Test bank
up up
for MCQs in Pediatrics Review of Nelson Textbook
up up up up up up up up
of Pediatrics 20 Edition
up up up up
, Nelson Pediatrics Review(MCQs) 19 Edition
up up up up
1. Whichu p ofu p theu p followingu p statementsu p regardingu p fosteru p careu p isu p 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
up up up up up up up up up up up up up up up up up up up up up up
□A minority of children in foster care have a history of abuse or neglect
up up up up up up up up up up up up up
□The mission of foster care is to safely care for children while providing services to families to promote reunification
up up up up up up up up up up up up up up up up up up
□Most (>70%) of children in foster care are reunited with their families
up up up up up up up up up up up
■ AupandupC
descriptionupTheupmissionupofupfosterupcareupisuptoupprovideupforuptheuphealth,upsafety,upandupwell-
beingupofupchildrenupwhileupassistinguptheirupfamiliesupwithupservicesuptouppromoteupreunification.upChildrenupenteringupfosterupcareupha
veupfrequentlyupexperiencedupearlyupchildhooduptrauma.upMoreupthanup70%uphaveupauphistoryupofupabuse,upneglect,uporupboth.upOnlyupab
outup50%upofupchildrenupachieveupreunification.upInuptheupUSA,uptheupAdoptionupandupSafeupFamiliesupActup(P.L.up105-
89)uppassedupinup1997uprequiresupthatupauppermanencyupplanupbeupmadeupforupeachupchildupnouplaterupthanup12upmoupafterupentryuptoupfost
erupcareupandupthatupauppetitionuptoupterminateupparentaluprightsuptypicallyupmustupbeupfiledupwhenupaupchilduphasupbeenupinupfosterupcareupf
orupatupleastup15upofuptheuppreviousup22upmo.up(SeeupChapterup35,uppageup134,upandupe35-1.)
2. Aup4upyrupoldupgirlupisupadmitteduptouptheuphospitalupforupherupthirdupevaluationupforupvaginalupbleeding.upThe
motherupnotedupbrightupredupblooduponuptheupchild'supunderwear.upPreviousupexaminationsuprevealed
upaupnormalup4upyrupold upgirl, upTannerupstageup1,upwithupnormalupexternalupgenitalia. upPelvicupultrasound upr
esultsupwereupnormal,upasupwasuptheupserumupestradioluplevel.upTheuphemoglobinupandupplateletupcount
supwereupnormal,upasupwereuptheupbleedinguptimeupandupcoagulationupstudies.upFindingsuponuppelvicupex
aminationupconductedupunderupanesthesiaupalsoupwereupnormal.upTheupnextupstepupinuptheupexaminati
onupisupto:
■ Determineuptheupblooduptypeupofuptheupblooduponuptheupunderwear
□Interrogate up theu p father
□Isolate the parents and child
up up up up
□Determine up vonu p Willebrandu p factoru p levels
, □Measure up fibronectinu p inuptheupvagina
descriptionupConsiderationupofupfactitiousupdisorderupbyupproxyupshouldupbeuptriggeredupwhenuptheupreportedupsymptomsupareuprep
eatedlyupnotedupbyuponlyuponeupparent,upappropriateuptestingupfailsuptoupconfirmupaupdiagnosis,upandupseeminglyupappropriateuptreatmentup
isupineffective.u p Atuptimes,uptheupchild'supsymptoms,uptheirupcourse,uporuptheupresponseuptouptreatmentupmayupbeupincompatibleupwithupan
yuprecognizedupdisease.u p Preverbalupchildrenupareupusuallyupinvolved.upBleedingupisupaupparticularlyupcommonuppresentation.upThisupm
ayupbeupcausedupbyupaddingupdyesu p toupsamples,upaddingupbloodup(e.g.,upfromuptheupmother)uptouptheupchild'supsample,uporupgivinguptheup
childupanupanticoagulantup(e.g.,upwarfarin).up(SeeupChapterup37,uppageup146.)
3. Munchausenupsyndromeup byup proxyup isup characterizedu p byu p allu p ofu p theu p followingu p EXCEPT:
□Mother up whoupappearsup devotedup andup winsup overup membersup ofup careupteam
□Multiple up hospitalizationsu p andu p investigationsu p withoutu p diagnosis
□Symptoms on history but not witnessed by medical team
up up up up up up up up
■ Symptomsupoccurringupinuppresenceupofupdifferentupcaregiversup(e.g.,upwhileupmotherupisupoutupofuptown)
□Use of medications or toxins
up up up up
descriptionupSymptomsupinupyoungupchildrenupareupmostlyupassociatedupwithupproximityupofuptheupoffendingupcaregiveruptouptheupchil
d.upTheupmotherupmayuppresentupasupaupdevoteduporupevenupmodelupparentupwhoupformsupcloseuprelationshipsupwithupmembersupofupt
heuphealthupcareupteam.upWhileupappearingupveryupinterestedupinupherupchild'supcondition,upsheupmayupbeuprelativelyupdistantupemotional
ly.up(SeeupChapterup37,uppageup146.)
