Care of Infant and Children 8.

According to WHO guideline in episiotomy

Core Competency procedure, the OB-GYNE or the TRAINED midwife
Post test will inappropriately do episiotomy in which of the
following reason/s?
1. The following are lists of diseases considered to a. Breech presentation and shoulder dystocia
contribute to increasing mortality and morbidity b. Fetal distress syndrome
during neonatal period, except: c. Poorly healed 3rd and 4th degree laceration
a. Diarrhea d. To shorten 2nd stage of labor for baby’s
b. Sepsis expulsion
c. Congenital anomalies 9. Very low weight babies are:
d. HIV-AIDS a. Less than 1000g
2. This is the campaign of the Philippines DOH, in b. Less than 1500g
cooperation with WHO, to adopt and embrace the c. 1500g to less than 2500g
safe and quality care of Essential intrapartum and d. Not more than 2.5kg but not less than 1.5kg
newborn care (EINC) for birthing mothers and 10. Which is an activity not observed within the first
their newborn. 30 seconds following delivery of the baby?
a. Under-5 Clinic Campaign a. Immediately drying of the baby
b. UNANG HALIK b. Call out time of birth
c. The First Embrace c. Cover the baby’s head with a bonnet
d. ESSENTIAL NEWBORN CARE (ENC) d. Cover the baby’s hands and feet
3. The following are the 4-core steps that saves life, 11. Routine suctioning among newborn is now
which is/are not included: contraindicated to children, unless:
1. Initiation of bathing on the first 6 hours of life a. The midwife chooses to perform even without
2. Early initiation of breastfeeding reason
3. Skin-to-skin contact with the mother b. The mouth and nose are not totally blocked of
4. Delayed cord clamping mucus
5. Immediate and thorough drying c. Baby is meconium stained and crying is shrill
6. Properly timed cord clamping even before pulsation d. The baby’s PR-120 and RR-45
stops 12. Immediate drying of the baby using clean and dry
a. 1 b. 4 c. 1 and 6 d. 1 and 4 cloth is done within:
4. The following are the 4-core steps that saves life, a. The first 3 seconds
arrange them in order: b. The first 5 seconds
1. Non separation for early initiation of c. The first 10 seconds
breastfeeding d. The first 30 seconds
2. Skin-to-skin contact with the mother 13. If the midwife observes that the newborn is only
3. Properly timed cord clamping GASPING or is not breathing, which intervention is
4. Immediate and thorough drying inappropariate?
a. 2,4,3,1 a. Call for help
b. 2,4,1,3 b. Clamp and cut the cord with sterile scissors
c. 4,3,2,1 and gloves
d. 4,2,3,1 c. Start ventilation using ambu bag
5. Which among the following is not included in d. Transfer the baby to warm and soft surface
filling out the WHO PARTOGRAPH monitoring? 14. Which of the following is inappropriate
1. Hours in active labor 5. fetal BP intervention in doing the skin-to-skin contact of
2. Vaginal bleeding 6. cervical dilatation the baby to the mother?
3. Severe headache 7. urine voided a. The baby should be positioned supine on the
4. Fetal heart rate 8. maternal temperature mother’s abdomen
a. 2 and 3 only b. While the baby is on her mother’s abdomen
b. 3 and 5 only turn head on one side
c. 2, 3, and 5 only c. Turn the baby’s head on either sides
d. 2, 3, 5 and 6 d. Position the baby on her abdomen at prone.
