Loksewa Model Question for HA, ANM, AHW, Staff Nurse with Answers : Set 1

Loksewa Model Question for HA, ANM, AHW, Staff Nurse with Answers: Set 1

There are 50 multiple choice questions based on the syllabus of HA Loksewa.

1) The fourth international conference on health promotion - the Jakarta declaration was held in :

a) Canada b) Kenya c) South Australia d) Indonesia

Correct Answer: Indonesia

Fourth international conference: Jakarta declaration held in Jakarta, Indonesia 1997
First international conference: Ottawa charter for health promotion held in Ottawa, Canada, in 1986.
Second international conference: Adelaide conference on a healthy public policy held in Adelaide, South Australia, 1988
Third international conference: held in Sundsvall, Sweden, 1991
Seventh global conference: Nairobi call to action: held in Nairobi, Kenya, 2009
8th global conference: 2013: This conference was co-hosted by WHO and the ministry of social affairs and health, Finland. The main theme of the conference was "Health in All Policies" (HiAP).

2) World Red Cross Day is celebrated in :

a) 11th June

b) 5th July

c) 8th May

d) 11th July

Correct Answer: 8th May

No tobacco day: 31st May
World human right day: 10th December
World Red Cross day: 8th May
World tuberculosis day: 24th march
World environmental day: 5th June
World Population Day: 11th July
World AIDS Day: 1st December
World health day: 7th April
World condom day: 1st Saturday after Dashain

3) In which disease, centripetal rashes are seen :

a) Chicken Pox

b) Theulla

c) Varicella

d) All of the above

Correct Answer: All of the above

Chickenpox: also known as Varicella/Theula. Principally a disease of children, but can affect adults.
Agent: Varicella-zoster virus, a DNA virus
IP: 14-21 days
Pleomorphic, centripetal rashes with macules papules, vesicles (dewdrop rashes) seen
Herpes zoster (Janai Khatira): Reactivation of varicella Zoster virus infection when the immunity is compromised.

4) Action which halts the progress of the disease is _______ level of Prevention.

a) Primary

b) Secondary

c) Tertiary

d) None of the above

Correct Answer: Secondary Prevention

Primordial Prevention:
Prevention of emergence or development of risk factors in a population group.
In primordial prevention efforts are directed towards discouraging children from adopting harmful lifestyles.
Primary prevention:
Action taken prior to the onset of disease.
Health promotion: Health education, Environmental modification, Nutritional intervention, lifestyle change and behaviour change.
Specific protection: Immunization, use of specific nutrients, chemoprophylaxis, etc
Secondary prevention:
Action which halts the progress of the disease.
Intervention: Early diagnosis and treatment
Tertiary prevention:
All measures to reduce or limit impairments and disability, minimize suffering caused by the disease process.
Intervention: Disability limitation and rehabilitation.

5) Which of the following symptom of TB is criteria for defining suspected TB?

a) Sputum Production

b) Cough for 2 or more weeks

c) Shortness of Breath

d) Hemoptysis

Correct Answer: Cough for 2 or more weeks

Tuberculosis: Infectious disease caused by Mycobacterium tuberculosis. It primarily affects the lungs and causes pulmonary tuberculosis.
Bovine tuberculosis primarily affects animals and may communicate to man.
MOT: Droplet infection or Droplet nuclei
Clinical features:
Cough for 2 or more weeks duration (It is the criterion for defining suspected TB)
Sputum production Shortness of breath
Chest or back pain Hemoptysis
Loss of appetite
The main aim of ATT is: Bacteriological cure

6) The most common extrapulmonary TB in the world is :

a) TB Meningitis

b) Gland TB

c) Abdominal TB

d) Genital TB

Correct Answer; Abdominal TB

Extra-pulmonary sites are: Intestine, meninges, bone and joint, glands, skin etc
Extrapulmonary tuberculosis: Spine (called Pott's spine), Skin (called Lupus vulgaris)
The most common extra-pulmonary TB in Nepal is Gland TB.
The most common extra-pulmonary TB in the world is: Abdominal TB

7) The element of supervision is ;

a) Suggestion

b) Counseling

c) Direction

d) All of the above

Correct Answer: All of the above

Supervision: The process of assisting, supporting, and monitoring for the purpose of improving skills and performance is supervision.
Supervision technique:
Supervisory visits, Interviews, meetings, Performance appraisal, feedback, Setting examples, Setting targets, and Following up on issues and problems.

