COMMUNITY HEALTH NURSING
By: Darius Candelario. INTEGRATED
MANAGEMENT OF CHILDHOOD
ILLNESS
A. SICK YOUNG INFANT AGED 1 WEEK
TO 2 MONTHS
(all the sick young infant referred
below are aged 1 week to 2 months)
1) What is the minimum axillary
temperature (in °C) for fever in sick
young infants?
a. 38.5
b. 37.5
c. 38
d. 37
2) In a sick young infant, which
respiratory rate is considered as “fast
breathing?”
a. 40 or more breaths per minute
b. 50 or more breaths per minute
c. 60 or more breaths per
minute
d. 70 or more breaths per minute
3) The sick young infant is said to have
low body temperature. The public
health nurse knows that the axillary
temperature of the infant would be
less than:
a. 36.5 °C
b. 36 °C
c. 35.5 °C
d. 35 °C
4) If assessment of a sick young infant
reveals convulsions, or fast breathing,
or severe chest indrawing, or nasal
flaring, or grunting, or bulging
fontanelle, which treatment would be
considered inappropriate?
a. Treat the infant to prevent the
lowering of his or her blood sugar
level.
b. Give the infant the first dose of
intramuscular antibiotics.
c. Treat the local infection in
the health center, and teach the
mother to treat local infections at
home.
d. Advise the mother regarding how
to keep the infant warm on the way to
the hospital
5) A young infant has a pus draining
from the ear, or umbilical redness
extending to the skin, fever, or low
body temperature, many/severe skin
pustules, or abnormal movement, or is
abnormally sleepy or difficult to
awaken. What treatment would be
appropriate?
a. Give an appropriate oral
antibiotic.
b. Refer the infant urgently to
a hospital.
c. Advise the mother regarding how
to give home care to the infant.
d. Follow up in 2 days.
6) The young infant who has diarrhea
has two or more of the following signs:
abnormally sleepy or difficult to
awaken, sunken eyes, pinched skin
goes back to its original state very
slowly (longer than 2 seconds). How
will you classify the diarrhea for
dehydration?
a. No dehydration
b. Severe dehydration
c. Some dehydration
d. Severe, persistent diarrhea
7) If the infant with Severe
Dehydration also has Possible Serious
Bacterial Infection or Dysentery, which
of the following treatment would be
considered inappropriate?
a. Give the infant fluid for
severe dehydration (Plan C: Treat
Severe Dehydration Quickly)
b. Refer the infant urgently to a
hospital, with the mother giving
frequent sips of ORS on the way.
c. Advise the mother to continue
breastfeeding the infant.
d. Advise the mother how to keep
the infant warm on the way to the
hospital.
8) If the infant who has diarrhea, has
two of the following sins—restless,
irritable; sunken eyes; pinched skin
goes back to its original state very
slowly—what will be the appropriate
treatment to give?
a. Refer the infant to a hospital.
b. Give the infant fluid to treat the
diarrhea at home (Plan A).
c. Give the infant fluid and food
for some dehydration (Plan B).
d. Refer the infant urgently to a
hospital, with the mother giving the
infant frequent sips of ORS on the way.
9) The community health nurse is
caring for the young infant with
diarrhea lasting for 14 days or more.
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Which of the following treatments is 17) What is the second-line antibiotic
appropriate? for local bacterial infection in the
a. Give Vitamin A young infant?
b. If the young infant has a. Amoxicillin
dehydration and has a Possible Serious b. Cotrimoxazole
Bacterial Infection, treat the c. Gentamicin
dehydration before referral to a d. Benzylpenicillin
hospital. 18) Which appropriate oral antibiotic
c. Refer the infant to a hospital for local infection should not be given
d. None of the above to infants < than 1 month of age who
10) Where will the community health are premature or jaundiced?
nurse pinch the skin, to look and feel a. Amoxicillin
for dehydration? b. Cotrimoxazole
a. Sternal area c. Gentamicin
b. Arm d. Benzylpenicillin
c. Elbow 19) Which appropriate oral antibiotic
d. Abdomen for local infection is given only twice
11) What signs should necessarily be daily for 5 days?