4. Whichu p statementu p isu p false?
■ MalnutritionupisuptheupsecondupleadingupcauseupofupacquiredupimmuneupdeficiencyupworldwideupbehindupHIVupinfection
□Zinc up isup importantupinup immuneupfunctionup andup linearup growth
□Kwashiorkor and up up marasmusupareuprareupinupdevelopedupcountries
□The Western diet is associated with increased noncommunicable disease
up up up up up up up up
descriptionupTheupsignificantupglobalupburdenupofupmalnutritionupandupundernutritionupisuptheupleadingupworldwideupcauseupofupacquire
dupimmunodeficiencyupanduptheupmajorupunderlyingupfactorupforupmorbidityupandupmortalityupgloballyupforupchildrenup<5upyrupofupage.upZi
ncupisupaupmicronutrientupthatupsupportsupmultipleupmetabolicupfunctionsupinuptheupbody,upisupessentialupforupnormalupimmuneupfunctionin
g,upandupisuprequireduptoupsupportuplinearupgrowth;upzincupdeficiencyupisupassociatedupwithupimpairedupimmuneupfunctioningupanduppoorupli
nearupgrowth.upInupparalleluptouptheupriskupforupnutrientupandupenergyupdeficiencies,upissuesuprelatinguptoupexcessesupposeupimportantupchall
engesupbecauseupofuptheirupnegativeuphealthupeffects,upsuchupasupobesityuporupcardiovascularupdiseaseupriskupfactors.upTheupnutritionuptr
ansitionupunderupwayupinupthe
, developingupworldupfromuptraditionalupdietsuptouptheupWesternupdietuphasupbeenupassociatedupwithupincreasesupinupnoncommunicableu
pdiseases,upoftenupcoexistingupwithupundernutritionupandupmalnutrition,upobservedupsometimesupinuptheupsameupcommunitiesuporupevenupt
heupsameupfamilies.up(Seeupe41-1.)
5. Componentsu p ofu p energyu p expenditureu p inu p childrenu p include:
□Thermal up effectupofupfood
□Basal up metabolicup rate
□Energy for up up physicalupactivity
□Energy up tou p supportu p growth
■ Allupofuptheupabove
descriptionupTheup3upcomponentsupofupenergyupexpenditureupinupadultsupareuptheupbasalupmetabolicuprate,uptheupthermalupeffectup
ofupfoodup(energyuprequiredupforupdigestionupandupabsorption),upandupenergyupforupphysicalupactivity.upAdditionalupenergyupintakeupan
dupexpenditureupareuprequireduptoupsupportupgrowthupandupdevelopmentupforupchildren.up(Seeupe41-4.)
6. WhichupofuptheupfollowingupclinicalupscenariosupincreasesuptheupriskupofupvitaminupAupdeficiency?
□Vegetarian diet up
□Chronic up intestinalu p disorders
□Zinc up deficiency
■ BupandupC
□All of the above
up up up
descriptionupVitaminupAupisupanupessentialupmicronutrientupbecauseupitupcannotupbeupbiogeneratedupdeupnovoupbyupanimals.upItup
mustupbeupobtainedupfromupplantsupinuptheupformupofupprovitamin-
Aupcarotenoids.upInuptheupUSA,upgrainsupandupvegetablesupsupplyupapproximatelyup55%upandupdairyupandupmeatupproductsupsupply
upapproximatelyup30%upofupvitaminupAupintakeupfromupfood.upVitaminupAupanduptheupprovitamins-
Aupareupfatupsoluble,upanduptheirupabsorptionupdependsuponuptheuppresenceupofupadequateuplipidupandupproteinupwithinuptheupmeal.u p Chro
nicupintestinalupdisordersuporuplipidupmalabsorptionupsyndromesupcanupresultupinupvitaminupAupdeficiency.upInupdevelopingupcountries,up
subclinicaluporupclinicalupzincupdeficiencyupcanupincreaseuptheupriskupofupvitaminupAupdeficiency.upThereupisupalsoupsomeupevidenceupofup
marginalupzincupintakesupinupchildrenupinuptheupUSA.up(SeeupChapterup45,uppageup188.)
