Maternal and Child Health Practice Questions

Q: Consider the following in respect of Navjyot Shishu Suraksha Karyakram (NSSK): 1. It is a programme aimed to train health personnel in basic newborn care and resuscitation 2. It addresses care at birth issues (i.e. prevention of hypothermia, prevention of infection, early initiation of breastfeeding and basic newborn resuscitation) 3. The objective is to have a trained health person in basic newborn care and resuscitation at every delivery point Which of the statements given above are correct?

1, 2 and 3. ***1, 2 and 3*** - The **Navjyot Shishu Suraksha Karyakram (NSSK)** focuses on training healthcare personnel in **basic newborn care and resuscitation** to reduce neonatal mortality. - It addresses critical **care at birth issues**, including preventing **hypothermia**, preventing **infections**, promoting **early breastfeeding initiation**, and providing **basic newborn resuscitation**. The overarching objective is to ensure that a trained health person is available at **every delivery point** to provide essential newborn care. *1 and 2 only* - This option incorrectly excludes the third statement regarding the objective of having a trained health person at every delivery point. - The target of ensuring trained personnel at every birth is a core component and objective of the NSSK. *2 and 3 only* - This option incorrectly excludes the first statement, which details the primary function of training health personnel. - The NSSK is fundamentally a training program designed to equip healthcare providers with the necessary skills. *1 and 3 only* - This option incorrectly excludes the second statement, which outlines the specific care at birth issues addressed by the program. - The identified issues such as preventing hypothermia, infection, and promoting breastfeeding are central to the effectiveness of the NSSK.

Q: Which of the following schemes is primarily aimed at promoting safe motherhood and reducing maternal mortality in India?

Janani Suraksha Scheme. ***Janani Suraksha Yojana (JSY)*** - This is the **flagship national scheme** launched in 2005 under the National Rural Health Mission (now National Health Mission). - It provides **cash incentives** to pregnant women for choosing to deliver in health facilities and to ASHA workers for promoting institutional deliveries. - Its primary objective is to reduce **maternal and neonatal mortality** by increasing institutional deliveries and ensuring access to essential obstetric care. *Ayushman Bharat Scheme* - This is a national health protection scheme (Pradhan Mantri Jan Arogya Yojana) that provides **health insurance coverage** up to ₹5 lakhs per family for secondary and tertiary care hospitalization. - While it contributes to overall health including maternal health, its primary focus is **broader healthcare access** rather than specifically promoting safe motherhood or reducing maternal mortality through institutional delivery incentives. *Mamta Scheme* - While several state-level maternal and child health programs exist under similar names (e.g., Bihar's MAMTA scheme), there is no widely recognized **national scheme** called "Mamta Scheme" that serves as the primary program for safe motherhood. - The **Janani Suraksha Yojana** remains the principal national initiative for this objective. *Vande Mataram Scheme* - This refers to voluntary initiatives encouraging private practitioners to provide maternal health services. - While supportive of safe motherhood, it is **not the primary comprehensive national scheme** with structured financial incentives and widespread implementation for reducing maternal mortality like JSY.

Q: After male sterilization, additional contraceptive protection is

needed for 2 to 3 months. ***needed for 2 to 3 months*** - After **vasectomy**, residual **sperm** distal to the ligation site can remain in the ejaculatory ducts and vas deferens. - It takes approximately **20 ejaculations** or **2 to 3 months** for these sperm to be cleared from the reproductive tract, requiring additional contraception until **azoospermia** is confirmed. *not needed* - This option is incorrect because the male reproductive tract is not immediately sterile after a vasectomy due to the presence of **pre-existing sperm**. - Without additional contraception, there is a risk of **unintended pregnancy** until sterility is confirmed by follow-up testing. *needed for 1 to 2 months* - While closer, a duration of **1 to 2 months** may not be sufficient for all residual sperm to be cleared from the system. - The standard recommendation often extends to **3 months** or a specific number of ejaculations to ensure complete sterility. *needed for 1 month* - This duration is generally too short to ensure the complete clearance of **viable sperm** from the ejaculatory ducts after a vasectomy. - Relying on this period alone would carry a higher risk of **contraceptive failure**.

Q: Steroidal contraceptives available in the basket of contraceptive choice from Ministry of Health & Family Welfare, Government of India are

Monophasic. ***Monophasic*** - **Monophasic oral contraceptive pills** are the formulation type available in India's National Family Planning Programme basket of contraceptive choices. - The Ministry of Health & Family Welfare provides **Mala-N** (Levonorgestrel 0.15mg + Ethinyl estradiol 0.03mg) and **Mala-D** (Desogestrel + Ethinyl estradiol) - both are monophasic formulations. - Monophasic pills contain a **fixed dose of estrogen and progestin** throughout the 21 active pill cycle, making them simpler to use and ensuring better compliance. *Biphasic* - **Biphasic pills** contain two different doses of hormones during the active pill cycle. - These are **not included** in the Government of India's national family planning programme basket of contraceptive choices. - Less commonly used compared to monophasic formulations. *Estrogen only pills* - **Estrogen-only pills** are not used as contraceptives due to the risk of **endometrial hyperplasia** and cancer if not balanced with progestin. - These are used for hormone replacement therapy or specific medical conditions, **not for contraception**. *Triphasic* - **Triphasic pills** contain three different dosages of hormones throughout the active pill cycle to mimic the natural menstrual cycle. - These are **not included** in the Government of India's national family planning programme basket. - Their varied dosing schedule is more complex and not preferred for widespread public health distribution.

Q: Which of the following are correct regarding failure rate of contraceptive methods? 1. Depot medroxyprogesterone acetate 0 to 1 per HWY 2. Norplant 0.1 per HWY 3. LNG-IUS 0.02 per HWY 4. Levonorgestrel-only pills 3 per HWY

1, 2 and 3. ***1, 2 and 3*** - **Depot medroxyprogesterone acetate (DMPA)**, **Norplant** (levonorgestrel implants), and **Levonorgestrel-releasing intrauterine system (LNG-IUS)** are highly effective contraceptive methods with very low failure rates, typically below 1 pregnancy per 100 women-years (HWY) for typical use. - The quoted failure rates of 0 to 1 per HWY for DMPA, 0.1 per HWY for Norplant, and 0.02 per HWY for LNG-IUS are consistent with their known efficacy as **long-acting reversible contraceptives (LARCs)** and hormonal methods. *1, 3 and 4* - This option incorrectly includes the failure rate for **levonorgestrel-only pills (minipills)**. While minipills are effective, their typical use failure rate is generally higher than 3 per HWY, often closer to 7-10 pregnancies per 100 women-years due to the strict adherence required for daily dosing. - The failure rates for DMPA and LNG-IUS are accurate, but the inclusion of incorrectly low typical failure rate for levonorgestrel-only pills makes this option incorrect. *1, 2 and 4* - This option is incorrect because the typical failure rate of **levonorgestrel-only pills** is much higher than 3 per HWY in real-world use, often due to missed doses or delayed administration. - While DMPA and Norplant have low failure rates, the inaccuracy for levonorgestrel-only pills makes this choice invalid. *2, 3 and 4* - This option inaccurately suggests that the failure rate for **levonorgestrel-only pills** is 3 per HWY, which is generally lower than their actual typical use failure rates (closer to 7-10 pregnancies per 100 women-years). - The failure rates for Norplant and LNG-IUS are correct, but the error regarding levonorgestrel-only pills renders this option incorrect.

Q: A screening programme for school children was undertaken with the following results: 1. 30% boys and 60% girls were found to be anemic 2. 50% children had history of passing worms in stool 3. 10% children had poor vision 4. 5% children had enlarged tonsils In this context, which of the following is not an appropriate follow up activity?

Referring those children with enlarged tonsils for surgery. ***Referring those children with enlarged tonsils for surgery*** - Only **5%** of children had enlarged tonsils, and many cases of enlarged tonsils are **asymptomatic** and do not require surgery. - **Tonsillectomy** is a surgical procedure with risks and is typically reserved for recurrent infections or significant airway obstruction, which is not indicated by simple enlargement. *Providing iron supplementation to all children* - A significant proportion of children (30% boys, 60% girls) were found to be **anemic**, making universal iron supplementation a reasonable public health intervention to address widespread nutritional deficiency. - Iron deficiency is common in school-aged children and can impact **cognitive development** and physical performance. *Administering mass deworming medication to all children* - **50%** of children had a history of passing worms in stool, indicating a high prevalence of **intestinal helminthiasis** in the school population. - **Mass deworming** is a cost-effective public health strategy in areas with high prevalence to reduce the burden of worm infections and improve child health outcomes. *Prescribing corrective spectacles to children with poor vision* - **10%** of children had poor vision, a significant percentage that warrants intervention. - Providing **corrective spectacles** is an appropriate and effective follow-up to address refractive errors, which are a common cause of poor vision in children and can impact academic performance.

Q: The following statements are correct for healthful school environment except:

In the classroom, desks should be of minus type.. ***In the classroom, desks should be of minus type.*** - This statement is **incorrect** and is the exception. For a healthful school environment, desks should ideally be of the **'plus type'**, which means the desk overlaps the bench by at least 2 inches to allow for a comfortable and ergonomically sound seating posture, preventing slouching. - A 'minus type' desk, where the bench overlaps the desk, would lead to poor posture and discomfort, making it an unhealthful arrangement. *Combined window and door area should be 25% of the floor space.* - This statement is **correct** for optimal **ventilation and natural lighting** in a school environment. - Adequate window and door area (typically 20-25% of floor space) ensures proper air circulation and reduces reliance on artificial lighting, contributing to a healthier learning space. *Per capita space for each student should be 6 sq. feet.* - This statement represents an **acceptable minimum per capita space requirement** for students in a classroom according to traditional standards. - Providing sufficient space (minimum 6 sq ft, though 8-10 sq ft is preferred by modern guidelines) prevents overcrowding, allows for mobility, and ensures a comfortable learning environment. *One urinal should be provided for 60 students.* - This statement reflects an **accepted standard** for the **provision of sanitation facilities** in schools. - Adequate numbers of urinals and toilets (ratio of 1:50-60) are crucial for maintaining hygiene, preventing long queues, and ensuring accessibility for students.

Q: The Pearl index of contraceptive failure is expressed as a rate per

100 women-years. ***100 women-years*** - The **Pearl Index** is a common measure of contraceptive failure rate, expressed as the number of pregnancies per **100 women-years** of exposure. - This metric allows for standardized comparison of contraceptive effectiveness across different methods and populations. *1000 women-years* - While other epidemiological rates might be expressed per 1000 person-years, the standard for the **Pearl Index** is specifically per 100 women-years. - Using 1000 would significantly underestimate the commonly reported failure rates of contraceptives. *1 woman-year* - Expressing the rate per **1 woman-year** would result in very small, often fractional, numbers that are difficult to interpret and compare. - The larger base of 100 women-years provides a more practical and understandable scale for reporting contraceptive failure. *10 women-years* - This increment is not the recognized standard for the **Pearl Index**. - Using 10 women-years would also make the reported failure rates less comparable with established data and harder to interpret clinically.

Q: Which of the following is not true regarding ‘no scalpel’ vasectomy?