8. MOHP designed a new push-pull system in:

a) 2002

b) 2003

c) 2004

d) 2005

Correct Answer: 2003

In 2003, MOHP designed a push-pull system
and in 2004/2005, the pull system was introduced in six districts
The key advantages of the pull system are:
All government- provide health commodities are merged under a single logistic distribution system making the sub-district distribution system cost-effective.

Field level health personnel are empowered because of the decentralization of logistics decision making.

9. Which of the following is not the centre of DOHS?

a) NTC

b) NHPL

c) FHD

d) NHTC

Correct Answer: FHD

Center of DOHS:
NTC: National Tuberculosis Center
NHTC: National Health Training Center
NPHL: National Public Health Laboratory
NCSAC: National Center for AIDS and STD Control
NHEICC: National Health Education, Information and Communication Center

10. CBIMCI program was piloted in 2015 in three districts they are:

a) Rasuwa, Nuwakot, Nwalparasi

b) Rasuwa, Kathmandu and Bhaktapur

c) Kathmandu, Lalitpur and Rasuwa

d) Kaski, Rasuwa and Nawalparasi

Correct Answer: Rasuwa, Nuwakot, Nwalparasi

CBIMNCI (Community Based Integrated Management of Neonatal and Childhood Illness) program is being piloted in 2014
Piloted in three districts namely Rasuwa, Nuwakot and Nawalparasi
And will be expanded rapidly to other districts.

11. Initially the approach was to select FCHV per ward; later on, population-based approach was introduced in:

a) 1993

b) 1995

c) 1998

d) none of the above

Correct Answer: 1993

FCHV Program: Initiated in FY 1988/89 in 27 districts. Initially, the approach was to select FCHV per ward. Later in 1993 population-based approach was introduced in selected 28 districts.
According to the revised FCHV strategy 2060, the population FCHV ratio is given as follows:
1 FCHV in 200 populations in upper hilly regions.
1 FCHV in 350 populations in mid hilly regions.
1 FCHV in 1000 populations in terai regions.
The basic training duration of FCHV is 18 days (9 +9)
Each FCHV has a Mother Group for Health (MGH): In a MG-H There will be at least 11 persons in the mountainous region, 15 persons in the hilly region and 21 persons in the Terai region.

12. In the national AIDS control program, how will you prevent high-risk population :

a) Targeted Intervention

b) Workplace Intervention

c) STD Treatment

d) Multisectoral Collaboration

Correct Answer: Targeted Intervention

The goal is to ensure 70-80% coverage of the most at-risk population (sex workers) with preventive programs and reduce the number of new HIV infections among the general population by 2011. Hence targeted intervention is needed to prevent high-risk populations.
HIV/AIDS: also known as Slim disease
First reported in 1981, Virus was detected in 1983, and the first case was detected in 1988 in Nepal.
Agent: HIV (Human Immunodeficiency virus)
Initial names: Human T – cell lymphotropic virus, Lymphadenopathy associated virus,
A retrovirus, which contains Reverse Transcriptase: that converts RNA to DNA
Mode of transmission of HIV/AIDS:
Sexual contact
Blood and blood-related products
From medical instruments, needle sharing,
Vertical transmission
No transmission from social contact, food, water, insect bite, sharing bathroom or clothes.

13. In which of the following disease Pseudomembrane formation take place:

a) Diphtheria

b) Bhyagute Rog

c) Both a and b

d) Measles

Correct Answer: Both a and b

Diphtheria: Also known as Bhyajute Rog

Types of diphtheria: Pharyngotonsilar type
Laryngotracheal type Nasal type
Cutaneous types Agent: Corynebacterium diphtheria.
MOT: Direct contact with skin lesions
Pseudo membrane formation, Bull neck appearance (due to oedema and enlarged lymph nodes of submandibular area.
Shick test is for diagnosis of diphtheria:
Alberts stain is also used to stain corynebacterium diphtheria