present to classify the infant’s feeding a. Amoxicillin
problem as “Possible Serious Bacterial b. Cotrimoxazole
Infection?” c. Gentamicin
a. Ulcers or white patches in the d. Benzylpenicillin
mouth 20) Which appropriate oral antibiotic
b. No attachment at all for local infection is given three times
c. Not suckling effectively daily for 5 days?
d. Breastfeeds less than 8 times in a. Amoxicillin
24 hours b. Cotrimoxazole
12) What treatment consists an c. Gentamicin
inappropriate nursing action for a d. Benzylpenicillin
young infant who has Possible Serious 21) Referral is the best option for a
Bacterial Infection? young infant classified as having a
a. Give the infant the first dose POSSIBLE SERIOUS BACTERIAL
of intravascular antibiotics. INFECTION. If referral is not possible,
b. Treat the infant to prevent the though, we give intramuscular
lowering of his or her blood sugar antibiotics for at least 5 days. How
level. often do we give benzylpenicillin?
c. Advise the mother regarding how a. q 4 hours
to keep the infant warm on the way to b. q 5 hours
the hospital. c. q 6 hours
d. Refer the infant urgently to a d. q 8 hours
hospital. 22) Referral is the best option for a
13), 14), 15) Complete the young infant classified as having a
Immunization Schedule POSSIBLE SERIOUS BACTERIAL
AGE VACCINE INFECTION. If referral is not possible,
Birth 13) _BCG_ though, we give intramuscular
6 weeks DPT-1,14) _OPV- antibiotics for at least 5 days. What is
1_, 15) _Hep-B the correct frequency in giving
1__ gentamicin?
16) What is the first-line antibiotic for a. QID
local bacterial infection in the young b. OD
infant? c. TID
a. Amoxicillin d. BID
b. Cotrimoxazole 23) & 24) Identify the right dose of
c. Gentamicin Gentamicin corresponding to the
d. Benzylpenicillin weight of the young infant

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WT GENTAMICIN her (the mother’s) finger and
Dose: 5 mg/kg dipped in tap water.
c. Paint the infant’s mouth with
half-strength Gentian Violet.
d. Wash her hands again.
1 kg 0.5 ml To answer # 30) – 38), write a. for 2
days; b. 14 days; c. 5 days; and d. 30
2 kg 1.0 ml days; e. return immediately
3 kg 1.5 ml If the child has: Return for follow-
4 kg 23) _2 ml_ up in:
5 kg 24) _2.5 ml_ LOCAL BACTERIAL 30) _a_
25) & 26) Identify the right dose of INFECTION
Benzylpenicillin corresponding to the
weight of the young infant
WT BENZYLPENICILLIN LOW WEIGHT FOR 31) _b_
AGE
ANY FEEDING 32) _a_
PROBLEM

1 kg 25) _0.2 mL_

THRUSH 33) _a_
2 kg 26) _0.4 ml_ Drinking poorly 34) _e__
3 kg 0.6 ml Has developed a 35) _e_
4 kg 0.8 ml fever
5 kg 1.0 ml Has fast breathing 36) _e_
27) In teaching the mother of a young Has difficulty in 37) _e_
infant to treat skin pustules at home, breathing
which of the following actions reflect Has blood in the 38) _e_
an incorrect teaching of the stool
community health nurse?
a. Gently wash of the pus and B. THE SICK YOUNG CHILD AGED 2
crusts with 70% ethyl alcohol MONTHS TO 5 YEARS
b. Dry the infected area (all the child or sick young child
c. Paint the infected area with referred below are aged 2 months to 5
Gentian Violet. years)
d. Wash her hands again. 39) If the child is 2 – 12 months, fast
28) In teaching the mother of a young breathing is:
infant to treat umbilical infection, a. 40 or more breaths per minute
which of the following actions reflect b. 50 or more breaths per
an erroneous teaching of the minute
community health nurse? c. 60 or more breaths per minute
a. Clean the infected area with d. 80 or more breaths per minute
soap and water. 40) If the child is 12 months old, fast
b. Wash her hands. breathing is:
c. Paint the infected area with a. 30 or more breaths per minute
Gentian Violet. b. 40 or more breaths per
d. Wash her hands again. minute
29) In teaching the mother of a young c. 50 or more breaths per minute
infant to treat oral thrush, which of the d. 60 or more breaths per minute
following actions reflect an 41) After counting the child’s breaths
inappropriate teaching of the in one minute, the nurse confirms the
community health nurse? presence of fast breathing. Which of
a. Wash her hands. the following treatments is considered
b. Wipe the infant’s mouth with to be inappropriate?
