, Nelson Pediatrics Review(MCQs) 19 Edition
x x x x
1. Which x of x the x following x statements x regarding x foster x care x is x true?
□A permanency
x x plan x must x be x made x for x a xchild xin x foster x care x no xlater xthan x 12 x mo x from xthe xchild's x entry xinto xcare
□A minority of children in foster care have a history of abuse or neglect
x x x x x x x x x x x x x
□The mission of foster care is to safely care for children while providing services to families to promote reunification
x x x x x x x x x x x x x x x x x x
□Most (>70%) of children in foster care are reunited with their families
x x x x x x x x x x x
■ A xand xC
description xThe xmission xof xfoster xcare xis xto xprovide xfor xthe xhealth, xsafety, xand xwell-being xof xchildren xwhile
xassisting xtheir xfamilies xwith xservices xto xpromote xreunification. xChildren xentering xfoster xcare xhave xfrequently
xexperienced xearly xchildhood xtrauma. xMore xthan x70% xhave xa xhistory xof xabuse, xneglect, xor xboth. xOnly xabout x50% xof
xchildren xachieve xreunification. xIn xthe xUSA, xthe xAdoption xand xSafe xFamilies xAct x(P.L. x105-89) xpassed xin x1997
xrequires xthat xa xpermanency xplan xbe xmade xfor xeach xchild xno xlater xthan x12 xmo xafter xentry xto xfoster xcare xand xthat xa
xpetition xto xterminate xparental xrights xtypically xmust xbe xfiled xwhen xa xchild xhas xbeen xin xfoster xcare xfor xat xleast x15 xof
xthe xprevious x22 xmo. x(See
xChapter x35, xpage x134, x and xe35-1.)
2. A x4 xyr xold xgirl xis xadmitted xto xthe xhospital xfor xher xthird xevaluation xfor xvaginal xbleeding. xThe
mother xnoted xbright xred xblood xon xthe xchild's xunderwear. xPrevious xexaminations xrevealed xa
xnormal x4 xyr xold xgirl, xTanner xstage x1, xwith xnormal xexternal xgenitalia. xPelvic xultrasound
xresults xwere xnormal, xas xwas xthe xserum xestradiol xlevel. xThe xhemoglobin xand xplatelet xcounts
xwere xnormal, xas xwere xthe xbleeding xtime xand xcoagulation xstudies. xFindings xon xpelvic
xexamination xconducted x under x anesthesia x also x were x normal. x The x next x step x in x the
x examination x is xto:
■ Determine xthe xblood xtype xof xthe xblood xon xthe xunderwear
□Interrogate x the x father
□Isolate the parents and child
x x x x
□Determine x von x Willebrand x factor x levels
, □Measure x fibronectin x in x the x vagina
description xConsideration xof xfactitious xdisorder xby xproxy xshould xbe xtriggered xwhen xthe xreported xsymptoms xare
xrepeatedly xnoted xby xonly xone xparent, xappropriate xtesting xfails xto xconfirm xa xdiagnosis, xand xseemingly xappropriate
xtreatment xis xineffective. x At xtimes, xthe xchild's xsymptoms, xtheir xcourse, xor xthe xresponse xto xtreatment xmay xbe
xincompatible xwith xany xrecognized xdisease. Preverbal xchildren xare xusually xinvolved. xBleeding xis xa xparticularly
xcommon xpresentation. xThis xmay xbe xcaused xby xadding xdyes x to xsamples, xadding xblood x(e.g., xfrom xthe xmother) xto xthe
xchild's xsample, xor xgiving xthe xchild xan xanticoagulant x(e.g., xwarfarin). x(See xChapter x37, xpage x146.)
3. Munchausen x syndrome x by x proxy x is x characterized x by x all x of x the x following x EXCEPT:
□Mother x who x appears x devoted x and x wins x over x members x of x care x team
□Multiple x hospitalizations x and x investigations x without x diagnosis
□Symptoms on history but not witnessed by medical team
x x x x x x x x
■ Symptoms x occurring x in xpresence x of x different x caregivers x (e.g., x while x mother xis x out x of x town)
□Use of medications or toxins
x x x x
description xSymptoms xin xyoung xchildren xare xmostly xassociated xwith xproximity xof xthe xoffending xcaregiver xto xthe
xchild. xThe xmother xmay xpresent xas xa xdevoted xor xeven xmodel xparent xwho xforms xclose xrelationships xwith
xmembers xof xthe xhealth xcare xteam. xWhile xappearing xvery xinterested xin xher xchild's xcondition, xshe xmay xbe
xrelatively xdistant xemotionally. x(See xChapter x37, xpage x146.)
4. Which x statement x is x false?
■ Malnutrition xis xthe x second xleading xcause x of xacquired ximmune x deficiency xworldwide x behind x HIV xinfection
□Zinc x is x important x in x immune x function x and x linear x growth
□Kwashiorkor x and x marasmus x are x rare x in x developed x countries
□The x Western xdiet xis x associated x with xincreased x noncommunicable x disease
description xThe xsignificant xglobal xburden xof xmalnutrition xand xundernutrition xis xthe xleading xworldwide xcause xof
xacquired ximmunodeficiency xand xthe xmajor xunderlying xfactor xfor xmorbidity xand xmortality xglobally xfor xchildren x<5 xyr xof
xage. xZinc xis xa x micronutrient xthat xsupports xmultiple xmetabolic xfunctions xin xthe xbody, xis xessential xfor xnormal ximmune
xfunctioning, xand xis xrequired xto xsupport xlinear xgrowth; x zinc x deficiency xis xassociated xwith ximpaired ximmune xfunctioning
xand xpoor xlinear xgrowth. x In xparallel xto xthe xrisk xfor xnutrient xand xenergy xdeficiencies, xissues xrelating xto xexcesses xpose
ximportant xchallenges xbecause xof x their x negative xhealth xeffects, xsuch xas xobesity xor xcardiovascular xdisease xrisk xfactors.
xThe xnutrition xtransition xunder xway xin xthe
, developing xworld xfrom xtraditional xdiets xto xthe xWestern xdiet xhas xbeen xassociated xwith xincreases xin
xnoncommunicable xdiseases, xoften xcoexisting xwith xundernutrition xand xmalnutrition, xobserved xsometimes xin xthe xsame
xcommunities xor xeven xthe xsame xfamilies. x(See xe41-1.)
5. Components x of x energy x expenditure x in x children x include:
□Thermal x effect x of x food
□Basal x metabolic x rate
□Energy x for x physical x activity
□Energy x to x support x growth
■ All xof xthe xabove
description xThe x3 xcomponents xof xenergy xexpenditure xin xadults xare xthe xbasal xmetabolic xrate, xthe xthermal
xeffect xof xfood x(energy xrequired xfor xdigestion xand xabsorption), xand xenergy xfor xphysical xactivity. xAdditional
xenergy xintake xand xexpenditure xare xrequired xto xsupport xgrowth xand xdevelopment xfor xchildren. x(See xe41-4.)
6. Which xof xthe xfollowing xclinical xscenarios xincreases xthe xrisk xof xvitamin xA xdeficiency?
□Vegetarian diet x
□Chronic x intestinal x disorders
□Zinc x deficiency
■ B xand xC
□All of the above
x x x
description xVitamin xA xis xan xessential xmicronutrient xbecause xit xcannot xbe xbiogenerated xde xnovo xby xanimals. xIt
xmust xbe xobtained xfrom xplants xin xthe xform xof xprovitamin-A xcarotenoids. xIn xthe xUSA, xgrains xand xvegetables
xsupply xapproximately x55% xand xdairy xand xmeat xproducts xsupply xapproximately x30% xof xvitamin xA xintake xfrom
xfood. xVitamin xA xand xthe xprovitamins-A xare xfat xsoluble, xand xtheir xabsorption xdepends xon xthe xpresence xof xadequate
xlipid xand xprotein xwithin xthe xmeal. Chronic xintestinal xdisorders xor xlipid xmalabsorption xsyndromes xcan xresult xin
xvitamin xA xdeficiency. xIn xdeveloping xcountries, xsubclinical xor xclinical xzinc xdeficiency xcan xincrease xthe xrisk xof
xvitamin xA xdeficiency. xThere xis xalso xsome xevidence xof xmarginal xzinc xintakes xin xchildren xin xthe xUSA. x(See
xChapter x45, xpage x188.)
7. Which x statement x about x vitamin x A x toxicity x is x NOT x true?
x x x x
1. Which x of x the x following x statements x regarding x foster x care x is x true?
□A permanency
x x plan x must x be x made x for x a xchild xin x foster x care x no xlater xthan x 12 x mo x from xthe xchild's x entry xinto xcare
□A minority of children in foster care have a history of abuse or neglect
x x x x x x x x x x x x x
□The mission of foster care is to safely care for children while providing services to families to promote reunification
x x x x x x x x x x x x x x x x x x
□Most (>70%) of children in foster care are reunited with their families
x x x x x x x x x x x
■ A xand xC
description xThe xmission xof xfoster xcare xis xto xprovide xfor xthe xhealth, xsafety, xand xwell-being xof xchildren xwhile
xassisting xtheir xfamilies xwith xservices xto xpromote xreunification. xChildren xentering xfoster xcare xhave xfrequently
xexperienced xearly xchildhood xtrauma. xMore xthan x70% xhave xa xhistory xof xabuse, xneglect, xor xboth. xOnly xabout x50% xof
xchildren xachieve xreunification. xIn xthe xUSA, xthe xAdoption xand xSafe xFamilies xAct x(P.L. x105-89) xpassed xin x1997
xrequires xthat xa xpermanency xplan xbe xmade xfor xeach xchild xno xlater xthan x12 xmo xafter xentry xto xfoster xcare xand xthat xa
xpetition xto xterminate xparental xrights xtypically xmust xbe xfiled xwhen xa xchild xhas xbeen xin xfoster xcare xfor xat xleast x15 xof
xthe xprevious x22 xmo. x(See
xChapter x35, xpage x134, x and xe35-1.)
2. A x4 xyr xold xgirl xis xadmitted xto xthe xhospital xfor xher xthird xevaluation xfor xvaginal xbleeding. xThe
mother xnoted xbright xred xblood xon xthe xchild's xunderwear. xPrevious xexaminations xrevealed xa
xnormal x4 xyr xold xgirl, xTanner xstage x1, xwith xnormal xexternal xgenitalia. xPelvic xultrasound
xresults xwere xnormal, xas xwas xthe xserum xestradiol xlevel. xThe xhemoglobin xand xplatelet xcounts
xwere xnormal, xas xwere xthe xbleeding xtime xand xcoagulation xstudies. xFindings xon xpelvic
xexamination xconducted x under x anesthesia x also x were x normal. x The x next x step x in x the
x examination x is xto:
■ Determine xthe xblood xtype xof xthe xblood xon xthe xunderwear
□Interrogate x the x father
□Isolate the parents and child
x x x x
□Determine x von x Willebrand x factor x levels
, □Measure x fibronectin x in x the x vagina
description xConsideration xof xfactitious xdisorder xby xproxy xshould xbe xtriggered xwhen xthe xreported xsymptoms xare
xrepeatedly xnoted xby xonly xone xparent, xappropriate xtesting xfails xto xconfirm xa xdiagnosis, xand xseemingly xappropriate
xtreatment xis xineffective. x At xtimes, xthe xchild's xsymptoms, xtheir xcourse, xor xthe xresponse xto xtreatment xmay xbe
xincompatible xwith xany xrecognized xdisease. Preverbal xchildren xare xusually xinvolved. xBleeding xis xa xparticularly
xcommon xpresentation. xThis xmay xbe xcaused xby xadding xdyes x to xsamples, xadding xblood x(e.g., xfrom xthe xmother) xto xthe
xchild's xsample, xor xgiving xthe xchild xan xanticoagulant x(e.g., xwarfarin). x(See xChapter x37, xpage x146.)
3. Munchausen x syndrome x by x proxy x is x characterized x by x all x of x the x following x EXCEPT:
□Mother x who x appears x devoted x and x wins x over x members x of x care x team
□Multiple x hospitalizations x and x investigations x without x diagnosis
□Symptoms on history but not witnessed by medical team
x x x x x x x x
■ Symptoms x occurring x in xpresence x of x different x caregivers x (e.g., x while x mother xis x out x of x town)
□Use of medications or toxins
x x x x
description xSymptoms xin xyoung xchildren xare xmostly xassociated xwith xproximity xof xthe xoffending xcaregiver xto xthe
xchild. xThe xmother xmay xpresent xas xa xdevoted xor xeven xmodel xparent xwho xforms xclose xrelationships xwith
xmembers xof xthe xhealth xcare xteam. xWhile xappearing xvery xinterested xin xher xchild's xcondition, xshe xmay xbe
xrelatively xdistant xemotionally. x(See xChapter x37, xpage x146.)
