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UP NHM CHO practice questions

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Question 1Community Health and Public Health

Under the National Health Mission, which cadre of health worker is the first point of contact for health care in rural areas and is selected from the local community?

  1. Auxiliary Nurse Midwife (ANM)
  2. Medical Officer (MO)
  3. Community Health Officer (CHO)
  4. Accredited Social Health Activist (ASHA) Correct answer.

Explanation

The ASHA is a community-based volunteer selected from and accountable to the local village, acting as the first point of contact and linking households to the public health system. ANMs and CHOs are facility-based service providers, not community-selected first contacts.

Question 2Community Health and Public Health

A CHO is calculating the infant mortality rate (IMR) for a block. Which combination correctly defines this indicator?

  1. Deaths under 1 year of age per 1,000 live births in the same year Correct answer.
  2. Deaths under 5 years of age per 1,000 live births in the same year
  3. Deaths under 1 year of age per 1,000 mid-year population
  4. Stillbirths per 1,000 total births in the same year

Explanation

IMR is the number of deaths of infants under one year of age in a given year per 1,000 live births in that same year. The denominator must be live births, not total population, and the numerator is restricted to infants below one year.

Question 3Community Health and Public Health

A pregnant woman at 28 weeks reports to the HWC. According to national guidance, what is the minimum recommended number of antenatal care visits she should complete during pregnancy?

  1. Four visits Correct answer.
  2. Six visits
  3. Three visits
  4. Eight visits

Explanation

India's national RMNCH guidance recommends a minimum of four antenatal care visits, with the first visit as early as possible in the first trimester. The four visits are scheduled at intervals through the pregnancy to allow risk detection and counselling.

Question 4Community Health and Public Health

A CHO is asked to classify a child's nutritional status using weight-for-age. Which condition does weight-for-age primarily detect?

  1. Underweight (both wasting and stunting combined) Correct answer.
  2. Obesity only
  3. Stunting only
  4. Wasting only

Explanation

Weight-for-age is a composite index: a low value reflects underweight, which can result from wasting, stunting, or both. To separate acute from chronic malnutrition, weight-for-height and height-for-age are used.

Question 5Community Health and Public Health

Under the national immunization schedule, at what age is the first dose of measles-rubella (MR) vaccine given?

  1. At birth
  2. 18 months
  3. 9 to 12 months Correct answer.
  4. 6 weeks

Explanation

The first MR dose is scheduled at 9 to 12 completed months of age, when maternal antibodies have waned enough for an adequate response. A second dose follows later in the second year of life.

Question 6Community Health and Public Health

A CHO is counselling a family about ORS and zinc in a child with acute watery diarrhoea and no dehydration. Which advice is correct?

  1. Give ORS only when the child becomes dehydrated
  2. Give zinc for 3 days only
  3. Give ORS after each loose stool and zinc for 14 days Correct answer.
  4. Withhold ORS and give only plain water

Explanation

For diarrhoea without dehydration, ORS is given after each loose stool to replace losses, and zinc supplementation continues for 14 days to reduce duration and recurrence. Zinc is not stopped when the stools settle.

Question 7Community Health and Public Health

Which vector is responsible for transmitting malaria in India?

  1. Sandfly
  2. Female Aedes mosquito
  3. Female Anopheles mosquito Correct answer.
  4. Housefly

Explanation

Malaria is transmitted by the bite of an infected female Anopheles mosquito, which feeds mainly at night. Aedes transmits dengue and chikungunya, while sandflies transmit kala-azar.

Question 8Community Health and Public Health

A CHO is recording a birth in the community. Which document is the primary legal record used to register the birth?

  1. Birth report to the local registrar under the civil registration system Correct answer.
  2. The child's immunization card
  3. The mother's antenatal card
  4. The HWC outpatient register

Explanation

Birth registration is a legal process under the civil registration system, and the birth certificate issued by the registrar is the primary legal record. Health records support notification but do not replace legal registration.

Question 9Community Health and Public Health

A CHO screens a 30-year-old man for hypertension at the HWC. Using standard criteria, a diagnosis of hypertension is supported when the blood pressure is persistently at or above which level?

