Skip to content
MedExams

Paediatric disorders, IMNCI and immunisation

65 M.Sc Nursing Entrance (AIIMS, LBS, PGIMER, JIPMER) practice questions on Paediatric disorders, IMNCI and immunisation, part of Child Health Nursing. 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.

  1. Question 1 · Easy

    Under IMNCI, a child with diarrhoea who has blood in the stool is classified as having:

    1. ADysentery
    2. BCholera
    3. CSevere dehydration
    4. DPersistent diarrhoea
    Show answer

    Answer: A · Dysentery

    Blood in the stool is the sign IMNCI uses to classify dysentery, a yellow-row condition usually caused by Shigella. It is treated with an oral antibiotic as per the chart booklet, with ORS for any dehydration and zinc, and a follow-up visit is arranged. Dehydration is classified separately from the signs of fluid loss.

    • B: Cholera causes profuse watery stools without blood.
    • C: Severe dehydration is classified from lethargy, sunken eyes, poor drinking and skin pinch.
    • D: Persistent diarrhoea is defined by a duration of 14 days or more.

  2. Question 2 · Easy

    A continuous 'machinery' murmur best heard below the left clavicle is typical of:

    1. APulmonary stenosis
    2. BPatent ductus arteriosus
    3. CVentricular septal defect
    4. DAtrial septal defect
    Show answer

    Answer: B · Patent ductus arteriosus

    In a patent ductus arteriosus, blood flows from the aorta to the pulmonary artery in both systole and diastole, because aortic pressure is higher throughout the cycle. This produces a continuous murmur at the upper left sternal border and below the clavicle. A large PDA also gives bounding pulses and a wide pulse pressure. Preterm infants are most often affected.

    • A: Pulmonary stenosis gives an ejection systolic murmur, not a continuous one.
    • C: A VSD gives a harsh pansystolic murmur at the lower left sternal border.
    • D: An ASD gives a soft ejection systolic murmur with fixed splitting of S2.

  3. Question 3 · Easy

    The most common malignancy in children is:

    1. AAcute lymphoblastic leukaemia
    2. BNeuroblastoma
    3. CWilms tumour
    4. DRetinoblastoma
    Show answer

    Answer: A · Acute lymphoblastic leukaemia

    Acute lymphoblastic leukaemia accounts for about a quarter to a third of all childhood cancers, with a peak at 2-5 years. Brain tumours are the commonest solid tumours, and neuroblastoma is the commonest extracranial solid tumour. With modern protocols, cure rates for childhood ALL exceed 80-90% in good centres. Fever, pallor, bruising and bone pain are the usual presenting features.

    • B: Neuroblastoma is the commonest extracranial solid tumour.
    • C: Wilms tumour is the commonest renal tumour of childhood, not the commonest cancer overall.
    • D: Retinoblastoma is the commonest eye tumour of childhood.

  4. Question 4 · Hard

    A 15-month-old has had diarrhoea for 16 days. He is restless, his eyes are sunken, and he drinks eagerly. There is no blood in the stool. Under IMNCI, his diarrhoea is classified as:

    1. ASome dehydration only
    2. BDysentery
    3. CSevere persistent diarrhoea
    4. DPersistent diarrhoea
    Show answer

    Answer: C · Severe persistent diarrhoea

    Diarrhoea lasting 14 days or more is persistent. Restlessness, sunken eyes and eager drinking are signs of some dehydration, and persistent diarrhoea with any dehydration is classified as severe persistent diarrhoea in the pink row. He is rehydrated first and then referred. Persistent diarrhoea without dehydration is treated at the facility with feeding advice.

    • A: Classifying only dehydration misses the duration of 16 days.
    • B: Dysentery needs blood in the stool.
    • D: Persistent diarrhoea alone is the class without dehydration.