7. Whichu p statementu p aboutu p vitaminu p Au p toxicityu p isu p NOTu p true?
up up
for MCQs in Pediatrics Review of Nelson Textbook
up up up up up up up up
of Pediatrics 20 Edition
up up up up
, Nelson Pediatrics Review(MCQs) 19 Edition
up up up up
1. Whichu p ofu p theu p followingu p statementsu p regardingu p fosteru p careu p isu p 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
up up up up up up up up up up up up up up up up up up up up up up
□A minority of children in foster care have a history of abuse or neglect
up up up up up up up up up up up up up
□The mission of foster care is to safely care for children while providing services to families to promote reunification
up up up up up up up up up up up up up up up up up up
□Most (>70%) of children in foster care are reunited with their families
up up up up up up up up up up up
■ AupandupC
descriptionupTheupmissionupofupfosterupcareupisuptoupprovideupforuptheuphealth,upsafety,upandupwell-
beingupofupchildrenupwhileupassistinguptheirupfamiliesupwithupservicesuptouppromoteupreunification.upChildrenupenteringupfosterupcareupha
veupfrequentlyupexperiencedupearlyupchildhooduptrauma.upMoreupthanup70%uphaveupauphistoryupofupabuse,upneglect,uporupboth.upOnlyupab
outup50%upofupchildrenupachieveupreunification.upInuptheupUSA,uptheupAdoptionupandupSafeupFamiliesupActup(P.L.up105-
89)uppassedupinup1997uprequiresupthatupauppermanencyupplanupbeupmadeupforupeachupchildupnouplaterupthanup12upmoupafterupentryuptoupfost
erupcareupandupthatupauppetitionuptoupterminateupparentaluprightsuptypicallyupmustupbeupfiledupwhenupaupchilduphasupbeenupinupfosterupcareupf
orupatupleastup15upofuptheuppreviousup22upmo.up(SeeupChapterup35,uppageup134,upandupe35-1.)
2. Aup4upyrupoldupgirlupisupadmitteduptouptheuphospitalupforupherupthirdupevaluationupforupvaginalupbleeding.upThe
motherupnotedupbrightupredupblooduponuptheupchild'supunderwear.upPreviousupexaminationsuprevealed
upaupnormalup4upyrupold upgirl, upTannerupstageup1,upwithupnormalupexternalupgenitalia. upPelvicupultrasound upr
esultsupwereupnormal,upasupwasuptheupserumupestradioluplevel.upTheuphemoglobinupandupplateletupcount
supwereupnormal,upasupwereuptheupbleedinguptimeupandupcoagulationupstudies.upFindingsuponuppelvicupex
aminationupconductedupunderupanesthesiaupalsoupwereupnormal.upTheupnextupstepupinuptheupexaminati
onupisupto:
■ Determineuptheupblooduptypeupofuptheupblooduponuptheupunderwear
□Interrogate up theu p father
□Isolate the parents and child
up up up up
□Determine up vonu p Willebrandu p factoru p levels
, □Measure up fibronectinu p inuptheupvagina
descriptionupConsiderationupofupfactitiousupdisorderupbyupproxyupshouldupbeuptriggeredupwhenuptheupreportedupsymptomsupareuprep
eatedlyupnotedupbyuponlyuponeupparent,upappropriateuptestingupfailsuptoupconfirmupaupdiagnosis,upandupseeminglyupappropriateuptreatmentup
isupineffective.u p Atuptimes,uptheupchild'supsymptoms,uptheirupcourse,uporuptheupresponseuptouptreatmentupmayupbeupincompatibleupwithupan
yuprecognizedupdisease.u p Preverbalupchildrenupareupusuallyupinvolved.upBleedingupisupaupparticularlyupcommonuppresentation.upThisupm
ayupbeupcausedupbyupaddingupdyesu p toupsamples,upaddingupbloodup(e.g.,upfromuptheupmother)uptouptheupchild'supsample,uporupgivinguptheup
childupanupanticoagulantup(e.g.,upwarfarin).up(SeeupChapterup37,uppageup146.)
3. Munchausenupsyndromeup byup proxyup isup characterizedu p byu p allu p ofu p theu p followingu p EXCEPT:
□Mother up whoupappearsup devotedup andup winsup overup membersup ofup careupteam
□Multiple up hospitalizationsu p andu p investigationsu p withoutu p diagnosis
□Symptoms on history but not witnessed by medical team
up up up up up up up up
■ Symptomsupoccurringupinuppresenceupofupdifferentupcaregiversup(e.g.,upwhileupmotherupisupoutupofuptown)
□Use of medications or toxins
up up up up
descriptionupSymptomsupinupyoungupchildrenupareupmostlyupassociatedupwithupproximityupofuptheupoffendingupcaregiveruptouptheupchil
d.upTheupmotherupmayuppresentupasupaupdevoteduporupevenupmodelupparentupwhoupformsupcloseuprelationshipsupwithupmembersupofupt
heuphealthupcareupteam.upWhileupappearingupveryupinterestedupinupherupchild'supcondition,upsheupmayupbeuprelativelyupdistantupemotional
ly.up(SeeupChapterup37,uppageup146.)
