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Free Practice Questions for Diploma in Child Health

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Key Facts: Diploma in Child Health Exam

Written Format: 100 Single Best Answer (SBA) questions in 2 hours

Clinical Format: 8-station remote OSCE clinical examination

Awarding Body: Royal College of Paediatrics and Child Health (RCPCH)

Target Audience: General Practitioners, GP trainees, and healthcare professionals in child health

Core Domains: General & Acute Paediatrics, Neonatology, Safeguarding, Child Development

The RCPCH Diploma in Child Health (DCH) combines a 120-minute, 100-SBA computer-based written theory paper (Foundation of Practice) and an 8-station clinical OSCE assessing child health, acute paediatrics, safeguarding, and child development.

Sample Diploma in Child Health Practice Questions

Try these sample questions to review concepts for the Diploma in Child Health exam. Each question includes a detailed explanation. Start the interactive quiz above for the full 100+ question experience with AI tutoring.

1A 4-year-old child presents to the emergency department with acute shortness of breath and wheezing. On examination, the child is conscious, speaks in short phrases, has a heart rate of 130 bpm, respiratory rate of 38 bpm, and SpO2 of 93% on air. According to BTS/SIGN paediatric asthma guidelines, how should this episode be classified?
A.Mild asthma exacerbation
B.Moderate asthma exacerbation
C.Severe asthma exacerbation
D.Life-threatening asthma exacerbation
Explanation: According to BTS/SIGN paediatric asthma guidelines for children aged 2-5 years, features of a severe exacerbation include SpO2 < 92% (or < 95% depending on threshold, but SpO2 < 92% is life-threatening/severe marker), respiratory rate > 40 bpm, heart rate > 140 bpm, or inability to complete sentences/short phrases in one breath. An SpO2 of 93% with tachypnoea and short phrase speech meets criteria for severe asthma exacerbation.
2What is the recommended first-line pharmacological intervention for a 3-year-old child presenting with a moderate acute asthma exacerbation?
A.Inhaled salbutamol via spacer (up to 10 puffs)
B.Intravenous aminophylline infusion
C.Nebulized ipratropium bromide alone
D.Oral montelukast chewable tablet
Explanation: Inhaled short-acting beta-2 agonist (salbutamol 2-10 puffs given one puff at a time via a volume spacer with face mask) is the recommended first-line bronchodilator therapy for moderate paediatric asthma exacerbations.
3A 5-month-old infant presents with a 2-day history of coryza, low-grade fever, harsh cough, and feeding difficulties. Examination reveals subcostal recessing, widespread fine inspiratory crackles, and high-pitched expiratory wheeze. SpO2 is 96% on air. According to NICE guidelines, what is the primary management strategy?
A.Immediate oral amoxicillin for 7 days
B.Nebulized salbutamol every 4 hours
C.Supportive care with feeding assessment and monitoring
D.Oral prednisolone 1 mg/kg once daily for 3 days
Explanation: NICE NG9 guidelines state that acute bronchiolitis is a self-limiting viral infection (most commonly RSV). Management is supportive, focusing on maintaining adequate hydration (nasogastric or IV if feeding < 50% of normal) and oxygenation (if SpO2 persistent < 92%). Antibiotics, bronchodilators, and corticosteroids are explicitly not recommended.
4Under the NICE traffic light system for feverish children under 5 years, which clinical sign classifies a child into the High Risk (Red) category?
A.Capillary refill time of 2 seconds
B.Non-blanching rash
C.Tachypnoea with respiratory rate of 35 in a 3-year-old
D.Temperature of 38.2°C in a 6-month-old infant
Explanation: Under the NICE traffic light system (NG143), a non-blanching rash is a Red (high risk) feature indicating potential meningococcal septicaemia or severe infection requiring urgent paediatric assessment and immediate parenteral antibiotics if septicaemia is suspected.
5A 2-year-old boy presents with a barking cough, hoarse voice, and mild inspiratory stridor when agitated, but no stridor at rest. What is the recommended first-line treatment according to NICE clinical knowledge summaries?
A.A single dose of oral dexamethasone (0.15 mg/kg)
B.Nebulized adrenaline 1:1000
C.Inhaled budesonide 2 mg via jet nebulizer
D.Oral clarithromycin for 5 days
