TESTBANK h
Nelson Textbook of Pediatrics 19th Edi
h h h h h
tion ISBN-10 1437707556 ISBN-
h h h
13 9781437707557
h
TESTBANK h
, Nelson Pediatrics Review(MCQs) 19 Edition
h h h h
1. hWhichh ofh theh followingh statementsh regardingh fosterh careh ish 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
h h h h h h h h h h h h h h h h h h h h h h
□A minority of children in foster care have a history of abuse or neglect
h h h h h h h h h h h h h
□The mission of foster care is to safely care for children while providing services to families to promote reunification
h h h h h h h h h h h h h h h h h h
□Most (>70%) of children in foster care are reunited with their families
h h h h h h h h h h h
■ AhandhC
descriptionhThehmissionhofhfosterhcarehishtohprovidehforhthehhealth,hsafety,handhwell-
beinghofhchildrenhwhilehassistinghtheirhfamilieshwithhserviceshtohpromotehreunification.hChildrenhenteringhfosterhcarehhavehfrequ
entlyhexperiencedhearlyhchildhoodhtrauma.hMorehthanh70%hhavehahhistoryhofhabuse,hneglect,horhboth.hOnlyhabouth50%hofhchild
renhachievehreunification.hInhthehUSA,hthehAdoptionhandhSafehFamilieshActh(P.L.h105-
89)hpassedhinh1997hrequireshthathahpermanencyhplanhbehmadehforheachhchildhnohlaterhthanh12hmohafterhentryhtohfosterhcarehandh
thathahpetitionhtohterminatehparentalhrightshtypicallyhmusthbehfiledhwhenhahchildhhashbeenhinhfosterhcarehforhathleasth15hofhthehpr
evioush22hmo.h(SeehChapterh35,hpageh134,handhe35-1.)
2. Ah4hyrholdhgirlhishadmittedhtohthehhospitalhforhherhthirdhevaluationhforhvaginalhbleeding.hThe
motherhnotedhbrighthredhbloodhonhthehchild'shunderwear.hPrevioushexaminationshrevealedhahnor
malh4hyrholdhgirl,hTannerhstageh1,hwithhnormalhexternalhgenitalia.hPelvichultrasoundhresultshwerehn
ormal,hashwashthehserumhestradiolhlevel.hThehhemoglobinhandhplatelethcountshwerehnormal,hashw
erehthehbleedinghtimehandhcoagulationhstudies.hFindingshonhpelvichexaminationhconductedhunde
rhanesthesiahalsohwerehnormal.hThehnexthstephinhthehexaminationhishto:
■ Determinehthehbloodhtypehofhthehbloodhonhthehunderwear
□Interrogate the father
h h
□Isolate the parents and child
h h h h
□Determine von Willebrand factor levels
h h h h
, □Measure fibronectin in the vagina
h h h h
descriptionhConsiderationhofhfactitioushdisorderhbyhproxyhshouldhbehtriggeredhwhenhthehreportedhsymptomsharehrepeatedlyh
notedhbyhonlyhonehparent,happropriatehtestinghfailshtohconfirmhahdiagnosis,handhseeminglyhappropriatehtreatmenthishineffective.h At
htimes,hthehchild'shsymptoms,h theirhcourse,h orhtheh responsehtohtreatmenth mayh behincompatibleh withhanyhrecognizedh disease.h Preve
rbalhchildrenharehusuallyhinvolved.hBleedinghishahparticularlyhcommonhpresentation.hThishmayhbehcausedhbyhaddinghdyesh tohsamp
les,haddinghbloodh(e.g.,hfromhthehmother)htohthehchild'shsample,horhgivinghthehchildhanhanticoagulanth(e.g.,hwarfarin).h(SeehCha
pterh37,hpageh146.)
3. Munchausenh syndromeh byh proxyh ish characterizedh byh allh ofh theh followingh EXCEPT:
□Mother who appears devoted and wins over members of care team
h h h h h h h h h h
□Multiple hospitalizations and investigations without diagnosis
h h h h h
□Symptoms on history but not witnessed by medical team
h h h h h h h h
■ Symptomshoccurringhinhpresencehofhdifferenthcaregiversh(e.g.,hwhilehmotherhishouthofhtown)
□Use of medications or toxins
h h h h
descriptionhSymptomshinhyounghchildrenharehmostlyhassociatedhwithhproximityhofhthehoffendinghcaregiverhtohthehchild.hThehm
otherhmayhpresenthashahdevotedhorhevenhmodelhparenthwhohformshclosehrelationshipshwithhmembershofhthehhealthhcarehtea
m.hWhilehappearinghveryhinterestedhinhherhchild'shcondition,hshehmayhbehrelativelyhdistanthemotionally.h(SeehChapterh37,hpageh
146.)
4. Whichh statementh ish false?
■ MalnutritionhishthehsecondhleadinghcausehofhacquiredhimmunehdeficiencyhworldwidehbehindhHIVhinfection
□Zinc is important in immune function and linear growth
h h h h h h h h
□Kwashiorkor and marasmus are rare in developed countries
h h h h h h h
□The Western diet is associated with increased noncommunicable disease
h h h h h h h h
descriptionhThehsignificanthglobalhburdenhofhmalnutritionhandhundernutritionhishthehleadinghworldwidehcausehofhacquiredhimmun
odeficiencyhandhthehmajorhunderlyinghfactorhforhmorbidityhandhmortalityhgloballyhforhchildrenh<5hyrhofhage.hZinchishahmicronutrie
nththathsupportshmultiplehmetabolichfunctionshinhthehbody,hishessentialhforhnormalhimmunehfunctioning,handhishrequiredhtohsupporth
linearhgrowth;hzinchdeficiencyhishassociatedhwithhimpairedhimmunehfunctioninghandhpoorhlinearhgrowth.hInhparallelhtohthehriskhforh
nutrienthandhenergyhdeficiencies,hissueshrelatinghtohexcesseshposehimportanthchallengeshbecausehofhtheirhnegativehhealthheffects,h
suchhashobesityhorhcardiovascularhdiseasehriskhfactors.hThehnutritionhtransitionhunderhwayhinhthe
, developinghworldhfromhtraditionalhdietshtohthehWesternhdiethhashbeenhassociatedhwithhincreaseshinhnoncommunicablehdiseases,
hoftenhcoexistingh withh undernutritionhandh malnutrition,hobservedhsometimeshinhthehsamehcommunitiesh orhevenhthehsamehfamilie
s.h(Seehe41-1.)
5. Componentsh ofh energyh expenditureh inh childrenh include:
□Thermal effect of food
h h h
□Basal metabolic rate
h h
□Energy for physical activity
h h h
□Energy to support growth
h h h
■ Allhofhthehabove
descriptionhTheh3hcomponentshofhenergyhexpenditurehinhadultsharehthehbasalhmetabolichrate,hthehthermalheffecthofhfoodh(
energyhrequiredhforhdigestionhandhabsorption),handhenergyhforhphysicalhactivity.hAdditionalhenergyhintakehandhexpenditurehareh
requiredhtohsupporthgrowthhandhdevelopmenthforhchildren.h(Seehe41-4.)
6. WhichhofhthehfollowinghclinicalhscenarioshincreaseshthehriskhofhvitaminhAhdeficiency?
□Vegetarian diet h
□Chronic intestinal disorders
h h
□Zinc deficiency
h
■ BhandhC
□All of the above
h h h
descriptionhVitaminhAhishanhessentialhmicronutrienthbecausehithcannothbehbiogeneratedhdehnovohbyhanimals.hIthmusthbeho
btainedhfromhplantshinhthehformhofhprovitamin-
Ahcarotenoids.hInhthehUSA,hgrainshandhvegetableshsupplyhapproximatelyh55%handhdairyhandhmeathproductshsupplyhapproxi
matelyh30%hofhvitaminhAhintakehfromhfood.hVitaminhAhandhthehprovitamins-
Aharehfathsoluble,handhtheirhabsorptionhdependshonhthehpresencehofhadequatehlipidhandhproteinhwithinhthehmeal.h Chronichintestin
alhdisordershorhlipidhmalabsorptionhsyndromeshcanhresulthinhvitaminhAhdeficiency.hInhdevelopinghcountries,hsubclinicalhorhclinic
alhzinchdeficiencyhcanhincreasehthehriskhofhvitaminhAhdeficiency.hTherehishalsohsomehevidencehofhmarginalhzinchintakeshinhchil
drenhinhthehUSA.h(SeehChapterh45,hpageh188.)