  1. 130/85 mmHg
  2. 140/90 mmHg Correct answer.
  3. 120/80 mmHg
  4. 160/100 mmHg

Explanation

Hypertension is generally defined as a persistent systolic pressure of 140 mmHg or more and/or diastolic pressure of 90 mmHg or more. Readings must be confirmed on repeated occasions before labelling a person hypertensive.

Question 10Community Health and Public Health

A CHO is calculating the body mass index of an adult who weighs 60 kg and is 1.5 m tall. What is the BMI and its category?

  1. 22.2, normal
  2. 30.0, obese
  3. 26.7, overweight Correct answer.
  4. 24.0, normal

Explanation

BMI equals weight in kilograms divided by height in metres squared, so 60 divided by 2.25 gives about 26.7. For adults, a BMI of 25 to 29.9 is classified as overweight.

Question 11Community Health and Public Health

A pregnant woman with severe anaemia is identified at the HWC. What is the most appropriate immediate action by the CHO?

  1. Reassure her and schedule a routine visit next month
  2. Refer urgently to a facility for management while starting iron-folic acid therapy as advised Correct answer.
  3. Advise only dietary iron-rich foods
  4. Start oral iron and review after three months

Explanation

Severe anaemia in pregnancy is a high-risk condition requiring urgent referral for parenteral iron or transfusion as indicated, alongside iron-folic acid therapy. Delay risks maternal and fetal complications.

Question 12Community Health and Public Health

A CHO is assessing a newborn for danger signs using IMNCI guidance. Which finding alone mandates immediate referral?

  1. Mild umbilical redness without pus
  2. Occasional hiccups after feeding
  3. A single episode of possetting
  4. Fast breathing with chest indrawing Correct answer.

Explanation

In the newborn, fast breathing with chest indrawing is a sign of possible severe bacterial infection or pneumonia and requires immediate referral. Minor findings such as possetting or mild redness without pus do not by themselves mandate urgent referral.

Question 13Community Health and Public Health

A CHO is explaining DOTS to a tuberculosis patient. Which statement correctly describes the purpose of direct observation of treatment?

  1. It replaces the need for sputum testing
  2. It ensures each dose is actually taken so adherence is supported and resistance is prevented Correct answer.
  3. It shortens the total treatment duration
  4. It removes the need for nutritional support

Explanation

Directly observed treatment provides a trained observer or treatment supporter to confirm each dose is swallowed, improving adherence and reducing the risk of relapse and drug resistance. It does not eliminate the need for monitoring tests or nutritional support.

Question 14Community Health and Public Health

A CHO is preparing a microplan for a measles-rubella vaccination campaign. Which element is most essential for reaching unvaccinated children in hard-to-reach hamlets?

  1. House-to-house mapping of target children with a defaulter list Correct answer.
  2. Posting notices only at the health centre
  3. Relying on walk-in attendance
  4. Distributing vaccines without a register

Explanation

Microplanning relies on mapping every household and listing target children so that missed or defaulting children can be tracked and vaccinated. Passive approaches such as walk-in attendance miss the most vulnerable children.

Question 15Community Health and Public Health

A CHO is investigating a cluster of jaundice cases in a village. Which route is the most likely mode of transmission for hepatitis A in this setting?

  1. Faecal-oral contamination of water or food Correct answer.
  2. Transplacental transmission
  3. Needle-stick injury
  4. Sexual contact

Explanation

Hepatitis A spreads mainly by the faecal-oral route through contaminated water and food, which explains village-level clustering. Blood-borne and sexual routes are associated with hepatitis B and C.

Question 16Community Health and Public Health

A CHO is asked to prioritise households for a vector-control drive. Which environmental measure is most effective in reducing Aedes breeding?

  1. Distributing mosquito nets
  2. Eliminating stagnant water in domestic containers weekly Correct answer.
  3. Spraying insecticide on house walls
  4. Fumigating drains once a year

Explanation

Aedes breeds in clean stagnant water in domestic containers, so source reduction through weekly emptying and scrubbing of containers attacks the breeding cycle directly. Adulticide spraying and nets have a secondary role for this vector.