Explanation: A single dose of oral dexamethasone (0.15 mg/kg) is recommended for all children with croup, regardless of severity (mild, moderate, or severe). It reduces symptom severity, need for re-consultation, and hospital admission.
6A 5-year-old child (weight 18 kg) experiences sudden urticaria, facial angioedema, inspiratory stridor, and wheezing 10 minutes after consuming peanuts at school. What is the correct dose and route of adrenaline (epinephrine) for immediate administration according to UK Resuscitation Council guidelines?
A.150 micrograms (0.15 mL of 1:1000) Intramuscularly into anterolateral thigh
B.300 micrograms (0.3 mL of 1:1000) Intramuscularly into anterolateral thigh
C.500 micrograms (0.5 mL of 1:1000) Intramuscularly into deltoid muscle
D.100 micrograms Intravenously over 5 minutes
Explanation: According to UK Resuscitation Council emergency anaphylaxis guidelines, the intramuscular dose of adrenaline (1:1000) for a child aged 6 months to 6 years is 150 micrograms (0.15 mL) injected into the anterolateral aspect of the middle third of the thigh.
7A 15-month-old toddler presents with acute watery diarrhoea and vomiting for 24 hours. Examination reveals a CRT of 2 seconds, moist mucous membranes, normal skin turgor, and normal urine output. How should the child's hydration status be categorized according to NICE NG8?
A.No clinically detectable dehydration
B.Clinical dehydration
C.Clinical shock
D.Severe hypernatraemic dehydration
Explanation: According to NICE NG8, a child with normal CRT (< 2 sec), moist mucous membranes, normal skin turgor, normal heart rate, and good urine output has no clinically detectable dehydration. Recommended treatment is continuing normal fluid/diet plus oral rehydration solution (ORS) maintenance.
8A 18-month-old child presents after a 2-minute generalized tonic-clonic seizure occurring during a spike in temperature to 39.1°C associated with otitis media. The child is now alert and neurologically intact. What feature confirms this event as a simple febrile convulsion?
A.Duration under 15 minutes, generalized seizure type, and complete recovery within 1 hour without focal neurological signs
B.Focal motor onset involving only the right arm and leg
C.Recurrence of a second seizure 4 hours after the initial episode within the same febrile illness
D.Post-ictal Todd's paresis lasting 6 hours
Explanation: A simple febrile convulsion is defined as a primary generalized seizure lasting less than 15 minutes, occurring once in a 24-hour period during a febrile illness, without focal neurological signs or post-ictal focal deficits.
9A 3-year-old child presents with fever, lethargy, neck stiffness, and photophobia. On examination, blood pressure is 100/60 mmHg, heart rate is 110 bpm, but the child has a GCS score of 12 and unequal pupils. What is the most appropriate initial management step regarding lumbar puncture?
A.Perform immediate lumbar puncture before administering parenteral antibiotics
B.Withhold lumbar puncture and administer immediate IV ceftriaxone plus urgent neuroimaging
C.Perform lumbar puncture under local anaesthesia after giving IV dexamethasone
D.Perform lumbar puncture immediately after obtaining a CT brain scan showing no mass effect
Explanation: Contraindications to immediate lumbar puncture in suspected bacterial meningitis include focal neurological signs, unequal/sluggish pupils, GCS < 13 (or drop in GCS > 2), papilloedema, shock, active fitting, or severe bleeding diathesis. LP must be postponed and parenteral antibiotics (IV ceftriaxone) started immediately without delay.
10A 9-month-old infant presents with fever of unknown origin (38.8°C), vomiting, and poor feeding for 48 hours. A clean-catch urine specimen demonstrates > 10^5 CFU/mL E. coli. What is the recommended imaging investigation strategy for an infant under 1 year with a first simple UTI responding well to oral antibiotics?
A.Renal ultrasound scan during the acute admission for all infants under 1 year
B.Renal ultrasound scan within 6 weeks of the acute infection
C.Immediate micturating cystourethrogram (MCUG) during acute hospital stay
D.Routine DMSA scan at 2 weeks post-infection
Explanation: According to NICE CG54 guidelines on UTI in infants under 1 year, an infant who responds well to treatment within 48 hours for a first simple UTI should undergo a renal ultrasound scan within 6 weeks post-infection (unless atypical or recurrent features are present, which warrant acute US).

