Test bank for nelson pediatrics review mcqs 19 edition

Test bank for MCQs in Pediatrics Review of Nelson
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Textbook of Pediatrics 20 Edition
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, Nelson Pediatrics Review(MCQs) 19 Edition g , j g , j g ,j g,j




1. Which of the following statements regarding foster care is true? g , j g , j g , j g , j g , j g , j g , j g , j g , j




□A permanency plan must be made for a childin fostercare no later than 12 mo from the child's entry into care
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□A minority of childrenin fostercare have a history of abuse or neglect
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□The mission offostercare istosafely care forchildren while providingservices tofamilies topromotereunification
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□Most (>70%) of childrenin fostercare arereunited withtheir families g ,j g,j g,j g,j g,j g ,j g,j g,j g,j g,j g,j




■ AandC g,j g,j




descriptionThemissionoffostercareistoprovideforthehealth,safety,andwell-beingofchildrenwhileassistingtheirfamilies g,j g,j g,j g,j g,j g,j g,j g,j g,j g,j g,j g,j g,j g,j g,j g,j g,j g,j g,j g,j




with services to promote reunification. Children entering foster care have frequently experienced early childhood trauma.More
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than70%haveahistoryofabuse,neglect,orboth.Onlyabout50%ofchildrenachievereunification.IntheUSA,theAdoptionand
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SafeFamiliesAct(P.L.105-89)passedin1997requiresthatapermanencyplanbemadefor each child no later than 12 mo after
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entry to foster care and that a petition to terminate parental rights typically must be filed whenachildhasbeeninfostercareforat
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least15oftheprevious22mo.(SeeChapter35,page134,ande35-1.)
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2. A4yroldgirlisadmittedtothehospitalforherthirdevaluationforvaginalbleeding.The
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mother noted bright red blood on the child's underwear. Previous examinations revealed a g,j g,j g,j g,j g,j g,j g,j g,j g,j g,j g,j g,j




normal4yroldgirl,Tannerstage1,withnormalexternalgenitalia.Pelvicultrasoundresults were
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normal, as was the serum estradiol level. The hemoglobin and platelet counts were normal, as were
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the bleeding time and coagulation studies. Findings on pelvic examination conducted under
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anesthesia also were normal. The next step in the examination is to:
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■ Determinethebloodtypeofthebloodontheunderwear g,j g,j g,j g,j g,j g,j g,j g,j g,j




□Interrogate the father g , j g , j




□Isolatethe parentsandchild g,j g,j g,j g,j




□Determine g , j von Willebrand factor levels g , j g , j g , j

, □Measure fibronectin g , j g , j in the vagina g,j g ,j




descriptionConsiderationoffactitiousdisorderbyproxyshouldbetriggeredwhenthereportedsymptomsarerepeatedlynoted by g,j g,j g,j g,j g,j g,j g,j g,j g,j g,j g,j g,j g,j g,j g,j g,j g, j




only one parent, appropriate testing fails to confirm a diagnosis, and seemingly appropriate treatment is ineffective. At times, the
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child's symptoms, their course, or the response to treatment may be incompatible with any recognized disease.
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children are usually involved. Bleeding is a particularly common presentation. This may be caused by adding dyes tosamples,
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addingblood(e.g.,fromthemother)tothechild'ssample,orgivingthechildananticoagulant(e.g.,warfarin).(See Chapter 37,
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page 146.)
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3. Munchausen syndrome by proxy is characterized by all of the following EXCEPT: g ,j g ,j g ,j g , j g ,j g , j g , j g ,j g , j g , j g , j




□Mother who appears devoted and wins over members of care team g ,j g,j g ,j g ,j g ,j g ,j g ,j g , j g ,j g ,j




□Multiple hospitalizations and investigations without diagnosis g , j g , j g , j g , j g , j




□Symptoms on history butnotwitnessed by medicalteam g ,j g ,j g ,j g,j g,j g ,j g ,j g ,j