a clean, soft cloth wrapped around a. Give Vitamin A

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 b. Give the child an appropriate
antibiotic for 5 days.
c. Soothe the throat and relieve the
cough with a safe remedy.
d. Advise the mother regarding
when to return immediately to the
health center.
42) The sick young child’s ear problem
is assessed to possess the following
signs: pus is seen draining from the
ear, and there has been discharge for
14 days or more. Which of the
following treatments represent an
incorrect nursing action?
a. Dry the ear by wicking
b. Do not give an antibiotic for 5
days
c. Do not give paracetamol for pain
d. Follow up in 7 days.
43), 44), 45) Complete the Child’s
Immunization Schedule
AGE VACCINE
Birth BCG
6 wks. DPT-1, OPV-1, 43) _Hepa-B
1_
44) DPT-2, OPV-2, 45) _Hepa-B 2
_10 _ d. Plan D
wks_
46) The community health nurse
knows that the first dose of Vitamin A
supplementation is scheduled at:
a. 4 months or above
b. 5 months or above
c. 6 months or above
d. 8 months or above
47) The community health nurse
knows that the subsequent doses of
Vitamin A supplementation is
scheduled to be given every:
a. 6 months
b. 4 months
c. 5 months
d. 9 months
48) A sick young child is seen in the
clinic with chest indrawing. What will
be the correct classification of his
condition?
a. No pneumonia
b. Cough or cold
c. Very Severe Disease
d. Pneumonia
49) A child has no signs of pneumonia
or a very severe disease, thus,
classified under “No pneumonia: cough
or cold.” For how long should the
coughing be present to entail that the
child be referred to a hospital for
assessment?
a. more than 20 days
b. more than 30 days
c. more than 40 days
d. more than 45 days
50) A child who has diarrhea also is
abnormally sleepy, has sunken eyes,
and is drinking poorly. If the child has
no other severe classification, the
community health nurse will give food
and fluid according to:
a. Plan A
b. Plan B
c. Plan C
d. Plan D
51) A child who has diarrhea also is
restless, irritable, and has sunken
eyes. If the child has no other severe
classification, the community health
nurse will give food and fluid according
to:
a. Plan A
b. Plan B
c. Plan C
52) A child who has diarrhea is
classified to have Severe Dehydration.
The community nurse is aware that
there is cholera in the child’s area.
What is the minimum age of the child
that will qualify him for an antibiotic
for cholera?
a. 2 years
b. 1 year
c. 1 ½ years
d. 3 years
53) A child who has diarrhea for 14
days or more has dehydration. Which
of the following treatments consists of
an appropriate nursing action?
a. Advise the mother regarding the
feeding of a child who has Persistent
Diarrhea
b. Do not give Vitamin A
c. Follow up in 5 days
d. Treat the dehydration before
referral to a hospital unless the
child has another severe
classification.
54) - 56)
AGE VACCINE
14 wks 54) _DPT-3_, 55) _OPV-3_,
Hep B-3
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56) _9 Measles
mos_
57) A child who has fever who has
malaria risk is seen with stiff neck.
What will be the appropriate
classification for this child?
a. Malaria
b. Very Severe Febrile Disease
c. Very Severe Febrile
Disease/Malaria
d. Fever: Malaria Unlikely
58) If a blood smear test was not done
in a child with fever who has malaria
risk. He has no runny nose, no
measles, and no other causes of fever.
