Feldsher Licensing Examination (Бага эмчийн мэргэжлийн үйл ажиллагаа эрхлэх зөвшөөрлийн шалгалт, Mongolia) Feed

Question

A 45-year-old herder presents to a bag health post complaining of sudden central chest tightness radiating to the left jaw that began 30 minutes ago while tending livestock. Blood pressure is 130/80 mmHg, pulse is 88 bpm and regular. What is the feldsher's most immediate pharmacological intervention while arranging emergency transport to the soum hospital?

Primary Care Practice

Question · Easy

Question

A feldsher at a remote soum health center is assessing a 3-year-old child with a 3-day history of acute watery diarrhea. The child is irritable, drinks water eagerly, skin pinch on the abdomen goes back slowly (in under 2 seconds), and the eyes appear sunken. According to IMCI guidelines, what degree of dehydration is present?

Primary Care Practice

Question · Easy

Question

A shepherd in an endemic plague (тарваган тахал) focus presents to a bag feldsher with a sudden high fever of 39.8°C, chills, severe headache, and an acutely painful, tense, enlarged right femoral lymph node with overlying erythematous skin. The patient skinned a dead marmot 4 days ago. What is the suspected diagnosis and mandatory immediate action?

Primary Care Practice

Question · Easy

Podcast

Nursing & Healthcare Exam Prep Podcast

Listen on Spotify

Podcast

Question

What is the recommended storage temperature range for the cold chain storage of routine vaccines (e.g., BCG, Hepatitis B, Pentavalent) at soum and bag health centers in Mongolia?

Primary Care Practice

Question · Easy

Question

A 30-year-old construction worker in a rural soum center falls from a roof, sustaining an open fracture of the right tibia with visible bone fragments and moderate active bleeding. What is the feldsher's priority sequence of first-aid management?

Primary Care Practice

Question · Easy

Question

A bag feldsher is called to a ger where a 24-year-old multiparous woman is in rapid, active second-stage labor. The fetal head is crowning and delivery is imminent; transport to the soum hospital is impossible. What is the essential maneuver during delivery of the fetal head to prevent perineal tears?

Primary Care Practice

Question · Easy

Question

A 52-year-old livestock herder presents with a 2-month history of fatigue, intermittent low-grade fever, night sweats, and severe bilateral sacroiliac and lumbar back pain. Physical examination reveals vertebral tenderness. He reports regularly drinking unboiled cow and goat milk and assisting ewes during lambing. What is the most likely diagnosis?

Primary Care Practice

Question · Medium

Question

A 28-year-old woman at 34 weeks gestation visits the soum health center for routine antenatal care. Her blood pressure is 155/100 mmHg on two readings 4 hours apart, and a dipstick urinalysis shows 2+ proteinuria. She denies headache, visual disturbance, or epigastric pain. What is the correct classification and initial management?

Primary Care Practice

Question · Medium

Question

A 3-year-old child with a 1-day history of runny nose and low-grade fever develops a barking cough, inspiratory stridor at rest, and marked chest indrawing. What is the feldsher's priority immediate treatment prior to emergency transfer?

Primary Care Practice

Question · Medium

Question

A 38-year-old pasture herder is bitten on the hand by a wolf that acted abnormally aggressive in daylight. What is the mandatory immediate local wound care and post-exposure prophylaxis protocol?

Primary Care Practice

Question · Medium

Question

A 60-year-old known hypertensive patient at a soum center suddenly develops acute shortness of breath, orthopnea, and coughing up pink frothy sputum. Physical examination reveals bilateral diffuse moist rales (crackles) up to the mid-lung fields and blood pressure 190/110 mmHg. What position should the feldsher place the patient in?

Primary Care Practice

Question · Medium

Question

A feldsher in a rural primary clinic is managing a 22-year-old patient who developed urticaria, facial angioedema, hoarseness, and wheezing 10 minutes after receiving an intramuscular penicillin injection. What is the single most critical drug, dose, and route to administer immediately?

Primary Care Practice

Question · Medium

Question

A 32-year-old herder is discovered unconscious in a snowdrift during a winter blizzard in rural Mongolia. The ambient temperature is -30°C. Core rectal temperature is 27.5°C (severe hypothermia). The pulse is slow, weak, and difficult to detect at 28 bpm. What is the essential guideline regarding cardiovascular resuscitation and active rewarming?

Primary Care Practice

Question · Medium

Question

A bag feldsher visits a household where the grandfather has just been diagnosed with bacteriologically confirmed pulmonary tuberculosis. His 3-year-old grandson has no cough, fever, weight loss or other symptoms. According to WHO guidance on TB contacts, what is the correct approach for this child?