Question 17Community Health and Public Health

A CHO is calculating a coverage indicator for the block. If 900 children received the third dose of pentavalent vaccine and the estimated eligible population is 1,000, what is the coverage?

  1. 90 percent Correct answer.
  2. 900 percent
  3. 45 percent
  4. 9 percent

Explanation

Coverage equals doses administered divided by the estimated eligible population, multiplied by 100. Here 900 divided by 1,000 equals 0.9, which is 90 percent.

Question 18Community Health and Public Health

A CHO is counselling a couple on family planning. Which method is classified as a long-acting reversible contraceptive?

  1. Oral contraceptive pill
  2. Withdrawal
  3. Copper intrauterine device Correct answer.
  4. Condom

Explanation

The copper intrauterine device is inserted once and provides protection for years without user action, making it a long-acting reversible method. Condoms, pills, and withdrawal all depend on consistent user behaviour.

Question 19Community Health and Public Health

A CHO is teaching a mother to prepare ORS at home. Which instruction is correct?

  1. Dissolve the entire packet in one litre of clean drinking water and use within 24 hours Correct answer.
  2. Add extra sugar to improve taste
  3. Dissolve the packet in half a litre of water
  4. Store the prepared solution for up to a week

Explanation

One standard ORS packet is dissolved in one litre of safe water, and the solution should be discarded after 24 hours to avoid bacterial contamination. Wrong concentrations can worsen dehydration or cause harm.

Question 20Community Health and Public Health

A CHO is assessing dehydration in a child with diarrhoea. Which combination of signs indicates severe dehydration requiring urgent IV fluids?

  1. Sunken eyes, skin pinch returning very slowly, and lethargy Correct answer.
  2. Dry mouth with normal skin pinch
  3. Restless irritability with thirst and slightly sunken eyes
  4. No signs of dehydration

Explanation

Severe dehydration is identified by two or more of sunken eyes, slow skin pinch return, and lethargy or unconsciousness, and requires urgent intravenous rehydration. Restlessness with thirst and slightly sunken eyes suggests some dehydration managed with ORS.

Question 21Community Health and Public Health

A CHO is interpreting a maternal death review. Which finding is classified as a direct obstetric cause of maternal death?

  1. Cardiac disease aggravated by pregnancy
  2. Anaemia aggravated by pregnancy
  3. Postpartum haemorrhage Correct answer.
  4. Suicide during pregnancy

Explanation

Direct obstetric deaths result from complications of pregnancy, labour, or their management, such as postpartum haemorrhage. Deaths from pre-existing disease aggravated by pregnancy are indirect, and injury or suicide is a coincidental cause.

Question 22Community Health and Public Health

A CHO is reviewing a block's performance. The infant mortality rate is high but the maternal mortality ratio is low. Which interpretation best fits this pattern?

  1. Neonatal and post-neonatal conditions dominate mortality while obstetric risk is comparatively controlled Correct answer.
  2. The denominator for live births is missing
  3. The data must be fabricated
  4. Maternal referral systems have failed completely

Explanation

A high IMR with a low MMR suggests that newborn and infant conditions such as prematurity, infection, and malnutrition are the main drivers, while obstetric care and referral are relatively effective. The two indicators respond to different sets of interventions.

Question 23Community Health and Public Health

A CHO is investigating a suspected cholera outbreak. Which case definition is most appropriate for initial case finding in the community?

  1. Acute watery diarrhoea in a person aged over two years in an affected area Correct answer.
  2. Vomiting without diarrhoea
  3. Any diarrhoea with fever
  4. Bloody diarrhoea with tenesmus

Explanation

In an outbreak of acute watery diarrhoea, the working case definition is acute watery diarrhoea in a person above two years in the affected area, which has high sensitivity for cholera. Dysentery-type definitions would miss cholera cases.

Question 24Community Health and Public Health

A CHO is planning a behaviour change communication activity for a village resistant to immunization. Which approach is most consistent with the principles of community-based communication?