What appropriate treatment will the
nurse give to the child?
a. Refer the child urgently to a
hospital.
b. Give the first dose of an
appropriate antibiotic.
c. Treat the child with an oral
antimalarial
d. Give one dose of paracetamol in
the health center for high fever
(37.5°C axillary temperature)
59) A child who has fever, no malaria
risk and no signs of a very severe
febrile disease would be referred to a
hospital for assessment only if:
a. Fever has been present
every day for more than 7 days.
b. Fever has been in on-and-off for
more than 7 days.
c. Fever has been present every
day for 7 days.
d. Fever has been present every
day for 10 days.
60) A child who has fever and no
malaria risk, is seen with a general
danger sign and stiff neck. Which of
the following treatments would be
appropriately carried out by the
community nurse?
a. Advise the mother regarding
when to return immediately to the
health center.
b. Follow up in two days if fever
persists.
c. Give 2 doses of paracetamol in
the health center for high fever (38.5
°C axillary temp.)
d. Treat the child to prevent the
lowering of his or her blood sugar
level.
61) A child who has fever and had
measles within the last 3 months, is
seen with clouding of the cornea. How
will the community nurse classify the
child’s case?
a. Measles
b. Measles with Eye or Mouth
Complications
c. Severe Complicated Measles
d. Very Severe Febrile Disease
62) If a child who has fever and
measles at the present has clouding of
the cornea or pus draining from the
eye, what eye ointment will the
community health nurse apply to the
child’s eye?
a. Tetracycline
b. Gentian Violet
c. Cotrimoxazole
d. Sulfadoxine
63) The community health nurse
examines a child who has fever and a
dengue risk. If none of the ASK, LOOK
and FEEL signs is present, you will
conduct a tourniquet test if fever has
been present for more than:
a. 3 days
b. 2 days
c. 1 day
d. 4 days
64) What positive signs of Severe
Dengue Hemorrhagic Fever will require
fluid replacement by giving ORS only?
a. Bleeding from nose or gums
b. Bleeding in the stool or vomitus
c. Black stool or vomitus
d. Abdominal pain and skin
petechiae
65) A child has been brought to the
health center with tender swelling
behind the ear. What action of the
nurse is appropriate?
a. Give the first dose of
paracetamol for pain.
b. Dry the ear by wicking.
c. Follow up in 5 days
d. Give an antibiotic for 5 days
66) Which treatment for an ear
problem should not be done to a child
with chronic ear infection?
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 a. Dry the ear by wicking c. Nalidixic Acid
b. Follow up in 5 days d. Tetracycline
c. Give an antibiotic for 5 days. 73) What is the second-line oral
d. Do not give paracetamol for pain antibiotic for Pneumonia, Acute Ear
67) Upon assessment of a child, the Infection, Very Severe Disease and
community health nurse found these Mastoiditis to be given at home?
signs in the child: pus is seen draining a. Cotrimoxazole
from the ear, and there has been b.Amoxycilin
discharge for less than 14 days; ear c. Nalidixic Acid
pain. What will be an appropriate d. Tetracycline
treatment for the child? 74) What is the second-line oral
a. Give the first dose of an antibiotic for Cholera to be given at
appropriate antibiotic. home?
b. Do not give paracetamol. a. Cotrimoxazole
c. Refer the child urgently to a b.Amoxycilin
hospital. c. Nalidixic Acid
d. Dry the ear by wicking. d. Tetracycline
68) What shall the community health 75) What is the second-line oral
nurse look and feel in a child to check antibiotic for Dysentery to be given at
for malnutrition and anemia? home?
a. Look for edema on both feet a. Cotrimoxazole
b. Feel for cold and clammy b.Amoxycilin
extremities c. Nalidixic Acid
c. Look for restlessness and d. Tetracycline
irritability 76) What is the first-line oral
d. Look for palmar erythema antimalarial to be given at home?
