Two infants died within a few hours of MR vaccination. Both doses came from a vial reconstituted at the previous day's session. The most likely cause is:

Toxic shock from a contaminated vial

Vaccine failure from heat exposure

Coincidental sudden infant death

Under the Integrated Disease Surveillance Programme, the 'S' form used by health workers reports:

Syndromes such as fever or diarrhoea

Presumptive diagnoses by doctors

National health programmes, epidemiology and immunisation

35 Kerala PSC Staff Nurse Gr II practice questions on National health programmes, epidemiology and immunisation, part of Community Health Nursing and Nutrition. The first 25 are below; the first 5 with answers and explanations (tap Show answer after you have chosen), the rest in Learn with a free account.

Question 1 · Hard
Two infants died within a few hours of MR vaccination. Both doses came from a vial reconstituted at the previous day's session. The most likely cause is:
1. AToxic shock from a contaminated vial
2. BAnaphylaxis to the vaccine
3. CVaccine failure from heat exposure
4. DCoincidental sudden infant death
Show answerHide answer
Answer: A · Toxic shock from a contaminated vial
Reconstituted MR vaccine has no preservative and must be discarded 4 hours after mixing or at the end of the session. A vial kept overnight can grow Staphylococcus aureus, which causes toxic shock syndrome with vomiting, fever and death within hours. Clustering of deaths from one vial points to this programme error. It is prevented by strict adherence to the 4-hour rule and by using the supplied diluent.
- B: Anaphylaxis occurs within minutes and is very rare, and would not explain the shared old vial.
- C: Heat exposure lowers potency but does not kill within hours.
- D: Two deaths from one vial make coincidence unlikely.
Question 2 · Easy
A study that starts with people who have a disease and looks back for past exposure is a:
1. ACohort study
2. BCross-sectional study
3. CCase-control study
4. DRandomised controlled trial
Show answerHide answer
Answer: C · Case-control study
A case-control study compares people with the disease (cases) with people without it (controls) and looks backward at their exposures. It is quick and cheap and suits rare diseases. It gives an odds ratio as its measure of association. It cannot measure incidence directly.
- A: A cohort study starts with exposure and follows people forward to disease.
- B: A cross-sectional study measures exposure and disease at one point in time.
- D: A randomised trial assigns an intervention and follows outcomes.
Question 3 · Easy
The interval between the entry of an infectious agent and the appearance of the first symptom is the:
1. AIncubation period
2. BCommunicable period
3. CSerial interval
4. DGeneration time
Show answerHide answer
Answer: A · Incubation period
The incubation period runs from infection to the first sign or symptom. It is used to set quarantine periods and to trace the source of an outbreak. Generation time ends at maximum infectivity instead. The serial interval is the gap between onset of primary and secondary cases.
- B: The communicable period is when the person can spread the infection.
- C: The serial interval is between onsets in successive cases.
- D: Generation time runs to the point of maximum infectivity, not first symptom.
Question 4 · Easy
The birth dose of hepatitis B vaccine should preferably be given within:
1. A24 hours of birth
2. B6 weeks of birth
3. C7 days of birth
4. D1 month of birth
Show answerHide answer
Answer: A · 24 hours of birth
The hepatitis B birth dose is given as early as possible, within 24 hours of birth, to prevent mother-to-child transmission. Its protective value falls sharply after the first day. In institutional deliveries it is given along with BCG and OPV-0. Later doses come through the pentavalent vaccine.
- B: Six weeks is when the pentavalent series starts.
- C: Seven days is too late for best protection against perinatal transmission.
- D: One month is far too late for the birth dose.
Question 5 · Medium
Under the Integrated Disease Surveillance Programme, the 'S' form used by health workers reports:
1. ALaboratory-confirmed diagnoses
2. BSyndromes such as fever or diarrhoea
3. CPresumptive diagnoses by doctors
4. DDeaths from all causes
Show answerHide answer
Answer: B · Syndromes such as fever or diarrhoea
IDSP uses three reporting formats. The S form is filled by health workers and reports syndromes, such as fever, acute diarrhoea or jaundice. The P form is filled by doctors with presumptive diagnoses, and the L form by laboratories with confirmed results. Syndromic reporting allows early warning of outbreaks.
- A: Laboratory-confirmed cases go on the L form.
- C: Doctors' presumptive diagnoses go on the P form.
- D: Deaths are not the content of the S form.
Question 6 · Easy
In the national schedule, BCG vaccine is injected at which site?
1. ALeft upper arm
2. BLeft anterolateral thigh
3. CRight upper arm
