, Nelson Pediatrics Review(MCQs) 19 Edition
v v v v
1. Which v of v the v following v statements v regarding v foster v care v is v true?
□A permanency plan must
v v v v be v made v for v a vchild vin v foster v care v no vlater vthan v 12 v mo v from vthe vchild's v entry vinto vcare
□A minority of children in foster care have a history of abuse or neglect
v v v v v v v v v v v v v
□The mission of foster care is to safely care for children while providing services to families to promote reunification
v v v v v v v v v v v v v v v v v v
□Most (>70%) of children in foster care are reunited with their families
v v v v v v v v v v v
■ A vand vC
description vThe vmission vof vfoster vcare vis vto vprovide vfor vthe vhealth, vsafety, vand vwell-being vof vchildren vwhile vassisting
vtheir vfamilies vwith vservices vto vpromote vreunification. vChildren ventering vfoster vcare vhave vfrequently vexperienced vearly
vchildhood vtrauma. vMore vthan v70% vhave va vhistory vof vabuse, vneglect, vor vboth. vOnly vabout v50% vof vchildren vachieve
vreunification. vIn vthe vUSA, vthe vAdoption vand vSafe vFamilies vAct v(P.L. v105-89) vpassed vin v1997 vrequires vthat va
vpermanencyvplan vbe vmade vfor veach vchild vno vlater vthan v12 vmo vafter ventry vto vfoster vcare vand vthat va vpetition vto vterminate
vparental vrights vtypically vmust vbe vfiled vwhen va vchild vhas vbeen vin vfoster vcare vfor vat vleast v15 vof vthe vprevious v22 vmo.
v(See
vChapter v35, vpage v134, v and ve35-1.)
2. A v4 vyr vold vgirl vis vadmitted vto vthe vhospital vfor vher vthird vevaluation vfor vvaginal vbleeding. vThe
mother vnoted vbright vred vblood von vthe vchild's vunderwear. vPrevious vexaminations vrevealed va
vnormal v4 vyr vold vgirl, vTanner vstage v1, vwith vnormal vexternal vgenitalia. vPelvic vultrasound vresults
vwere vnormal, vas vwas vthe vserum vestradiol vlevel. vThe vhemoglobin vand vplatelet vcounts vwere
vnormal, vas vwere vthe vbleeding vtime vand vcoagulation vstudies. vFindings von vpelvic vexamination
vconducted v under v anesthesia v also v were v normal. v The v next v step v in v the v examination v is vto:
■ Determine vthe vblood vtype vof vthe vblood von vthe vunderwear
□Interrogate v the v father
□Isolate the parents and child
v v v v
□Determine v von v Willebrand v factor v levels
, □Measure v fibronectin v in v the v vagina
description vConsideration vof vfactitious vdisorder vby vproxy vshould vbe vtriggered vwhen vthe vreported vsymptoms vare
vrepeatedly vnoted vby vonly vone vparent, vappropriate vtesting vfails vto vconfirm va vdiagnosis, vand vseemingly vappropriate
vtreatment vis vineffective. v At vtimes, vthe vchild's vsymptoms, vtheir vcourse, vor vthe vresponse vto vtreatment vmay vbe
vincompatible vwith vany vrecognized vdisease. Preverbal vchildren vare vusually vinvolved. vBleeding vis va vparticularly vcommon
vpresentation. vThis vmay vbe vcaused vby vadding vdyes v to vsamples, vadding vblood v(e.g., vfrom vthe vmother) vto vthe vchild's
vsample, vor vgiving vthe vchild van vanticoagulant v(e.g., vwarfarin). v(See vChapter v37, vpage v146.)
3. Munchausen v syndrome v by v proxy v is v characterized v by v all v of v the v following v EXCEPT:
□Mother v who v appears v devoted v and v wins v over v members v of v care v team
□Multiple v hospitalizations v and v investigations v without v diagnosis
□Symptoms on history but not witnessed by medical team
v v v v v v v v
■ Symptoms v occurring v in vpresence v of v different v caregivers v (e.g., v while v mother v is v out v of v town)
□Use of medications or toxins
v v v v
description vSymptoms vin vyoung vchildren vare vmostly vassociated vwith vproximity vof vthe voffending vcaregiver vto vthe
vchild. vThe vmother vmay vpresent vas va vdevoted vor veven vmodel vparent vwho vforms vclose vrelationships vwith
vmembers vof vthe vhealth vcare vteam. vWhile vappearing vvery vinterested vin vher vchild's vcondition, vshe vmay vbe vrelatively
vdistant vemotionally. v(See vChapter v37, vpage v146.)
