PART 1

Sample code no.

 Demographic Variables

Introduction to participant

Dear participant,

Kindly write down the need information or place a thick mark for the most appropriate
answer in front of each item.

The information provided will be kept confidential. Do not leave any question without
answering.

1. Age in years.....

a) 17-18 years
b) 18-19 years
c) 19-20 years
d) 20-21 years

2. Religion.......

a) Hindu
b) Muslim
c) Christian
d) Sikh

3. Type of family.........

a) Joint

b) Nuclear

c) Extended

4. Diet...........

a) Non-vegetarian

b) Vegetarian
5. Previous knowledge..........

a) Yes

b) No

6. Family income.........

a) < 1 lakh

b) > 1 lakh
c) 1 lakh- 2 lakh
d) >2 lakh

7. Residence.........

a) Urban

b) Rural

8. Parent’s education..........

a) Illiterate

b) 10th

c) Intermediate

d) Graduate and above

9. Source of knowledge........

a) Newspaper

b) Internet

c) Television

d) Study centre
 PART 2

 QUESTIONNAIRE TO ASSESS THE KNOWLEDGE REGRADING

NUTRITIONAL ANAEMIA AMONG ADOLESCENCE GIRLS.

Dear participant,

Kindly tick the most appropriate answer in the front of each item. There will be
only one correct answer for each item and each correct answer is given one (1) score and
wrong answer will be given zero (o) score.

1. Iron absorbed in

a) Stomach ( )

b) Duodenum ( )

c) Jejunum ( )

d) Proximal ileum ( )

2. Vitamin B12 absorbed in

a) Stomach ( )

b) Duodenum ( )

c) Jejunum ( )

d) Distal ileum ( )

3. The most important determinant of iron endowment at birth.

a) Gestational ( )
b) The mother’s iron stores ( )
c) Race ( )
d) Gender ( )

4. The percentage of ferrous sulphate (by weight) is elemental iron

a) 0.06 ( )
b) 2% ( )
c) 20% ( )
d) 60% ( )
 5. The following foods provides non- home iron

a) Eggs ( )
b) Milk ( )
c) Vegetables ( )
d) Meats ( )
e) All of above ( )

6. High intake of iron in certain people can lead to

a) Anaemia ( )
b) Liver damage ( )
c) Hypertension ( )
d) Nerve damage ( )

7. Iron deficiency anaemia affects teenagers

a) More trouble with written experia ( )

b) Can’t concentrate ( )

c) Hyperactivity ( )

d) A and B ( )

8. The most reliable food source of zink is

a) Meats and seafood ( )

b) Orange juice ( )
c) Dark green vegetables ( )
d) Iodized salt ( )

9. Iodine deficiency results in

a) Anaemia ( )

b) Scurvy ( )

c) Osteomalacia ( )

d) Goitre ( )
10. In the body iron is found

a) In the liver ( )
b) In the blood ( )
c) In mucus tissue ( )
d) In every living cell ( )

11. A clinical symptom of iron- deficiency anaemia

a) Fatigue ( )
b) Pale skin ( )
c) Intolerance to cold temperature ( )
d) All of above ( )

12. The most common cause of anaemia is

a) Too little sleep ( )

b) Too much sugar ( )
c) Too little iron in the blood ( )
d) Exposure to x- ray radiation ( )

13. Total R B C count for women is

a) 4.4-6 ( )
b) 4.2-5 ( )
c) 4.0-5.0 ( )
d) 4.2-5.2 ( )

14. The main cause of Iron deficiency anaemia

a) Bleeding from ulcers ( )

b) Inadequate intake of dietary iron ( )

c) Malnutrition ( )

d) Minor injuries ( )
15. The most type of anaemia

a) Thrombocytopenia ( )
b) Aplastic anaemia ( )
c) Sickle cell anaemia ( )
d) Nutritional anaemia ( )

16. Common sign and symptom of nutritional anaemia

a) Sore tongue ( )
b) Brittle and ridged nails ( )
c) Fever ( )
d) All of above ( )

17. The diagnosis of iron deficiency anaemia can be done by

a) Bone marrow aspiration ( )
b) Blood test ( )
c) Total RBC count ( )
d) Schilling test ( )

18. The common type of nutritional anaemia

a) Folic acid deficiency ( )

b) Iron deficiency ( )
c) Vitamin B12 deficiency ( )
d) All of the above ( )

19. Most of the iron in the red blood cell is located in

a) Ferritin ( )

b) Myoglobin ( )

c) Haemoglobin ( )

d) Cytocromes ( )
 20. The group more likely to have anaemia is

a) Men ( )

b) Women ( )

c) Teenagers ( )

d) Older adults ( )

21. In anemia hemoglobin level is

a) 12 g/dl ( )
b) Above 12 g/dl ( )
c) Below 12 g/dl ( )
d) None of these ( )

22. In anemia, ___________ content is decreased in the blood

a) Iron ( )
b) Calcium ( )
c) Iodine ( )
d) Vitamin A ( )

23. Causes of anemia includes

a) Excessive blood loss ( )
b) Less intake of food ( )
c) Malabsorption ( )
d) Infection ( )

24. Anemia is common in

a) Men ( )
b) Children ( )
c) Women at reproductive age ( )
d) All of these ( )
25. Diagnosis of anemia are

a) Physical examination ( )
b) Blood investigations ( )
c) Stool examination ( )
d) None of these ( )

26. Effect of anemia on immunity causes

a) Frequent infection ( )
b) Infection very rarely ( )
c) No effects ( )
d) a and b ( )

27. Effects of anemia on pregnancy are

a) Abortion ( )
b) Hemorrhage ( )
c) Premature delivery ( )
d) None of these ( )
28. Effect of anemia on fetus leads to
a) Low birth weight ( )
b) Intra-uterine death ( )
c) Premature birth ( )
d) All of these ( )
29. Anemia is treated by
a) Administration of iron supplements ( )
b) Consuming iron rich content food ( )
c) Intravenous fluids ( )
d) All of these ( )
30. Severe anemia is treated by
a) Consuming iron rich diet ( )
b) Blood transfusion ( )
c) Adequate rest ( )
d) None of these ( )
 iz”ukoyh
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