■ Symptoms occurring in presence of different caregivers (e.g., while mother is out of town) g,j g,j g,j g ,j g,j g ,j g,j g ,j g ,j g,j g,j g,j g,j




□Useofmedications ortoxins g,j g,j g,j g,j




description Symptoms in young children are mostly associated with proximity of the offending caregiver to the child. The mother
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may present as a devoted or even model parent who forms close relationships with members of the health care team. While
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appearing very interested in her child's condition, she may be relatively distant emotionally. (See Chapter 37, page 146.)
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4. Which statement is false? g , j g , j g , j




■ Malnutrition is the second leading cause of acquired immune deficiency worldwide behind HIV infection g,j g,j g,j g,j g,j g,j g,j g,j g,j g,j g, j g,j g,j




□Zinc is important in immune function and linear growth
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□Kwashiorkor and marasmus are rare in developed countries g,j g ,j g ,j g ,j g ,j g ,j g,j




□The Western diet is associated withincreased noncommunicable disease
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description The significant global burden of malnutrition and undernutrition is the leading worldwide cause of acquired g ,j g ,j g ,j g ,j g ,j g ,j g ,j g ,j g ,j g, j g, j g ,j g ,j g ,j g ,j




immunodeficiency and the major underlying factor for morbidity and mortality globally for children <5 yr of age. Zinc is a
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micronutrient that supports multiple metabolic functions in the body, is essential for normal immune functioning, and is required to
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support linear growth; zinc deficiency is associated with impaired immune functioning and poor linear growth. In parallel to the risk
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for nutrient and energy deficiencies, issues relating to excesses pose important challenges because of their negativehealtheffects,
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suchasobesityorcardiovasculardiseaseriskfactors.Thenutritiontransitionunderwayinthe
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, developing world from traditional dietstothe Western diet has beenassociated with increases innoncommunicablediseases, often
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coexisting with undernutrition and malnutrition, observed sometimes in the same communities or even the same families. (See
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e41-1.)
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5. Components of energy expenditure in children include: g , j g , j g , j g , j g , j g , j




□Thermal effect of food g ,j g ,j g, j




□Basal metabolic rate g ,j g ,j




□Energy for physical activity g,j g ,j g ,j




□Energy to support g ,j g , j g , j growth


■ Alloftheabove g,j g,j g,j




description The 3 components of energyexpenditure in adults are the basal metabolic rate,the thermal effect of food (energy g,j ,jg g,j g,j g,j g,j g,j g,j g,j g,j g,j g,j g,j g,j g,j g,j g,j g,j g,j




required for digestion and absorption), and energy for physical activity. Additional energy intake and expenditure are required to
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support growth and development for children. (See e41-4.)
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6. WhichofthefollowingclinicalscenariosincreasestheriskofvitaminAdeficiency? g,j g,j g,j g,j g,j g,j g,j g,j g,j g,j g,j g,j




□Vegetarian diet g,j




□Chronic intestinal disorders g , j g , j




□Zinc g , j deficiency


■ BandC g,j g,j




□All of the above g,j g,j g,j




descriptionVitaminAisanessentialmicronutrientbecauseitcannotbebiogenerateddenovobyanimals.Itmustbeobtained g,j g,j g,j g,j g,j g,j g,j g,j g,j g,j g,j g,j g,j g,j g,j g,j g,j g,j g,j




from plants in the form of provitamin-A carotenoids. In the USA, grains and vegetables supply approximately55%anddairy
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andmeatproductssupplyapproximately30%ofvitaminAintakefromfood.VitaminAandthe provitamins-A are fat soluble,
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and their absorption depends on the presence of adequate lipid and protein within the meal. Chronic intestinal disorders or lipid
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malabsorption syndromes can result in vitamin A deficiency. In developing countries, subclinical or clinical zinc deficiency can
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increase the risk of vitamin A deficiency. There is also some evidence of marginal zinc intakes in children in the USA. (See
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Chapter 45, page 188.)
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7. Which statement about vitamin A toxicity is NOT true? g , j g , j g , j g , j g , j g , j g , j g , j