4. Which v statement v is v false?
■ Malnutrition vis vthe v second vleading vcause v of vacquired vimmune v deficiency vworldwide v behind v HIV vinfection
□Zinc v is v important v in v immune v function v and v linear v growth
□Kwashiorkor and v v marasmus v are v rare v in v developed v countries
□The Western diet is associated with increased noncommunicable disease
v v v v v v v v
description vThe vsignificant vglobal vburden vof vmalnutrition vand vundernutrition vis vthe vleading vworldwide vcause vof vacquired
vimmunodeficiency vand vthe vmajor vunderlying vfactor vfor vmorbidity vand vmortality vglobally vfor vchildren v<5 vyr vof vage. vZinc vis
va v micronutrient vthat vsupports vmultiple vmetabolic vfunctions vin vthe vbody, vis vessential vfor vnormal vimmune vfunctioning,
vand vis vrequired vto vsupport vlinear vgrowth; v zinc v deficiency vis vassociated vwith vimpaired vimmune vfunctioning vand vpoor
vlinear vgrowth. v In vparallel vto vthe vrisk vfor vnutrient vand venergy vdeficiencies, vissues vrelating vto vexcesses vpose vimportant
vchallenges vbecause vof v their v negative vhealthveffects, vsuchvas vobesityvor vcardiovascular vdisease vrisk vfactors. vThe
vnutrition vtransition vunder vway vin vthe
, developing vworld vfrom vtraditional vdiets vto vthe vWestern vdiet vhas vbeen vassociated vwith vincreases vin vnoncommunicable
vdiseases, voften vcoexisting vwith vundernutrition vand vmalnutrition, vobserved vsometimes vin vthe vsame vcommunities vor veven vthe
vsame vfamilies. v(See ve41-1.)
5. Components v of v energy v expenditure v in v children v include:
□Thermal v effect v of v food
□Basal v metabolic v rate
□Energy for physical
v v v activity
□Energy v to v support v growth
■ All vof vthe vabove
description vThe v3 vcomponents vof venergy vexpenditure vin vadults vare vthe vbasal vmetabolic vrate, vthe vthermal veffect
vof vfood v(energy vrequired vfor vdigestion vand vabsorption), vand venergy vfor vphysical vactivity. vAdditional venergy
vintake vand vexpenditure vare vrequired vto vsupport vgrowth vand vdevelopment vfor vchildren. v(See ve41-4.)
6. Which vof vthe vfollowing vclinical vscenarios vincreases vthe vrisk vof vvitamin vA vdeficiency?
□Vegetarian diet v
□Chronic v intestinal v disorders
□Zinc v deficiency
■ B vand vC
□All of the above
v v v
description vVitamin vA vis van vessential vmicronutrient vbecause vit vcannot vbe vbiogenerated vde vnovo vby vanimals. vIt
vmust vbe vobtained vfrom vplants vin vthe vform vof vprovitamin-A vcarotenoids. vIn vthe vUSA, vgrains vand vvegetables vsupply
vapproximately v55% vand vdairy vand vmeat vproducts vsupply vapproximately v30% vof vvitamin vA vintake vfrom vfood.
vVitamin vA vand vthe vprovitamins-A vare vfat vsoluble, vand vtheir vabsorption vdepends von vthe vpresence vof vadequate vlipid vand
vprotein vwithin vthe vmeal. Chronic vintestinal vdisorders vor vlipid vmalabsorption vsyndromes vcan vresult vin vvitamin vA
vdeficiency. vIn vdeveloping vcountries, vsubclinical vor vclinical vzinc vdeficiency vcan vincrease vthe vrisk vof vvitamin vA
vdeficiency. vThere vis valso vsome vevidence vof vmarginal vzinc vintakes vin vchildren vin vthe vUSA. v(See vChapter v45,
vpage v188.)
