, Nelson Pediatrics Review(MCQs) 19 Edition
1. Which of the following statements regarding foster care is true?
□A permanency plan must be made for a child in foster care no later than 12 mo from the child's entry into care
□A minority of children in foster care have a history of abuse or neglect
□The mission of foster care is to safely care for children while providing services to families to promote reunification
□Most (>70%) of children in foster care are reunited with their families
■ A and C
description The mission of foster care is to provide for the health, safety, and well-being of children while assisting their
families with services to promote reunification. Children entering foster care have frequently experienced early childhood
trauma. More than 70% have a history of abuse, neglect, or both. Only about 50% of children achieve reunification. In the
USA, the Adoption and Safe Families Act (P.L. 105-89) passed in 1997 requires that a permanency plan be made for
each child no later than 12 mo after entry to foster care and that a petition to terminate parental rights typically must be filed
when a child has been in foster care for at least 15 of the previous 22 mo. (See Chapter 35, page 134, and e35-1.)
2. A 4 yr old girl is admitted to the hospital for her third evaluation for vaginal bleeding. The
mother noted bright red blood on the child's underwear. Previous examinations revealed a
normal 4 yr old girl, Tanner stage 1, with normal external genitalia. Pelvic ultrasound results
were normal, as was the serum estradiol level. The hemoglobin and platelet counts were
normal, as were the bleeding time and coagulation studies. Findings on pelvic examination
conducted under anesthesia also were normal. The next step in the examination is to:
■ Determine the blood type of the blood on the underwear
□Interrogate the father
□Isolate the parents and child
□Determine von Willebrand factor levels
, □Measure fibronectin in the vagina
description Consideration of factitious disorder by proxy should be triggered when the reported symptoms are repeatedly
noted by only one parent, appropriate testing fails to confirm a diagnosis, and seemingly appropriate treatment is ineffective.
At times, the child's symptoms, their course, or the response to treatment may be incompatible with any recognized disease.
Preverbal children are usually involved. Bleeding is a particularly common presentation. This may be caused by adding dyes
to samples, adding blood (e.g., from the mother) to the child's sample, or giving the child an anticoagulant (e.g., warfarin).
(See Chapter 37, page 146.)
3. Munchausen syndrome by proxy is characterized by all of the following EXCEPT:
□Mother who appears devoted and wins over members of care team
□Multiple hospitalizations and investigations without diagnosis
□Symptoms on history but not witnessed by medical team
■ Symptoms occurring in presence of different caregivers (e.g., while mother is out of town)
□Use of medications or toxins
description BSymptoms Bin Byoung Bchildren Bare Bmostly Bassociated Bwith Bproximity Bof Bthe Boffending Bcaregiver Bto Bthe Bchild.
BThe B mother Bmay Bpresent Bas Ba Bdevoted Bor Beven Bmodel Bparent Bwho Bforms Bclose Brelationships Bwith Bmembers Bof Bthe
Bhealth Bcare B
team. BWhile Bappearing Bvery Binterested Bin Bher Bchild's Bcondition, Bshe Bmay Bbe Brelatively Bdistant Bemotionally.
B(See B Chapter B 37, Bpage B146.)
4. Which Bstatement Bis Bfalse?
■ Malnutrition Bis B the B second B leading B cause B of B acquired B immune B deficiency B worldwide B behind B HIV Binfection
□Zinc B is B important B in B immune B function B and B linear B growth
□Kwashiorkor and B B marasmus B are B rare B in B developed B countries
□The Western diet is associated with increased
B B B B B B B noncommunicable B disease
description B The B significant B global B burden B of B malnutrition B and B undernutrition Bis Bthe Bleading B worldwide B cause B of
B acquired Bimmunodeficiency B and Bthe B major B underlying B factor B for B morbidity Band B mortality B globally B for B children B <5 B yr B of
Bage. B Zinc B is B a B micronutrient Bthat B supports B multiple B metabolic B functions B in Bthe B body, Bis B essential B for B normal Bimmune
B functioning, Band Bis B required B to B support B linear B growth; B zinc B deficiency B is B associated B with B impaired B immune B functioning
B and B poor B linear B growth. B In Bparallel B to B the B risk B for B nutrient B and B energy B deficiencies, B issues B relating B to B excesses B pose
B important B challenges B because B of B theirBnegative Bhealth Beffects, Bsuch Bas Bobesity Bor Bcardiovascular Bdisease Brisk Bfactors. BThe
