Protein-energy malnutrition can be assessed by:

DSSSB 13 August 2024

Applied Nutrition & Dietetics

Medium

Appeared in: DSSSB 13 August 2024

Explanation

The Bangle test is a simple, effective screening tool for identifying severe malnutrition in children, typically those between 1 and 5 years of age.
It functions by using a bangle of a specific internal diameter (4 cm) to quickly assess the Mid-Upper Arm Circumference (MUAC).
If the bangle passes easily over the child's elbow onto the upper arm, it indicates significant muscle wasting, a key sign of severe Protein-Energy Malnutrition (PEM).
This method is particularly useful for rapid screening in community health settings by field workers.

Option A: The Lepromin test is an immunological skin test used to classify the type of leprosy a patient has (lepromatous vs. tuberculoid), not to assess nutritional status.
Option B: The Widal test is a serological agglutination test used for the diagnosis of enteric fever (typhoid fever) by detecting antibodies against Salmonella Typhi antigens.
Option C: The Mantoux test (or Tuberculin Skin Test) is a screening tool used to detect if a person has been exposed to Mycobacterium tuberculosis, the bacterium that causes tuberculosis.

Clinical Relevance

Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Assessment methods for Protein-Energy Malnutrition (PEM) as background academic context rather than a clinical decision trigger.
Early identification of PEM using simple, low-cost tools like the Bangle test is crucial in community health for preventing severe complications and reducing child mortality.
Nurses and community health workers (like ASHA workers in India) are often the first line of defense in screening children, making their proficiency with these tools vital for timely referral and nutritional intervention.
What if a more precise measurement is needed in a clinical setting? In that case, a nurse would use a flexible measuring tape (like a Shakir's tape or a standard measuring tape) to get an exact MUAC measurement in centimeters, and also measure weight and height to calculate indices like weight-for-height.

How to Approach the Question

First, identify the core concept of the question, which is the method of assessment for 'Protein-energy malnutrition' (PEM).
Next, systematically evaluate each option by recalling its primary medical purpose.
Recall or deduce that the Lepromin test is for leprosy, the Widal test is for typhoid, and the Mantoux test is for tuberculosis.
Recognize that these three tests are diagnostic tools for specific infectious diseases, not for assessing general nutritional status.
By elimination, the Bangle test remains. Even if unfamiliar, its context among the other options suggests it is the correct answer related to a different field, which is nutritional assessment.
Confirm this by associating the Bangle test with anthropometric measurements like Mid-Upper Arm Circumference (MUAC), a key indicator for PEM.

Concept Tested & Keywords

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E6 Comprehensive Textbook of Community Health NursingShyamala D part 1 (pp 26-389 of 389) p. 195-197