14. Adult hookworms mainly live in which part of the intestine:

a) Duodenum

b) ileum

c) Jejunum

d) Ascending Colon and Caecum

Correct Answer: Jejunum

Hookworm infestation: It is the commonest cause of iron deficiency anaemia in Nepal.
Agent: Ancylostoma duodenale
Habitat: Jejunum
MOT: Percutaneous (i.e Walking barefoot on contaminated soil)
Oral (Only in A. duodenale)
C/F: Itch, abdomen pain and discomfort, Malabsorption, diarrhoea etc
Filariform larva is the infective form.
Prevention: Good sanitation and wearing shoes

15. In case of poisoning suspected of organophosphorus is best assessed by with:

a) Torchlight

b) Stethoscope

c) BP Instrument

d) USG

Correct Answer: Torchlight

Poisoning: Organophosphate poisoning (commonest in Nepal).
Pupils are constricted (Pinpoint) in Organophosphate and in case of morphine poisoning.
Kerosene poisoning is most common in children.
Vomiting shouldn’t be performed in patients who have ingested kerosene and petroleum products.

16. Neurocysticercosis is caused by:

a) Taenia Solium

b) Taenia Saginata

c) Echinococcus granulosus

d) Schistosoma

Correct Answer: Taenia Solium

Taeniasis: agent
Taenia solium (Pork Tapeworm) and Taenia saginata (Beef tapeworm)
MOT: Ingestion of infective larvae from uncooked beef or pork
Definitive host: Man
Intermediate host: Pig/Cattle
Neurocysticercosis: Most dangerous
Agent: Larva of Taenia solium. (Cysticercous cellulose)
MOT: Ingestion of food, water or vegetable contaminated with the eggs of T. solium.
By ingestion of uncooked pork.
Taeniasis only occurs in Non-vegetarians but cysticercosis can occur in both vegetarians and non-vegetarians.

17. Initiation of treatment of XDR-TB is in:

a) 2008

b) 2009

c) 2010

d) 2012

Correct Answer: 2010

The key milestones of TB control in Nepal are:
1995 – DOTS policy 1996 – DOTS strategy
1998 – DOTS in the private sector 2001 – DOTS throughout the country
2005 – DOTS plus 2007 – Fixed Dose Combination system
2010 – XDR-TB

18. Which one is not a complication of pertusis?

a) Pneumonia

b) Convulsion

c) Cerebellar ataxia

d) Subcuntival haemorrhage

Correct Answer: Cerebellar ataxia

Pertussis: Whooping cough/Lahare khoki
Also called 100 days cough and Kala khansi.
Agent: Bordetella pertusis, gm –ve
C/F: It has 3 stages
Catarrhal stage: running nose, cough, fever
Paroxymal stage: Irritating cough, Whoop (loud crowing inspiration)
Convalescent stage: Recovery
Complication of pertusis:
Respiratory- Ottitis media, Bronchopneumonia, Emphysema, bronchiectasis
Neurological: Convulsion, Encephalopathy
Bleeding disorders: Epistaxis, Retinal haemorrhages
Malnutrition, Inguinal hernia, Rectal prolapsed

19. Sign of left sided CCF is:

a) Ascites

b) Hepatomegaly

c) Pulmonary oedema

d) Swelling of Feet

Correct Answer: Pulmonary oedema

CCF: Inability of the heart to meet the oxygen demands of the body.

Sign of left CCF /heart failure:
Dyspnea from the fluid within the lungs, Orthopnea, fatigue, restlessness, Paroxysmal nocturnal dyspnea
Decrease oxygen saturation peripheral cyanosis, Decrease urinary output

Sign of right ventricular failure:
Abdominal pain, fatigue, Jugular vein distension, Pitting oedema, hepatomegaly, anorexia, Respiratory distress, and decreased urinary output.

20. Wernick's encephalopathy is caused due to the deficiency of:

a) Vitamin B1

b) Vitamin A

c) Vitamin D

d) Vitamin E

Correct Answer: Vitamin B1

The outer core of rice contains Thiamine.Thiamin is one of the water-soluble B vitamins. It is also known as vitamin B1. It helps the body's cells change carbohydrates into energy.
It is lost by milling, washing and cooking.
Deficiency: Beriberi, Wernicke's encephalopathy and Korsakoff psychosis (Alcoholics are at greatest risk of deficiency).
Bodybuilding food: Proteins
Energy giving food: Fat and Carbohydrate
Protective food: Vitamins, vegetables, fruits.
Fat soluble vitamins: A, D, E and K
Water soluble vitamins: B-complex and C

21. Which is not a killed vaccine?

a) Salk

b) Hepatitis B

c) Measles

d) Pertusis

Correct Answer: Measles

EPI (Expanded Programme on Immunization)
Brought by WHO
Nepal gets vaccine via universal child immunization of UNICEF
Live Vaccine are: (MY RIBS) Measles, yellow fever, rubella, influenza, BCG, sabin
Killed vaccines are Hepatitis B, Rabies, Salk, Pertusis, Cholera, Typhoid
Combined vaccines are: DPT, TD, MMR

22. Glucose is used for the:

a) Co-transport of Potassium

b) Co-transport of Sodium

c) both a and b

d) none of the above

Correct Answer : Co-transport of Sodium

ORS should be given within 24 hours.
Glucose is used for the co-transport of sodium
No use of oral glucose (Osmotic diarrhoea)
No use of dextrose solution (Affects brain)
Composition of Oral rehydration solution (ORS)
Components Formula
NaCl 2.6 g
KCl 1.5 g
Trisodium citrate 2.9 g
Glucose 13.5g

23. Which is not affected by chlorination of water?

a) spores

b) poliovirus

c) protozoan cyst

d) all of the above

Correct Answer: All of the above

Chlorination of water: Chlorination has the greatest advances in water purification. Chlorine kills pathogenic bacteria.
It has no effect on spores and certain viruses like polio, hepatitis B etc
The disinfection action of chlorine in water is mainly due to hypochlorous acid and a minor role by hypochlorite ions.
The action of chlorine depends on:
Contact time, Organic matter, metals and bacterial content
Temperature and pH, chlorine is less effective at low temperature and high pH.
Amount of free residual chlorine and chloramines

24. The amount of sewage flowing in a system in 24 hrs is:

a) Sewage Water

b) Dry Weather Flow

c) RCA Index

d) Effluent rate

Correct Answer: Dry Weather Flow

Septic tank: It is a satisfactory method of disposing of liquid and excreta wastes.
Ideal retention period: 24 hours.
Both aerobic and anaerobic digestion takes place in the septic tank.
Dry weather flow: Average amount of sewage flows in sewerage system in 24 hours.
Biological oxygen demand: indicate organic matter in the sewage system.
Sewage: wastewater from the community containing solid and liquid excreta.
Trap: is a water seal it holds water, prevents access by flies and suppresses nuisance.
Sludge: Heavier solids setting down in the tank.
Scum: Lighter solids including grease and facts on the surface.
Effluent: The liquid that passes out of the outlet pipe from time to time.

25. Recognized association with hyperemesis gravidarum includes:

a) Hydatidiform mole

b) Age more than 50 years

c) Primi in less than 20 years

d) Preeclampsia

Correct Answer: Hydatidiform mole

Hyperemesis gravidarum is defined variably as vomiting sufficiently severe to produce weight loss, dehydration, acidosis from starvation, alkalosis from loss of hydrochloric acid in vomitus, and hypokalemia.

26. According to NDHS 2016, the Percentage of deliveries conducted by a skilled birth attendant is:

a) 40%

b) 58%

c) 45%

d) 57%

Correct Answer: 58%

Achievement of some indicators
Maternal Health (among women age 15-49) NDHS 2016 NDHS 2011
ANC visit with a skilled provider (%)           84                58
Births delivered in a health facility (%)           57                35
Births assisted by a skilled provider (%)        58                36

27. Incubation period of mumps is:

a) 14-21 days

b) 2-3 weeks

c) both a and b

d) 7-14 days

Correct Answer: Both a and b

Mumps (Hade, Gulfulo)
The virus has an affinity for glandular and nervous tissue.
The incidence of mumps is highest among 5- 9 years children.
Mode of transmission: Droplet infection, Droplet nuclei, and direct contact
Incubation period: 14-21 days
C/F: Fever, Pain and swelling on one or both parotid glands. Trismus
Complication: Orchitis, Oophoritis, Pancreatitis and later can cause meningo-encephalitis.