6. If the mother is at the active phase of the first 15. Baby’s identification band is placed on his/her:
stage of labor, her vital signs should be monitored a. Wrist
according to WHO guideline as every: b. Neck
a. 30 minutes c. Thigh
b. 1 hour d. Ankle
c. 2 hours 16. Which among the following activities should not
d. 4 hours be done during the 30 seconds to 3 minutes
7. The correct temperature of the delivery room following after delivery?
should be maintained at a minimum of: a. Identification band is placed on the newborn
a. 23 degree Celsius b. Explaining to the mother the need for oxytocin
b. 25 degree Celsius c. Do not wipe off vernix caseosa
c. 28 degree Celsius d. Tub bath the baby on a prepared water with
d. 25-28 degree Celsius appropriate temperature
17. In doing appropriate timed cord clamping and
cutting, the midwife is doing an inappropriate
action if she:
a. Clamp and cut the cord after pulsation stops
b. Apply a sterile plastic cord clamp at 2 cm from
the umbilical base
c. Apply second clamp 5 cm away from the
sterile plastic clamp
d. Apply second clamp 3 cm away from the
sterile plastic clamp
18. When the baby is ready for breastfeeding, the
midwife should advise the mother to, except:
a. Make sure that the baby’s head is not flexed
b. Hold the baby’s body close to her body
c. Move the baby onto her breast, aiming upper
lip well below the nipple
d. Wait until her baby’s mouth is opened wide
19. Upon initiation of breastfeeding, the midwife must
observe for signs of good attachment, except:
a. Lower lip turned outwards
b. Fast and deep suckling
c. Baby’s chin touching breast
d. Mouth wide open
20. In breastfeeding, the midwife should realize this
following correct understanding. Which one is
that?
a. The midwife manipulates the baby’s head in
order to follow the correct latch-on technique
b. Breastfeeding is expected to all newly born
baby
c. Breastfeeding on the first days of life is
inadequate for the baby
d. Baby will make several attempts because
breastfeeding is a learned behaviour
21. What is the normal temperature of a newborn?
a. 36.5 -37.0 degree Celsius
b. 36.0-37.0 degree Celsius
c. 36.2-37.2 degree Celsius
d. 36.5-37.5 degree Celsius
22. When the midwife assess for signs of breathing
difficulty, which group of sign and symptoms is
correct about this codition?
a. grunting, nasal flaring and eupnea
b. Orthopnea, wheezing and eupnea
c. Nasal flaring, and apneic episodes
d. Grunting and chest indrawing
23. Routine vitamin K administration is done during:
a. First 30 seconds
b. 30 seconds to 3 minutes
c. Within the first 90 minutes
d. 90 minutes to 6 hours
24. Routine injection of immunization is done during:
a. First 30 seconds
b. 30 seconds to 3 minutes
c. Within the first 90 minutes
d. 90 minutes to 6 hours
25. What are the two vaccines that the newborn will
receive on the same day of their birth?
a. HEPA B and OPV
b. IPV and OPV
c. HEPA B and BCG
d. BCG and OPV
26. Crede’s prophylaxis in current Philippines setting is
with the use of?
a. Tetracycline eye ointment
b. Terramycin eye ointment
c. Silver nitrate
d. 0.5% betadine solution
27. The midwife should know when to refer the
neonate to a pediatrician. All but one are
considered danger signs among newborn?
a. Severe chest in-drawing
b. Yellow palms and soles at any age
c. Spontaneous movement
d. Low body temperature (less than 35degC)
28. According to WHO, schedule postnatal check-ups
are the following but inappropriate when it is
conducted?
a. Within 24 hours
b. After 2-3 days
c. After 7-14 days
d. After 8 weeks
29. Upon assessment of the newborn, the midwife
noted that the baby’s head is abnormally small. A
condition where the baby’s head has no skull is
termed as:
a. Microencephaly
b. Macrosomia
c. Anencephaly
d. Hydrocephalus
30. When assessing a newborn the midwife will not
interpret this finding as normal. Which one is
being referred by this statement?
a. It is normal to observe white patches on the
newborn’s gum
b. Document it as normal when the head
circumference is 1-2cm higher than the chest
circumference
c. Abdominal and chest circumference are
measurable the same
d. The head circumference of the newborn is
lesser than the chest circumference
31. Kangaroo Mother Care (KMC) is started when the
baby is free of life-threatening conditions. Which
among the following is a correct technique in
doing KMC?
a. Place the baby in upright position between the
mother’s legs
b. Position the baby’s hips in a “frog leg”
position with arms also flexed
c. It’s okay to constrict or tighten the abdomen
of the baby to maintain temperature
d. Eye to eye contact with the mother is not
related to this procedure
32. When feeding a child who is toddler, the midwife
should bear in mind that?
a. toddler could stay on a the same diet for long
period of time
b. Can feed themselves without assistance
c. Develops “food fads” wherein they cannot
stay long for the same diet
d. Toddlers love vegetables than fruits
33. Why it is that breastmilk are more digestible than
formula milk?