, nutrition Btransition Bunder Bway Bin Bthe
B
1. Which of the following statements regarding foster care is true?
□A permanency plan must be made for a child in foster care no later than 12 mo from the child's entry into care
□A minority of children in foster care have a history of abuse or neglect
□The mission of foster care is to safely care for children while providing services to families to promote reunification
□Most (>70%) of children in foster care are reunited with their families
■ A and C
description The mission of foster care is to provide for the health, safety, and well-being of children while assisting their
families with services to promote reunification. Children entering foster care have frequently experienced early childhood
trauma. More than 70% have a history of abuse, neglect, or both. Only about 50% of children achieve reunification. In the
USA, the Adoption and Safe Families Act (P.L. 105-89) passed in 1997 requires that a permanency plan be made for
each child no later than 12 mo after entry to foster care and that a petition to terminate parental rights typically must be filed
when a child has been in foster care for at least 15 of the previous 22 mo. (See Chapter 35, page 134, and e35-1.)
2. A 4 yr old girl is admitted to the hospital for her third evaluation for vaginal bleeding. The
mother noted bright red blood on the child's underwear. Previous examinations revealed a
normal 4 yr old girl, Tanner stage 1, with normal external genitalia. Pelvic ultrasound results
were normal, as was the serum estradiol level. The hemoglobin and platelet counts were
normal, as were the bleeding time and coagulation studies. Findings on pelvic examination
conducted under anesthesia also were normal. The next step in the examination is to:
■ Determine the blood type of the blood on the underwear
□Interrogate the father
□Isolate the parents and child
□Determine von Willebrand factor levels
, □Measure fibronectin in the vagina
description Consideration of factitious disorder by proxy should be triggered when the reported symptoms are repeatedly
noted by only one parent, appropriate testing fails to confirm a diagnosis, and seemingly appropriate treatment is ineffective.
At times, the child's symptoms, their course, or the response to treatment may be incompatible with any recognized disease.
Preverbal children are usually involved. Bleeding is a particularly common presentation. This may be caused by adding dyes
to samples, adding blood (e.g., from the mother) to the child's sample, or giving the child an anticoagulant (e.g., warfarin).
(See Chapter 37, page 146.)
3. Munchausen syndrome by proxy is characterized by all of the following EXCEPT:
□Mother who appears devoted and wins over members of care team
□Multiple hospitalizations and investigations without diagnosis
□Symptoms on history but not witnessed by medical team
■ Symptoms occurring in presence of different caregivers (e.g., while mother is out of town)
□Use of medications or toxins
description BSymptoms Bin Byoung Bchildren Bare Bmostly Bassociated Bwith Bproximity Bof Bthe Boffending Bcaregiver Bto Bthe Bchild.
BThe B mother Bmay Bpresent Bas Ba Bdevoted Bor Beven Bmodel Bparent Bwho Bforms Bclose Brelationships Bwith Bmembers Bof Bthe
Bhealth Bcare B
team. BWhile Bappearing Bvery Binterested Bin Bher Bchild's Bcondition, Bshe Bmay Bbe Brelatively Bdistant Bemotionally.
B(See B Chapter B 37, Bpage B146.)
4. Which Bstatement Bis Bfalse?
■ Malnutrition Bis B the B second B leading B cause B of B acquired B immune B deficiency B worldwide B behind B HIV Binfection
□Zinc B is B important B in B immune B function B and B linear B growth
□Kwashiorkor and B B marasmus B are B rare B in B developed B countries
□The Western diet is associated with increased
B B B B B B B noncommunicable B disease
description B The B significant B global B burden B of B malnutrition B and B undernutrition Bis Bthe Bleading B worldwide B cause B of
B acquired Bimmunodeficiency B and Bthe B major B underlying B factor B for B morbidity Band B mortality B globally B for B children B <5 B yr B of
Bage. B Zinc B is B a B micronutrient Bthat B supports B multiple B metabolic B functions B in Bthe B body, Bis B essential B for B normal Bimmune
B functioning, Band Bis B required B to B support B linear B growth; B zinc B deficiency B is B associated B with B impaired B immune B functioning
B and B poor B linear B growth. B In Bparallel B to B the B risk B for B nutrient B and B energy B deficiencies, B issues B relating B to B excesses B pose
B important B challenges B because B of B theirBnegative Bhealth Beffects, Bsuch Bas Bobesity Bor Bcardiovascular Bdisease Brisk Bfactors. BThe
, nutrition Btransition Bunder Bway Bin Bthe
B