4. DRight anterolateral thigh
Answer and explanation in LearnFree account
Question 7 · Medium
All of the following vaccines are damaged by freezing EXCEPT:
1. AOral polio vaccine
2. BTd vaccine
3. CHepatitis B vaccine
4. DPentavalent vaccine
Answer and explanation in LearnFree account
Question 8 · Hard
A pentavalent vial was found beside ice packs. In the shake test it settles as fast as a deliberately frozen control vial. What should the nurse do?
1. AUse it for the next session only
2. BUse it, since the VVM is fine
3. CWarm the vial, then use it
4. DDiscard it as freeze-damaged
Answer and explanation in LearnFree account
Question 9 · Medium
After reconstitution, BCG, measles-rubella and JE vaccines must be used within:
1. A24 hours in the ILR
2. B4 weeks under open vial policy
3. C4 hours or end of session
4. D1 hour of mixing
Answer and explanation in LearnFree account
Question 10 · Hard
An adult in Kerala (outside the North-East) has uncomplicated P. falciparum malaria. Under the national guidelines, the correct treatment is:
1. AArtemether-lumefantrine for 3 days
2. BArtesunate 3 days plus SP, with primaquine 0.75 mg/kg
3. CChloroquine 3 days plus primaquine for 14 days
4. DQuinine alone for 7 days
Answer and explanation in LearnFree account
Question 11 · Medium
After a dog bite, the biting dog should be kept under observation for:
1. A3 days
2. B21 days
3. C10 days
4. D6 weeks
Answer and explanation in LearnFree account
Question 12 · Medium
In suspected dengue with fever of two days, which test is most useful to confirm the diagnosis?
1. ANS1 antigen ELISA
2. BTourniquet test
3. CIgG antibody ELISA
4. DWidal test
Answer and explanation in LearnFree account
Question 13 · Medium
After floods in Kerala, people wading in floodwater are advised chemoprophylaxis against leptospirosis with:
1. AAzithromycin 500 mg daily
2. BChloroquine 300 mg once a week
3. CCiprofloxacin 500 mg twice daily
4. DDoxycycline 200 mg once a week
Answer and explanation in LearnFree account
Question 14 · Hard
A village has 4,000 people. On 1 January 80 had known diabetes; 40 new cases were found during the year and no case died or left. What is the point prevalence on 31 December?
1. A3 per 1,000
2. B20 per 1,000
3. C30 per 1,000
4. D10 per 1,000
Answer and explanation in LearnFree account
Question 15 · Easy
Which vaccine in the national schedule is given as a fractional 0.1 mL intradermal dose?
1. ARotavirus vaccine
2. BInactivated polio vaccine
3. CHepatitis B vaccine
4. DPneumococcal conjugate vaccine
Answer and explanation in LearnFree account
Question 16 · Easy
Notification of every diagnosed tuberculosis case, including by private practitioners, was made mandatory in India in:
1. A2006
2. B1997
3. C2012
4. D2020
Answer and explanation in LearnFree account
Question 17 · Medium
Blood smears for microfilariae of Wuchereria bancrofti in India are collected late at night because the parasite:
1. AShows nocturnal periodicity
2. BLives in lymph by night
3. CDies in daytime blood
4. DIs only seen after DEC
Answer and explanation in LearnFree account
Question 18 · Medium
A woman in her first pregnancy with no previous Td vaccination should receive:
1. ATwo doses of Td four weeks apart
2. BOne dose of Td at term
3. CThree doses at monthly intervals
4. DOne booster dose only
Answer and explanation in LearnFree account
Question 19 · Easy
The National Mental Health Programme of India was launched in:
1. A1982
2. B1996
3. C1987
4. D2017
Answer and explanation in LearnFree account
Question 20 · Easy
Kyasanur Forest Disease, seen in the Western Ghats, is transmitted by:
1. ARat fleas
2. BCulex mosquitoes
3. CSandflies
4. DHard ticks
Answer and explanation in LearnFree account
Question 21 · Easy
Which vaccine in the national immunisation schedule is the most sensitive to heat?
1. APentavalent vaccine
2. BHepatitis B vaccine
3. CTetanus-diphtheria vaccine
4. DOral polio vaccine
Answer and explanation in LearnFree account
Question 22 · Medium
The larvivorous fish widely used for biological control of mosquito larvae in wells and tanks is:
1. AGambusia
2. BRohu
3. CCatla
4. DTilapia
Answer and explanation in LearnFree account
Question 23 · Medium
Unvaccinated children in a village with high measles vaccine coverage are also protected. This is due to:
1. AHerd immunity
2. BPassive immunity
3. CInnate immunity
4. DCross immunity
Answer and explanation in LearnFree account
Question 24 · Hard
A PHC receives reports of many diarrhoea cases from one ward in two days. What is the first step in investigating this outbreak?
1. AVerify the diagnosis and confirm an outbreak
2. BClose the schools in the ward
3. CChlorinate all wells in the ward
4. DStart antibiotics for every household
Answer and explanation in LearnFree account
Question 25 · Medium
Relative risk, the ratio of incidence among exposed and unexposed people, is directly obtained from a:
1. ACase series
2. BCohort study
3. CCase-control study
4. DCross-sectional survey
Answer and explanation in LearnFree account