a. It contains more complex carbohydrates
b. It contains lesser protein than formula milk
c. It contains more iron
d. It has lower level of carbohydrates
34. Exclusive breastfeeding is one that is:
1. Child is not drinking water
2. Breastmilk with a very little amount of water
3. Breastmilk with a very liitle amount of vitamins
and minerals supplementation
4. The mother is within 6 months postpartum
5. Breast milk only
a. 1,3,5 only c. 1,3,4,5
b. 1,2,5 only d. 1,2,4,5
35. You will advise the breastfeeding mother to
breastfeed the neonate on demand. Which among
the following is true about feeding on demand?
a. It is done 10-18 times per day
b. Averagely, feeding should occur 12 times in a
day
c. It doesn’t matter how often the child
breastfeeds
d. Feeding the child with infant formula is not
possible under feeding-on demand criteria
36. When the midwife is assessing the newborn for
dehydration if the skin turgor returns slower and
the fontanel is very depressed the degree of
dehydration is?
a. Some
b. Moderate
c. Severe
d. Absent
37. If the child is lethargic because of dehydration the
best management is:
a. Intravenous Fluid
b. Oresol
c. Extra fluids
d. Am soup
38. If you are asked by your supervisor to manage a
severely dehydrated infant, you anticipate that the
doctor will obtain order of:
a. IM antibiotic
b. IVF of normal saline solution
c. D5W in normal saline solution
d. Hypertonic solution
39. A child who has persistent diarrhea is at risk of
what electrolyte imbalance?
a. Hyponatremia
b. Hypoglycemia
c. Hypercalcemia
d. Hypokalemia
40. Which among the following signs are consistently
observed to a child who is suffering from severe
diarrhea ?
a. hypothermia, hypotension, bradycardia
b. Hypothermia, hypotension, tachypnea,
bradycardia
c. Hyperthermia, hypotension, tachycardia
d. Hypothermia, tachycardia, hypotension,
tachypnea
41. Which among the following is correct about caput
succedaneum?
a. Notify the OB-GYNE for this is an abnormal
phenomenon.
b. No need to worry because it is a normal
occurrence to newborn when the second
stage of labor is shortened.
c. This is normal and usually resolves few days
to weeks after birth.
d. There is collection of blood in the periosteum
42. Collection of blood clots between the scalp layers
that occurs when there is injury to the fetal head is
termed as:
a. Caput succedaneum
b. Caput ka sa akein
c. Cephalhematoma
d. Cephalhematochesia
43. When overriding of the newborn’s suture line has
resulted from prolonged second stage of labor and
crowning, normally it is termed as:
a. Cephaltamapaako
b. Cephalhematoma
c. Caput succedaneum
d. Molding of the suture line
44. When cephalhematoma is assessed to a
newborn’s head, the registered midwife should:
a. Refer the condition to the OB-GYNE for further
assessment
b. Not be a cause of worrisome because these
are all normal and resolves few weeks after
birth
c. Remove the blood clots using sterile forceps
d. Notify the pediatrician at once
45. For a newborn and mother achieve bonding during
the first hours of delivery, which among the
following midwife activity is inappropriate?
a. Provide health teaching on the benefits of
breastfeeding.
b. Initiate breastfeeding as early as possible after
birth.
c. Teach mother on the proper latch-on
technique.
d. Breastfeeding is initiated by the midwife 6
hours after delivery.
46. Which among the following anthropometric
measurement is considered abnormal in assessing
the newborn?
a. The head circumference is 2-4 cm greater than
the chest circumference
b. The head circumference is always larger than
the crown-to-rump measurement
c. The chest circumference is larger than the
head circumference
d. The abdominal circumference is sometime
equal or less than 1 cm to the chest
circumference
47. The psychosocial task that an infant needs to
beachieved according to Erik Erikson is________.
a. Autonomy c. Independence
b. Trust d. Love
48. For toddlers to develop sense of independence,
which among the following whould be done by the
midwife?
a. Prevent the child of feeding himself when he
further insists on it.
b. Encourage the child to participate to other
children during play sessions.
c. Allow the child to choose between
alternatives.
d. Reprimand the child’s when they throw
tantrums.
49. If the child is distractive and physically harms
other children on a playground, what should a
midwife do to intervene on this situation?
a. Let the child hurt other children, anyway they
are too young to be reprimanded.
b. Encourage the parent to impose punishment
to the child.
c. Set realistic limits and be consistent when
stating boundaries.
d. State boundaries and put the child inside a
locked room.
