Test bank for MCQs in Pediatrics Review of Nelson
Textbook of Pediatrics 20 Edition
, 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
gk gk gk gk gk gk gk gk gk gk gk gk gk gk gk gk gk
mother noted bright red blood on the child's underwear. Previous examinations revealed a
gk gk gk gk gk gk gk gk gk gk gk gk gk
normal 4 yr old girl, Tanner stage 1, with normal external genitalia. Pelvic ultrasound results
gk gk gk gk gk gk gk gk gk gk gk gk gk gk gk
were normal, as was the serum estradiol level. The hemoglobin and platelet counts were no
gk gk gk gk gk gk gk gk gk gk gk gk gk gk
rmal, as were the bleeding time and coagulation studies. Findings on pelvic examination co
gk gk gk gk gk gk gk gk gk gk gk gk gk
nducted under anesthesia also were normal. The next step in the examination is to:
gk gk gk gk gk gk gk gk gk gk gk gk gk
■ Determine the blood type of the blood on the underwear
gk gk gk gk gk gk gk gk gk
□Interrogate gk the father
gk
□Isolate the parents and child
gk gk gk gk
□Determine gk von Willebrand factor levels
gk gk gk
, □Measure gk fibronectin in the vagina gk gk gk
description Consideration of factitious disorder by proxy should be triggered when the reported symptoms are repeate
gk gk gk gk gk gk gk gk gk gk gk gk gk gk gk
dly noted by only one parent, appropriate testing fails to confirm a diagnosis, and seemingly appropriate treatment is ineff
gk gk gk gk gk gk gk gk gk gk gk gk gk gk gk gk gk gk
ective. At times, the child's symptoms, their course, or the response to treatment may be incompatible with any recognize
g k gk gk gk gk gk gk gk gk gk gk gk gk gk gk gk gk gk
d disease. Preverbal children are usually involved. Bleeding is a particularly common presentation. This may be caused
gk g k gk gk gk gk gk gk gk gk gk gk gk gk gk gk gk
by adding dyes to samples, adding blood (e.g., from the mother) to the child's sample, or giving the child an anticoagul
gk gk g k gk gk gk gk gk gk gk gk gk gk gk gk gk gk gk gk gk
ant (e.g., warfarin). (See Chapter 37, page 146.)
gk gk gk gk gk gk gk
3. Munchausen syndrome by proxy is characterized by all of the following EXCEPT:
gk gk gk gk gk gk gk gk gk gk gk
□Mother who appears devoted and wins over members
gk gk gk gk gk gk gk gk of care team
gk gk
□Multiple gk hospitalizations and investigations without diagnosis gk gk gk gk
□Symptoms on history but not witnessed by medical team
gk gk gk gk gk gk gk gk
■ Symptoms occurring in presence of different caregivers (e.g., while mother is out of town)
gk gk gk gk gk gk gk gk gk gk gk gk gk
□Use of medications or toxins
gk gk gk gk
description Symptoms in young children are mostly associated with proximity of the offending caregiver to the child. T
gk gk gk gk gk gk gk gk gk gk gk gk gk gk gk gk gk
he mother may present as a devoted or even model parent who forms close relationships with members of the healt
gk gk gk gk gk gk gk gk gk gk gk gk gk gk gk gk gk gk gk
h care team. While appearing very interested in her child's condition, she may be relatively distant emotionally. (See Ch
gk gk gk gk gk gk gk gk gk gk gk gk gk gk gk gk gk gk
apter 37, page 146.)gk gk gk
4. Which statement is false? gk gk gk
■ Malnutrition is the second leading cause of acquired immune deficiency worldwide behind HIV infection
gk gk gk gk gk gk gk gk gk gk gk gk gk
□Zinc is important in immune function and linear growth
gk gk gk gk gk gk gk gk
□Kwashiorkor and marasmus are rare in developed countries gk gk gk gk gk gk gk
□The Western diet is associated with increased noncommunicable disease
gk gk gk gk gk gk gk gk
description The significant global burden of malnutrition and undernutrition is the leading worldwide cause of acquired i
gk gk gk gk gk gk gk gk gk gk gk gk gk gk gk gk
mmunodeficiency and the major underlying factor for morbidity and mortality globally for children <5 yr of age. Zinc is a
gk gk gk gk gk gk gk gk gk gk gk gk gk gk gk gk gk gk gk
gkmicronutrient that supports multiple metabolic functions in the body, is essential for normal immune functioning, and is r
gk gk gk gk gk gk gk gk gk gk gk gk gk gk gk gk gk
equired to support linear growth; zinc deficiency is associated with impaired immune functioning and poor linear growth.