7. Whichh statementh abouth vitaminh Ah toxicityh ish NOTh true?
Nelson Textbook of Pediatrics 19th Edi
h h h h h
tion ISBN-10 1437707556 ISBN-
h h h
13 9781437707557
h
TESTBANK h
, Nelson Pediatrics Review(MCQs) 19 Edition
h h h h
1. hWhichh ofh theh followingh statementsh regardingh fosterh careh ish 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
h h h h h h h h h h h h h h h h h h h h h h
□A minority of children in foster care have a history of abuse or neglect
h h h h h h h h h h h h h
□The mission of foster care is to safely care for children while providing services to families to promote reunification
h h h h h h h h h h h h h h h h h h
□Most (>70%) of children in foster care are reunited with their families
h h h h h h h h h h h
■ AhandhC
descriptionhThehmissionhofhfosterhcarehishtohprovidehforhthehhealth,hsafety,handhwell-
beinghofhchildrenhwhilehassistinghtheirhfamilieshwithhserviceshtohpromotehreunification.hChildrenhenteringhfosterhcarehhavehfrequ
entlyhexperiencedhearlyhchildhoodhtrauma.hMorehthanh70%hhavehahhistoryhofhabuse,hneglect,horhboth.hOnlyhabouth50%hofhchild
renhachievehreunification.hInhthehUSA,hthehAdoptionhandhSafehFamilieshActh(P.L.h105-
89)hpassedhinh1997hrequireshthathahpermanencyhplanhbehmadehforheachhchildhnohlaterhthanh12hmohafterhentryhtohfosterhcarehandh
thathahpetitionhtohterminatehparentalhrightshtypicallyhmusthbehfiledhwhenhahchildhhashbeenhinhfosterhcarehforhathleasth15hofhthehpr
evioush22hmo.h(SeehChapterh35,hpageh134,handhe35-1.)
2. Ah4hyrholdhgirlhishadmittedhtohthehhospitalhforhherhthirdhevaluationhforhvaginalhbleeding.hThe
motherhnotedhbrighthredhbloodhonhthehchild'shunderwear.hPrevioushexaminationshrevealedhahnor
malh4hyrholdhgirl,hTannerhstageh1,hwithhnormalhexternalhgenitalia.hPelvichultrasoundhresultshwerehn
ormal,hashwashthehserumhestradiolhlevel.hThehhemoglobinhandhplatelethcountshwerehnormal,hashw
erehthehbleedinghtimehandhcoagulationhstudies.hFindingshonhpelvichexaminationhconductedhunde
rhanesthesiahalsohwerehnormal.hThehnexthstephinhthehexaminationhishto:
■ Determinehthehbloodhtypehofhthehbloodhonhthehunderwear
□Interrogate the father
h h
□Isolate the parents and child
h h h h
□Determine von Willebrand factor levels
h h h h
, □Measure fibronectin in the vagina
h h h h
descriptionhConsiderationhofhfactitioushdisorderhbyhproxyhshouldhbehtriggeredhwhenhthehreportedhsymptomsharehrepeatedlyh
notedhbyhonlyhonehparent,happropriatehtestinghfailshtohconfirmhahdiagnosis,handhseeminglyhappropriatehtreatmenthishineffective.h At
htimes,hthehchild'shsymptoms,h theirhcourse,h orhtheh responsehtohtreatmenth mayh behincompatibleh withhanyhrecognizedh disease.h Preve
rbalhchildrenharehusuallyhinvolved.hBleedinghishahparticularlyhcommonhpresentation.hThishmayhbehcausedhbyhaddinghdyesh tohsamp
les,haddinghbloodh(e.g.,hfromhthehmother)htohthehchild'shsample,horhgivinghthehchildhanhanticoagulanth(e.g.,hwarfarin).h(SeehCha
pterh37,hpageh146.)
3. Munchausenh syndromeh byh proxyh ish characterizedh byh allh ofh theh followingh EXCEPT:
□Mother who appears devoted and wins over members of care team
h h h h h h h h h h
□Multiple hospitalizations and investigations without diagnosis
h h h h h
□Symptoms on history but not witnessed by medical team
h h h h h h h h
■ Symptomshoccurringhinhpresencehofhdifferenthcaregiversh(e.g.,hwhilehmotherhishouthofhtown)
□Use of medications or toxins
h h h h
descriptionhSymptomshinhyounghchildrenharehmostlyhassociatedhwithhproximityhofhthehoffendinghcaregiverhtohthehchild.hThehm
otherhmayhpresenthashahdevotedhorhevenhmodelhparenthwhohformshclosehrelationshipshwithhmembershofhthehhealthhcarehtea
m.hWhilehappearinghveryhinterestedhinhherhchild'shcondition,hshehmayhbehrelativelyhdistanthemotionally.h(SeehChapterh37,hpageh
146.)