About the Diploma in Child Health Exam

The Diploma in Child Health (DCH), awarded by the Royal College of Paediatrics and Child Health (RCPCH), evaluates General Practitioners, paediatric trainees, and healthcare professionals on core paediatric knowledge, acute child health management, developmental milestones, safeguarding, and child health promotion. Note: Practice questions provide an English MCQ study adaptation for the official assessment; it does not replace required writing, oral, portfolio, clinical, or hands-on performance.

Exam sponsor: Royal College of Paediatrics and Child Health. The requirements and fees below concern the certification or admission exam, separate from our free practice resources.

Questions

100 questions

Time Limit

120 minutes

Passing Score

Angoff standard setting pass mark

Exam / Certification Fees

~£1,005 - £1,075 (FOP theory + DCH Clinical combined)

Exam sponsor website

Fees, eligibility, and exam policies can change. Confirm them with the exam sponsor before applying or paying.

Our practice resources: topics covered

We aim to reflect publicly available exam outlines and topic information in our study resources. Coverage, format, and difficulty may differ from the actual exam, and we cannot guarantee that every detail is accurate or current. Confirm exam requirements, fees, and policies with the official exam sponsor.

25%

General & Acute Paediatrics

Acute respiratory, infection, sepsis, resuscitation, and emergencies

25%

Child Development & Neurodisability

Developmental milestones, delay screening, ASD, ADHD, cerebral palsy

20%

Safeguarding, Child Protection & Ethics

Physical abuse, neglect, safeguarding laws, Gillick competence, consent

15%

Neonatology & Infant Care

NIPE screening, neonatal jaundice, resuscitation, infant nutrition

15%

Chronic Paediatric Conditions & Community Paediatrics

Type 1 diabetes, epilepsy, eczema, growth charts, juvenile arthritis

Preparing for the Diploma in Child Health Exam

What You Need to Know

  • Passing score: Angoff standard setting pass mark
  • Exam length: 100 questions
  • Time limit: 120 minutes
  • Exam / certification fees: ~£1,005 - £1,075 (FOP theory + DCH Clinical combined) Official sources

Using Our Practice Resources

  • Work through all 100 available questions
  • Review every answer and explanation
  • Track weak areas and revisit them
  • Use our AI tutor for tough concepts

Diploma in Child Health: Suggested Study Strategy

1Familiarize yourself thoroughly with the UK NIPE (Newborn and Infant Physical Examination) screening standards and developmental milestone age ranges.
2Review NICE guidelines for fever in under 5s, acute asthma management, and paediatric gastroenteritis.
3Memorize statutory child safeguarding definitions, non-accidental injury fracture patterns, and multi-agency referral steps.
4Understand Gillick competence criteria and legal frameworks for emergency treatment in minors.

Frequently Asked Questions

What is the structure of the RCPCH DCH examination?

The DCH consists of two parts: the written Foundation of Practice (FOP) theory exam (100 SBA questions in 2 hours) and the DCH Clinical examination (an 8-station OSCE circuit).

Who is the DCH qualification designed for?

The DCH is specifically designed for General Practitioners, GP trainees, emergency medicine doctors, and healthcare professionals who care for children in non-specialist paediatric settings.

How is the written theory component delivered?

The Foundation of Practice (FOP) examination is a computer-based test delivered at test centres or via remote invigilation.

What passing standard is applied to the DCH?

The pass mark is set using criterion-referenced Angoff standard setting, ensuring a consistent benchmark across exam diets.

Does this practice bank replace clinical practice?

No. Our practice questions provide an English MCQ study adaptation for written knowledge preparation; they do not replace required clinical, practical, or hands-on performance training.