The first action of a nurse when a child has a febrile convulsion on the ward is to:

Place the child on the side and protect from injury

Put a padded spoon between the teeth to guard the tongue

Restrain the arms and legs firmly on the bed

Common paediatric disorders, IMNCI and paediatric care

60 Staff nurse recruitment practice questions on Common paediatric disorders, IMNCI and paediatric care, 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.

Question 1 · Easy
Projectile non-bilious vomiting with a palpable olive-shaped mass in a 4-week-old infant suggests:
1. AIntussusception
2. BDuodenal atresia
3. CHirschsprung disease
4. DHypertrophic pyloric stenosis
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Answer: D · Hypertrophic pyloric stenosis
Hypertrophic pyloric stenosis presents at 2-8 weeks with forceful non-bilious vomiting after feeds. A firm olive-shaped mass is felt in the right upper abdomen, and visible gastric waves may be seen. Loss of gastric acid causes hypochloraemic metabolic alkalosis. Treatment is pyloromyotomy after correcting fluids and electrolytes.
- A: Intussusception occurs later with colicky pain and red jelly stools.
- B: Duodenal atresia gives bilious vomiting from birth and a double bubble sign.
- C: Hirschsprung disease causes delayed meconium and distension.
Question 2 · Easy
Simple febrile seizures most commonly occur between the ages of:
1. A6 months and 5 years
2. B10 years and 15 years
3. C5 years and 10 years
4. DBirth and 3 months
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Answer: A · 6 months and 5 years
Simple febrile seizures occur with fever in children aged 6 months to 5 years without a brain infection. They are generalised, last less than 15 minutes and do not recur within 24 hours. A family history is common. Most children have no later epilepsy and need no long-term drug.
- B: Adolescents with fever and seizures need evaluation for other causes.
- C: First seizures with fever after 5 years are not typical febrile seizures.
- D: Seizures with fever in early infancy need meningitis excluded.
Question 3 · Easy
A left-to-right shunt at atrial level with a fixed split second heart sound suggests:
1. ATetralogy of Fallot
2. BVentricular septal defect
3. CPatent ductus arteriosus
4. DAtrial septal defect
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Answer: D · Atrial septal defect
An ASD lets blood pass from left to right atrium, overloading the right heart. The pulmonary valve closes late in both phases of breathing, giving a wide fixed split second sound. A soft ejection murmur is heard over the pulmonary area. Many children have no symptoms until later.
- A: Tetralogy is cyanotic with a single second sound.
- B: VSD gives a harsh pansystolic murmur.
- C: PDA gives a continuous machinery murmur.
Question 4 · Easy
The first action of a nurse when a child has a febrile convulsion on the ward is to:
1. APut a padded spoon between the teeth to guard the tongue
2. BPlace the child on the side and protect from injury
3. CRestrain the arms and legs firmly on the bed
4. DGive oral paracetamol at once
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Answer: B · Place the child on the side and protect from injury
During a seizure the nurse turns the child onto the side, clears the area and protects the head so saliva drains and the airway stays open. Nothing is placed in the mouth, and limbs are not held down. Oral medicine is unsafe during a fit because of aspiration. The nurse times the seizure and gives oxygen.
- A: Objects in the mouth break teeth and block the airway.
- C: Restraint can cause fractures and does not stop the seizure.
- D: Oral drugs during a seizure risk aspiration.
Question 5 · Medium
The first-line drug used to stop a febrile seizure lasting longer than 5 minutes at home or before IV access is:
1. AIV phenytoin
2. BOral phenobarbitone
3. CBuccal or intranasal midazolam
4. DOral paracetamol
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Answer: C · Buccal or intranasal midazolam
Seizures lasting over 5 minutes need a benzodiazepine. Without IV access, buccal or intranasal midazolam, or rectal diazepam, is used. With IV access, lorazepam or diazepam is given. Paracetamol lowers fever but does not stop a seizure.
- A: Phenytoin is second line after a benzodiazepine fails.
- B: Oral phenobarbitone is slow and unsafe during a fit.
- D: Paracetamol does not stop seizures.
Question 6 · Hard
Amoxicillin is ordered at 40 mg/kg/day in two divided doses for a 9-kg child. What is each dose?
1. A120 mg
2. B360 mg
3. C90 mg
4. D180 mg
Answer and explanation in LearnFree account
Question 7 · Easy
In IMNCI, the respiratory rate of a sick child is counted for:
1. AFifteen seconds
2. BThirty seconds
3. CTwo full minutes
4. DOne full minute
Answer and explanation in LearnFree account
Question 8 · Easy
Which vitamin is given to a child with measles to reduce complications and deaths?
1. AVitamin C
2. BVitamin K
3. CVitamin A
4. DVitamin D
Answer and explanation in LearnFree account
Question 9 · Hard
A 10-kg child is judged to be 10% dehydrated. What is the estimated fluid deficit?
1. A500 mL
2. B1000 mL
3. C1500 mL
4. D100 mL
Answer and explanation in LearnFree account
Question 10 · Medium
The best time to start corrective treatment for congenital talipes equinovarus (clubfoot) by Ponseti method is:
1. AAfter the child starts walking
2. BAfter 5 years of age
3. CIn the first weeks after birth
4. DAt school age
Answer and explanation in LearnFree account
Question 11 · Medium
The main reason elbow restraints are used after cleft lip repair is to:
1. AStop the infant touching the suture line
2. BHelp the infant sleep longer
3. CKeep the infant still for feeds
4. DPrevent the infant from rolling
Answer and explanation in LearnFree account
Question 12 · Medium
In the initial phase of managing severe acute malnutrition, the therapeutic feed used is:
1. AF-75
2. BFull-strength cow milk
3. CF-100
4. DRUTF
Answer and explanation in LearnFree account
Question 13 · Hard
A 2-year-old with SAM is admitted. Blood glucose is 2.8 mmol/L (50 mg/dL). The child is alert. The nurse should first:
1. AWait for the next feed in 3 hours
2. BGive 50 mL of 10% glucose orally or F-75 at once
3. CGive a 25% dextrose IV bolus straight away
4. DStart ReSoMal and recheck later
Answer and explanation in LearnFree account
Question 14 · Easy
Excessive frothing of saliva and choking with the first feed in a newborn should make the nurse suspect:
1. APyloric stenosis
2. BCleft lip
3. CTracheo-oesophageal fistula
4. DDiaphragmatic hernia
Answer and explanation in LearnFree account
Question 15 · Medium
The cyanotic congenital heart lesion that causes severe cyanosis soon after birth and depends on a patent ductus is:
1. AAtrial septal defect
2. BTransposition of great arteries
3. CCoarctation of the aorta
4. DVentricular septal defect
Answer and explanation in LearnFree account
Question 16 · Hard
An IV infusion of 300 mL is to run over 6 hours in a child using a microdrip set (60 drops/mL). The drip rate is:
1. A25 drops per minute
2. B100 drops per minute
3. C300 drops per minute
4. D50 drops per minute
Answer and explanation in LearnFree account
Question 17 · Medium
In a child with hydrocephalus after a ventriculoperitoneal shunt, an early sign of shunt blockage is:
1. ASunken anterior fontanelle
2. BVomiting with irritability
3. CRapid weight gain
4. DIncreased appetite
Answer and explanation in LearnFree account
Question 18 · Easy
A toddler with tetralogy of Fallot who squats after play does so mainly to:
1. ARest the legs after effort
2. BLower systemic resistance and improve the venous return
3. CRaise systemic resistance and reduce right-to-left shunt
4. DRelieve abdominal pain
Answer and explanation in LearnFree account
Question 19 · Easy
Flaky-paint dermatosis and sparse depigmented hair are seen in:
1. ARickets
2. BMarasmus
3. CScurvy
4. DKwashiorkor
Answer and explanation in LearnFree account
Question 20 · Easy
In the IMNCI colour coding, a pink row classification means the child needs:
1. ATreatment at home with advice
2. BUrgent referral to hospital
3. CSpecific treatment at the clinic
4. DFollow-up after two days
Answer and explanation in LearnFree account
Question 21 · Medium
In acute post-streptococcal glomerulonephritis, the urine typically looks:
1. ASmoky or cola coloured
2. BBright yellow
3. CClear and frothy
4. DMilky white
Answer and explanation in LearnFree account
Question 22 · Medium
Antibiotics are indicated in a child with acute diarrhoea under IMNCI when the child has:
1. ASome dehydration
2. BBlood in the stool
3. CWatery stools for 3 days
4. DMild fever with vomiting
Answer and explanation in LearnFree account
Question 23 · Medium
For a child with severe acute malnutrition and some dehydration, the rehydration fluid preferred is:
1. AStandard ORS
2. BReSoMal
3. CNormal saline IV
4. DRinger lactate IV
Answer and explanation in LearnFree account
Question 24 · Easy
In low-osmolarity ORS, the glucose concentration is kept equal to the sodium concentration at:
1. A90 mmol/L
2. B111 mmol/L
3. C20 mmol/L
4. D75 mmol/L
Answer and explanation in LearnFree account
Question 25 · Easy
The surgical repair of cleft lip is usually done at about:
1. A1 week of age
2. B3 years of age
3. C3 months of age
4. D12-18 months of age
Answer and explanation in LearnFree account