  1. Publishing a government circular in the local language
  2. Warning families of legal consequences for refusal
  3. Engaging local influencers and addressing specific fears through dialogue Correct answer.
  4. Distributing leaflets without discussion

Explanation

Effective behaviour change communication uses dialogue with trusted local influencers and addresses the specific concerns behind hesitancy. One-way information such as leaflets or warnings rarely shifts deeply held fears.

Question 25Community Health and Public Health

A CHO is calculating the annual parasite incidence (API) for malaria in a block. Which formula is correct?

  1. Confirmed malaria cases in a year divided by population, multiplied by 100
  2. Confirmed malaria cases divided by slide examinations
  3. Confirmed malaria cases in a year divided by population, multiplied by 1,000 Correct answer.
  4. Deaths from malaria divided by total cases

Explanation

API is the number of confirmed malaria cases in a year per 1,000 population at risk. It is a case-detection indicator, not a proportion of slides examined or a case-fatality measure.

Question 26Community Health and Public Health

A CHO is conducting a household survey and needs to estimate the prevalence of tobacco use in a village. Which measure of disease frequency is most appropriate for this purpose?

  1. Case fatality rate
  2. Incidence rate
  3. Prevalence proportion Correct answer.
  4. Attack rate

Explanation

Prevalence proportion measures the total number of existing cases (new and old) in a population at a given point or period, which is exactly what a survey of current tobacco use captures. Incidence rate counts only new cases arising over time, so it cannot describe the existing burden. Case fatality and attack rate describe outcomes of specific disease episodes or outbreaks, not chronic habit prevalence.

Question 27Community Health and Public Health

A CHO is preparing a village health plan and wants to classify households below the poverty line using the official multidimensional deprivation approach. Which set of dimensions is used in the national MPI framework applied in India?

  1. Only income and asset ownership
  2. Land holding and livestock ownership
  3. Health, education, and standard of living Correct answer.
  4. Caste, religion, and occupation

Explanation

The national multidimensional poverty index used in India assesses deprivation across three broad dimensions: health, education, and standard of living, each with weighted indicators such as nutrition, school attendance, sanitation, and cooking fuel. It is explicitly not a purely income-based measure. Caste, religion, land holding, and livestock are not the MPI dimensions.

Question 28Community Health and Public Health

A CHO is asked to calculate the sex ratio of a sub-centre population where there are 950 females and 1,000 males. How should the sex ratio be expressed using the standard Indian demographic convention?

  1. 1,000 males per 950 females
  2. 950 females per 1,000 males Correct answer.
  3. 1,000 females per 950 males
  4. 950 males per 1,000 females

Explanation

In Indian demographic reporting, the sex ratio is conventionally expressed as the number of females per 1,000 males. With 950 females and 1,000 males, the ratio is therefore 950 females per 1,000 males. Reversing the numerator or denominator changes the meaning and is not the standard convention.

Question 29Community Health and Public Health

A CHO is explaining the epidemiological triad to a newly trained ASHA. Which statement best describes the interaction among agent, host, and environment in disease causation?

  1. The host's genetic makeup is the single most important determinant
  2. Environmental factors act only after the agent has entered the host
  3. The agent alone determines whether disease occurs in a population
  4. Disease results from a balance among agent, host, and environmental factors Correct answer.

Explanation

The epidemiological triad holds that disease arises from the interaction of an agent, a susceptible host, and an environment that brings them together. A change in any one component can shift the balance toward or away from disease. No single element is considered sufficient on its own.

Question 30Community Health and Public Health

A CHO is analysing weekly fever surveillance data and wants to detect an unusual rise in cases early. Which method is most suitable for detecting a temporal cluster of febrile illness in the block?

  1. Reviewing the case fatality rate of the previous year
  2. Comparing the current week's cases with a historical baseline for the same week Correct answer.
  3. Calculating the annual parasite incidence for the whole year
  4. Conducting a one-time prevalence survey of the block

Explanation

Early detection of an unusual rise requires comparing current counts with an expected baseline for the same time period, which controls for seasonal variation. Annual or yearly indicators are too aggregated to detect a short-term cluster. A one-time prevalence survey and past case fatality data do not capture week-to-week changes.