10 more National health programmes, epidemiology and immunisation questions

Answer them one by one, keep your score and see your weak topics in Learn. Signed-out visitors try 25 per exam; sign in with Google to see them all.

Study Community Health Nursing and Nutrition

National health programmes, epidemiology and immunisation

Two infants died within a few hours of MR vaccination. Both doses came from a vial reconstituted at the previous day's session. The most likely cause is:

A study that starts with people who have a disease and looks back for past exposure is a:

The interval between the entry of an infectious agent and the appearance of the first symptom is the:

The birth dose of hepatitis B vaccine should preferably be given within:

Under the Integrated Disease Surveillance Programme, the 'S' form used by health workers reports:

In the national schedule, BCG vaccine is injected at which site?

All of the following vaccines are damaged by freezing EXCEPT:

A pentavalent vial was found beside ice packs. In the shake test it settles as fast as a deliberately frozen control vial. What should the nurse do?

After reconstitution, BCG, measles-rubella and JE vaccines must be used within:

An adult in Kerala (outside the North-East) has uncomplicated P. falciparum malaria. Under the national guidelines, the correct treatment is:

After a dog bite, the biting dog should be kept under observation for:

In suspected dengue with fever of two days, which test is most useful to confirm the diagnosis?

After floods in Kerala, people wading in floodwater are advised chemoprophylaxis against leptospirosis with:

A village has 4,000 people. On 1 January 80 had known diabetes; 40 new cases were found during the year and no case died or left. What is the point prevalence on 31 December?

Which vaccine in the national schedule is given as a fractional 0.1 mL intradermal dose?

Notification of every diagnosed tuberculosis case, including by private practitioners, was made mandatory in India in:

Blood smears for microfilariae of Wuchereria bancrofti in India are collected late at night because the parasite:

A woman in her first pregnancy with no previous Td vaccination should receive:

The National Mental Health Programme of India was launched in:

Kyasanur Forest Disease, seen in the Western Ghats, is transmitted by:

Which vaccine in the national immunisation schedule is the most sensitive to heat?

The larvivorous fish widely used for biological control of mosquito larvae in wells and tanks is:

Unvaccinated children in a village with high measles vaccine coverage are also protected. This is due to:

A PHC receives reports of many diarrhoea cases from one ward in two days. What is the first step in investigating this outbreak?

Relative risk, the ratio of incidence among exposed and unexposed people, is directly obtained from a: