A 4-month old infant was brought to the health center of cough. Her respiratory rate is

Correct Answer: A

Rationale: The correct answer is A because using the Integrated Management of Childhood Illness (IMCI) guidelines, the respiratory rate of a 4-month-old infant is crucial in determining the severity of illness. IMCI guidelines help classify respiratory rates as fast, normal, or slow based on age-specific ranges. By following these guidelines, healthcare providers can accurately assess the infant's respiratory status and provide appropriate interventions. Choice B is incorrect as simply stating "fast" does not provide a standardized assessment based on guidelines. Choice C is incorrect as labeling the respiratory rate as "slow" without reference to guidelines can lead to misinterpretation. Choice D is incorrect as it does not specify the assessment based on IMCI guidelines, which are essential for accurate evaluation in pediatric cases.

Correct Answer: D

Rationale: The correct answer is D: Edema. In severe protein energy malnutrition like kwashiorkor, edema is a hallmark sign due to low protein levels causing fluid to leak into tissues. A: Voracious appetite is incorrect as malnourished children often have reduced appetite. B: Wasting is more associated with marasmus, another form of malnutrition. C: Apathy can be seen in malnourished children, but it is not specific to kwashiorkor. In summary, edema is the most apparent sign in a child with 3rd-degree protein energy malnutrition, distinguishing it from other forms of malnutrition.

Correct Answer: D

Rationale: The correct answer is D: Conjunctival xerosis. This is the earliest sign of xerophthalmia as it indicates dryness and thickening of the conjunctiva due to lack of vitamin A. Keratomalacia (A) and corneal opacity (B) occur at later stages and are more severe manifestations. Night blindness (C) is a symptom of vitamin A deficiency but typically appears after conjunctival xerosis. Therefore, observing conjunctival xerosis during a physical examination of a young child would be the earliest sign of xerophthalmia.

Correct Answer: D

Rationale: Step 1: Lower conjunctival sac is the best area to examine for pallor as it is a mucous membrane that reflects the true color of blood vessels. Step 2: Anemia causes decreased hemoglobin levels, leading to paleness visible in lower conjunctival sac. Step 3: Palms, nailbeds, and around the lips may also show pallor, but they can be affected by other factors like skin pigmentation or lighting. Summary: Lower conjunctival sac is the best site for assessing pallor due to its direct reflection of blood vessel color, making it superior to other areas prone to external influences.

Correct Answer: C

Rationale: The correct answer is C: Instruct mothers to keep their babies at home to prevent disease transmission. This is the best course of action during a measles epidemic because keeping babies at home helps reduce their exposure to the virus and prevent its spread. Babies under 6 months are too young for the measles vaccine (choice A), and giving high doses of Retinol (choice B) is not a recommended treatment for measles. Adequate nutrition (choice D) is important for overall health but does not directly address preventing measles transmission.