50. Which among the following fears is present among
preschoolers?
a. Fear of stranger
b. Fear of separation
c. Fear of permanent death
d. Fear of mutilation
51. Separation anxiety is present among toddlers.
Which among the following is true about
separation anxiety?
a. It is usually present when the child is at
school-age
b. Toddlers experience it the most and
responded by trying to neglect their parents.
c. Preschoolers are most likely to experience
because initiative is starting to develop.
d. It is related to infant’s anxiety reaction when
an unusual person is present.
52. Which among the following is the correct follow
up guideline of most classifications at yellow row
of the IMCI management chart?
a. 2 days
b. 3 days
c. 2-3 days
d. 3-5 days
53. If the child is not able to drink or breastfeed, the
midwife should consider which among the
following most appropriate intervention?
a. refer the child urgently to the hospital
b. monitor further for main symptoms
c. monitor for the presence of cough
d. monitor for the presence diarrhea
54. Which among the following is/are the most
common cause/s of death to children below 5
years old?
a. very severe disease
b. sepsis
c. pneumonia
d. all of these are possible answer
Situations: The following questions are appropriate for
a child assess for the presence of dehydration:
55. If the diarrhea is present for at least 14 days, this
is classifies as:
a. severe diarrhea
b. severe dehydration
c. persistent diarrhea
d. chronic diarrhea
56. Which among the following statements below is a
correct understanding when PLAN C management
is used to treat severe dehydration?
a. Oresol is not given because IVF is already
enough to reverse the child’s condition.
b. The child’s fluid status is depending on her
weight and height.
c. IVF replacement is indicated as soon as possible
so as not to jeopardize the child’s condition
d. Lactated Ringer’s solution if not available should
be replaced with D5W.
57. For how many hours you are allowed to
administer the ORESOL of a child with SOME
dehydration?
A. 2-4 HOURS
B. 4-6 HOURS
C. WITHIN 4 HOURS
D. WITHIN 2-3 HOURS ONLY
58. You are about to assess a child with one sign and
symptom in the pink row or one sign and symptom
in the yellow row. In which degree of dehydration
will you classify this child?
a. some dehydration
b. moderate dehydration
c. no dehydration
d. severe dehydration
59. You assess a 2 year-old child who has diarrhea for
3 days already. Signs and symptoms revealed are
sunken eyes, skin pinch goes back very slowly but
still the child is able to respond with restlessness
and irritability. The child will be classified as:
a. major dehydration
b. severe persistent diarrhea
c. some dehydration
d. severe dehydration
60. A child is assessed for bloody and mucopurulent
stool and another mother with a child with
diarrhea is complaining of a stool that looks like
white and watery. Based on these clinical findings,
the latter child on this situation is manifesting
pathognomonic sign of:
a. shigellosis compactum
b. bacillary dysentery
c. cholera (El tor)
d. Typhoid fever
61. A child with acute diarrhea should be assessed for
____________.
a. presence of any sign and symptom
ofdehydration
b. should never be assessed because acute
diarrhea is not a part of IMCI
c. any classification as to what degree the
dehydration of the child is.
d. presence of rashes all over the extremities and
high-grade fever.
62. The child was also assess not having diarrhea. As a
nurse/midwife what will be the next action to be
done?
a. Check if the child has fever
b. Check if the child has ear problem
c. Go to the next question, check for
malnutrition
d. Check if the child has ear discharge
63. What is the 1st question to be asked to the
mother if the child arrived to your clinic?
a. Ask how old is the child
b. Ask what is going on
c. Ask the mother what will be the best thing to
do
d. Ask for the child’s problem
64. A mother brought her daughter, 4 years old to the
RHU because of cough and colds. Following the
IMCI assessment guide, which of the following is a
danger sign that indicates the need for urgent
referral to the hospital?
a. High grade fever
b. Signs of severe dehydration
c. Inability to drink
d. Cough for more than 30 days
65. If a child Maria had diarrhea for 14 days and
dehydration was noted to be present, how is the
child classified?
a. dehydration
b. persistent diarrhea
c. severe persistent diarrhea
d. persistent diarrhea with dehydration
66. If a child Maria had diarrhea for 14 days, the child
should be classified in?