Question 31Community Health and Public Health

A CHO is reviewing the cold chain at a health and wellness centre. Which vaccine requires storage at the coldest temperature range among routine immunisation products?

  1. Measles-rubella vaccine
  2. Tetanus toxoid vaccine
  3. Oral polio vaccine Correct answer.
  4. Diphtheria-pertussis-tetanus vaccine

Explanation

Oral polio vaccine is a live attenuated vaccine that must be kept frozen at very low temperatures for long-term storage, making it the coldest-requiring product among these options. DPT, measles-rubella, and tetanus toxoid are stored at refrigerated temperatures of 2 to 8 degrees Celsius. Live viral vaccines such as measles-rubella still require cold storage but not the deep-freeze range used for OPV.

Question 32Community Health and Public Health

A CHO is planning a nutrition counselling session for mothers of children under three years. Which practice is recommended for complementary feeding beginning at six months?

  1. Continue exclusive breastfeeding until the child is two years old
  2. Start complementary feeds only after the first tooth appears
  3. Introduce semisolid foods while continuing breastfeeding up to two years or beyond Correct answer.
  4. Replace breast milk entirely with cow's milk at six months

Explanation

Infant and young child feeding guidance recommends initiating adequate, safe complementary feeding at six months while continuing breastfeeding up to two years or beyond. Exclusive breastfeeding alone after six months is insufficient for energy and micronutrient needs. Replacing breast milk with cow's milk or delaying feeds until teething is inappropriate.

Question 33Community Health and Public Health

A CHO is assessing a 24-year-old woman with a body mass index of 17.5 kg/m2 who reports fatigue. According to WHO classification, how should her nutritional status be categorised?

  1. Underweight Correct answer.
  2. Obese
  3. Normal weight
  4. Overweight

Explanation

WHO classifies a body mass index below 18.5 kg/m2 as underweight, so 17.5 kg/m2 falls in the underweight category. Normal weight spans 18.5 to 24.9, overweight 25 to 29.9, and obesity 30 and above. This categorisation guides counselling and further nutritional assessment.

Question 34Community Health and Public Health

A CHO is investigating a food-borne outbreak after a village feast. Which study design is most efficient for identifying the food item responsible?

  1. A retrospective cohort study comparing attack rates among those who ate and did not eat each food Correct answer.
  2. A case series describing the symptoms of affected persons
  3. A cross-sectional survey of the entire district population
  4. A randomised controlled trial assigning villagers to different foods

Explanation

In a defined group exposed at a common event, a retrospective cohort study calculates attack rates for exposed and unexposed persons for each food item, quickly identifying the item with the highest risk. A randomised trial is neither ethical nor feasible during an outbreak. A district-wide survey and a case series cannot compare exposure between ill and well persons.

Question 35Community Health and Public Health

A CHO is asked to interpret a screening test result. The test has high sensitivity but low specificity. What is the main consequence for the population being screened?

  1. Many people without disease will test positive and need further evaluation Correct answer.
  2. All true cases will be missed by the test
  3. The test will be useless for any public health purpose
  4. Many people without disease will be falsely reassured

Explanation

High sensitivity means few true cases are missed, but low specificity means many people without the disease will test positive, generating false positives and follow-up burden. A highly sensitive test is not falsely reassuring, since it rarely misses disease. It remains useful for ruling out disease and for initial screening.

Question 36Community Health and Public Health

A CHO is counselling a community about dengue prevention. Which Aedes aegypti breeding behaviour should the CHO emphasise for source reduction?

  1. Breeding in fast-flowing streams and rivers
  2. Breeding in stagnant water collected in domestic containers around houses Correct answer.
  3. Breeding in dry sandy soil away from water
  4. Breeding in deep wells with a high water table

Explanation

Aedes aegypti is a domestic container breeder that lays eggs in clean stagnant water in items such as drums, pots, tyres, and overhead tanks near human dwellings. Source reduction therefore focuses on emptying and covering domestic water containers. Fast-flowing water, deep wells, and dry soil are not its typical breeding habitats.

Question 37Community Health and Public Health

A CHO is reviewing maternal health data and wants to compute the maternal mortality ratio. Which numerator and denominator combination is correct?