Scrotal skin is cut with LASER to expose the vas.. ***Scrotal skin is cut with LASER to expose the vas.*** - The "no-scalpel" technique specifically avoids cutting the scrotal skin with a **scalpel** or **LASER**. - Instead, a **small puncture** is made using a specialized instrument to access the vas deferens. *The failure rate is same as that of conventional vasectomy.* - The failure rate for no-scalpel vasectomy is generally very low and comparable to, or even slightly lower than, conventional vasectomy. - This is due to the precise identification and handling of the **vas deferens** through the small puncture. *Special instruments are used to deliver the vas instead of cutting the skin.* - This statement is true; the no-scalpel technique utilizes **specialized forceps** to puncture and stretch the scrotal skin. - This creates a small opening to access the vas deferens without needing a traditional incision. *It is a very popular method in China.* - The no-scalpel vasectomy technique was developed in China in 1974 by Dr. Li Shunqiang, where it gained widespread adoption. - Its popularity in China significantly contributed to its global recognition as a minimally invasive and effective method for male contraception.

Question 1

Consider the following in respect of Navjyot Shishu Suraksha Karyakram (NSSK):

1. It is a programme aimed to train health personnel in basic newborn care and resuscitation
2. It addresses care at birth issues (i.e. prevention of hypothermia, prevention of infection, early initiation of breastfeeding and basic newborn resuscitation)
3. The objective is to have a trained health person in basic newborn care and resuscitation at every delivery point

Which of the statements given above are correct?

Accepted Answer

1, 2 and 3

Answer

1 and 2 only

Answer

2 and 3 only

Answer

1 and 3 only

Question 2

Which one of the following statements regarding the growth chart is NOT true?

Accepted Answer

It is used as a tool for action against the Anganwadi worker

Answer

It is used as a tool for growth monitoring and diagnosis

Answer

It is used for planning and policy making

Answer

It is used as a tool for teaching and evaluation of effectiveness of programme

Question 3

Which of the following schemes is primarily aimed at promoting safe motherhood and reducing maternal mortality in India?

Accepted Answer

Janani Suraksha Scheme

Answer

Ayushman Bharat Scheme

Answer

Mamta Scheme

Answer

Vande Mataram Scheme

Question 4

After male sterilization, additional contraceptive protection is

Accepted Answer

needed for 2 to 3 months

Answer

not needed

Answer

needed for 1 to 2 months

Answer

needed for 1 month

Question 5

Steroidal contraceptives available in the basket of contraceptive choice from Ministry of Health & Family Welfare, Government of India are

Accepted Answer

Monophasic

Answer

Biphasic

Answer

Estrogen only pills

Answer

Triphasic

Question 6

Which of the following are correct regarding failure rate of contraceptive methods?

1. Depot medroxyprogesterone acetate 0 to 1 per HWY
2. Norplant 0.1 per HWY
3. LNG-IUS 0.02 per HWY
4. Levonorgestrel-only pills 3 per HWY

Accepted Answer

1, 2 and 3

Answer

1, 3 and 4

Answer

1, 2 and 4

Answer

2, 3 and 4

Question 7

A screening programme for school children was undertaken with the following results:

1. 30% boys and 60% girls were found to be anemic
2. 50% children had history of passing worms in stool
3. 10% children had poor vision
4. 5% children had enlarged tonsils

In this context, which of the following is not an appropriate follow up activity?

Accepted Answer

Referring those children with enlarged tonsils for surgery

Answer

Providing iron supplementation to all children

Answer

Administering mass deworming medication to all children

Answer

Prescribing corrective spectacles to children with poor vision

Question 8

The following statements are correct for healthful school environment except:

Accepted Answer

In the classroom, desks should be of minus type.

Answer

Combined window and door area should be 25% of the floor space.

Answer

Per capita space for each student should be 6 sq. feet.

Answer

One urinal should be provided for 60 students.

Question 9

The Pearl index of contraceptive failure is expressed as a rate per

Accepted Answer

100 women-years

Answer

1000 women-years

Answer

1 woman-year

Answer

10 women-years

Question 10

Which of the following is not true regarding ‘no scalpel’ vasectomy?

Accepted Answer

Scrotal skin is cut with LASER to expose the vas.

Answer

The failure rate is same as that of conventional vasectomy.

Answer

Special instruments are used to deliver the vas instead of cutting the skin.

Answer

It is a very popular method in China.

Maternal and Child Health — MCQs

Maternal and Child Health — MCQs

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