28. Leprosy is the:

a) highly infectious disease but low pathogenicity

b) low infectious disease but high pathogenicity

c) highly infectious disease and high pathogenicity

d) low infectious disease and low pathogenicity

Correct Answer: Highly Infectious but low pathogenicity

It is also known as a social disease.
A chronic infectious disease mainly affects peripheral nerves and also affects skin, muscles, eyes, bone, testes and internal organs.
Leprosy is mainly characterized by one or more of the following cardinal features:
Hypopigmented patches
Partial or total loss of cutanuous sensation in affected areas. ( The earliest sensation to be affected is light touch).
Presence of thickened nerves and
Presence of Acid fast bacilli in the skin or nasal smears.
Leprosy is probably the oldest disease known to Mankind.
The nose is the major portal of exit.
Leprosy is a highly infectious disease but of low pathogenicity.
Multibacillary cases are the most important source of infection.

29. In which, Grey's Turner's sign is positive:

a) Blunt Injury abdomen

b)) acute pancreatitis

c) acute appendicitis

d) acute cholecystitis

Correct Answer: Acute Pancreatitis

Acute appendicitis:
Blumberg's sign or release signs at Mc's burneys point.
Roving sign, Psoas sign positive, Obturator sign positive.
Murphys traid
Acute Cholecystitis:
Murphy's sign, Boas's sign may be positive.
Acute pancreatitis:
Cullens signs positive, Greys Turners sign positive
Acute Peritonitis:
Sudden severe pain, which starts over one part and spreads all over the abdomen.
The patient lies on their back with flexed knees and tries very hard not to move as movement causes pain.

30. Lodgement, development and reproduction of arthropods on the surface of the body are called:

a) exotic

b) infestation

c) epornithic

d) infection

Correct Answer : Infestation

Infection: The entry and development or multiplication of an infectious agent in the body of man or animals.
Infestation: Lodgement, development and reproduction of arthropods on the surface of the body or in the clothing eg lice, itchmite
Exotic: Diseases which is imported into a country in which they don’t otherwise occur.
Epornithic: Epidemic of disease in an animal population.

31. Poor housing causes which of the following diseases:

a) Scabies

b) Plague

c) Leprosy

d) All of the above

Correct Answer : All of the above

Housing is important for many aspects of healthy living and well being. The home is important for psychosocial reasons as well as its protection against the elements but it can also be the source of a wide range of hazards (Physical, Chemical, Biological). It is the environment in which most people spend the majority of their time.
Housing and health
A healthy home needs to have a sound structure, be free of hazards, provide adequate facilities for sleeping, personal hygiene, the preparation and storage of food, be an environment for comfortable relaxation, privacy and quiet, and to provide the facility for social exchange with friends, family and others.
Health problems:
Poor housing leads to an increased risk of cardiovascular and respiratory disease as well as anxiety and depression.
The risk of accidents is also present.
Transmit infectious diseases like Scabies, leprosy, diarrhea, cholera etc

32. Solid waste from street, houses and industry in city/urban is known as:

a) Sewage

b) Refuse

c) Rubbish

d) Demolition

Correct Answer : Refuse

Garbage: Processed food waste generated from the kitchen.
Rubbish: Paper clothing, wood, metal glass, dust.
Refuse: Solid waste from streets, horses and industry in the city/Urban.
Demolition: Bricks, Masonary, Pipes.
Blackwater: is water from toilets.
Sewage: Wastewater from the community containing solid and liquid excreta.
Sullage: Wastewater that does not contain human excreta.

33. Inhalation of moulds in moist hay can cause:

a) Bagassosis

b) Byssinosis

c) Tobacosis

d) Farmer's Lung

Correct Answer: Farmer's Lung

Byssinosis, though mainly caused by the inhalation of flax, soft hemp and sisal, as cotton dust is an organic substance. The symptoms are that of an asthma type of illness these symptoms usually occur after several years of exposure to cotton dust.
Bagassosis: It is caused by the inhalation of sugarcane dust.
Farmer's lung: Inhalation of moulds in moist hay.
Tobacosis: By inhalation of tobacco dust

34. What is the meaning of X2 in the classification of Vitamin A deficiency?

a) Corneal xerosis

b) Conjunctival xerosis

c) Corneal scarring

d) Bitots spots

Correct Answer: Corneal xerosis

WHO Classification:

XN – Night blindness.
X1A – Conjunctival xerosis

X1B – Bitots spots
X2 – Corneal xerosis

X3A – Corneal ulceration less than 1/3 of cornea
X3 B - Corneal ulceration more than 1/3 of cornea
Xs – Corneal scarring

XF – Xeropthalmic fundus

35. According to WHO Anemia is diagnosed when the Hb level of the children (less than 5) is below:

a) 9 gm %

b) 11 gm %

c) 13 gm %

d) none of the above

Correct Answer : 11 gm %

Anaemia: is usually defined as a decrease in the number of RBCs or haemoglobin in the blood. It can be defined as a lowered ability of the blood to carry oxygen.
Causes:
Impaired production
Increased destruction
Blood loss
Fluid overload
WHO classification of anemia
Age Hb threshold (g/dl)
Children ( less than 5 years) 11
Children (5 – 12 years) 11.5
Teens (12-15 years) 12
Women, non-pregnant (>15 years) 12
Women, Pregnant 11
Men (>15 years) 13

36. Which of the following is the mission of National health policy 2014?

a) To Provide PHC free of cost

b) Establish effective and accountable health services system

c) To promote community participation and public and private involvement

d) Ensure the fundamental right of people to be healthy.

Correct Answer: Ensure the fundamental right of people to be healthy.

National health policy 2071:
It was endorsed after 22 years of the first national health policy.
Altogether there are 14 policies and 119 strategies.
Objectives:
To provide PHC free of cost as a fundamental right of the citizen
To establish an effective and accountable health service system
To promote community participantion and public and private sector involvement in health service delivery.
Mission:
To ensure the fundamental right of people to be healthy through maximum utilization of available resources and strategic coordination among health services providers, clients and stakeholders.

37. The active fetal movement can felt by the mother is in:

a) 12 weeks

b) 20 weeks

c) 24 weeks

d) 36 weeks

Correct Answer : 20 weeks

Fundal height during pregnancy:

At pubis: 12 weeks
At umbilicus: 24 weeks

At xyphoid process: 36 weeks
Active fetal movement: 20 weeks

38. HIV patient treatment card register is:

a) 7.2

b) 7.4

c) 7.5

d) 7.6

Correct Answer: 7.5

HMIS 7 HIV/AIDS and STI
7.1 – HIV testing and counselling

7.2 – STI treatment register
7.3 – PMTCT service register

7.4 – HIV treatment and care register
7.5 – HIV patient treatment card – Opoid substitution therapy register.

39. Which of the following is not the symptom of Whipple's disease?

a) Diarrhea

b ) Fever

c) weight loss

d) Constipation

Correct Answer; Constipation

Whipple's disease
It is a disease of the digestive system.
Occurs more commonly in men, with a peak incidence in middle age.
Caused by Tropheryma whippelii-C/F:
Streatorrhoea-Diarrhea-Weight loss-Fever-Increased skin pigmentation etc

40. Spontaneous abortion can be defined as:

a) One or more pregnancies terminating subsequently

b) Pregnancy terminated by artificial instrumentations

c) Spontaneous termination of a pregnancy

d) pregnancy terminated illegally

Correct Answer : Spontaneous termination of a pregnancy

Abortion is the spontaneous termination of pregnancy before the period of viability.
Threatened abortion: Clinically entity where the process of abortion has started but not progressed to a state from which recovery is impossible.
Inevitable abortion: the process of abortion has progressed to a state where the continuation of pregnancy is impossible.

41. The syndrome of acute psychosis is:

a) Dementia

b) Hallucination

c) Amnesthia

d) Delirium

Correct Answer : Hallucination

Psychosis is defined as any major mental disorder of organic or emotional origin marked by derangement of personality and loss of contact with reality with DELUSION and HALLUCINATION.

42. The lenses less eye is said to be:

a) Subject to cataract formation

b) Useless

c) Insensitivity

d) Aphakia

Correct Answer : Aphakia

Aphakia – Absence of crystalline lens
Pseudophakia – Presence of Intraocular lens (Artificail).

