TEST BANK For MCQs in Pediatrics Review of Nelson Textbook of Pediatrics 20th Edition, Verified Chapters, Complete Newest Version

Test bank for MCQs in Pediatrics Review of Nelson
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nn Textbook of Pediatrics 20 Edition
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, Nelson Pediatrics Review(MCQs) 19 Edition nn nn nn nn




1. Which of the following statements regarding foster care is true?
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□A permanency plan must be made for a child in foster care no later than 12 mo from the child's entry into care
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□A minority of children in foster care have a history of abuse or neglect
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□The mission of foster care is to safely care for children while providing services to families to promote reunification
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□Most (>70%) of children in foster care are reunited with their families
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■ A and C nn nn




description The mission of foster care is to provide for the health, safety, and well-being of children while assisting their
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families with services to promote reunification. Children entering foster care have frequently experienced early childhood
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trauma. More than 70% have a history of abuse, neglect, or both. Only about 50% of children achieve reunification. In
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the USA, the Adoption and Safe Families Act (P.L. 105-89) passed in 1997 requires that a permanency plan be made
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for each child no later than 12 mo after entry to foster care and that a petition to terminate parental rights typically must
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be filed when a child has been in foster care for at least 15 of the previous 22 mo. (See Chapter 35, page 134, and e35-
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1.)




2. A 4 yr old girl is admitted to the hospital for her third evaluation for vaginal bleeding. The
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mother noted bright red blood on the child's underwear. Previous examinations revealed a
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normal 4 yr old girl, Tanner stage 1, with normal external genitalia. Pelvic ultrasound results
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were normal, as was the serum estradiol level. The hemoglobin and platelet counts were
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normal, as were the bleeding time and coagulation studies. Findings on pelvic examination
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conducted under anesthesia also were normal. The next step in the examination is to:
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■ Determine the blood type of the blood on the underwearnn nn nn nn nn nn nn nn nn




□Interrogate nn the father nn




□Isolate the parents and child nn nn nn nn




□Determine n n von Willebrand factor levels
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, □Measure nn fibronectin in the vagina nn nn nn




description Consideration of factitious disorder by proxy should be triggered when the reported symptoms are
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repeatedly noted by only one parent, appropriate testing fails to confirm a diagnosis, and seemingly appropriate treatment
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is ineffective. At times, the child's symptoms, their course, or the response to treatment may be incompatible with any
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recognized disease. Preverbal children are usually involved. Bleeding is a particularly common presentation. This may
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be caused by adding dyes to samples, adding blood (e.g., from the mother) to the child's sample, or giving the child an
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anticoagulant (e.g., warfarin). (See Chapter 37, page 146.)
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3. Munchausen syndrome by proxy is characterized by all of the following EXCEPT:
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□Mother who appears devoted and wins over members
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□Multiple nn hospitalizations and investigations without diagnosis nn nn nn nn




□Symptoms on history but not witnessed by medical team nn nn nn nn nn nn nn nn




■ Symptoms occurring in presence of different caregivers (e.g., while mother is out of town)
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□Use of medications or toxins
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description Symptoms in young children are mostly associated with proximity of the offending caregiver to the child.
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The mother may present as a devoted or even model parent who forms close relationships with members of the health
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care team. While appearing very interested in her child's condition, she may be relatively distant emotionally. (See
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Chapter 37, page 146.)
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4. Which statement is false? nn nn nn




■ Malnutrition is the second leading cause of acquired immune deficiency worldwide behind HIV infection
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□Zinc is important in immune function
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□Kwashiorkor and marasmus are rare in developed countries nn nn nn nn nn nn nn




□The Western diet is associated with increased noncommunicable disease
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description The significant global burden of malnutrition and undernutrition is the leading worldwide cause of acquired
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immunodeficiency and the major underlying factor for morbidity and mortality globally for children <5 yr of age. Zinc is
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a micronutrient that supports multiple metabolic functions in the body, is essential for normal immune functioning, and is
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required to support linear growth; zinc deficiency is associated with impaired immune functioning and poor linear growth.
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In parallel to the risk for nutrient and energy deficiencies, issues relating to excesses pose important challenges because of
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their negative health effects, such as obesity or cardiovascular disease risk factors. The nutrition transition under way in
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the
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, developing world from traditional diets to the Western diet has been associated with increases in noncommunicable
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diseases, often coexisting with undernutrition and malnutrition, observed sometimes in the same communities or even the
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same families. (See e41-1.)
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5. Components of energy expenditure in children include: nn nn nn nn nn nn




□Thermal effect of food nn nn nn




□Basal metabolic rate nn nn




□Energy for physical activity nn nn nn




□Energy to nn nn support growth nn




■ All of the above nn nn nn




description The 3 components of energy expenditure in adults are the basal metabolic rate, the thermal effect of food
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(energy required for digestion and absorption), and energy for physical activity. Additional energy intake and
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expenditure are required to support growth and development for children. (See e41-4.)
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6. Which of the following clinical scenarios increases the risk of vitamin A deficiency?
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□Vegetarian diet nn




□Chronic nn intestinal disorders nn




□Zinc nn deficiency


■ B and C nn nn




□All of the above nn nn nn




description Vitamin A is an essential micronutrient because it cannot be biogenerated de novo by animals. It must
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be obtained from plants in the form of provitamin-A carotenoids. In the USA, grains and vegetables supply
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approximately 55% and dairy and meat products supply approximately 30% of vitamin A intake from food. Vitamin
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A and the provitamins-A are fat soluble, and their absorption depends on the presence of adequate lipid and protein
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within the meal. Chronic intestinal disorders or lipid malabsorption syndromes can result in vitamin A deficiency. In
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developing countries, subclinical or clinical zinc deficiency can increase the risk of vitamin A deficiency. There is also
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some evidence of marginal zinc intakes in children in the USA. (See Chapter 45, page 188.)
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7. Which statement about vitamin A toxicity is NOT true?
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