35 more Common paediatric disorders, IMNCI and paediatric care questions

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Common paediatric disorders, IMNCI and paediatric care

Projectile non-bilious vomiting with a palpable olive-shaped mass in a 4-week-old infant suggests:

Simple febrile seizures most commonly occur between the ages of:

A left-to-right shunt at atrial level with a fixed split second heart sound suggests:

The first action of a nurse when a child has a febrile convulsion on the ward is to:

The first-line drug used to stop a febrile seizure lasting longer than 5 minutes at home or before IV access is:

Amoxicillin is ordered at 40 mg/kg/day in two divided doses for a 9-kg child. What is each dose?

In IMNCI, the respiratory rate of a sick child is counted for:

Which vitamin is given to a child with measles to reduce complications and deaths?

A 10-kg child is judged to be 10% dehydrated. What is the estimated fluid deficit?

The best time to start corrective treatment for congenital talipes equinovarus (clubfoot) by Ponseti method is:

The main reason elbow restraints are used after cleft lip repair is to:

In the initial phase of managing severe acute malnutrition, the therapeutic feed used is:

A 2-year-old with SAM is admitted. Blood glucose is 2.8 mmol/L (50 mg/dL). The child is alert. The nurse should first:

Excessive frothing of saliva and choking with the first feed in a newborn should make the nurse suspect:

The cyanotic congenital heart lesion that causes severe cyanosis soon after birth and depends on a patent ductus is:

An IV infusion of 300 mL is to run over 6 hours in a child using a microdrip set (60 drops/mL). The drip rate is:

In a child with hydrocephalus after a ventriculoperitoneal shunt, an early sign of shunt blockage is:

A toddler with tetralogy of Fallot who squats after play does so mainly to:

Flaky-paint dermatosis and sparse depigmented hair are seen in:

In the IMNCI colour coding, a pink row classification means the child needs:

In acute post-streptococcal glomerulonephritis, the urine typically looks:

Antibiotics are indicated in a child with acute diarrhoea under IMNCI when the child has:

For a child with severe acute malnutrition and some dehydration, the rehydration fluid preferred is:

In low-osmolarity ORS, the glucose concentration is kept equal to the sodium concentration at:

The surgical repair of cleft lip is usually done at about: