TESTBANK r
Nelson Textbook of Pediatrics 19th Edit
r r r r r
ion ISBN-10 1437707556 ISBN-
r r r
13 9781437707557
r
TESTBANK r
, Nelson Pediatrics Review(MCQs) 19 Edition r r r r
1. Whichr ofr ther followingr statementsr regardingr fosterr carer isr 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
r r r r r r r r r r r r r r r r r r r r r r
□A minority of children in foster care have a history of abuse or neglect
r r r r r r r r r r r r r
□The mission of foster care is to safely care for children while providing services to families to promote reunification
r r r r r r r r r r r r r r r r r r
□Most (>70%) of children in foster care are reunited with their families
r r r r r r r r r r r
■ ArandrC
descriptionrThermissionrofrfosterrcarerisrtorproviderforrtherhealth,rsafety,randrwell-
beingrofrchildrenrwhilerassistingrtheirrfamiliesrwithrservicesrtorpromoterreunification.rChildrenrenteringrfosterrcarerhaverfrequentl
yrexperiencedrearlyrchildhoodrtrauma.rMorerthanr70%rhaverarhistoryrofrabuse,rneglect,rorrboth.rOnlyraboutr50%rofrchildrenrachi
everreunification.rInrtherUSA,rtherAdoptionrandrSaferFamiliesrActr(P.L.r105-
89)rpassedrinr1997rrequiresrthatrarpermanencyrplanrbermaderforreachrchildrnorlaterrthanr12rmorafterrentryrtorfosterrcarerandrthatra
rpetitionrtorterminaterparentalrrightsrtypicallyrmustrberfiledrwhenrarchildrhasrbeenrinrfosterrcarerforratrleastr15rofrtherpreviousr22r
mo.r(SeerChapterr35,rpager134,randre35-1.)
2. Ar4ryrroldrgirlrisradmittedrtortherhospitalrforrherrthirdrevaluationrforrvaginalrbleeding.rThe
motherrnotedrbrightrredrbloodronrtherchild'srunderwear.rPreviousrexaminationsrrevealedrarnor
malr4ryrroldrgirl,rTannerrstager1,rwithrnormalrexternalrgenitalia.rPelvicrultrasoundrresultsrwererno
rmal,rasrwasrtherserumrestradiolrlevel.rTherhemoglobinrandrplateletrcountsrwerernormal,rasrwere
rtherbleedingrtimerandr coagulation rstudies.r Findingsronr pelvicr examinationr conductedrunderr ane
sthesiaralsorwerernormal.rThernextrsteprinrtherexaminationrisrto:
■ Determinertherbloodrtyperofrtherbloodronrtherunderwear
□Interrogate the father
r r
□Isolate the parents and child
r r r r
□Determine von Willebrand factor levels
r r r r
, □Measure fibronectin in the vagina
r r r r
descriptionrConsiderationrofrfactitiousrdisorderrbyrproxyrshouldrbertriggeredrwhenrtherreportedrsymptomsrarerrepeatedlyrnot
edrbyronlyronerparent,rappropriatertestingrfailsrtorconfirmrardiagnosis,randrseeminglyrappropriatertreatmentrisrineffective.r Atrtimes,r
therchild'srsymptoms,rtheirrcourse,rorrtherresponsertortreatmentrmayrberincompatiblerwithranyrrecognizedrdisease.r Preverbalrchildr
enrarerusuallyrinvolved.rBleedingrisrarparticularlyrcommonrpresentation.rThisrmayrbercausedrbyraddingrdyesr torsamples,raddingrbl
oodr(e.g.,rfromrthermother)rtortherchild'srsample,rorrgivingrtherchildranranticoagulantr(e.g.,rwarfarin).r(SeerChapterr37,rpager14
6.)
3. Munchausenr syndromer byr proxyr isr characterizedr byr allr ofr ther followingr EXCEPT:
□Mother who appears devoted and wins over members of care team
r r r r r r r r r r
□Multiple hospitalizations and investigations without diagnosis
r r r r r
□Symptoms on history but not witnessed by medical team
r r r r r r r r
■ Symptomsroccurringrinrpresencerofrdifferentrcaregiversr(e.g.,rwhilermotherrisroutrofrtown)
□Use of medications or toxins
r r r r
descriptionrSymptomsrinryoungrchildrenrarermostlyrassociatedrwithrproximityrofrtheroffendingrcaregiverrtortherchild.rThermoth
errmayrpresentrasrardevotedrorrevenrmodelrparentrwhorformsrcloserrelationshipsrwithrmembersrofrtherhealthrcarerteam.rWhil
erappearingrveryrinterestedrinrherrchild'srcondition,rshermayrberrelativelyrdistantremotionally.r(SeerChapterr37,rpager146.)
4. Whichr statementr isr false?
■ MalnutritionrisrthersecondrleadingrcauserofracquiredrimmunerdeficiencyrworldwiderbehindrHIVrinfection
□Zinc is important in immune function and linear growth
r r r r r r r r
□Kwashiorkor and marasmus are rare in developed countries
r r r r r r r
□The Western diet is associated with increased noncommunicable disease
r r r r r r r r
descriptionrThersignificantrglobalrburdenrofrmalnutritionrandrundernutritionrisrtherleadingrworldwidercauserofracquiredrimmunod
eficiencyrandrthermajorrunderlyingrfactorrforrmorbidityrandrmortalityrgloballyrforrchildrenr<5ryrrofrage.rZincrisrarmicronutrientrthatr
supportsrmultiplermetabolicrfunctionsrinrtherbody,risressentialrforrnormalrimmunerfunctioning,randrisrrequiredrtorsupportrlinearrgro
wth;rzincrdeficiencyrisrassociatedrwithrimpairedrimmunerfunctioningrandrpoorrlinearrgrowth.rInrparallelrtortherriskrforrnutrientrandre
nergyrdeficiencies,rissuesrrelatingrtorexcessesrposerimportantrchallengesrbecauserofrtheirrnegativerhealthreffects,rsuchrasrobesityro
rrcardiovascularrdiseaserriskrfactors.rThernutritionrtransitionrunderrwayrinrthe
, developingrworldrfromrtraditionalrdietsrtortherWesternrdietrhasrbeenrassociatedrwithrincreasesrinrnoncommunicablerdiseases,roft
enrcoexistingrwithrundernutritionrandrmalnutrition,robservedrsometimesrinrthersamercommunitiesrorrevenrthersamerfamilies.r(Se
ere41-1.)
5. Componentsr ofr energyr expenditurer inr childrenr include:
□Thermal effect of food
r r r
□Basal metabolic rate
r r
□Energy for physical activity
r r r
□Energy to support growth
r r r
■ Allrofrtherabove
descriptionrTher3rcomponentsrofrenergyrexpenditurerinradultsrarertherbasalrmetabolicrrate,rtherthermalreffectrofrfoodr(ener
gyrrequiredrforrdigestionrandrabsorption),randrenergyrforrphysicalractivity.rAdditionalrenergyrintakerandrexpenditurerarerrequir
edrtorsupportrgrowthrandrdevelopmentrforrchildren.r(Seere41-4.)
6. WhichrofrtherfollowingrclinicalrscenariosrincreasesrtherriskrofrvitaminrArdeficiency?
□Vegetarian diet r
□Chronic intestinal disorders
r r
□Zinc deficiency
r
■ BrandrC
□All of the above
r r r
descriptionrVitaminrArisranressentialrmicronutrientrbecauseritrcannotrberbiogeneratedrdernovorbyranimals.rItrmustrberobtai
nedrfromrplantsrinrtherformrofrprovitamin-
Arcarotenoids.rInrtherUSA,rgrainsrandrvegetablesrsupplyrapproximatelyr55%randrdairyrandrmeatrproductsrsupplyrapproxima
telyr30%rofrvitaminrArintakerfromrfood.rVitaminrArandrtherprovitamins-
Ararerfatrsoluble,randrtheirrabsorptionrdependsronrtherpresencerofradequaterlipidrandrproteinrwithinrthermeal.r Chronicrintestinalrdi
sordersrorrlipidrmalabsorptionrsyndromesrcanrresultrinrvitaminrArdeficiency.rInrdevelopingrcountries,rsubclinicalrorrclinicalrzincrd
eficiencyrcanrincreasertherriskrofrvitaminrArdeficiency.rThererisralsorsomerevidencerofrmarginalrzincrintakesrinrchildrenrinrther
USA.r(SeerChapterr45,rpager188.)
7. Whichr statementr aboutr vitaminr Ar toxicityr isr NOTr true?
Nelson Textbook of Pediatrics 19th Edit
r r r r r
ion ISBN-10 1437707556 ISBN-
r r r
13 9781437707557
r
TESTBANK r
, Nelson Pediatrics Review(MCQs) 19 Edition r r r r
1. Whichr ofr ther followingr statementsr regardingr fosterr carer isr 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
r r r r r r r r r r r r r r r r r r r r r r
□A minority of children in foster care have a history of abuse or neglect
r r r r r r r r r r r r r
□The mission of foster care is to safely care for children while providing services to families to promote reunification
r r r r r r r r r r r r r r r r r r
□Most (>70%) of children in foster care are reunited with their families
r r r r r r r r r r r
■ ArandrC
descriptionrThermissionrofrfosterrcarerisrtorproviderforrtherhealth,rsafety,randrwell-
beingrofrchildrenrwhilerassistingrtheirrfamiliesrwithrservicesrtorpromoterreunification.rChildrenrenteringrfosterrcarerhaverfrequentl
yrexperiencedrearlyrchildhoodrtrauma.rMorerthanr70%rhaverarhistoryrofrabuse,rneglect,rorrboth.rOnlyraboutr50%rofrchildrenrachi
everreunification.rInrtherUSA,rtherAdoptionrandrSaferFamiliesrActr(P.L.r105-
89)rpassedrinr1997rrequiresrthatrarpermanencyrplanrbermaderforreachrchildrnorlaterrthanr12rmorafterrentryrtorfosterrcarerandrthatra
rpetitionrtorterminaterparentalrrightsrtypicallyrmustrberfiledrwhenrarchildrhasrbeenrinrfosterrcarerforratrleastr15rofrtherpreviousr22r
mo.r(SeerChapterr35,rpager134,randre35-1.)
2. Ar4ryrroldrgirlrisradmittedrtortherhospitalrforrherrthirdrevaluationrforrvaginalrbleeding.rThe
motherrnotedrbrightrredrbloodronrtherchild'srunderwear.rPreviousrexaminationsrrevealedrarnor
malr4ryrroldrgirl,rTannerrstager1,rwithrnormalrexternalrgenitalia.rPelvicrultrasoundrresultsrwererno
rmal,rasrwasrtherserumrestradiolrlevel.rTherhemoglobinrandrplateletrcountsrwerernormal,rasrwere
rtherbleedingrtimerandr coagulation rstudies.r Findingsronr pelvicr examinationr conductedrunderr ane
sthesiaralsorwerernormal.rThernextrsteprinrtherexaminationrisrto:
■ Determinertherbloodrtyperofrtherbloodronrtherunderwear
□Interrogate the father
r r
□Isolate the parents and child
r r r r
□Determine von Willebrand factor levels
r r r r
, □Measure fibronectin in the vagina
r r r r
descriptionrConsiderationrofrfactitiousrdisorderrbyrproxyrshouldrbertriggeredrwhenrtherreportedrsymptomsrarerrepeatedlyrnot
edrbyronlyronerparent,rappropriatertestingrfailsrtorconfirmrardiagnosis,randrseeminglyrappropriatertreatmentrisrineffective.r Atrtimes,r
therchild'srsymptoms,rtheirrcourse,rorrtherresponsertortreatmentrmayrberincompatiblerwithranyrrecognizedrdisease.r Preverbalrchildr
enrarerusuallyrinvolved.rBleedingrisrarparticularlyrcommonrpresentation.rThisrmayrbercausedrbyraddingrdyesr torsamples,raddingrbl
oodr(e.g.,rfromrthermother)rtortherchild'srsample,rorrgivingrtherchildranranticoagulantr(e.g.,rwarfarin).r(SeerChapterr37,rpager14
6.)
3. Munchausenr syndromer byr proxyr isr characterizedr byr allr ofr ther followingr EXCEPT:
□Mother who appears devoted and wins over members of care team
r r r r r r r r r r
□Multiple hospitalizations and investigations without diagnosis
r r r r r
□Symptoms on history but not witnessed by medical team
r r r r r r r r
■ Symptomsroccurringrinrpresencerofrdifferentrcaregiversr(e.g.,rwhilermotherrisroutrofrtown)
□Use of medications or toxins
r r r r
descriptionrSymptomsrinryoungrchildrenrarermostlyrassociatedrwithrproximityrofrtheroffendingrcaregiverrtortherchild.rThermoth
errmayrpresentrasrardevotedrorrevenrmodelrparentrwhorformsrcloserrelationshipsrwithrmembersrofrtherhealthrcarerteam.rWhil
erappearingrveryrinterestedrinrherrchild'srcondition,rshermayrberrelativelyrdistantremotionally.r(SeerChapterr37,rpager146.)
4. Whichr statementr isr false?
■ MalnutritionrisrthersecondrleadingrcauserofracquiredrimmunerdeficiencyrworldwiderbehindrHIVrinfection
□Zinc is important in immune function and linear growth
r r r r r r r r
□Kwashiorkor and marasmus are rare in developed countries
r r r r r r r
□The Western diet is associated with increased noncommunicable disease
r r r r r r r r
descriptionrThersignificantrglobalrburdenrofrmalnutritionrandrundernutritionrisrtherleadingrworldwidercauserofracquiredrimmunod
eficiencyrandrthermajorrunderlyingrfactorrforrmorbidityrandrmortalityrgloballyrforrchildrenr<5ryrrofrage.rZincrisrarmicronutrientrthatr
supportsrmultiplermetabolicrfunctionsrinrtherbody,risressentialrforrnormalrimmunerfunctioning,randrisrrequiredrtorsupportrlinearrgro
wth;rzincrdeficiencyrisrassociatedrwithrimpairedrimmunerfunctioningrandrpoorrlinearrgrowth.rInrparallelrtortherriskrforrnutrientrandre
nergyrdeficiencies,rissuesrrelatingrtorexcessesrposerimportantrchallengesrbecauserofrtheirrnegativerhealthreffects,rsuchrasrobesityro
rrcardiovascularrdiseaserriskrfactors.rThernutritionrtransitionrunderrwayrinrthe
, developingrworldrfromrtraditionalrdietsrtortherWesternrdietrhasrbeenrassociatedrwithrincreasesrinrnoncommunicablerdiseases,roft
enrcoexistingrwithrundernutritionrandrmalnutrition,robservedrsometimesrinrthersamercommunitiesrorrevenrthersamerfamilies.r(Se
ere41-1.)
5. Componentsr ofr energyr expenditurer inr childrenr include:
□Thermal effect of food
r r r
□Basal metabolic rate
r r
□Energy for physical activity
r r r
□Energy to support growth
r r r
■ Allrofrtherabove
descriptionrTher3rcomponentsrofrenergyrexpenditurerinradultsrarertherbasalrmetabolicrrate,rtherthermalreffectrofrfoodr(ener
gyrrequiredrforrdigestionrandrabsorption),randrenergyrforrphysicalractivity.rAdditionalrenergyrintakerandrexpenditurerarerrequir
edrtorsupportrgrowthrandrdevelopmentrforrchildren.r(Seere41-4.)
6. WhichrofrtherfollowingrclinicalrscenariosrincreasesrtherriskrofrvitaminrArdeficiency?
□Vegetarian diet r
□Chronic intestinal disorders
r r
□Zinc deficiency
r
■ BrandrC
□All of the above
r r r
descriptionrVitaminrArisranressentialrmicronutrientrbecauseritrcannotrberbiogeneratedrdernovorbyranimals.rItrmustrberobtai
nedrfromrplantsrinrtherformrofrprovitamin-
Arcarotenoids.rInrtherUSA,rgrainsrandrvegetablesrsupplyrapproximatelyr55%randrdairyrandrmeatrproductsrsupplyrapproxima
telyr30%rofrvitaminrArintakerfromrfood.rVitaminrArandrtherprovitamins-
Ararerfatrsoluble,randrtheirrabsorptionrdependsronrtherpresencerofradequaterlipidrandrproteinrwithinrthermeal.r Chronicrintestinalrdi
sordersrorrlipidrmalabsorptionrsyndromesrcanrresultrinrvitaminrArdeficiency.rInrdevelopingrcountries,rsubclinicalrorrclinicalrzincrd
eficiencyrcanrincreasertherriskrofrvitaminrArdeficiency.rThererisralsorsomerevidencerofrmarginalrzincrintakesrinrchildrenrinrther
USA.r(SeerChapterr45,rpager188.)
7. Whichr statementr aboutr vitaminr Ar toxicityr isr NOTr true?