  5. Question 5 · Easy

    The commonest type of nephrotic syndrome in children is:

    1. AFocal segmental glomerulosclerosis
    2. BMembranous nephropathy
    3. CPost-streptococcal glomerulonephritis
    4. DMinimal change disease
    Show answer

    Answer: D · Minimal change disease

    Minimal change disease causes about 80-90% of nephrotic syndrome in children aged 1-10 years. Light microscopy of the glomeruli looks normal, and electron microscopy shows effacement of the podocyte foot processes. Most children respond to prednisolone, so a renal biopsy is not needed at first. Relapses are common, often after a viral infection.

    • A: FSGS is a less common cause and is often steroid-resistant.
    • B: Membranous nephropathy is a common cause in adults, not children.
    • C: Post-streptococcal disease causes a nephritic picture with haematuria and hypertension.

  6. Question 6 · Medium

    A 7-year-old with haemophilia A falls in the playground. His right knee is now swollen, warm and painful. Which action is most appropriate?

    1. AAspirate the joint first, then give factor VIII
    2. BGive intramuscular analgesia and observe the knee
    3. CArrange factor VIII infusion and rest the joint with ice
    4. DApply heat packs and encourage active knee exercise

    Answer and explanation in LearnFree account

  7. Question 7 · Hard

    A child with SAM weighed 7.00 kg when he started F-100. Four days later he weighs 7.42 kg. WHO grades weight gain as poor below 5, moderate 5-10 and good above 10 g/kg/day. How is his weight gain graded?

    1. APoor, about 4 g/kg/day
    2. BGood, about 60 g/kg/day
    3. CGood, about 15 g/kg/day
    4. DModerate, about 7.5 g/kg/day

    Answer and explanation in LearnFree account

  8. Question 8 · Hard

    A 9-month-old boy has bouts of screaming every 15-20 minutes, drawing up his legs, with vomiting between bouts. A sausage-shaped mass is felt in the right upper abdomen. Which investigation is preferred first?

    1. AUpper GI endoscopy
    2. BBarium meal and follow-through
    3. CPlain X-ray of the chest
    4. DAbdominal ultrasound

    Answer and explanation in LearnFree account

  9. Question 9 · Medium

    A newborn has an unrepaired myelomeningocele with an intact sac over the lumbar spine. Which nursing measure is correct before surgery?

    1. ANurse supine on a soft foam ring to protect the sac
    2. BLeave the sac open to the air so it stays dry
    3. CNurse prone with a sterile, moist, non-adherent dressing
    4. DNurse propped up in an infant seat for comfort

    Answer and explanation in LearnFree account

  10. Question 10 · Easy

    Under Plan A for diarrhoea at home, a child under 2 years should be given how much ORS after each loose stool?

    1. A100-200 mL
    2. B50-100 mL
    3. CAs much as the child wants
    4. D10-20 mL

    Answer and explanation in LearnFree account

  11. Question 11 · Hard

    A 2-year-old awaiting surgery for Hirschsprung disease develops fever, a very distended abdomen and explosive, foul-smelling watery stools. What is the most likely complication?

    1. AConstipation with overflow
    2. BIntussusception
    3. CEnterocolitis
    4. DRotavirus gastroenteritis

    Answer and explanation in LearnFree account

  13. Question 13 · Easy

    The Right of Children to Free and Compulsory Education Act, 2009 covers children aged:

    1. A0-18 years
    2. B5-16 years
    3. C6-14 years
    4. D3-10 years

    Answer and explanation in LearnFree account

  14. Question 14 · Hard

    A 2-year-old in a high malaria-risk district has fever for 3 days. He is alert and drinking, but his neck is stiff. The malaria RDT is positive. Under IMNCI, how is he classified and managed?

