Test bank for MCQs in Pediatrics Review of Nelson Textbook of
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Pediatrics 20 Edition
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,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|Symptoms|in|young|children|are|mostly|associated |with |proximity|of|the |offending|caregiver|to|the|child. |The
| mother |may |present |as |a |devoted |or |even |model |parent |who |forms |close |relationships |with |members |of |the
|health |care | team. |While |appearing |very |interested |in |her |child's |condition, |she |may |be |relatively |distant
|emotionally. |(See |Chapter |37, | |page |146.)
4. Which | statement | is |false?
■ Malnutrition |is |the |second |leading |cause |of |acquired |immune |deficiency |worldwide |behind |HIV |infection
□Zinc|is|important|in|immune|function |and|linear|growth
□Kwashiorkor |and |marasmus |are |rare |in |developed |countries
□The |Western |diet |is |associated |with |increased |noncommunicable |disease
description|The|significant|global|burden|of|malnutrition|and|undernutrition|is|the|leading|worldwide|cause|of|acquired
| immunodeficiency|and|the|major|underlying|factor|for|morbidity|and|mortality|globally|for|children|<5|yr|of|age. |Zinc|is
|a | micronutrient|that|supports|multiple|metabolic|functions|in|the|body,|is|essential|for|normal|immune|functioning,|and|is
| required|to|support|linear|growth;|zinc|deficiency|is|associated|with|impaired|immune|functioning|and|poor|linear|growth.
|In | parallel|to|the|risk|for|nutrient|and|energy|deficiencies,|issues|relating|to|excesses|pose|important|challenges|because
|of|their | negative |health|effects, |such|as |obesity |or |cardiovascular |disease|risk |factors. |The |nutrition |transition
|under |way |in |the
, developing |world |from |traditional |diets |to |the |Western |diet |has |been |associated |with |increases |in |noncommunicable
| diseases, |often |coexisting |with |undernutrition |and |malnutrition, |observed |sometimes |in |the |same |communities |or |even |the
| same |families. |(See |e41-1.)
5. Components | of | energy | expenditure | in | children | include:
□Thermal|effect|of|food
□Basal |metabolic | rate
□Energy |for |physical |activity
□Energy|to|support|growth
■ All |of |the |above
description |The |3 |components |of |energy |expenditure |in |adults |are |the |basal |metabolic |rate, |the |thermal |effect |of
|food | (energy |required |for |digestion |and |absorption), |and |energy |for |physical |activity. |Additional |energy |intake
|and |expenditure | are |required |to |support |growth |and |development |for | children. |(See |e41-4.)
6. Which|of |the |following |clinical |scenarios |increases |the |risk |of |vitamin |A|deficiency?
□Vegetarian | diet
□Chronic | intestinal |disorders
□Zinc |deficiency
■ B |and |C
□All|of|the|above
description |Vitamin |A |is |an |essential |micronutrient |because |it |cannot |be |biogenerated |de |novo |by |animals. |It |must
|be | obtained |from |plants |in |the |form |of |provitamin-A |carotenoids. |In |the |USA, |grains |and |vegetables |supply
|approximately | 55% |and |dairy|and |meat |products |supply |approximately |30% |of |vitamin |A |intake |from |food.
|Vitamin |A |and |the | provitamins-A|are|fat|soluble,|and|their|absorption|depends|on|the|presence|of|adequate|lipid|and
|protein|within|the|meal.
Chronic |intestinal |disorders |or |lipid |malabsorption |syndromes |can |result |in |vitamin |A |deficiency. |In |developing |countries,
| subclinical|or|clinical|zinc|deficiency|can|increase|the|risk|of|vitamin|A|deficiency.|There|is|also|some|evidence|of|marginal
| zinc |intakes | in |children |in |the |USA. |(See |Chapter |45, | page |188.)
7. Which | statement | about | vitamin | A | toxicity | is | NOT | true?
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Pediatrics 20 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|Symptoms|in|young|children|are|mostly|associated |with |proximity|of|the |offending|caregiver|to|the|child. |The
| mother |may |present |as |a |devoted |or |even |model |parent |who |forms |close |relationships |with |members |of |the
|health |care | team. |While |appearing |very |interested |in |her |child's |condition, |she |may |be |relatively |distant
|emotionally. |(See |Chapter |37, | |page |146.)
4. Which | statement | is |false?
■ Malnutrition |is |the |second |leading |cause |of |acquired |immune |deficiency |worldwide |behind |HIV |infection
□Zinc|is|important|in|immune|function |and|linear|growth
□Kwashiorkor |and |marasmus |are |rare |in |developed |countries
□The |Western |diet |is |associated |with |increased |noncommunicable |disease
description|The|significant|global|burden|of|malnutrition|and|undernutrition|is|the|leading|worldwide|cause|of|acquired
| immunodeficiency|and|the|major|underlying|factor|for|morbidity|and|mortality|globally|for|children|<5|yr|of|age. |Zinc|is
|a | micronutrient|that|supports|multiple|metabolic|functions|in|the|body,|is|essential|for|normal|immune|functioning,|and|is
| required|to|support|linear|growth;|zinc|deficiency|is|associated|with|impaired|immune|functioning|and|poor|linear|growth.
|In | parallel|to|the|risk|for|nutrient|and|energy|deficiencies,|issues|relating|to|excesses|pose|important|challenges|because
|of|their | negative |health|effects, |such|as |obesity |or |cardiovascular |disease|risk |factors. |The |nutrition |transition
|under |way |in |the
, developing |world |from |traditional |diets |to |the |Western |diet |has |been |associated |with |increases |in |noncommunicable
| diseases, |often |coexisting |with |undernutrition |and |malnutrition, |observed |sometimes |in |the |same |communities |or |even |the
| same |families. |(See |e41-1.)
5. Components | of | energy | expenditure | in | children | include:
□Thermal|effect|of|food
□Basal |metabolic | rate
□Energy |for |physical |activity
□Energy|to|support|growth
■ All |of |the |above
description |The |3 |components |of |energy |expenditure |in |adults |are |the |basal |metabolic |rate, |the |thermal |effect |of
|food | (energy |required |for |digestion |and |absorption), |and |energy |for |physical |activity. |Additional |energy |intake
|and |expenditure | are |required |to |support |growth |and |development |for | children. |(See |e41-4.)
6. Which|of |the |following |clinical |scenarios |increases |the |risk |of |vitamin |A|deficiency?
□Vegetarian | diet
□Chronic | intestinal |disorders
□Zinc |deficiency
■ B |and |C
□All|of|the|above
description |Vitamin |A |is |an |essential |micronutrient |because |it |cannot |be |biogenerated |de |novo |by |animals. |It |must
|be | obtained |from |plants |in |the |form |of |provitamin-A |carotenoids. |In |the |USA, |grains |and |vegetables |supply
|approximately | 55% |and |dairy|and |meat |products |supply |approximately |30% |of |vitamin |A |intake |from |food.
|Vitamin |A |and |the | provitamins-A|are|fat|soluble,|and|their|absorption|depends|on|the|presence|of|adequate|lipid|and
|protein|within|the|meal.
Chronic |intestinal |disorders |or |lipid |malabsorption |syndromes |can |result |in |vitamin |A |deficiency. |In |developing |countries,
| subclinical|or|clinical|zinc|deficiency|can|increase|the|risk|of|vitamin|A|deficiency.|There|is|also|some|evidence|of|marginal
| zinc |intakes | in |children |in |the |USA. |(See |Chapter |45, | page |188.)
7. Which | statement | about | vitamin | A | toxicity | is | NOT | true?