7. Which v statement v about v vitamin v A v toxicity v is v NOT v true?
v v v v
1. Which v of v the v following v statements v regarding v foster v care v is v true?
□A permanency plan must
v v v v be v made v for v a vchild vin v foster v care v no vlater vthan v 12 v mo v from vthe vchild's v entry vinto vcare
□A minority of children in foster care have a history of abuse or neglect
v v v v v v v v v v v v v
□The mission of foster care is to safely care for children while providing services to families to promote reunification
v v v v v v v v v v v v v v v v v v
□Most (>70%) of children in foster care are reunited with their families
v v v v v v v v v v v
■ A vand vC
description vThe vmission vof vfoster vcare vis vto vprovide vfor vthe vhealth, vsafety, vand vwell-being vof vchildren vwhile vassisting
vtheir vfamilies vwith vservices vto vpromote vreunification. vChildren ventering vfoster vcare vhave vfrequently vexperienced vearly
vchildhood vtrauma. vMore vthan v70% vhave va vhistory vof vabuse, vneglect, vor vboth. vOnly vabout v50% vof vchildren vachieve
vreunification. vIn vthe vUSA, vthe vAdoption vand vSafe vFamilies vAct v(P.L. v105-89) vpassed vin v1997 vrequires vthat va
vpermanencyvplan vbe vmade vfor veach vchild vno vlater vthan v12 vmo vafter ventry vto vfoster vcare vand vthat va vpetition vto vterminate
vparental vrights vtypically vmust vbe vfiled vwhen va vchild vhas vbeen vin vfoster vcare vfor vat vleast v15 vof vthe vprevious v22 vmo.
v(See
vChapter v35, vpage v134, v and ve35-1.)
2. A v4 vyr vold vgirl vis vadmitted vto vthe vhospital vfor vher vthird vevaluation vfor vvaginal vbleeding. vThe
mother vnoted vbright vred vblood von vthe vchild's vunderwear. vPrevious vexaminations vrevealed va
vnormal v4 vyr vold vgirl, vTanner vstage v1, vwith vnormal vexternal vgenitalia. vPelvic vultrasound vresults
vwere vnormal, vas vwas vthe vserum vestradiol vlevel. vThe vhemoglobin vand vplatelet vcounts vwere
vnormal, vas vwere vthe vbleeding vtime vand vcoagulation vstudies. vFindings von vpelvic vexamination
vconducted v under v anesthesia v also v were v normal. v The v next v step v in v the v examination v is vto:
■ Determine vthe vblood vtype vof vthe vblood von vthe vunderwear
□Interrogate v the v father
□Isolate the parents and child
v v v v
□Determine v von v Willebrand v factor v levels
, □Measure v fibronectin v in v the v vagina
description vConsideration vof vfactitious vdisorder vby vproxy vshould vbe vtriggered vwhen vthe vreported vsymptoms vare
vrepeatedly vnoted vby vonly vone vparent, vappropriate vtesting vfails vto vconfirm va vdiagnosis, vand vseemingly vappropriate
vtreatment vis vineffective. v At vtimes, vthe vchild's vsymptoms, vtheir vcourse, vor vthe vresponse vto vtreatment vmay vbe
vincompatible vwith vany vrecognized vdisease. Preverbal vchildren vare vusually vinvolved. vBleeding vis va vparticularly vcommon
vpresentation. vThis vmay vbe vcaused vby vadding vdyes v to vsamples, vadding vblood v(e.g., vfrom vthe vmother) vto vthe vchild's
vsample, vor vgiving vthe vchild van vanticoagulant v(e.g., vwarfarin). v(See vChapter v37, vpage v146.)
3. Munchausen v syndrome v by v proxy v is v characterized v by v all v of v the v following v EXCEPT:
□Mother v who v appears v devoted v and v wins v over v members v of v care v team
□Multiple v hospitalizations v and v investigations v without v diagnosis
□Symptoms on history but not witnessed by medical team
v v v v v v v v
■ Symptoms v occurring v in vpresence v of v different v caregivers v (e.g., v while v mother v is v out v of v town)
□Use of medications or toxins
v v v v
description vSymptoms vin vyoung vchildren vare vmostly vassociated vwith vproximity vof vthe voffending vcaregiver vto vthe
vchild. vThe vmother vmay vpresent vas va vdevoted vor veven vmodel vparent vwho vforms vclose vrelationships vwith
vmembers vof vthe vhealth vcare vteam. vWhile vappearing vvery vinterested vin vher vchild's vcondition, vshe vmay vbe vrelatively
vdistant vemotionally. v(See vChapter v37, vpage v146.)