gk gk gk gk gk gk gk gk gk gk gk gk gk gk gk gk gk
In parallel to the risk for nutrient and energy deficiencies, issues relating to excesses pose important challenges because of
gk gk gk gk gk gk gk gk gk gk gk gk gk gk gk gk gk gk g
ktheir negative health effects, such as obesity or cardiovascular disease risk factors. The nutrition transition under way i
gk gk gk gk gk gk gk gk gk gk gk gk gk gk gk gk gk
n thegk
, developing world from traditional diets to the Western diet has been associated with increases in noncommunicable dis
gk gk gk gk gk gk gk gk gk gk gk gk gk gk gk gk
eases, often coexisting with undernutrition and malnutrition, observed sometimes in the same communities or even the sa
gk gk gk gk gk gk gk gk gk gk gk gk gk gk gk gk
me families. (See e41-1.)
gk gk gk
5. Components of energy expenditure in children include: gk gk gk gk gk gk
□Thermal effect of food gk gk gk
□Basal metabolic rate gk gk
□Energy for physical activity gk gk gk
□Energy to gk gk support growth gk
■ All of the above
gk gk gk
description The 3 components of energy expenditure in adults are the basal metabolic rate, the thermal effect of fo
gk gk gk gk gk gk gk gk gk gk gk gk gk gk gk gk gk gk
od (energy required for digestion and absorption), and energy for physical activity. Additional energy intake and expend
gk gk gk gk gk gk gk gk gk gk gk gk gk gk gk gk
iture are required to support growth and development for children. (See e41-4.)
gk gk gk gk gk gk gk gk gk gk gk
6. Which of the following clinical scenarios increases the risk of vitamin A deficiency?
gk gk gk gk gk gk gk gk gk gk gk gk
□Vegetarian diet gk
□Chronic gk intestinal disorders gk
□Zinc gk deficiency
■ B and Cgk gk
□All of the above gk gk gk
description Vitamin A is an essential micronutrient because it cannot be biogenerated de novo by animals. It must
gk gk gk gk gk gk gk gk gk gk gk gk gk gk gk gk gk
be obtained from plants in the form of provitamin-
gk gk gk gk gk gk gk gk gk
A carotenoids. In the USA, grains and vegetables supply approximately 55% and dairy and meat products supply ap
gk gk gk gk gk gk gk gk gk gk gk gk gk gk gk gk gk
proximately 30% of vitamin A intake from food. Vitamin A and the provitamins-
gk gk gk gk gk gk gk gk gk gk gk gk
A are fat soluble, and their absorption depends on the presence of adequate lipid and protein within the meal. Chronic
gk gk gk gk gk gk gk gk gk gk gk gk gk gk gk gk gk gk g k gk
intestinal disorders or lipid malabsorption syndromes can result in vitamin A deficiency. In developing countries, subclini
gk gk gk gk gk gk gk gk gk gk gk gk gk gk gk
cal or clinical zinc deficiency can increase the risk of vitamin A deficiency. There is also some evidence of marginal zin
gk gk gk gk gk gk gk gk gk gk gk gk gk gk gk gk gk gk gk gk
c intakes in children in the USA. (See Chapter 45, page 188.)
