Integrated Management of Childhood Illness
Jennelyn Pondang-Ginturo RN, MAN, LPT
NAME:
Instructions: Select the correct answer for each following questions. Mark only one answer for each item by encircling the letter of your
choice. STRICTLY NO ERASURES ALLOWED.
SITUATION: Jeo Jonas, 7 weeks old was brought by his
mother to the health care because of diarrhea occurring 4
to 5 times a day.
1. Your assessment revealed that Jeo Jonas has sunken
eyes and he is restless and irritable. What will be your
diagnosis?
a. Some dehydration
b. No signs of dehydration
c. Severe dehydration
d. You need to assess him further to be able to make
a diagnosis
2. Based on your diagnosis, which of the following is
best done for Jeo Jonas?
a. Give Jeo Jonas’ mother instruction in home
management
b. Give Jeo Jonas 200-400ml Oresol in 24 hours
c. Accompany Jeo Jonas to the nearest facility
where IV fluids can be given
d. Keep him in your health center for close
observation
3. You know that the hallmark of nursing accountability is
the:
a. Fever or hypothermia
b. The presence of blood in his stool
c. Severe under nutrition
d. All of these
4. After your management of Jeo Jonas’ condition. Your
assessment revealed that he has no more signs of
dehydration. What instruction should you give to Jeo
Jonas’ mother?
a. Continue breastfeeding him frequently
b. Give him Oresol 50-100ml after every loose stool
c. Observe him for danger sign
d. All of these instructions
SITUATION: A health worker is assessing a 3-week old infant,
who is breastfeeding, for feeding problem. While
breastfeeding, the health worker sits quietly and watch the
infant breastfeed. The infant’s chin is not touching the
breast, there is more areola visible below the infant’s
mouth than above it. The mother reports less than 6
breastfeeds in 24 hours.
5. The young infant is classified under:
a. Not able to feed – possible serious bacterial
infection
b. Feeding problem or low weight
c. No feeding problem
d. Very serious feeding problem
6. Appropriate management would include:
a. Advice mother to increase frequency of
breastfeeding
b. Treat to prevent low blood sugar
c. Refer urgently to the hospital
d. Give ORS
7. The nurse assesses for chest indrawing and knows
which of the following is true about chest indrawing?
a. It must be clearly visible and present only during
crying and feeding
b. It is more accurate if assessed as the child is in
upright position
c. It is when the intercostals area goes out as the
child breathes in
d. It involves only the lower and upper chest walls
(subcostal)
8. Dwayne has had diarrhea for a week and he is very
irritable with sunken eyeballs, but no blood in the stool.
When the nurse pinches the skin on the child’s
abdomen, it goes back slowly. His parents told the
nurse that he is eager to drink whenever they offer
fluids. These signs are classified on to what type of
dehydration?
a. Severe dehydration
b. Some dehydration
SCORE: ____
c. Very severe dehydration
d. No dehydration
9. After administration of additional fluids, the child
vomits. The mother correctly understands the nurse’s
instructions if she did which of the following?
a. Stop the feeding and bring the child to the health
center
b. Pause for 10 minutes and resume more slowly
c. Let the child lie down on his side
d. Discontinue the feeding until the child asks for
water
10. Sophia, a 1-year old child was brought by her mother
to the health center because of diarrhea. Based on the
assessment, she has sunken eyes and the skin pinch
goes back slowly. The first thing that Nurse Tamee will
give is:
a. Plan A
b. Plan B
c. Plan C
d. Plan D
SITUATION: Carmen, a two-year old, 11 kg child was brought
for initial visit by her mother to the health center due to
diarrhea. Carmen is awake and conscious but unable to
drink or breastfeed, her skin pinch goes back very slowly.
No vomiting and no convulsion noted.
11. Which of the following assessment data would warn
you that Carmen most probably needs urgent
attention?
a. Not able to drink or breastfed
b. Vomits everything
c. Diarrhea
d. 11 kilogram
12. You encircled the sign she previously identified and
ticked yes. What should you do next?
a. Rehydrate according to Plan C
b. Finish the whole assessment step by step and
refer the child urgently
c. Give first dose of appropriate antibiotic
d. Send a referral note with the patient
13. The IV fluid suggested for rehydration:
a. Plain LR
b. D5 NaCl
c. D5 LR
d. None of the above
14. If the nurse is not trained to give intravenous fluid in
cases of severe dehydration, what is her best
alternative?
a. Give Oresol by mouth (NGT)
b. Give Oresol in a cup
c. Refer to the hospital without rehydration
d. None of the above
SITUATION: Nurse Krizia is about to utilize the Updated
IMCI chart to assess and classify sick children aged 2
months up to 5 years.