a. Severe dehydration
b. Acute diarrhea
c. Chronic diarrhea
d. Persistent diarrhea with dehydration
67. What will be the treatment for Maria’s
classification?
a. Refer to the nearest hospital
b. Treat the dehydration 1st before referring
c. Ask the health worker to assist you
d. Refer and then treat the dehydration
68. How will you classify a 5 month old child with
blood in the stool?
a. Red b. Pink c. Yellow d. Green
69. A 5 week old child with blood in the stool is
classified to have dysentery. What is the appropriate
treatment now to this child?
a. refer to the hospital
b. give Vitamin A
c. treatment of antibiotic
d. give the Plan C
70. If a child with diarrhea registers one sign in the
pink row and one in the yellow row, in the IMCI chart;
we can classify the child as:
a. Severe dehydration c. Moderate
dehydration
b. Some dehydration d. No dehydration
71. If a child with diarrhea registers one sign in the
pink row or one in the yellow row, in the IMCI chart;
we can classify the child as:
a. Severe dehydration c. Moderate
dehydration
b. Some dehydration d. No dehydration
72. A 5mos old child with sunken eyes was brought to
the clinic, what is the classification of the child?
a. Severe dehydration c. Moderate dehydration
b. Some dehydration d. No dehydration
73. Aling Juana came in at the barangay health station
together with her baby because of diarrhea for almost
5 days. Further assessment and data shows: Child is
turning 11 months tomorrow, no blood is seen in the
stool, the client is abnormally sleepy, not restless,
irritable, nor sunken eyes was not noted. The
nurse/midwife offers fluid to the child, and the client
drinks eagerly. When you pinch the skin, it goes back
immediately. This is classified as:
a. Severe dehydration c. Moderate
dehydration
b. Some dehydration d. No dehydration
74. Baby Andrea 9 months of age and weighs 10
kilograms was ushered by his mother. Aling Cindy at
the barangay health center, Andrea has sunken eyes,
she is restless and irritable and skin when pinch it goes
back longer than 2 seconds. The condition’ is under
what classification in IMCI:
a. Severe dehydration c. Moderate
dehydration
b. Some dehydration d. No dehydration
Situation 16: Integrated Management for childhood
illnesses (IMCI) chart management will be utilized by
the nurse when assessing a child 5 years old and
below. The following IMCI guidelines are applied to
these set of questions.
75. Which among the following signs is NOT
considered a danger sign in IMCI?
a. Convulsion
b. Inability to drink/bottle feed
c. Severe headache
d. Severe vomiting
Situation 17: If the child presents with Diarrhea as the
MAIN SYMPTOM, the nurse assess the child for the
degree of dehydration.
76. If the child has ONE sign on the PINK ROW and
ONE sign on the YELLOW ROW the child is classified on
what row?
a. YELLOW ROW
b. PINK ROW
c. GREEN
d. BLACK
77. Neo, is a 2 year old child who is being assessed by
Nurse Jocelyn as lethargic and with sunken eyes.
Nurse Jocelyn knows that Neo will be classified with
what degree of dehydration based on IMCI Guidelines
a. YELLOW
b. PINK
c. SOME
d. SEVERE
78. What is the BEST treatment for NEO that if given
will NOT ALWAYS require Neo for referral?
a. PLAN B
b. PLAN C
c. IVF of D5W
d. Plan A
79. Another child, Allan 5-year old is assessed for the
presence of ACUTE diarrhea. Presenting signs are not
observed by Nurse Shigella except for SUNKEN EYES.
What is the degree of dehydration of Allan?
a. SEVERE b. SOME c. MODERATE d. NO
Situation 18: IMCI management is a process by which
step-by-step approach is utilized.
80. Arrange the following in correct sequence.
1.Assess for malnutrition and anemia
2. Check for cough, diarrhea, fever and ear problem
3. Check for general danger signs
4. Asks the mother what is the problem of her child
5. Check the child’s immunization card
81. Counsel the mother about the child’s nutrition
a. 4, 3, 2, 6, 1, 5 c. 4, 3, 2, 1, 6, 5
b. 3, 4, 2, 1, 5, 6 d. 3, 4, 2, 1, 6, 5
82. What is the color classification in the IMCI chart 90. After checking the nutritional status of the child,
when a child needs appropriate treatment AT THE what should the nurse do next?
