San Pedro College

12 C. De Guzman St., Davao City

Shifting Examination
IMCI Rotation

March 17, 2010

Name: _________________________________________________ BSN 3Q Group 2

I. Multiple Choice
Write the letter before the number that corresponds to your answer.

1) Ryan is suspected to have malaria after a business trip in Palawan. The most important
diagnostic test in malaria is
A. WBC count B. Urinalysis C. ELISA D. Peripheral blood smear

2) A bacteria which causes diphtheria is also known as

A. Amoeba B. Cholera C. Klebs-loeffler bacillus D. Spirochete

3) What is the first line for dysentery?

A. Amoxicillin B. Tetracycline C. Cefalexin D. Cotrimoxazole

4) Raiza comes to the health center bringing her 1½-year-old child. The child was classified as
having 3rd degree of protein energy malnutrition, kwashiorkor. Which of the following signs will be
most apparent in this child?
A. Voracious appetite B. Visible severe wasting C. Apathy D. Edema

5) The major sign of iron deficiency anemia is pallor. What part is best examined for pallor?
A. Palms B. Nailbeds C. Around the lips D. Lower conjunctival sac

6) The nurse has been teaching Chad, who has iron deficiency anemia, about those foods that he
needs to include in his meal plans. Which of the following, if selected by Chad, would indicate to the
nurse that he understands the dietary instructions?
A. Citrus fruits and green leafy vegetables
B. Bananas and nuts
C. Coffee and tea
D. Dairy products

7) In the Philippines, which condition is the most frequent cause of death associated by
schistosomiasis?
A. Liver cancer
B. Liver cirrhosis
C. Bladder cancer
D. Intestinal perforation

8) What is the most effective way of controlling schistosomiasis in an endemic area?

A. Use of molluscicides
B. Building of foot bridges
C. Proper use of sanitary toilets
D. Use of protective footwear, such as rubber boots

9) Joyce Ann comes to the health center complaining of itchiness. After thorough assessment, she
was diagnosed with scabies. What herbal medicine can the nurse encourage her to take?
A. Bayabas tincture B. Acapulco ointment C. SLK syrup D. ALS liniment
10) John Vincent, 73 years old, complains of joint pain on his knees. The nurse is correct if she tells
John Vincent to use
A. Bayabas tincture B. Acapulco ointment C. SLK syrup D. ALS liniment

11) Which of the following is the screening test for dengue hemorrhagic fever?
A. Complete blood count B. ELISA C. Western Blot test D. Rumple-Lead Test

12) Diana Joyce was diagnosed with dengue hemorrhagic fever. Which of the following is the most
important treatment of patients with dengue?
A. Give aspirin for fever
B. Replacement of body fluids
C. Avoid unnecessary movement of patient
D. Ice cap over the abdomen in case of melena

13) Which among the biological used in Expanded Program on Immunization (EPI) is stored in the
freezer?
A. DPT
B. Tetanus toxoid
C. Measles vaccine
D. Hepatitis B vaccine

14) Nurse Jeff knows not give DPT 2 if the mother says that the infant had
A. Seizures a day after DPT1
B. Fever for 3 days after DPT1
C. Abscess formation after DPT1
D. Local tenderness for 3 days after DPT1

15) Jacky, a 2-month-old infant, was brought to the health center for immunization. During
assessment, the infant’s temperature registered 38.1 C. Which is the best course of action that you
will take?
A. Go on with the infants immunization
B. Give paracetamol and wait for his fever to subside
C. Refer the infant to the physician for further assessment
D. Advise the infant’s mother to bring him back for immunization when he is well

16) To improve compliance to treatment, what innovation is being implemented in DOTS?

A. Having the health worker follow up the client at home
B. Having the health worker or a responsible family member monitor drug intake
C. Having the patient come to the health center every month to get his medications
D. Having a target list to check on whether the patient has collected his monthly supply of drugs

17) While on treatment for tuberculosis, Romeo complains of orange-colored urine and sweat. The
nurse is correct in informing Romeo that this is a common side effect of
A. Streptomycin
B. Isoniazid
C. Rifampicin
D. Pyrazinamide

18) Yenyen is being followed in the outpatient clinic for a diagnosis of active TB. She is receiving
isoniazid 200mg po qd, rifampicin 500mg po qd, and streptomycin 1500mg IM twice weekly. Which
statement by the client best indicates she understands her therapeutic regime?
A. “I’m glad I only have to take these drugs for a week.”
B. “I need to take these two drugs every day and come back to the clinic once a week for the shot.”
C. “It may work best to take these pills in the evening right before bed.”
D. “I’m glad my birth control pills aren’t affected by these drugs – the doctor told me not to get
pregnant!”

19) In IMCI, severe conditions generally require urgent referral to a hospital. Which of the following
severe conditions does not always require urgent referral to hospital?
A. Mastoiditis
B. Severe dehydration
C. Severe pneumonia
D. Severe febrile disease

20) A mother brings her 3-year-old child, Wendee, to the health center. A student nurse assessed her
using the IMCI guidelines, and classified her as having severe pneumonia. Which of the following
signs will indicate that the young child is suffering from severe pneumonia?
A. Dyspnea
B. Wheezing
C. Fast breathing
D. Chest indrawing

21) Faith brought her 10-month-old infant for consultation because of fever, which started 4 days prior
to consultation. To determine malaria risk, what will you do?
A. Do a tourniquet test
B. Ask where the family resides
C. Get a specimen for blood smear
D. Ask if the fever is present everyday

22) While assessing Debbie, an 8-month-old infant, who has diarrhea, you noted that the diarrhea
has been for 2 days without presence of blood. The child kept playing with her rattle while sitting on
her mother’s lap. The patient’s eyes were not sunken. When offered milk, the baby greedily drank
from the feeding bottle. What other symptom will you look into before you classify the patient’s
diarrhea?
A. Capillary refill
B. Pallor of palm
C. Skin turgor
D. Dryness of mouth

23) A mother comes with her 2 month old child with a chief complaint of fever. To assess for general
danger signs, the nurse would ask all of these questions EXCEPT?
A. How long has your child had fever?
B. Is your child able to drink or breastfeed?
C. Has she vomited everything she ate?
D. Has the child had convulsions?

24) In assessing for the presence of measles, the nurse would take note of all of the following
EXCEPT?
A. generalized rash and redness of the eyes
B. generalized rash or presence of cough or runny nose
C. clouding of the cornea
D. mouth sores

25) A mother comes in with her 3 week old infant. The nurse would know that part of basic
assessment in IMCI would include:
A. assessing for breast infection
B. assessing for good mother-father and child bonding
C. assessing for breastfeeding
 D. assessing for uterine involution of the mother

II. Fill in the Blanks

A. Expanded Program on Immunization

Vaccine Minimum age No. of Route Site
of 1st dose doses
1.) At birth 1 7.) 9.)
Measles 3.) 5.) 8.) Upper outer portion of the arm
Oral polio vaccine 6 weeks 6.) Oral Mouth
Hepatitis B vaccine 4.) 3 Intramuscular 10.)
Upper outer portion of the
2.) 6 weeks 3 Intramuscular
thigh

B. Tetanus Toxoid
Vaccine Minimum age/interval Percent protected Duration of protection for the
mother
TT1 1.) 80% ---
TT2 At least 4 weeks later 3.) 3 years
TT3 At least 6 months later 95% 5.)
TT4 2.) 99% 10 years
TT5 At least 1 year later 4.) lifetime

III. True or False. Write T on the blank provided if the statement is correct, and F if otherwise.
___ 1. A classification in a yellow row means the child does not need specific medical treatment such as
antibiotics.
___ 2. It is called an acute diarrhea if the diarrhea lasts for 14 days or more.
___ 3. The measles rash is a generalized rash with vesicles.
___ 4. Nasal flaring is the widening of the nostrils when the young infant breathes out.
___ 5. An 11-month-old child, with a respiratory rate of 48 cpm, is considered breathing fast.

IV. Word Search. Encircle the word(s) that answers the questions. (can either be horizontal or vertical)

A W H E E Z I N G T H F J J M S D
D D M K E E B F E V E R D L E A F
Y G J C X W V R L V B M E R A F Y
S H A M A H E M O P T Y S I S E H
E C S A I B P D L Z N G R P L R K
N W D R O V P V H N I C O L E N C
T K W A S H I O R K O R Y E S A V
E F P S L C F T S T R I D O R N U
R G O M E L E N A I G I E K A D I
Y J I U L G Z T G B Q U L S S O O
X N J S P F Z H E A T R A S H D P
 1.) A harsh noise made when the child breaths in.
2.) Medical term for diarrhea and blood in the stool.
3.) It is the main symptom of malaria.
4.) A form of severe malnutrition where a child has visible severe wasting.
5.) It is a generalized rash without vesicles or pustules.

Answer Key: II A
1 bacillus calmette-guerin
I. 2 diphtheria-pertussis-tetanus vaccine
3 9 months
1 D 4 At birth
2 C 5 1
3 D 6 3
4 D 7 Intradermal
5 A 8 Subcutaneous
6 A 9 Deltoid region of the arm
7 B 10 Upper outer portion of the thigh
8 C
9 B II B
10 D 1 as early as possible during pregnancy
11 D 2 at least 1 year later
12 B 3 80%
13 C 4 99%
14 A 5 5 years
15 A
16 B III True or False
17 C 1F
18 C 2F
19 B 3F
20 D 4F
21 B 5F
22 C
23 A IV
24 B 1 stridor
25 C 2 dysentery
3 fever
4 marasmus
5 measles rash

A W H E E Z I N G T H F J J M S D
D D M K E E B F E V E R D L E A F
Y G J C X W V R L V B M E R A F Y
S H A M A H E M O P T Y S I S E H
E C S A I B P D L Z N G R P L R K
N W D R O V P V H N I C O L E N C
T K W A S H I O R K O R Y E S A V
E F P S L C F T S T R I D O R N U
R G O M E L E N A I G I E K A D I
Y J I U L G Z T G B Q U L S S O O
X N J S P F Z H E A T R A S H D P