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Test 15: Childhood mortality

  1. The under-5 mortality rate is expressed as the number of infants who die under the age of 5 years per:
    • 100 live births.
    • 1000 live births.
    • 100 000 live births.
    • 1 million live births.
  2. The infant mortality rate includes all infants who die under the age of:
    • 1 week.
    • 1 month.
    • 1 year.
    • 3 years.
  3. How is mortality rate best expressed?
    • Deaths per month.
    • Deaths per 6 months.
    • Deaths per year.
    • Deaths per 10 years.
  4. It is best to calculate the mortality rate:
    • For each hospital separately.
    • For all the clinics in a health district combined.
    • For the hospital and all the clinics in a health region combined.
    • For the whole region which is serviced by that hospital and those clinics.
  5. Why is it important to know the under-5 mortality rate?
    • It is one of the best methods of assessing the wellbeing of children.
    • It is important for medicolegal reasons.
    • It is important for political reasons.
    • It is important to motivate for more paediatrically trained nurses.
  6. What determines the under-5 mortality rate?
    • The gross national income.
    • The number of private doctors in the country.
    • The health, nutrition and home environment of children.
    • The number of tertiary hospitals.
  7. What is the under-5 mortality rate in most well resourced countries?
    • Less than 5
    • Less than 10
    • Less than 50
    • Less than 100.
  8. What is the estimated under-5 mortality rate in South Africa?
    • 15
    • 30
    • 70
    • 90
  9. Which childhood deaths should be notified?
    • All childhood deaths.
    • Only deaths in hospital.
    • Deaths in all hospitals and clinics.
    • Only deaths where the cause is known.
  10. When is the best time to record the clinical details after a child has died?
    • As soon as possible after the death.
    • When the patient’s hospital notes are summarised.
    • Only after the post mortem examination.
    • Only after the death has been fully discussed.
  11. What is the best way of determining the cause of childhood deaths?
    • A doctor should examine all dead children.
    • A post mortem examination should be done on all dead children.
    • All childhood deaths should be discussed at a mortality meeting.
    • All very ill children should be admitted to hospital to die.
  12. What is the aim of mortality meetings?
    • To discipline the staff.
    • To decide the cause of death and identify modifiable factors.
    • To lecture the staff on the common causes of death.
    • To collect accurate data for the annual hospital report.
  13. What is an important benefit of a mortality meeting?
    • It saves having to summarise all the notes while writing a death report.
    • It avoids doctors or nurses being sued for malpractice.
    • It is an excellent opportunity to learn.
    • It saves having to have staff meetings.
  14. Who at a mortality meeting should decide why the child died?
    • The most senior doctor.
    • The hospital administrator.
    • The doctor and nurse who last cared for the child.
    • Everyone who attends the meeting.
  15. What is a modifiable factor?
    • An example of good care.
    • A missed opportunity or substandard care.
    • Part of care that only doctors can provide.
    • Something which cannot be corrected.
  16. Modifiable factors:
    • Are always related to the family or caregiver.
    • Are never related to the clinical personnel.
    • Are the responsibility of the administration.
    • May be due to factors relating to the family, staff or administration.
  17. What is the commonest cause of under-5 deaths in South Africa (and most developing countries)?
    • Infection.
    • Malnutrition.
    • Violence.
    • Cancer.
  18. How will AIDS affect the under-5 mortality in developing countries?
    • Very little as there are so many other causes.
    • It should make little difference as children are unlikely to become infected with HIV.
    • It may increase the number of deaths in the towns and cities only.
    • It will cause a marked increase in the mortality rate.
  19. When should the HIV status be assessed in childhood deaths?
    • It is not routinely recorded as most ill children do not have an HIV screening test.
    • It is not needed if the cause of death is already known.
    • It should always be assessed clinically if screening tests have not been done.
    • Blood tests for HIV should be done on all dead children.
  20. The nutritional status should be assessed and recorded:
    • In all childhood deaths.
    • Only if the child came from a poor home or was neglected.
    • Only if the child died of infection such as TB or diarrhoea.
    • Only if the child had not routinely attended clinic.