  1. Maternal deaths in a year divided by total female population, multiplied by 100,000
  2. All deaths of women of reproductive age divided by live births, multiplied by 1,000
  3. Maternal deaths in a year divided by live births in the same year, multiplied by 100,000 Correct answer.
  4. Maternal deaths divided by total deaths in the year, multiplied by 100

Explanation

The maternal mortality ratio expresses maternal deaths per 100,000 live births in a given period, linking deaths to the number of pregnancies that ended in birth. Using the total female population gives a mortality rate, not the ratio. The other options use incorrect denominators or multipliers.

Question 38Community Health and Public Health

A CHO is managing a suspected measles case in a village. Which action best reflects the principle of outbreak response under integrated disease surveillance?

  1. Report immediately, isolate the case, and begin listing and following contacts Correct answer.
  2. Wait for laboratory confirmation before informing the block surveillance officer
  3. Advise the family to bring the child back only if a rash appears on the palms
  4. Discontinue routine immunisation activities until the outbreak ends

Explanation

Under integrated disease surveillance, a suspected measles case must be reported promptly while investigation proceeds, and control measures include isolation and contact tracing with vaccination of susceptible contacts. Waiting for laboratory results delays response. Continuing routine immunisation is essential during outbreaks.

Question 39Community Health and Public Health

A CHO is asked to explain the concept of herd immunity during a community meeting. Which statement is accurate?

  1. It can be achieved with a very low coverage level for highly transmissible diseases
  2. It protects unvaccinated individuals when a sufficiently high proportion of the population is immune Correct answer.
  3. It applies equally to all diseases regardless of how contagious they are
  4. It means every individual in the community has been vaccinated

Explanation

Herd immunity occurs when enough people are immune that transmission chains break, indirectly protecting those who are not immune. The threshold depends on the infectiousness of the pathogen and is higher for more transmissible diseases such as measles. It does not require universal vaccination.

Question 40Community Health and Public Health

A CHO is planning a behaviour change activity to improve sanitation in a village where open defecation is common. Which approach is most consistent with community-led total sanitation principles?

  1. Punishing households that continue open defecation with fines
  2. Distributing cash incentives to households that build toilets first
  3. Facilitating community analysis of faecal-oral contamination and collective action Correct answer.
  4. Building toilets for households without involving them in the decision

Explanation

Community-led total sanitation uses participatory facilitation so that the community itself analyses the health consequences of open defecation and commits to collective behaviour change. External punishment, cash prizes, or constructing toilets without community involvement undermine ownership and sustained use. The emphasis is on triggering collective action rather than top-down enforcement.

Question 41Primary Health Care and National Health Programs

Under the National Health Mission, which cadre of worker is the first point of contact for health care in the community and is chosen from the village itself after a community selection process?

  1. Accredited Social Health Activist (ASHA) Correct answer.
  2. Auxiliary Nurse Midwife (ANM)
  3. Community Health Officer (CHO)
  4. Medical Officer at the PHC

Explanation

The ASHA is a community-level volunteer selected by and from the village through a participatory process and acts as the first point of contact linking households to the public health system. ANMs and CHOs are facility-based trained providers, not community-selected volunteers.

Question 42Primary Health Care and National Health Programs

A Health and Wellness Centre under Ayushman Bharat is designed to deliver which package of services?

  1. Only maternal and child health services
  2. Comprehensive primary health care including non-communicable diseases and free essential drugs and diagnostics Correct answer.
  3. Only emergency obstetric referral services
  4. Only national programme immunization services

Explanation

The Health and Wellness Centre component of Ayushman Bharat upgrades sub-centres and PHCs to deliver comprehensive primary health care, adding care for non-communicable diseases, mental health, and free essential medicines and diagnostics to existing services.

Question 43Primary Health Care and National Health Programs

A pregnant woman in her second trimester reports to the ANM for her first antenatal check-up. Under the national antenatal care protocol, how many total antenatal visits should be ensured during pregnancy?