gk gk gk gk gk gk gk gk gk gk gk
7. Which statement about vitamin A toxicity is NOT true?
gk gk gk gk gk gk gk gk
Textbook of Pediatrics 20 Edition
, 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
gk gk gk gk gk gk gk gk gk gk gk gk gk gk gk gk gk
mother noted bright red blood on the child's underwear. Previous examinations revealed a
gk gk gk gk gk gk gk gk gk gk gk gk gk
normal 4 yr old girl, Tanner stage 1, with normal external genitalia. Pelvic ultrasound results
gk gk gk gk gk gk gk gk gk gk gk gk gk gk gk
were normal, as was the serum estradiol level. The hemoglobin and platelet counts were no
gk gk gk gk gk gk gk gk gk gk gk gk gk gk
rmal, as were the bleeding time and coagulation studies. Findings on pelvic examination co
gk gk gk gk gk gk gk gk gk gk gk gk gk
nducted under anesthesia also were normal. The next step in the examination is to:
gk gk gk gk gk gk gk gk gk gk gk gk gk
■ Determine the blood type of the blood on the underwear
gk gk gk gk gk gk gk gk gk
□Interrogate gk the father
gk
□Isolate the parents and child
gk gk gk gk
□Determine gk von Willebrand factor levels
gk gk gk
, □Measure gk fibronectin in the vagina gk gk gk
description Consideration of factitious disorder by proxy should be triggered when the reported symptoms are repeate
gk gk gk gk gk gk gk gk gk gk gk gk gk gk gk
dly noted by only one parent, appropriate testing fails to confirm a diagnosis, and seemingly appropriate treatment is ineff
gk gk gk gk gk gk gk gk gk gk gk gk gk gk gk gk gk gk
ective. At times, the child's symptoms, their course, or the response to treatment may be incompatible with any recognize
g k gk gk gk gk gk gk gk gk gk gk gk gk gk gk gk gk gk
d disease. Preverbal children are usually involved. Bleeding is a particularly common presentation. This may be caused
gk g k gk gk gk gk gk gk gk gk gk gk gk gk gk gk gk
by adding dyes to samples, adding blood (e.g., from the mother) to the child's sample, or giving the child an anticoagul
gk gk g k gk gk gk gk gk gk gk gk gk gk gk gk gk gk gk gk gk
ant (e.g., warfarin). (See Chapter 37, page 146.)
gk gk gk gk gk gk gk
3. Munchausen syndrome by proxy is characterized by all of the following EXCEPT:
gk gk gk gk gk gk gk gk gk gk gk
□Mother who appears devoted and wins over members
gk gk gk gk gk gk gk gk of care team
gk gk
□Multiple gk hospitalizations and investigations without diagnosis gk gk gk gk
□Symptoms on history but not witnessed by medical team
gk gk gk gk gk gk gk gk
■ Symptoms occurring in presence of different caregivers (e.g., while mother is out of town)
gk gk gk gk gk gk gk gk gk gk gk gk gk
□Use of medications or toxins
gk gk gk gk
description Symptoms in young children are mostly associated with proximity of the offending caregiver to the child. T
gk gk gk gk gk gk gk gk gk gk gk gk gk gk gk gk gk
he mother may present as a devoted or even model parent who forms close relationships with members of the healt
gk gk gk gk gk gk gk gk gk gk gk gk gk gk gk gk gk gk gk
h care team. While appearing very interested in her child's condition, she may be relatively distant emotionally. (See Ch
gk gk gk gk gk gk gk gk gk gk gk gk gk gk gk gk gk gk
apter 37, page 146.)gk gk gk
4. Which statement is false? gk gk gk
■ Malnutrition is the second leading cause of acquired immune deficiency worldwide behind HIV infection
gk gk gk gk gk gk gk gk gk gk gk gk gk
□Zinc is important in immune function and linear growth
gk gk gk gk gk gk gk gk
□Kwashiorkor and marasmus are rare in developed countries gk gk gk gk gk gk gk
□The Western diet is associated with increased noncommunicable disease
gk gk gk gk gk gk gk gk
description The significant global burden of malnutrition and undernutrition is the leading worldwide cause of acquired i
gk gk gk gk gk gk gk gk gk gk gk gk gk gk gk gk
mmunodeficiency and the major underlying factor for morbidity and mortality globally for children <5 yr of age. Zinc is a
gk gk gk gk gk gk gk gk gk gk gk gk gk gk gk gk gk gk gk
gkmicronutrient that supports multiple metabolic functions in the body, is essential for normal immune functioning, and is r
gk gk gk gk gk gk gk gk gk gk gk gk gk gk gk gk gk
equired to support linear growth; zinc deficiency is associated with impaired immune functioning and poor linear growth.