Primary Care Practice

Question · Hard

Question

A 26-year-old primigravida presents to a soum health center at 38 weeks gestation with sudden painless bright-red vaginal bleeding soaking two sanitary pads in one hour. Uterine tone is soft and non-tender, and fetal heart rate is 142 bpm. What physical examination procedure is strictly contraindicated by the feldsher?

Primary Care Practice

Question · Hard

Question

A herder working in an abattoir develops an isolated, painless, pruritic reddish papule on the forearm that forms a fluid-filled vesicle and subsequently ruptures to form a characteristic painless, black, coal-like necrotic eschar surrounded by non-pitting edema. What is the diagnosis?

Primary Care Practice

Question · Easy

Question

A 5-year-old child presents to the bag health post with high fever, sore throat, and a diffuse fine erythematous 'sandpaper-like' rash that blanches on pressure, prominent in the groin and axillae, along with a 'strawberry tongue'. What is the most appropriate first-line antibiotic treatment?

Primary Care Practice

Question · Easy

Question

What is the primary action of the bag feldsher upon delivering a healthy full-term newborn who cries immediately, to ensure thermal protection and maternal-infant bonding?

Primary Care Practice

Question · Easy

Question

A 22-year-old man in a rural soum sustains a deep knife wound to his thigh, resulting in pulsatile, bright-red active arterial bleeding. What is the immediate first-aid step to arrest hemorrhage?

Primary Care Practice

Question · Easy

Question

In a patient who is unresponsive with no normal breathing and no carotid pulse detected within 10 seconds, what is the compression-to-ventilation ratio for adult cardiopulmonary resuscitation (CPR) performed by a single rescuer?

Primary Care Practice

Question · Easy

Question

A 35-year-old herder presents with acute, colicky right flank pain that radiates anteriorly to the groin and scrotum, accompanied by nausea, vomiting, and microscopic hematuria. What is the most likely initial clinical diagnosis?

Primary Care Practice

Question · Medium

Question

A feldsher at a bag post delivers a baby in an emergency setting. Immediately following the delivery of the placenta, the mother experiences brisk vaginal bleeding exceeding 500 mL. On palpation, the uterus is soft, boggy, and enlarged above the umbilicus. What is the most common cause of this postpartum hemorrhage (PPH) and its immediate treatment?

Primary Care Practice

Question · Medium

Question

A 14-month-old child presents to the soum clinic with acute fever and bilateral painful swelling of the parotid glands. The child did not receive the scheduled MMR vaccine (measles, mumps and rubella) at 9 months. What is the most likely diagnosis?

Primary Care Practice

Question · Medium

Question

A 29-year-old motorcycle driver crashes on an unpaved steppe road. He is conscious but tachypneic (respiratory rate 32/min), cyanotic, with severe right-sided chest pain, absent breath sounds on the right, hyperresonance to percussion, and tracheal deviation toward the left. Blood pressure is 80/50 mmHg. What is the diagnosis and urgent lifesaving intervention?

Primary Care Practice

Question · Medium

Question

A 4-year-old child presents with a 5-day history of high fever (39.5°C), conjunctival injection without purulence, dry cracked lips, swollen red tongue ('strawberry tongue'), cervical lymphadenopathy, and erythema of the palms and soles with slight edema. What serious condition must the feldsher suspect, requiring urgent referral for echocardiography and immunoglobulin therapy?

Primary Care Practice

Question · Medium

Question

A 70-year-old bedridden stroke patient in a ger develops a localized area of persistent, non-blanchable erythema over the sacrum with intact skin. How is this pressure injury classified according to clinical staging?

Primary Care Practice

Question · Medium

Question

A 19-year-old soldier stationed in a rural aimag develops sudden high fever, rigors, petechial and purpuric rash on the lower limbs and trunk, severe headache, and neck stiffness. Blood pressure drops to 75/40 mmHg. While arranging immediate transport, what empirical parenteral antibiotic must the feldsher administer at once?

Primary Care Practice

Question · Hard

Question

A 48-year-old man presents with acute severe epigastric pain that began suddenly 2 hours ago. He describes it as feeling like 'a knife piercing through his stomach.' On examination, his abdomen is rigid, completely silent with absent bowel sounds, and demonstrates board-like involuntary guarding throughout. What is the definitive initial diagnostic suspicion and proper management?

Primary Care Practice

Question · Hard

Question

A feldsher is evaluating a 28-year-old woman at 10 weeks gestation with acute unilateral lower abdominal pain, slight vaginal spotting, and dizziness. Her pulse is 112 bpm, blood pressure is 90/55 mmHg, and cervical motion tenderness ('chandelier sign') is elicited on gentle bimanual examination. What is the most critical life-threatening diagnosis to rule out?