  1. Two visits
  2. Eight visits
  3. Four visits Correct answer.
  4. Three visits

Explanation

India's national guidance follows the minimum of four antenatal visits, with the first as early as possible, then at 14–26 weeks, 28–34 weeks, and 36 weeks onwards. This schedule is used for risk assessment, haemoglobin and blood pressure checks, and counselling.

Question 44Primary Health Care and National Health Programs

Under the Janani Suraksha Yojana, cash assistance is provided primarily to promote which outcome?

  1. Institutional delivery among pregnant women from eligible households Correct answer.
  2. Permanent sterilisation of eligible couples
  3. Nutritional supplementation for adolescent girls
  4. Immunization of children under five years

Explanation

JSY is a conditional cash transfer scheme that incentivises pregnant women, especially from BPL and SC/ST households, to deliver in a health facility with skilled attendance. It also provides compensation to ASHAs for facilitating the process.

Question 45Primary Health Care and National Health Programs

A 30-year-old woman in a high-focus district is being counselled under the Janani Shishu Suraksha Karyakram. Which entitlement applies to her?

  1. Free delivery including caesarean section, drugs, diagnostics, and diet in public health facilities Correct answer.
  2. Free treatment limited to private empanelled hospitals
  3. Cash incentive paid only after the child turns one year
  4. Free transport only for the newborn

Explanation

JSSK entitles pregnant women and sick newborns to free delivery (including caesarean), free drugs and consumables, free diagnostics, free diet, and free transport between home and facility in public institutions. It eliminates out-of-pocket expenditure for these services.

Question 46Primary Health Care and National Health Programs

Under the Universal Immunization Programme, at what age is the first dose of measles-rubella vaccine scheduled?

  1. At birth
  2. At 18 months
  3. At 9–12 months Correct answer.
  4. At 5 years

Explanation

The first measles-rubella dose is given at 9–12 completed months of age, followed by a second dose at 16–24 months. Giving it earlier than 9 months risks interference from maternal antibodies.

Question 47Primary Health Care and National Health Programs

A mother brings a 10-month-old with a history of no BCG scar and no immunization records. What is the correct action regarding BCG?

  1. Refuse BCG as the child is older than 6 months
  2. Do a tuberculin skin test before giving BCG
  3. Give BCG only after the child completes one year
  4. Give BCG immediately as the child is still within the eligible age Correct answer.

Explanation

BCG can be given up to five years of age if not given earlier, and a tuberculin test is not a routine prerequisite before vaccination. A missing scar alone does not contraindicate revaccination decisions at the programme level.

Question 48Primary Health Care and National Health Programs

Under the Revised National Tuberculosis Control Programme, which diagnostic test is recommended as the initial test for drug-resistant TB?

  1. Chest radiograph
  2. Mantoux test
  3. Cartridge-based nucleic acid amplification test (CBNAAT) Correct answer.
  4. Sputum smear microscopy

Explanation

CBNAAT detects Mycobacterium tuberculosis and rifampicin resistance simultaneously, making it the preferred upfront test for presumptive drug-resistant TB. Smear microscopy cannot detect resistance.

Question 49Primary Health Care and National Health Programs

A patient with newly diagnosed pulmonary TB is started on daily regimen under NTEP. Which drug combination forms the intensive phase of first-line therapy?

  1. Isoniazid and streptomycin only
  2. Isoniazid, rifampicin, pyrazinamide, ethambutol Correct answer.
  3. Rifampicin and ethambutol only
  4. Isoniazid, pyrazinamide, and ciprofloxacin

Explanation

First-line therapy for drug-sensitive TB uses four drugs-isoniazid, rifampicin, pyrazinamide, and ethambutol-during the intensive phase. The continuation phase drops pyrazinamide and ethambutol.

Question 50Primary Health Care and National Health Programs

Under the National Programme for Prevention and Control of Non-Communicable Diseases, which of the following is a key screening target at the primary level?

  1. Raised blood pressure and raised blood glucose in adults above 30 years Correct answer.
  2. Only anaemia in adolescent girls
  3. Only congenital heart disease in children
  4. Only cancer screening in women

Explanation

NPCDCS focuses on screening adults above 30 years for hypertension and diabetes, along with oral, breast, and cervical cancer screening. This enables early detection and referral at the primary level.