# Situation: The nurse supervises barangay nutrition scholars (BNS) and barangay health workers (BHWs) during growth monitoring and child health activities for children under 5 years of age. During a child health day, the nurse identifies which children should start micronutrient powder under the Department of Health (DOH) micronutrient supplementation program. Which child is eligible?

> source: MyMerci (mymerci.kr)  
> url: https://mymerci.kr/pages/nclex_q.php?qn_id=629634  
> language: ko  
> subject: Nursing Practice II — Maternal and Child Health Nursing

## 문제

Situation: The nurse supervises barangay nutrition scholars (BNS) and barangay health workers (BHWs) during growth monitoring and child health activities for children under 5 years of age.

During a child health day, the nurse identifies which children should start micronutrient powder under the Department of Health (DOH) micronutrient supplementation program. Which child is eligible?

## 보기

1. A 25-month-old who eats soft family foods three times a day
2. A 5-month-old who is exclusively breastfed and growing well
3. A 4-year-old who is underweight and eats poorly at meals
4. A 22-month-old who eats soft family foods three times a day **✔ 정답**

**정답: 4**

## 해설

Micronutrient powder is given to children 6 to 23 months and is mixed into their complementary food. The 22-month-old is within the age range and eats semisolid food into which the powder can be mixed. Being underweight or a poor eater does not extend the age range; those children are served by other nutrition services.

## 심화 해설

Target population and age window

The DOH micronutrient supplementation program provides micronutrient powder (MNP) to children 6 to 23 months of age. The powder is a single-dose packet containing multiple vitamins and minerals, especially iron, vitamin A, and zinc, which are the micronutrients most commonly deficient during rapid early growth [1][2][3]. The powder is designed to be sprinkled onto or mixed into any semi-solid complementary food, so the child must already be receiving foods other than breast milk [1][3].

Watch out! The age range is fixed by policy. Being underweight, having poor appetite, or eating poorly does not extend eligibility beyond 23 months. Those children are referred to other nutrition services, such as targeted supplementary feeding or clinical management of acute malnutrition.

| Child | Age | Feeding status | MNP eligibility | Reason |
| --- | --- | --- | --- | --- |
| Option 1 | 25 months | Soft family foods 3 times daily | Not eligible | Outside the 6–23 month age window |
| Option 2 | 5 months | Exclusively breastfed | Not eligible | Below 6 months and no complementary food to mix with |
| Option 3 | 4 years | Underweight, poor eater | Not eligible | Far above 23 months; other nutrition services apply |
| Option 4 | 22 months | Soft family foods 3 times daily | Eligible | Within 6–23 months and has semi-solid food for mixing |

Why the age window matters

Young children are highly vulnerable to micronutrient deficiencies because of rapid growth and inadequate dietary practices during the complementary feeding period [1][2]. The period from 6 to 23 months is when breast milk alone no longer meets iron and zinc requirements, yet the child’s diet is often still limited in variety and nutrient density. MNP is a home fortification strategy that targets this specific developmental window, when the risk of iron deficiency anemia and other micronutrient gaps is highest [1][3].

The lower age limit of 6 months is important because MNP must be mixed into semi-solid food; an exclusively breastfed infant has no appropriate vehicle for the powder [3]. The upper limit of 23 months reflects both the program design and the evidence base, which has focused on children under two years of age [1][2][3].

Clinical and supervisory application

During growth monitoring and child health activities, the nurse supervising barangay nutrition scholars (BNS) and barangay health workers (BHWs) should teach caregivers two simple checks before giving MNP: confirm the child is 6 to 23 months old, and confirm the child is already eating semi-solid or soft family foods. The powder is sprinkled onto one serving of food, not mixed into liquids or given alone [1][3].

Key point! The 22-month-old in option 4 meets both criteria: age within the window and a semi-solid food vehicle. The 25-month-old in option 1 is only two months older but is already outside the program’s target range, which is why age must be verified precisely rather than estimated.

