l# l# l# l#
1. Which l#of l#the l#following l#statements l#regarding l#foster l#care l#is l#true?
□A permanency plan must be made for a child in foster care no later than 12 mo from the child's entry into
l# l# l# l# l# l# l# l# l# l# l# l# l# l# l# l# l# l# l# l# l#
care
l#
□A minority of children in foster care have a history of abuse or neglect
#
l #
l #
l #
l #
l #
l #
l #
l #
l #
l #
l #
l #
l
□The mission of foster care is to safely care for children while providing services to families to promote
#
l #
l #
l #
l #
l #
l #
l #
l #
l #
l #
l #
l #
l #
l #
l #
l #
l
#
lreunification
□Most (>70%) of children in foster care are reunited with their families
#
l #
l #
l #
l #
l #
l #
l #
l l# #
l #
l
■ A l#and l#C
description l#The l#missionl#of l#fosterl#carel#is l#to l#provide l#for #l the l#health, l#safety, #l and l#well-being l#of l#children l#while
l#assisting l#their l # families# l with# l services#lto#l promote# lreunification.# lChildren# lentering# l foster# l care# l have
lfrequently#
# lexperienced # learly # lchildhood l # trauma. l#More l#than l#70% l#have l#a l#history l#of l#abuse, l#neglect, l#or
l#both. l#Only l#about l#50% l#of l#children l#achieve l#reunification. l#In l#the l # USA,# lthe#
l Adoption# l and# l Safe# lFamilies
l Act#
# l (P.L.#
l 105-89)#l passed# lin#l 1997# l requires# l that# la#
lpermanency# l plan#lbe# l made#
lfor l# l # each l#child l#no l#later l#than
l#12 l#mo l#after l#entry l#to l#foster l#care l#and l#that l#a l#petition l#to l#terminate l#parental l#rights l#typically l#must l#be l#filed
l # whenl#al#childl#hasl#beenl#inl#fosterl#carel#forl#atl#least l#15l#ofl#thel#previousl#22l#mo.l#(Seel#Chapterl#35,l#pagel#134, l#and
l#e35-1.)
2. A l#4 l#yr l#old l#girl l#is l#admitted l#to l#the l#hospital l#for l#her l#third l#evaluation l#for l#vaginal
l#bleeding. l#The
mother l#noted l#bright l#red l#blood l#on l#the l#child's l#underwear. l#Previous l#examinations
l#revealed l#a l # normal l#4 l#yr l#old l#girl, l#Tanner l#stage l#1, l#with l#normal l#external l#genitalia.
l#Pelvic l#ultrasound l#results l # were l#normal, l#as l#was l#the l#serum l#estradiol l#level. l#The
l#hemoglobin l#and l#platelet l#counts l#were l # normal, l#as l#were l#the l#bleeding l#time l#and
l#coagulation l#studies. l#Findings l#on l#pelvic l#examination l # conducted l#under l#anesthesia
l#also l#were l#normal. l#The l#next l#step l#in l#the l#examination l#is l#to:
■ Determine#lthe#lblood#ltype#lof#lthe#lblood#lon#lthe#lunderwear
□Interrogate the father
l# l#
,□Isolate the l#parents l#and l#child
l#
□Determine von Willebrand factor levels
l# l# l# l#
, □Measure fibronectin l#in l#the l#vagina
l#
description l#Consideration l#of l#factitious l#disorder l#by l#proxy l#should l#be l#triggered l#when l#the l#reported l#symptoms
l#are l#repeatedly l # noted # l by l#only #l one #
l parent, #
l appropriate # l testing # l fails #
l to #l confirm #l a l#diagnosis, # l and # l seemingly
l appropriate #
# l treatment # l is#
l ineffective. l # At l#times, l#the l#child's l#symptoms, l#their l#course, l#or l#the l#response l#to
l#treatment l#may l#be l#incompatible l#with l#any l#recognized l#disease. l # Preverbal l#children # l are l#usually # l involved.
l Bleeding #
# l is#
l a l#particularly # l common # l presentation. # l This l#may #l be #l caused # l by #
l adding # l dyes l # to l#samples, l#adding
l#blood l#(e.g., l#from l#the l#mother) l#to # l the l#child's l#sample, l#or l#giving l#the l#child l#an # l anticoagulant l#(e.g., l#warfarin).
l # (See l#Chapter l#37, l#page l#146.)
3. Munchausenl#syndrome l#byl#proxy l#is l#characterized l#by l#all l#of l#the l#following l#EXCEPT:
□Mother who appears devoted and wins over members of care team
l# l# l# l# l# l# l# l# l# l#
□Multiple l# hospitalizations l # and l # investigations l # without l # diagnosis
□Symptoms on history but not witnessed by medical team
#
l #
l #
l #
l #
l #
l #
l l#
■ Symptoms #l occurring #l in #l presence l#ofl#different l#caregivers l#(e.g., l#while l#mother l#is #l out l#of #l town)
□Use of medications or toxins
l# l# l# l#
description l#Symptoms l#in l#young l#children l#are l#mostly l#associated l#with l#proximity l#of #l the l#offending #l caregiver l#to
l the l#child. l#The
# l # mother l#may # l present #l as #
l a#
l devoted #
l or #
l even #
l model #
l parent #
l who l#forms l#close #
l relationships
l#with l#members l#of l#the l#health l#care l # team. l#While l#appearing l#very l#interested l#in l#her l#child's l#condition, l#she
l#may l#be l#relatively l#distant l#emotionally. l#(See l#Chapter l#37, l# l#page l#146.)
4. Which l#statement l#is l#false?
■ Malnutrition#lis#lthe#l second#lleading#lcause#lof#lacquired#limmune#l deficiency#l worldwide#lbehind#l HIV #linfection
□Zinc is important in immune function and linear growth
#
l l# l# l# l# l# l# l#
□Kwashiorkor and marasmus are rare in developed countries
l# #
l #
l #
l #
l #
l #
l
□The l# Western l# diet l# is l# associated l# with l#increased l# noncommunicable l# disease
description#lThe#lsignificant#lglobal#lburden#lof#lmalnutrition#land#lundernutritionl#is#lthe#lleading#l worldwide#l cause#l of
acquired l # immunodeficiency #l and#lthe#l major#l underlying#l factor#l forl#morbidity#l and #l mortality#l globally#l for
#
l