4. Which x statement x is x false?
■ Malnutrition xis xthe x second xleading xcause x of xacquired ximmune x deficiency xworldwide x behind x HIV xinfection
□Zinc x is x important x in x immune x function x and x linear x growth
□Kwashiorkor x and x marasmus x are x rare x in x developed x countries
□The x Western xdiet xis x associated x with xincreased x noncommunicable x disease
description xThe xsignificant xglobal xburden xof xmalnutrition xand xundernutrition xis xthe xleading xworldwide xcause xof
xacquired ximmunodeficiency xand xthe xmajor xunderlying xfactor xfor xmorbidity xand xmortality xglobally xfor xchildren x<5 xyr xof
xage. xZinc xis xa x micronutrient xthat xsupports xmultiple xmetabolic xfunctions xin xthe xbody, xis xessential xfor xnormal ximmune
xfunctioning, xand xis xrequired xto xsupport xlinear xgrowth; x zinc x deficiency xis xassociated xwith ximpaired ximmune xfunctioning
xand xpoor xlinear xgrowth. x In xparallel xto xthe xrisk xfor xnutrient xand xenergy xdeficiencies, xissues xrelating xto xexcesses xpose
ximportant xchallenges xbecause xof x their x negative xhealth xeffects, xsuch xas xobesity xor xcardiovascular xdisease xrisk xfactors.
xThe xnutrition xtransition xunder xway xin xthe
, developing xworld xfrom xtraditional xdiets xto xthe xWestern xdiet xhas xbeen xassociated xwith xincreases xin
xnoncommunicable xdiseases, xoften xcoexisting xwith xundernutrition xand xmalnutrition, xobserved xsometimes xin xthe xsame
xcommunities xor xeven xthe xsame xfamilies. x(See xe41-1.)
5. Components x of x energy x expenditure x in x children x include:
□Thermal x effect x of x food
□Basal x metabolic x rate
□Energy x for x physical x activity
□Energy x to x support x growth
■ All xof xthe xabove
description xThe x3 xcomponents xof xenergy xexpenditure xin xadults xare xthe xbasal xmetabolic xrate, xthe xthermal
xeffect xof xfood x(energy xrequired xfor xdigestion xand xabsorption), xand xenergy xfor xphysical xactivity. xAdditional
xenergy xintake xand xexpenditure xare xrequired xto xsupport xgrowth xand xdevelopment xfor xchildren. x(See xe41-4.)
6. Which xof xthe xfollowing xclinical xscenarios xincreases xthe xrisk xof xvitamin xA xdeficiency?
□Vegetarian diet x
□Chronic x intestinal x disorders
□Zinc x deficiency
■ B xand xC
□All of the above
x x x
description xVitamin xA xis xan xessential xmicronutrient xbecause xit xcannot xbe xbiogenerated xde xnovo xby xanimals. xIt
xmust xbe xobtained xfrom xplants xin xthe xform xof xprovitamin-A xcarotenoids. xIn xthe xUSA, xgrains xand xvegetables
xsupply xapproximately x55% xand xdairy xand xmeat xproducts xsupply xapproximately x30% xof xvitamin xA xintake xfrom
xfood. xVitamin xA xand xthe xprovitamins-A xare xfat xsoluble, xand xtheir xabsorption xdepends xon xthe xpresence xof xadequate
xlipid xand xprotein xwithin xthe xmeal. Chronic xintestinal xdisorders xor xlipid xmalabsorption xsyndromes xcan xresult xin
xvitamin xA xdeficiency. xIn xdeveloping xcountries, xsubclinical xor xclinical xzinc xdeficiency xcan xincrease xthe xrisk xof
xvitamin xA xdeficiency. xThere xis xalso xsome xevidence xof xmarginal xzinc xintakes xin xchildren xin xthe xUSA. x(See
xChapter x45, xpage x188.)
7. Which x statement x about x vitamin x A x toxicity x is x NOT x true?