Caregiver education also matters for correct use. Evidence from urban health settings shows that caregivers’ knowledge, attitudes, and practices regarding infant feeding and MNP use can be improved through structured nutrition education delivered during routine child health contacts . The nurse can use growth monitoring sessions to reinforce when to start MNP, how to mix it, and when to stop, which supports both adherence and appropriate targeting .References (research sources)

- [1]Home fortification of foods with multiple micronutrient powders for health and nutrition in children under two years of age (Review).Research articleDe-Regil LM, Suchdev PS, Vist GE, Walleser S, Peña-Rosas JP (2013) · DOI: 10.1002/ebch.1895

- [2]Home fortification of foods with multiple micronutrient powders for health and nutrition in children under two years of age.Research articleDe-Regil LM, Suchdev PS, Vist GE, Walleser S, Peña-Rosas JP (2011) · DOI: 10.1002/14651858.CD008959.pub2

- [3]Home fortification of foods with multiple micronutrient powders for health and nutrition in children under two years of age.Research articleSuchdev PS, Jefferds MED, Ota E, da Silva Lopes K, De-Regil LM (2020) · DOI: 10.1002/14651858.CD008959.pub3

## 임상 시나리오

MNP Eligibility in Growth MonitoringScreening children 6–23 months during child health days
Micronutrient powder is given only to children 6 to 23 months of age. The child must already be receiving complementary food so the powder can be mixed into a semi-solid meal.

During child health day, check the age first and the feeding status second. A 22-month-old eating soft family foods three times daily meets both criteria and is eligible.

CautionDo not extend MNP beyond 23 months for underweight or poor eaters. Those children need referral to targeted supplementary feeding or clinical management of acute malnutrition instead.

## 핵심 개념

- **Micronutrient powder (MNP)** — Single-dose powder containing iron, vitamin A, zinc, and other vitamins/minerals, sprinkled onto semi-solid complementary food for children 6–23 months.
- **Complementary feeding** — Introduction of semi-solid or solid foods alongside breast milk, typically starting around 6 months of age.
- **DOH micronutrient supplementation program** — National program providing MNP to children 6–23 months to address common micronutrient deficiencies during rapid early growth.
- **Targeted supplementary feeding** — Nutrition service for underweight or poorly eating children who fall outside MNP eligibility, such as those older than 23 months.

## 같은 주제 문제

- [Situation: A nurse from the Rural Health Unit (RHU) makes postnatal home visits to healthy…](https://mymerci.kr/pages/nclex_q.php?qn_id=629426)
- [Situation: A nurse from the Rural Health Unit (RHU) makes postnatal home visits to healthy…](https://mymerci.kr/pages/nclex_q.php?qn_id=629427)
- [Situation: A nurse from the Rural Health Unit (RHU) makes postnatal home visits to healthy…](https://mymerci.kr/pages/nclex_q.php?qn_id=629428)
- [Situation: A nurse from the Rural Health Unit (RHU) makes postnatal home visits to healthy…](https://mymerci.kr/pages/nclex_q.php?qn_id=629429)
- [Situation: A nurse from the Rural Health Unit (RHU) makes postnatal home visits to healthy…](https://mymerci.kr/pages/nclex_q.php?qn_id=629430)
- [Situation: The nurse holds a weekly well-baby clinic at a Barangay Health Station (BHS) fo…](https://mymerci.kr/pages/nclex_q.php?qn_id=629431)
- [Situation: The nurse holds a weekly well-baby clinic at a Barangay Health Station (BHS) fo…](https://mymerci.kr/pages/nclex_q.php?qn_id=629432)
- [Situation: The nurse holds a weekly well-baby clinic at a Barangay Health Station (BHS) fo…](https://mymerci.kr/pages/nclex_q.php?qn_id=629433)

---

More free questions: [기출문제](https://mymerci.kr/)

_학습 참고용입니다. 실제 임상은 최신 지침과 소속 기관 프로토콜을 따르세요._