4. Which v statement v is v false?
■ Malnutrition vis vthe v second vleading vcause v of vacquired vimmune v deficiency vworldwide v behind v HIV vinfection
□Zinc v is v important v in v immune v function v and v linear v growth
□Kwashiorkor and v v marasmus v are v rare v in v developed v countries
□The Western diet is associated with increased noncommunicable disease
v v v v v v v v
description vThe vsignificant vglobal vburden vof vmalnutrition vand vundernutrition vis vthe vleading vworldwide vcause vof vacquired
vimmunodeficiency vand vthe vmajor vunderlying vfactor vfor vmorbidity vand vmortality vglobally vfor vchildren v<5 vyr vof vage. vZinc vis
va v micronutrient vthat vsupports vmultiple vmetabolic vfunctions vin vthe vbody, vis vessential vfor vnormal vimmune vfunctioning,
vand vis vrequired vto vsupport vlinear vgrowth; v zinc v deficiency vis vassociated vwith vimpaired vimmune vfunctioning vand vpoor
vlinear vgrowth. v In vparallel vto vthe vrisk vfor vnutrient vand venergy vdeficiencies, vissues vrelating vto vexcesses vpose vimportant
vchallenges vbecause vof v their v negative vhealthveffects, vsuchvas vobesityvor vcardiovascular vdisease vrisk vfactors. vThe
vnutrition vtransition vunder vway vin vthe
, developing vworld vfrom vtraditional vdiets vto vthe vWestern vdiet vhas vbeen vassociated vwith vincreases vin vnoncommunicable
vdiseases, voften vcoexisting vwith vundernutrition vand vmalnutrition, vobserved vsometimes vin vthe vsame vcommunities vor veven vthe
vsame vfamilies. v(See ve41-1.)
5. Components v of v energy v expenditure v in v children v include:
□Thermal v effect v of v food
□Basal v metabolic v rate
□Energy for physical
v v v activity
□Energy v to v support v growth
■ All vof vthe vabove
description vThe v3 vcomponents vof venergy vexpenditure vin vadults vare vthe vbasal vmetabolic vrate, vthe vthermal veffect
vof vfood v(energy vrequired vfor vdigestion vand vabsorption), vand venergy vfor vphysical vactivity. vAdditional venergy
vintake vand vexpenditure vare vrequired vto vsupport vgrowth vand vdevelopment vfor vchildren. v(See ve41-4.)
6. Which vof vthe vfollowing vclinical vscenarios vincreases vthe vrisk vof vvitamin vA vdeficiency?
□Vegetarian diet v
□Chronic v intestinal v disorders
□Zinc v deficiency
■ B vand vC
□All of the above
v v v
description vVitamin vA vis van vessential vmicronutrient vbecause vit vcannot vbe vbiogenerated vde vnovo vby vanimals. vIt
vmust vbe vobtained vfrom vplants vin vthe vform vof vprovitamin-A vcarotenoids. vIn vthe vUSA, vgrains vand vvegetables vsupply
vapproximately v55% vand vdairy vand vmeat vproducts vsupply vapproximately v30% vof vvitamin vA vintake vfrom vfood.
vVitamin vA vand vthe vprovitamins-A vare vfat vsoluble, vand vtheir vabsorption vdepends von vthe vpresence vof vadequate vlipid vand
vprotein vwithin vthe vmeal. Chronic vintestinal vdisorders vor vlipid vmalabsorption vsyndromes vcan vresult vin vvitamin vA
vdeficiency. vIn vdeveloping vcountries, vsubclinical vor vclinical vzinc vdeficiency vcan vincrease vthe vrisk vof vvitamin vA
vdeficiency. vThere vis valso vsome vevidence vof vmarginal vzinc vintakes vin vchildren vin vthe vUSA. v(See vChapter v45,
vpage v188.)
7. Which v statement v about v vitamin v A v toxicity v is v NOT v true?