15. After checking the general danger signs, the nurse
would then asks about the main symptoms EXCEPT:
a. Jaundice c. Fever
b. Diarrhea d. Malnutrition
16. In responding to the care concerns of children with
severe diseases, referral to the hospital is of the
essence especially if the child manifests which of the
following?
a. Fast breathing c. Convulsion
b. Stopped feeding well d. Chest Indrawing
17. The mother of any sick child should return
immediately to health worker with which of the
following signs?
a. Pneumonia c. Diarrhea
b. Malnutrition d. Malaria
18. The child with cough also manifests with wheezing
and chest indrawing, which of the following should be
done before classifying child’s illness?
 a. Give first dose of appropriate antibiotic d. Persistent Diarrhea
b. Soothe the throat with safe remedy SITUATION: The following numbers relate to assessment and
c. Give trial rapid acting inhaled bronchodilator management of child with fever.
d. Count the breaths and look for chest indrawing again. 31. When the child has fever, the nurse would classify it as
19. The child has been classified with Pneumonia with to which of the following, EXCEPT:
coughing for more than 3 weeks, which of the a. Malaria c. Measles
following should be done next? b. Dysentery d. Dengue Hemorrhagic Fever
a. Refer assessment for TB or asthma 32. If the child has measles with the following
b. Advise mother when to return immediately manifestations: clouding of the cornea, deep and
c. Refer urgently to the hospital extensive mouth ulcers, which of the following is the
d. Treat the child to prevent low blood sugar correct classification?
20. When should the nurse advise the mother with a. Severe, complicated measles
pneumonia to come for follow – up visit: b. Measles with mouth complications
a. 3 days b.5 days c. 1 week d. 2 weeks c. Measles
SITUATION: Tricia, a 1 year old patient was brought by her d. Very Severe Febrile Disease
mother with chief complaint of cough for 3 days. 33. Which of the following treatment should be given for a
21. If Tricia would only experience chest in drawing, how child with pus draining from the eyes?
would you classify this: a. Vitamin A c. Gentian Violet
a. Severe Pneumonia c. No Pneumonia b. Tetracycline ointment d. Silver Nitrate Ointment
b. Pneumonia d. Cough or cold 34. Upon physical examination, Thomas is abnormally
22. Based on your answer on # 128, which of the sleepy or lethargic and with stiff neck, the nurse
following should be give? classifies the fever as to?
a. Amoxicillin a. Very Severe Febrile Disease/ Malaria
b. Cotrimoxazole b. Malaria
c. Ciprofloxacin c. Fever: Malaria Unlikely
d. Chloramphenicol d. Fever: No Malaria
SITUATION: Bugoy, a 6 month old infant sought consultation 35. Which of the following treatment would Thomas should
at the nearby health center due to diarrhea. receive?
23. The following signs were noted by the community nurse a. Quinine
on duty: Irritable with sunken eyes. We can classify the patient b. chloroquine
as: c. Artemether lumefanthrine
a. Moderate dehydration c. Severe dehydration d. Prmaquine
b. No dehydration d. Some dehydration 36. In a Barangay in Iloilo where there were high
24. Based on your answer on # 23, which of the following incidences of malaria, a child was brought by her
treatment would you implement? mother with on and off feeling of dryness and warm
a. Give Zinc supplement skin, temperature reached 37.5°C and above, the
b. (Plan B) child has no general danger signs, with stiff neck, no
c. Give Vitamin A runny nose, no measles, and no other obvious causes
d. Advise mother to treat diarrhea at home of fever. The child may be classified as having:
SITUATION: Aling Martha brought her 6 weeks old Daniela a. Very Severe febrile disease c. Malaria
to seek consultation about the infant’s diarrhea. b. Fever: no malaria d. Severe malaria
25. If Daniela’s diarrhea persist for 14 days but has no sign of 37. It is understood that if a child were living in a “no
dehydration, it is classified as: malaria risk area” but who has presenting signs of stiff
a. Severe complicated dehydration neck and convulsion. The child may be classified as
b. Dysentery having;
c. Severe persistent diarrhea a. Very Severe febrile disease
d. Persistent diarrhea b. Fever
26. Which of the following treatment is expected to be given for c. Malaria
Daniela? d. Severe malaria
a. Refer to hospital 38. You attended to a 3 year old child with measles and
b. Give Ciprofloxacin for 3 days with eye complications. This child should be treated
c. Tell the mother to return in 2 days with the following EXCEPT:
d. Give multivitamins and minerals for 14 days a. Apply gentian violet.
27. Another patient 3 year old named Marlon, has diarrhea for b. Apply tetracycline ointment.
5 days. He is irritable. His eyes are sunken. The nurse offers c. Give vitamin A.
fluid to the child and she drinks eagerly. When the nurse d. Follow-up in 2 days
pinched the abdomen, it goes back slowly. How would you 39. Which of the following assessment would confirm the
classify the child’s illness? diagnosis of Severe Complicated Measles?
a. No dehydration c. Severe dehydration a. Pus draining from the eye
b. Moderate dehydration d. Some dehydration b. Measles now/within 3 months
28. If another child with diarrhea has blood in the stool, which c. Mouth ulcer
of the following would you classify the illness? d. Extensive mouth ulcers
a. Severe Persistent, Diarrhea 40. Upon assessment the nurse observed convulsion, the
b. Dysentery child will be classified under?
c. Persistent Diarrhea a. A child with GDS c. Urgent referral
d. No Dehydration b. Very severe disease d. None of the above
29. The child with blood in the stool would receive which of
the following treatment?
a. Ciprofloxacin for 3 days
b. Vitamin A
c. Multivitamins and minerals for 14 days
d. ORS at home
SITUATION: Beck, a 2 year old child was brought to the
nearest RHU due to diarrhea.
30. The nurse assessed Beck and noted the following:
abnormally sleepy with sunken eyes. Which of the
following would be the correct classification?
a. Severe Dehydration
b. Some Dehydration
c. Severe Persistent Diarrhea