43. In Mass drug administration for filariasis program, the dose for age group 2-5 years is:

a) 1 DEC plus 2 Albendazole

b) 2 DEC plus 2 Albendazole

c) 1 DEC plus 1 albendazole

d) 2 DEC plus 1 Albendazole

Correct Answer : 1 DEC plus 1 albendazole

Filariasis: Caused by Cematode worm also called Blood worm.
Definitive host: Man
Intermediate host: Mosquito
MOT: Bite of infected vector mosquito
61 endemic districts (new Darchula)
Mass Drug Adiministration For filariasis was started in 2003 in the Parsa district.
Dosing in MDA program
Age groups DEC – 100mg tablets Albendazole 400 mg tablets
2-5 years 1 tab 1 tab
6-14 years 2 tabs 1 tab
>14 years 3 tabs 1 tab

44. What is the target of the fourth ANC according to SLTHP?

a) 75%

b) 80%

c) 85%

d) 90%

Correct Answer : 80%

Targets of SLTHP IMR: 34.4 per thousand live births
U5MR: 62.5 per thousand live births MMR: 250 per lakh live births
CDR: 6 per thousand populations TFR: 3.05 per women
Life expectancy: 68.2 years CPR: 58.2%
Delivery by trained personnel: 95% 4 ANC: 80% LBW: 12% etc
Some achievements According to the Multiple Indicator Cluster Survey 2014.
Neonatal Mortality rate: 23 Infant Mortality rate: 33
Under five mortality rate: 38 Stunting among under five: 37.4
Underweight among under five: 30.1 Wasting among under five: 11.3
Low birth weight infant: 24.2 Total Fertility Rate: 2.3
Unmet need for FP: 25.2 Institutional Delivery: 55.2
Skilled Birth Attendant at delivery: 55.6 etc

45. Dyspnoea is a common symptom of patients suffering from :

a) Dehydration

b) Heart disease

c) Ascites

d) Acidosis

Correct Answer : Heart disease

Dyspnoea: It refers to sudden and severe shortness of breath or difficulty in breathing. It is one of the most common reasons for visits to the accident and emergency department of the hospital. Breathlessness may be normal after exercise or exertion.
Causes of Dyspnoea: Most cases of dyspnea result from asthma, heart failure and myocardial ischemia, chronic obstructive pulmonary disease, interstitial lung disease, pneumonia, or psychogenic disorders.

46. According to NDHS 2016, unmet need for family planning is:

a) 24%

b) 26%

c) 27%

d) 35%

Correct Answer : 24%

47. The height of baby doubles in:

a) 12 months

b) 24 months

c) 18 months

d) 48 months

Correct Answer : 48 months

Birth length/height
Average length at birth: 50cm
Birth length doubles at 4 years of age
Height increase in this pattern
Age Height increments
1st year 25 cms per year
2nd year 12 cms per year
3rd year 9cms per year

48. Intrauterine fetal death (IUFD) means:

a) Death of fetus less than and equal to 500gms

b) Death of fetus greater than 500 gms

c) Death of fetus less than 500 mgs

d) Death of fetus less than 500 gms

Correct Answer: Intrauterine fetal death (IUFD) is defined as the death of a fetus beyond the period of viability (>28 weeks or > 500gms) and retained within the uterus.

Investigation:
USG – Absence of all fetal movement.
X-ray abdomen – Spalding sign (Overlapping of the cranial bones on one another due to liquefaction of the brain, usually appears 7 days after death) SUREST sign of IUFD.

49. Nepal Health Professional Council Act came in:

a) 2051

b) 2053

c) 2055

d) 2056

Correct Answer : 2053

Policies, Acts and Regulation of Nepal:
First National Health Policy – 1991AD
New National Health Policy – 2071BS
Nepal Health Service Act – 2053 BS
Nepal Health Service Regulation – 2055
Nepal Health Professional Council Act – 2053BS
Nepal Health Professional Council Regulation – 2056 BS

50. When did the health service act-edited the fourth time?

a) 2070/7/22

b) 2070/8/22

c) 2063/7/22

d) 2070/12/12

Correct Answer : 2070/12/12

Nepal health service act: 2053
First edited: 2055/10/27
Second edited: 2058/7/22
Third edited: 2063/8/22
Fourth edited: 2070/12/12

Health Sewa Tayari

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