69) A child who has malnutrition is a. Chloroquine and Primaquine
seen with edema on both feet and b. Chloroquine and Pyrimethamine
severe palmar pallor. What will be the c. Sulfadoxine and Pyrimethamine
nurse’s appropriate action? d. Sulfadoxine and Primaquine
a. Give Vitamin A. 77) What is the second-line oral
b. If the weight for age is very low, antimalarial to be given at home?
give Vit A. a. Chloroquine and Primaquine
c. Give albendazole. b. Chloroquine and Pyrimethamine
d. Assess the child’s feeding and c. Sulfadoxine and
counsel the mother regarding the Pyrimethamine
child’s feeding. d. Sulfadoxine and Primaquine
70) What is the first-line oral antibiotic 78) – 91) Advise the mother to come
for Pneumonia, Acute Ear Infection, to the health center for follow-up at
Very Severe Disease and Mastoiditis to the earliest time indicated for the
be given at home? child’s problems. Answers: a. 2 days,
a. Cotrimoxazole b. 5 days, c. 30 days, d. return
b.Amoxycilin immediately
c. Nalidixic Acid Pneumonia 78)
d. Tetracycline _a__
71) What is the first-line oral antibiotic Dysentery 79) _ a
for Cholera to be given at home? __
a. Cotrimoxazole Malaria, if the fever persists 80) _ a
b.Amoxycilin __
c. Nalidixic Acid Fever: Malaria Unlikely, if the 81) _ a
d. Tetracycline fever persists __
72) What is the first-line oral antibiotic Fever: No Malaria, if the 82) _ a
for Shigella to be given at home? fever persists __
a. Cotrimoxazole Measles with Eye or Mouth 83) _ a
b.Amoxycilin Complications __

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Dengue Hemorrhagic Fever 84) _ a there is chest indrawing or a general
Unlikely, if the fever persists _ danger sign, what will be the
Persistent Diarrhea 85) appropriate action of the community
_b__ health nurse?
Acute Ear Infection 86) _ b a. Consume the 5-day dosage of
__ the antibiotic
Chronic Ear Infection 87) _ b b. Change to second-line antibiotic
__ and advise the mother to return in 2
Feeding Problems 88) _ b days
__ c. Give a dose of the second-
Many Other Illnesses, if the 89) _ b line antibiotic or intramuscular
child’s condition is not __ chloramphenicol
improving d. Change to the second-line
Anemia 90) _ b antibiotic recommended for shigella in
__ your area.
Very Low Weight for Age 91) 99) After 2 days, a child less than 12
_c__ months old, with dysentery was
Any sick child, who is not 92) evaluated with the following findings:
able to drink or breastfeed, _d__ number of loose stool evacuations, the
becomes sicker, and amount of blood in the stool, fever,
develops a fever abdominal pain, or eating are the
same. What will be the correct action
A child who has No 93) _ d
of the nurse?
Pneumonia: Cough or Cold, __
a. Treat the dehydration
who has fast breathing or
b. Change to the second-line
difficulty in breathing
antibiotic recommended for shigella in
A child who has Diarrhea: 94) _ d
your area. Give it for 5 days.
has blood in the stool, and is __
c. Refer the child to a hospital
drinking poorly
d. Continue giving the same
A child who has Fever: 95) _ d
antibiotic until the 5-day dosage has
Dengue Hemorrhagic Fever __
been consumed
Unlikely, who has any sign of
100) After 5 days, a child with
bleeding, persistent
persistent diarrhea is brought to the
abdominal pain, and
health center for follow-up care. The
persistent vomiting
diarrhea has not stopped. What will be
96) According to “Plan B: Treat Some
the correct action of the nurse?
Dehydration with ORS,” how long will
a. Change to the second-line
the community health nurse give the
antibiotic recommended for shigella in
recommended amount of ORS in the
your area. Give it for 5 days.
health center?
b. Conduct a full assessment of
a. over a period of 4 hours
the child. Give him or her any
b. over a period of 3 hours
treatment he or she needs. Then,
c. over a period of 6 hours
refer the child to a hospital.
d. over a period of 5 hours
c. Continue giving the same
97) In implementing “Plan B” in giving
antibiotic until the 5-day dosage has
extra fluid for diarrhea and continue
been consumed
feeding, the approximate amount of
d. Give second-line antibiotic or
ORS required (in mL) can also be
intramuscular chloramphenicol
calculated by multiplying the child’s
weight by:
a. 50
b. 75
c. 80
d. 90
98) After 2 days, follow-up care is
given to a child with pneumonia. If

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