CLINIC LEVEL and referral is no longer indicated? A. Check for main symptoms
a. YELLOW GREEN c. PINK B. Check for immunization status
b. YELLOW d. GREEN C. Check for other problems
84. When a danger sign is noted and another severe D. Check for danger signs
classification is assessed, the nurse should MOST 91. Which of the following is a general danger sign?
APPROPRIATELY: A. Wheezing
a. Give treatment prior to sending the child back B. Skin pinch goes back very slowly
home. C. Sunken eyes
b. Provide specific treatment in the clinic and D. None of the above
observed the child if needs to be referred 92. In the IMCI classification tables, the green card
c. Should not give pre-referral treatment. indicates that a:
d. Refer the child to the nearest hospital at once. A. Child needs appropriate antibiotic or other
85. A mother brought her 10 month old infant for treatment
consultation because of fever, which started 5 days B. Child does not need specific medical treatment but
prior to consultation. To determine malaria risk, what needs to be observed
will you do? C. Referral or admission is needed
a. Do a tourniquet test D. Chief complaint needs an urgent attention
b. Ask where the family resides 93. Which of the following structures represents the
c. Get a specimen for blood smear intra - abdominal remnants of the umbilical vein?
d. Ask if the fever is present everyday a. Umbilical ligaments c. Ligamentum
86. The following are considered correct principles of venosus
IMCI, with the exception of? b. Ligamentum teres d.
a. IMCI is an approach under the Ligamentum portal
reproductive health bill. 94. Which of the following vitamins is important to be
b. IMCI utilizes step by step approach but given prophylactic ally for the fetus soon after
can be changed if the midwife wants birth (especially in the breastfeeding newborn)?
to. A. Vitamin K b. Vitamin A c. Vitamin C d.
c. The midwife is the only health care Vitamin D
personnel that can utilized IMCI chart 95. In the fetus or neonate, what are the two sutures
d. The midwife’s functions is broaden between the posterior margin of the parietal bones
with this chart management and the upper margin of the occipital bone called?
87. Severe signs and symptoms of diseases are A. Occipitalis b. Sagittal c. Lambdoid d.
classified in the PINK row. Which treatment should Coronal
never be included in this classification? 96. What APGAR score would you assign to a male
a. Pre-referral treatment. infant at 5 minutes of life whose respiratory effort is
b. IM antibiotic given first at the RHU. irregular, pulse is 90, who is floppy and blue and with
c. Oral Antibiotic for 5 days TID only minimal grimaces?
d. Refer the child in the hospital at once A. 1 b. 3 c. 5 d. 7
88. IMCI was initiated jointly in 1992 by the DOH, 96. Which of the following is NOT part of the APGAR
WHO and UNICEF in order to address the health score?
situation in the Philippines affecting younger children a. Heart rate
aged less than 5 years. Which among the following is b. Color
the main goal of IMCI? c. Respiratory effort
A. To significantly reduce mortality and morbidity d. Amniotic fluid consistency
associated with the major causes of disease in children 97. Vitamin K is given to neonate to prevent:
B. To contribute to healthy growth and development a. infection b. Jaundice c. anemia d.
of children bleeding
C. To provide preventive interventions and adjust 98. The midwife dries the infant after birth in order to:
curative interventions to the capacity and functions of a. stimulate the circulatory system
the health system b. avoid excess heat loss
D. To involve the family members and the community c. removes organisms acquired during pregnancy
in the health care process d. removes the skin’s white substance
89. Arrange the following steps according to proper 98. Shortly after the baby is given vitamin K primary to
IMCI protocol: help:
I. Treatment a. stimulate bilirubin c. increase sodium
II. Focused Asssessment absorption
III. Counsel and Follow-up b. start peristalsis movement d. improve blood
IV. Classification coagulation
A. I, II, III, IV 99. Which of the following is NOT considered as basic
B. III, I, IV, II life support?
C. IV, II, I, III a. airway intervention c. therapeutic intervention
D. II, IV, I, III b. ventilation d. circulation
100. Upon delivery of the baby what should be the
ideal temperature of the Delivery Room:
21-23 C b. 23- 25 C c. 25-28 C d. 18 -20 C