4. Whichu p statementu p isu p false?
■ MalnutritionupisuptheupsecondupleadingupcauseupofupacquiredupimmuneupdeficiencyupworldwideupbehindupHIVupinfection
□Zinc up isup importantupinup immuneupfunctionup andup linearup growth
□Kwashiorkor and up up marasmusupareuprareupinupdevelopedupcountries
□The Western diet is associated with increased noncommunicable disease
up up up up up up up up
descriptionupTheupsignificantupglobalupburdenupofupmalnutritionupandupundernutritionupisuptheupleadingupworldwideupcauseupofupacquire
dupimmunodeficiencyupanduptheupmajorupunderlyingupfactorupforupmorbidityupandupmortalityupgloballyupforupchildrenup<5upyrupofupage.upZi
ncupisupaupmicronutrientupthatupsupportsupmultipleupmetabolicupfunctionsupinuptheupbody,upisupessentialupforupnormalupimmuneupfunctionin
g,upandupisuprequireduptoupsupportuplinearupgrowth;upzincupdeficiencyupisupassociatedupwithupimpairedupimmuneupfunctioningupanduppoorupli
nearupgrowth.upInupparalleluptouptheupriskupforupnutrientupandupenergyupdeficiencies,upissuesuprelatinguptoupexcessesupposeupimportantupchall
engesupbecauseupofuptheirupnegativeuphealthupeffects,upsuchupasupobesityuporupcardiovascularupdiseaseupriskupfactors.upTheupnutritionuptr
ansitionupunderupwayupinupthe
, developingupworldupfromuptraditionalupdietsuptouptheupWesternupdietuphasupbeenupassociatedupwithupincreasesupinupnoncommunicableu
pdiseases,upoftenupcoexistingupwithupundernutritionupandupmalnutrition,upobservedupsometimesupinuptheupsameupcommunitiesuporupevenupt
heupsameupfamilies.up(Seeupe41-1.)
5. Componentsu p ofu p energyu p expenditureu p inu p childrenu p include:
□Thermal up effectupofupfood
□Basal up metabolicup rate
□Energy for up up physicalupactivity
□Energy up tou p supportu p growth
■ Allupofuptheupabove
descriptionupTheup3upcomponentsupofupenergyupexpenditureupinupadultsupareuptheupbasalupmetabolicuprate,uptheupthermalupeffectup
ofupfoodup(energyuprequiredupforupdigestionupandupabsorption),upandupenergyupforupphysicalupactivity.upAdditionalupenergyupintakeupan
dupexpenditureupareuprequireduptoupsupportupgrowthupandupdevelopmentupforupchildren.up(Seeupe41-4.)
6. WhichupofuptheupfollowingupclinicalupscenariosupincreasesuptheupriskupofupvitaminupAupdeficiency?
□Vegetarian diet up
□Chronic up intestinalu p disorders
□Zinc up deficiency
■ BupandupC
□All of the above
up up up
descriptionupVitaminupAupisupanupessentialupmicronutrientupbecauseupitupcannotupbeupbiogeneratedupdeupnovoupbyupanimals.upItup
mustupbeupobtainedupfromupplantsupinuptheupformupofupprovitamin-
Aupcarotenoids.upInuptheupUSA,upgrainsupandupvegetablesupsupplyupapproximatelyup55%upandupdairyupandupmeatupproductsupsupply
upapproximatelyup30%upofupvitaminupAupintakeupfromupfood.upVitaminupAupanduptheupprovitamins-
Aupareupfatupsoluble,upanduptheirupabsorptionupdependsuponuptheuppresenceupofupadequateuplipidupandupproteinupwithinuptheupmeal.u p Chro
nicupintestinalupdisordersuporuplipidupmalabsorptionupsyndromesupcanupresultupinupvitaminupAupdeficiency.upInupdevelopingupcountries,up
subclinicaluporupclinicalupzincupdeficiencyupcanupincreaseuptheupriskupofupvitaminupAupdeficiency.upThereupisupalsoupsomeupevidenceupofup
marginalupzincupintakesupinupchildrenupinuptheupUSA.up(SeeupChapterup45,uppageup188.)
7. Whichu p statementu p aboutu p vitaminu p Au p toxicityu p isu p NOTu p true?
