Community Medicine — Maternal and Child Health, NMC MBBS licence examination syllabus (Nepal Medical Council).
Maternal and child health — NMC-style practice questions
Practice questions written for this chapter. These are not past NMC papers.
📋 About these questions: These are practice questions written to test the reasoning in this chapter. They are NOT reproduced from any past Nepal Medical Council examination, and no verified past NMC questions were supplied for this chapter. Questions here test definitions and reasoning rather than national statistics, which change between survey rounds.
Level 1–2 — recall and understanding
Q1. The maternal mortality ratio is expressed as maternal
deaths per:
A. 1,000 live births
B. 100,000 LIVE BIRTHS
C. 1,000 total births
D. 100,000 women of reproductive age
ANSWER: B — per 100,000 live births.
Why: maternal death is comparatively rare, so a larger
denominator is used. The child mortality measures use per
1,000 live births.
LEARNING POINT: the denominator is the commonest trap in
indicator questions.
Q2. Stunting is defined as:
A. Low weight for height
B. Low HEIGHT FOR AGE
C. Low weight for age
D. Low mid-upper arm circumference
ANSWER: B — low height for age.
Why: stunting reflects CHRONIC undernutrition, because height
takes a long time to be lost. Wasting is low weight for height
and reflects acute undernutrition.
LEARNING POINT: height = time, weight-for-height = now.
Level 3–4 — application and reasoning
Q3. A woman with postpartum haemorrhage recognises the
danger, arrives at the facility within an hour, and dies
because no blood was available. This represents:
A. The first delay
B. The second delay
C. The THIRD delay
D. No delay
ANSWER: C — the third delay.
Why: she decided promptly and travelled quickly. The failure
was in receiving adequate care on arrival — blood, staff and
emergency obstetric capability.
LEARNING POINT: arriving at a facility is not the same as
receiving care.
Q4. A district has cut under-five mortality with
immunisation and ORS, but the rate has plateaued. Further
progress most requires:
A. More immunisation coverage
B. NEWBORN care — skilled attendance, resuscitation,
warmth, infection control
C. More oral rehydration
D. Adult health services
ANSWER: B — newborn care.
Why: as deaths in older children fall, the remaining deaths
are increasingly NEONATAL, concentrated in the first days of
life and not addressed by immunisation or ORS.
LEARNING POINT: neonatal ⊂ infant ⊂ under-five — the residue
moves earlier.
Q5. A new road and free ambulance service fail to increase
facility deliveries, and women report that the decision to
travel was not theirs. The unaddressed delay is:
A. The FIRST delay — deciding to seek care
B. The second delay
C. The third delay
D. All were addressed
ANSWER: A — the first delay.
Why: the intervention targeted delay two, which was not the
binding constraint. Recognition of danger signs, cost and
women's autonomy in household decisions all act before anyone
travels.
LEARNING POINT: match the intervention to the actual delay.
Level 5 — exception-based
Q6. Which mortality measure uses TOTAL births rather than
live births as its denominator?
A. Infant mortality rate
B. Neonatal mortality rate
C. PERINATAL mortality rate
D. Under-five mortality rate
ANSWER: C — perinatal mortality rate.
Why: it counts stillbirths plus first-week deaths. Because
stillbirths appear in the numerator, they must also appear in
the denominator, so total births are used.
LEARNING POINT: numerator and denominator must describe the
same population.
Q7. Two 2-year-olds are both "underweight". One is short with
normal weight-for-height; the other is of normal height
but thin. Which needs URGENT intervention?
A. The short child, who is stunted
B. The thin child, who is WASTED
C. Both equally urgent
D. Neither
ANSWER: B — the wasted child.
Why: wasting is acute undernutrition and carries a high
immediate mortality risk, requiring urgent therapeutic
feeding. Stunting is chronic and needs long-term nutrition and
food-security measures.
LEARNING POINT: "underweight" is a composite that conceals
which of the two is present.
Syllabus points
Recall and understanding questions
Application and reasoning questions
Exception-based questions
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