the toothbrush and the paste OR 1
ask the patient to start chewing the
stick.
5. With any preferred method, 6
demonstrating how to clean the back
of his/her teeth as well as the front
using an upward movement for the
lower teeth, and downward strokes for
the upper teeth, and Give the patient
chance to ask questions.
6. Brush the front ,back and top of all 4
teeth
7. Give him fresh water to wash out 1
his/her mouth or salt water for
chewing stick method.
8. Ask the patient to spit out 1

9. Wash the tooth brush /dispose the 1

chewing stick.
10. Give appropriate instruction, follow- 1
up and return the materials to the
appropriate places.

Sub-Total 20

Requirement for Distance Vision Test

1. E- Test Chart
2. A wall or standing pillar
3. Hanger/ sole tape
4. Space room/ Hall with good source of light
5. Cardboard paper.
E-Chart for 6 Meter Visual Test

Source: (modified from CHEW Training Curriculum)

Common Signs of Visual Defect during E-Chart Test
1. Exclusive eye-blinking
2. Thrusting head forward
3. Tearing or red of eye
4. Head felting
5. Eye squinting

Student’s No:__________________________

Examiners
 → Name____________________

→Signature__________________

Marks Marks Remarks

IV VISUAL ACUITY TEST Obtainable Scored

1. Approach (Greeting, explanation of 2

purpose).

2. Measurement of the distance (6 meters 3

away).

3. Proper positioning of the chair and the 3

patient.

Procedure (closing of eyes

4. intermittently, pointing and 4

communicating with patient).

5. Proper recording. 3

6. Interpretation and advice. 4

7. Cleaning of the materials used. 1

Sub-Total 20

Time allowed: 8 minute

SHAKIR’S STRIP
 SHAKIR’S STRIP MEASUREMENT
1. Locate the mid-point of the upper arm, as described previously
2. Place the strip round identified point without squeezing the muscles or skin where the 0
cm mark meets the various colours is the correct measurement of the child’s mid upper
arm circumference
3. Note the colours and record
4. Readings for Shakir’s strip and tape methods - 13.5-25.0cm = green = Normal
- 12.5-13.5cm =yellow = mildly malnourished, - 7.5-12.5cm = red = severally malnourished
Green-= Normal
Yellow=Mild and malnourished
Red =Malnourished.

Student’s No:__________________________
 Examiners
→ Name____________________
→Signature__________________
→Date______________________
Time allowed: 10 minutes
XIII ARM CIRCUMFERENCE Marks Marks Remarks
. MEASUREMENT Obtainable Scored

1. Explanation of purpose and 2

procedure.
Pick-up Shakir’s strip.
2. 1

3. Make sure that the Shakir’s strip 1

has the mark
4. Tell the mother to retrieve the cloth 3
on the left or right upper arm.
5. Apply the Shakir’s strip 3
appropriately to the mid-way
between the elbow joint and
shoulder joint.
6. Read and interpret result/reading. 4

7. Interpret the reading to the mother. 2

8. Document the findings 1
appropriately.
9. Give appropriate information about 3
what to do about the reading
and when to call back.
Sub-Total 20

Student’s No:__________________________
 Examiners
→ Name____________________
→Signature__________________
→Date______________________
Time Allowed: 8 Minutes
III. WEIGHING AND CHARTING Marks Marks Remarks
(INFANTS AND TODDLERS) Obtainabl Scored
e
Explanation of purpose and procedure
1. establish rapport with mother/child 2
for cooperation to weigh.

2. Scale appropriate scale for patient 1

/client.

3. Balancing scale at zero before 2

weighing.

4. Inviting mother and child for 1

weighing.

5. Correct placement of baby on the 3

scale.

6. Reading, recording of baby’s weight. 3

Charting the weight accordingly on the

7. growth chart. 3

8. Appropriate interpretation. 3

9. Recording on tally sheet. 2

Sub-Total 20

Diagnostic Set
This is another important clinical instrument used in examining various body parts of the
patient which comprised of –the eyes, ears, the pharynx {throat}, the teeth, the nasal cavity
etc. It is made up of the following parts:-
a. Pen torch {1}
b. Ear pieces {3 or more} (Small size aperture, Medium size aperture & Large size aperture-
Children, Adolescents and Adults)
c. Dental mirror {1}
d. Laryngoscope {1}
e. Tongue depressor/spatula {1}
f. Pen torch head {1}
g. Nasal speculum {1}
h. Battery (dry cells) {2}
i. Ophthalmoscope {1}
g. Adapter (1)

Student’s No:__________________________
 Examiners
→ Name____________________
→Signature__________________
→Date______________________
Time allowed: 10 minutes
Marks Marks Remarks
V. USE OF AUROSCOPE FOR EAR Obtainabl Scored
EXAMINATION. e
1. Hand washing with soap and water 1
and proper drying.

2. Explanation of purpose and 1

procedure to the client.

3. Checking of auroscope to ensure light 2

is bright and speculum clean.

4. Choosing the right size of speculum 1

for the client.
5. Instruct the client to keep head 1
steady.
6. Inspection of the ear lobes for shape, 3
infection, sores, discharge and
swelling behind the ears.
7. Inspection of the ear for crusts, 3
blood, sores, discharge and foreign
body.
8. Correctly pulling ear lobe to locate 3
the eardrum.(in adult it is pulled
upwards, outwards and backwards,
whereas in children outwards and
downward) so as to straighten the
external auditory canal.
9. Correct description of the normal 3
eardrum as grey and shiny.

10. Recording of findings in the client’s 2

card.

Sub-Total 20
 PREPARATION OF ORAL REHYDRATION SOLUTION

Oral rehydration solution is prepared to be consumed orally in order to replace the lost body
fluid containing electrolytes (sodium, chloride, potassium chloride, carbonates etc) due to
diarrhoea or emesis (vomiting) to prevent dehydration which may lead to
oligaemic/hypovolemic shock.

FUNCTIONS OF ORAL REHYDRATION SOLUTION (ORS) IN THE BODY

1. It is used to correct electrolytes depletion/imbalance caused by diarrhoea and sometimes

vomiting etc.

2. It prevents dehydration and also corrects dehydration in individuals with diarrhoea and or
emesis.

REQUIREMENTS FOR ORS PREPARATION

1-One (1) clean empty beer bottle or two empty Fanta or coca cola bottles each with a
volume capacity of 30centilitre/cl (300ml) (X 2=600ml)

2-Clean drinking water in container covered with a lid.

3-Container with a lid containing sugar cubes or granulated sugar.

4-Container with lid containing salt.

5-Measuring spoon (8 x 3ml).

6-Container with lid for storing prepared solution of the ORS.

7-Stirrer or long spoon for mixing the solution.

8- Marking tosh

9-Cup

10-Clean up.
 PROCEDURE FOR PREPARING ORS SOLUTION

1-Explain the procedure to the mother/Care giver or patient.

2-Wash hands with soap and water, allow your hand to dry

3- Separate the marking tosh.

4-Fill one empty beer bottle or two empty (30cl) soft drink bottle with clean drinking water.

5-Pour the water into a clean container.

6-Measure ½ level spoon (3ml) of salt in to the water.

7-Put five (5) cubes of sugar or eight (8) level spoon of granulated sugar into the water and
stir to mix well.

8-Taste the mixture, which will taste like tears or coconut water.

9-Educate the patient or mother on how to take the solution.

For further details refer to standing orders pages 355---356, 2015 edition.