Primary Care Practice

Question · Hard

Question

A 10-year-old boy in a rural bag falls from a horse, hitting his head. He had brief loss of consciousness for 2 minutes, then awoke fully alert and oriented. Two hours later, he becomes increasingly drowsy, develops a dilated, non-reactive pupil on the right side, and vomits. What intracranial hemorrhage is classically characterized by this 'lucid interval'?

Primary Care Practice

Question · Hard

Question

At a bag immunization session, a feldsher reconstitutes a 10-dose vial of freeze-dried measles-mumps-rubella (MMR) vaccine. According to the WHO multi-dose vial policy, when must the opened vial be discarded?

Primary Care Practice

Question · Easy

Question

A bag feldsher visits a 2-month-old infant for routine well-child assessment. Which developmental milestone is expected in a typically developing 2-month-old infant?

Primary Care Practice

Question · Easy

Question

When assessing a conscious choking adult who is clutching their neck and unable to speak, breathe, or cough effectively, what is the recommended immediate first-aid maneuver?

Primary Care Practice

Question · Easy

Question

What is the standard first-aid treatment for an acute partial-thickness thermal scald burn on the hand and forearm?

Primary Care Practice

Question · Easy

Question

A 7-year-old child presents to the soum clinic with itchy, honey-colored crusted lesions around the nose and mouth. No systemic fever is present. What is the most likely diagnosis?

Primary Care Practice

Question · Medium

Question

A 55-year-old male smoker presents with a 3-month history of productive cough, exertional breathlessness, and wheezing. Physical examination reveals a barrel chest, prolonged expiratory phase, and decreased breath sounds bilaterally. What chronic obstructive pulmonary disease (COPD) management step is most effective in slowing disease progression?

Primary Care Practice

Question · Medium

Question

A pregnant woman at 30 weeks gestation presents to a soum health center complaining of intense generalized pruritus, predominantly on the palms and soles, which worsens noticeably at night. There is no primary cutaneous rash, but excoriations are visible. Laboratory testing reveals elevated serum bile acids and mild transaminitis. What is the diagnosis?

Primary Care Practice

Question · Medium

Question

A 12-year-old child presents to the bag post with severe ear pain, fever (38.5°C), and reduced hearing on the right side. Otoscopic examination shows an intensely erythematous, bulging tympanic membrane with loss of the normal light reflex and landmarks. What is the primary diagnosis and standard first-line antibiotic if indicated?

Primary Care Practice

Question · Medium

Question

An 8-month-old infant is brought to the clinic with fever, cough, and rapid breathing. On examination, the respiratory rate is 55 breaths per minute. There is no chest indrawing and no stridor. Under IMCI guidelines, how is this infant categorized?

Primary Care Practice

Question · Medium

Question

A 65-year-old known diabetic patient in a soum center presents with sweating, tremulousness, confusion, tachycardia (110 bpm), and slurred speech. Capillary blood glucose test shows 2.2 mmol/L. What is the immediate first-line treatment if the patient is able to swallow?

Primary Care Practice

Question · Medium

Question

A 24-year-old male presents with acute pain, redness, and swelling on the dorsum of his hand after a minor scrape 2 days ago. Physical examination reveals advancing erythema with poorly demarcated borders, warmth, and local tenderness. No fluctuance or purulent discharge is noted. What is the diagnosis?

Primary Care Practice

Question · Medium

Question

A 4-year-old child weighing 16 kg is brought to the soum health center 1 hour after a hot-water scald covering 25% of the total body surface area (TBSA). Using the Parkland formula (4 mL x body weight in kg x %TBSA of Ringer's lactate over the first 24 hours), how much Ringer's lactate should be given in the first 8 hours after the injury?

Primary Care Practice

Question · Medium

Question

During a winter soum clinic visit, an elderly patient is brought in following carbon monoxide poisoning from a malfunctioning ger stove (пийшин). The patient is lethargic and complains of throbbing headache, nausea, and dizziness. The pulse oximeter shows 98% SpO2. What is the fundamental trap in using standard pulse oximetry, and what is the primary treatment?

Primary Care Practice

Question · Hard

Question

A 23-year-old woman in her third trimester of pregnancy is brought to the clinic following a sudden generalized tonic-clonic convulsion lasting 2 minutes. Her blood pressure is 170/110 mmHg, and urine dipstick reveals 3+ protein. What is the drug of choice for arresting and preventing further eclamptic seizures, and what is the primary monitoring parameter for toxicity?

Primary Care Practice

Question · Hard

Question

A 3-year-old child presents with sudden severe stridor, drooling, dysphagia, high fever (40°C), and assumes a 'tripod' posture (sitting upright, leaning forward with neck hyperextended and chin thrust forward). The child appears pale and toxic. What diagnosis must be immediately suspected, and what action is strictly avoided?

Primary Care Practice

Question · Hard

Loading more…