4. Whichh statementh ish false?
■ MalnutritionhishthehsecondhleadinghcausehofhacquiredhimmunehdeficiencyhworldwidehbehindhHIVhinfection
□Zinc is important in immune function and linear growth
h h h h h h h h
□Kwashiorkor and marasmus are rare in developed countries
h h h h h h h
□The Western diet is associated with increased noncommunicable disease
h h h h h h h h
descriptionhThehsignificanthglobalhburdenhofhmalnutritionhandhundernutritionhishthehleadinghworldwidehcausehofhacquiredhimmun
odeficiencyhandhthehmajorhunderlyinghfactorhforhmorbidityhandhmortalityhgloballyhforhchildrenh<5hyrhofhage.hZinchishahmicronutrie
nththathsupportshmultiplehmetabolichfunctionshinhthehbody,hishessentialhforhnormalhimmunehfunctioning,handhishrequiredhtohsupporth
linearhgrowth;hzinchdeficiencyhishassociatedhwithhimpairedhimmunehfunctioninghandhpoorhlinearhgrowth.hInhparallelhtohthehriskhforh
nutrienthandhenergyhdeficiencies,hissueshrelatinghtohexcesseshposehimportanthchallengeshbecausehofhtheirhnegativehhealthheffects,h
suchhashobesityhorhcardiovascularhdiseasehriskhfactors.hThehnutritionhtransitionhunderhwayhinhthe
, developinghworldhfromhtraditionalhdietshtohthehWesternhdiethhashbeenhassociatedhwithhincreaseshinhnoncommunicablehdiseases,
hoftenhcoexistingh withh undernutritionhandh malnutrition,hobservedhsometimeshinhthehsamehcommunitiesh orhevenhthehsamehfamilie
s.h(Seehe41-1.)
5. Componentsh ofh energyh expenditureh inh childrenh include:
□Thermal effect of food
h h h
□Basal metabolic rate
h h
□Energy for physical activity
h h h
□Energy to support growth
h h h
■ Allhofhthehabove
descriptionhTheh3hcomponentshofhenergyhexpenditurehinhadultsharehthehbasalhmetabolichrate,hthehthermalheffecthofhfoodh(
energyhrequiredhforhdigestionhandhabsorption),handhenergyhforhphysicalhactivity.hAdditionalhenergyhintakehandhexpenditurehareh
requiredhtohsupporthgrowthhandhdevelopmenthforhchildren.h(Seehe41-4.)
6. WhichhofhthehfollowinghclinicalhscenarioshincreaseshthehriskhofhvitaminhAhdeficiency?
□Vegetarian diet h
□Chronic intestinal disorders
h h
□Zinc deficiency
h
■ BhandhC
□All of the above
h h h
descriptionhVitaminhAhishanhessentialhmicronutrienthbecausehithcannothbehbiogeneratedhdehnovohbyhanimals.hIthmusthbeho
btainedhfromhplantshinhthehformhofhprovitamin-
Ahcarotenoids.hInhthehUSA,hgrainshandhvegetableshsupplyhapproximatelyh55%handhdairyhandhmeathproductshsupplyhapproxi
matelyh30%hofhvitaminhAhintakehfromhfood.hVitaminhAhandhthehprovitamins-
Aharehfathsoluble,handhtheirhabsorptionhdependshonhthehpresencehofhadequatehlipidhandhproteinhwithinhthehmeal.h Chronichintestin
alhdisordershorhlipidhmalabsorptionhsyndromeshcanhresulthinhvitaminhAhdeficiency.hInhdevelopinghcountries,hsubclinicalhorhclinic
alhzinchdeficiencyhcanhincreasehthehriskhofhvitaminhAhdeficiency.hTherehishalsohsomehevidencehofhmarginalhzinchintakeshinhchil
drenhinhthehUSA.h(SeehChapterh45,hpageh188.)
7. Whichh statementh abouth vitaminh Ah toxicityh ish NOTh true?