gk gk gk gk gk gk gk gk gk gk gk gk gk gk gk gk gk
In parallel to the risk for nutrient and energy deficiencies, issues relating to excesses pose important challenges because of
gk gk gk gk gk gk gk gk gk gk gk gk gk gk gk gk gk gk g
ktheir negative health effects, such as obesity or cardiovascular disease risk factors. The nutrition transition under way i
gk gk gk gk gk gk gk gk gk gk gk gk gk gk gk gk gk
n thegk
, developing world from traditional diets to the Western diet has been associated with increases in noncommunicable dis
gk gk gk gk gk gk gk gk gk gk gk gk gk gk gk gk
eases, often coexisting with undernutrition and malnutrition, observed sometimes in the same communities or even the sa
gk gk gk gk gk gk gk gk gk gk gk gk gk gk gk gk
me families. (See e41-1.)
gk gk gk
5. Components of energy expenditure in children include: gk gk gk gk gk gk
□Thermal effect of food gk gk gk
□Basal metabolic rate gk gk
□Energy for physical activity gk gk gk
□Energy to gk gk support growth gk
■ All of the above
gk gk gk
description The 3 components of energy expenditure in adults are the basal metabolic rate, the thermal effect of fo
gk gk gk gk gk gk gk gk gk gk gk gk gk gk gk gk gk gk
od (energy required for digestion and absorption), and energy for physical activity. Additional energy intake and expend
gk gk gk gk gk gk gk gk gk gk gk gk gk gk gk gk
iture are required to support growth and development for children. (See e41-4.)
gk gk gk gk gk gk gk gk gk gk gk
6. Which of the following clinical scenarios increases the risk of vitamin A deficiency?
gk gk gk gk gk gk gk gk gk gk gk gk
□Vegetarian diet gk
□Chronic gk intestinal disorders gk
□Zinc gk deficiency
■ B and Cgk gk
□All of the above gk gk gk
description Vitamin A is an essential micronutrient because it cannot be biogenerated de novo by animals. It must
gk gk gk gk gk gk gk gk gk gk gk gk gk gk gk gk gk
be obtained from plants in the form of provitamin-
gk gk gk gk gk gk gk gk gk
A carotenoids. In the USA, grains and vegetables supply approximately 55% and dairy and meat products supply ap
gk gk gk gk gk gk gk gk gk gk gk gk gk gk gk gk gk
proximately 30% of vitamin A intake from food. Vitamin A and the provitamins-
gk gk gk gk gk gk gk gk gk gk gk gk
A are fat soluble, and their absorption depends on the presence of adequate lipid and protein within the meal. Chronic
gk gk gk gk gk gk gk gk gk gk gk gk gk gk gk gk gk gk g k gk
intestinal disorders or lipid malabsorption syndromes can result in vitamin A deficiency. In developing countries, subclini
gk gk gk gk gk gk gk gk gk gk gk gk gk gk gk
cal or clinical zinc deficiency can increase the risk of vitamin A deficiency. There is also some evidence of marginal zin
gk gk gk gk gk gk gk gk gk gk gk gk gk gk gk gk gk gk gk gk
c intakes in children in the USA. (See Chapter 45, page 188.)
gk gk gk gk gk gk gk gk gk gk gk
7. Which statement about vitamin A toxicity is NOT true?
gk gk gk gk gk gk gk gk