    1. AFever, malaria unlikely: paracetamol and review in 2 days
    2. BMalaria: oral ACT at home with follow-up in 3 days
    3. CVery severe febrile disease: pre-referral treatment and urgent referral
    4. DMalaria with stiff neck: oral ACT and observe at the PHC

    Answer and explanation in LearnFree account

  15. Question 15 · Medium

    Newborn screening for congenital hypothyroidism is worthwhile mainly because treatment with levothyroxine started in the first 2 weeks:

    1. AAvoids the need for lifelong therapy
    2. BCorrects the thyroid gland's structure
    3. CPrevents permanent intellectual disability
    4. DPrevents neonatal jaundice

    Answer and explanation in LearnFree account

  16. Question 16 · Medium

    Potassium chloride is ordered to be added to the IV fluid of a dehydrated child. Before adding it, the nurse must confirm that the child:

    1. AIs no longer vomiting
    2. BHas a normal blood pressure
    3. CHas passed urine
    4. DHas received a full bolus

    Answer and explanation in LearnFree account

  17. Question 17 · Hard

    A 4-year-old choking on a peanut becomes unresponsive while the nurse is giving abdominal thrusts. She lays him on the floor and calls for help. What should she do next?

    1. AStart CPR with chest compressions, checking the mouth before breaths
    2. BContinue abdominal thrusts with the child lying on his back
    3. CDo a blind finger sweep of the mouth to find the peanut
    4. DTurn him prone and give 5 back blows, then reassess

    Answer and explanation in LearnFree account

  18. Question 18 · Medium

    The UN Convention on the Rights of the Child (1989), ratified by India, has a guiding principle that in all actions concerning children:

    1. AThe best interests of the child are a primary consideration
    2. BThe State decides all treatment for children
    3. CParents alone decide every aspect of the child's care
    4. DChildren's views are heard only after the age of 18

    Answer and explanation in LearnFree account

  19. Question 19 · Medium

    The 'rule of 10s' is often used to time cleft lip repair. It says the infant should be at least:

    1. A10 days old, 10 kg in weight, Hb 10 g/dL
    2. B10 months old, 10 lb in weight, WBC 10,000
    3. C10 weeks old, 10 kg in weight, Hb 12 g/dL
    4. D10 weeks old, 10 lb in weight, Hb 10 g/dL

    Answer and explanation in LearnFree account

  20. Question 20 · Medium

    A nurse finds a newborn abandoned outside the hospital gate. Under India's 2015 law on the care and protection of children, she must ensure it is reported within:

    1. A24 hours
    2. B3 days
    3. C6 hours
    4. D1 week

    Answer and explanation in LearnFree account

  21. Question 21 · Medium

    A 20-month-old with MUAC 10.9 cm and no oedema is alert, but at the clinic she does not eat the test dose of RUTF. What is the right plan?

    1. AAdvise family foods with extra oil and sugar
    2. BGive multivitamins and recheck her in a month
    3. CStart RUTF at home with weekly clinic visits
    4. DRefer for inpatient care of complicated SAM

    Answer and explanation in LearnFree account

  22. Question 22 · Medium

    When India adapted the WHO IMCI strategy as IMNCI, which major change was made?

    1. AOnly hospital doctors were to use it
    2. BChildren up to 10 years were included
    3. CMalaria and measles were removed
    4. DCare in the first week of life was added

    Answer and explanation in LearnFree account

  23. Question 23 · Medium

    A 2-year-old weighs 6.6 kg. The reference weight for his age is 12 kg, and he has no oedema. By the IAP classification, his nutritional grade is:

    1. AGrade II
    2. BGrade IV
    3. CGrade I
    4. DGrade III

    Answer and explanation in LearnFree account

  24. Question 24 · Medium

    A 9-month-old is coughing weakly, cannot cry and is turning blue after putting a bead in his mouth. He is still conscious. What should the nurse do?

    1. ASweep the mouth blindly with a finger
    2. BGive 5 back blows, then 5 chest thrusts
    3. CTurn him upside down and shake him
    4. DGive abdominal thrusts until the bead comes out

    Answer and explanation in LearnFree account

40 more Paediatric disorders, IMNCI 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 Child Health Nursing