Test bank for MCQs in Pediatrics Review of Nelson
b b b b b b b b
Textbook of Pediatrics 20 Edition
b b b b b b
, Nelson Pediatrics Review(MCQs) 19 Edition b b b b
1. Which of the following statements regarding foster care is true?
b b b b b b b b b
□A permanency plan must be made for a child in foster care no later than 12 mo from the child's entry into care
b b b b b b b b b b b b b b b b b b b b b b
□A minority of children in foster care have a history of abuse or neglect
b b b b b b b b b b b b b
□The mission of foster care is to safely care for children while providing services to families to promote reunification
b b b b b b b b b b b b b b b b b b
□Most (>70%) of children in foster care are reunited with their families
b b b b b b b b b b b
■ A and C b b
description The mission of foster care is to provide for the health, safety, and well-being of children while assisting their
b b b b b b b b b b b b b b b b b b b
families with services to promote reunification. Children entering foster care have frequently experienced early childhood
b b b b b b b b b b b b b b b
trauma. More than 70% have a history of abuse, neglect, or both. Only about 50% of children achieve reunification. In the
b b b b b b b b b b b b b b b b b b b b b
USA, the Adoption and Safe Families Act (P.L. 105-89) passed in 1997 requires that a permanency plan be made for
b b b b b b b b b b b b b b b b b b b b
each child no later than 12 mo after entry to foster care and that a petition to terminate parental rights typically must be filed
b b b b b b b b b b b b b b b b b b b b b b b b
when a child has been in foster care for at least 15 of the previous 22 mo. (See Chapter 35, page 134, and e35-1.)
b b b b b b b b b b b b b b b b b b b b b b b b
2. A 4 yr old girl is admitted to the hospital for her third evaluation for vaginal bleeding. The
b b b b b b b b b b b b b b b b b
mother noted bright red blood on the child's underwear. Previous examinations revealed a
b b b b b b b b b b b b
normal 4 yr old girl, Tanner stage 1, with normal external genitalia. Pelvic ultrasound results
b b b b b b b b b b b b b b b
were normal, as was the serum estradiol level. The hemoglobin and platelet counts were
b b b b b b b b b b b b b b
normal, as were the bleeding time and coagulation studies. Findings on pelvic examination
b b b b b b b b b b b b b
conducted under anesthesia also were normal. The next step in the examination is to:
b b b b b b b b b b b b b b
■ Determine the blood type of the blood on the underwear
b b b b b b b b b
□Interrogate the father b b
□Isolate the parents and child b b b b
□Determine b von Willebrand factor levels
b b b
, □Measure fibronectin in the vagina b b b b
description Consideration of factitious disorder by proxy should be triggered when the reported symptoms are repeatedly
b b b b b b b b b b b b b b b
noted by only one parent, appropriate testing fails to confirm a diagnosis, and seemingly appropriate treatment is ineffective.
b b b b b b b b b b b b b b b b b b
bAt times, the child's symptoms, their course, or the response to treatment may be incompatible with any recognized disease.
b b b b b b b b b b b b b b b b b b
b Preverbal children are usually involved. Bleeding is a particularly common presentation. This may be caused by adding dyes
b b b b b b b b b b b b b b b b b
bto samples, adding blood (e.g., from the mother) to the child's sample, or giving the child an anticoagulant (e.g., warfarin).
b b b b b b b b b b b b b b b b b b b
(See Chapter 37, page 146.)
b b b b b
3. Munchausen syndrome by proxy is characterized by all of the following EXCEPT:
b b b b b b b b b b b
□Mother who appears devoted and wins over members of care team
b b b b b b b b b b
□Multiple hospitalizations and investigations without diagnosis
b b b b b
□Symptoms on history but not witnessed by medical team
b b b b b b b b
■ Symptoms occurring in presence of different caregivers (e.g., while mother is out of town)
b b b b b b b b b b b b b
□Use of medications or toxins
b b b b
description Symptoms in young children are mostly associated with proximity of the offending caregiver to the child. The
b b b b b b b b b b b b b b b b b
mother may present as a devoted or even model parent who forms close relationships with members of the health care
b b b b b b b b b b b b b b b b b b b b
team. While appearing very interested in her child's condition, she may be relatively distant emotionally. (See Chapter 37,
b b b b b b b b b b b b b b b b b b
page 146.)
b b
4. Which statement is false? b b b
■ Malnutrition is the second leading cause of acquired immune deficiency worldwide behind HIV infection
b b b b b b b b b b b b b
□Zinc is important in immune function and linear growth
b b b b b b b b
□Kwashiorkor and marasmus are rare in developed countries b b b b b b b
□The Western diet is associated with increased noncommunicable disease
b b b b b b b b
description The significant global burden of malnutrition and undernutrition is the leading worldwide cause of acquired
b b b b b b b b b b b b b b b
immunodeficiency and the major underlying factor for morbidity and mortality globally for children <5 yr of age. Zinc is a
b b b b b b b b b b b b b b b b b b b b
micronutrient that supports multiple metabolic functions in the body, is essential for normal immune functioning, and is
b b b b b b b b b b b b b b b b b
required to support linear growth; zinc deficiency is associated with impaired immune functioning and poor linear growth. In
b b b b b b b b b b b b b b b b b b
parallel to the risk for nutrient and energy deficiencies, issues relating to excesses pose important challenges because of their
b b b b b b b b b b b b b b b b b b b
negative health effects, such as obesity or cardiovascular disease risk factors. The nutrition transition under way in the
b b b b b b b b b b b b b b b b b b
, developing world from traditional diets to the Western diet has been associated with increases in noncommunicable
b b b b b b b b b b b b b b b
diseases, often coexisting with undernutrition and malnutrition, observed sometimes in the same communities or even the
b b b b b b b b b b b b b b b b
same families. (See e41-1.)
b b b b
5. Components of energy expenditure in children include: b b b b b b
□Thermal effect of food b b b
□Basal metabolic rateb b
□Energy for physical activityb b b
□Energy to support growth b b b
■ All of the above
b b b
description The 3 components of energy expenditure in adults are the basal metabolic rate, the thermal effect of food
b b b b b b b b b b b b b b b b b b
(energy required for digestion and absorption), and energy for physical activity. Additional energy intake and expenditure
b b b b b b b b b b b b b b b b
are required to support growth and development for children. (See e41-4.)
b b b b b b b b b b b
6. Which of the following clinical scenarios increases the risk of vitamin A deficiency?
b b b b b b b b b b b b
□Vegetarian diet b
□Chronic intestinal disorders b b
□Zinc deficiency b
■ B and C
b b
□All of the above
b b b
description Vitamin A is an essential micronutrient because it cannot be biogenerated de novo by animals. It must be
b b b b b b b b b b b b b b b b b b
obtained from plants in the form of provitamin-A carotenoids. In the USA, grains and vegetables supply approximately
b b b b b b b b b b b b b b b b b
55% and dairy and meat products supply approximately 30% of vitamin A intake from food. Vitamin A and the
b b b b b b b b b b b b b b b b b b b
provitamins-A are fat soluble, and their absorption depends on the presence of adequate lipid and protein within the meal.
b b b b b b b b b b b b b b b b b b b
bChronic intestinal disorders or lipid malabsorption syndromes can result in vitamin A deficiency. In developing countries,
b b b b b b b b b b b b b b b
subclinical or clinical zinc deficiency can increase the risk of vitamin A deficiency. There is also some evidence of marginal
b b b b b b b b b b b b b b b b b b b b
zinc intakes in children in the USA. (See Chapter 45, page 188.)
b b b b b b b b b b b b
7. Which statement about vitamin A toxicity is NOT true?
b b b b b b b b
b b b b b b b b
Textbook of Pediatrics 20 Edition
b b b b b b
, Nelson Pediatrics Review(MCQs) 19 Edition b b b b
1. Which of the following statements regarding foster care is true?
b b b b b b b b b
□A permanency plan must be made for a child in foster care no later than 12 mo from the child's entry into care
b b b b b b b b b b b b b b b b b b b b b b
□A minority of children in foster care have a history of abuse or neglect
b b b b b b b b b b b b b
□The mission of foster care is to safely care for children while providing services to families to promote reunification
b b b b b b b b b b b b b b b b b b
□Most (>70%) of children in foster care are reunited with their families
b b b b b b b b b b b
■ A and C b b
description The mission of foster care is to provide for the health, safety, and well-being of children while assisting their
b b b b b b b b b b b b b b b b b b b
families with services to promote reunification. Children entering foster care have frequently experienced early childhood
b b b b b b b b b b b b b b b
trauma. More than 70% have a history of abuse, neglect, or both. Only about 50% of children achieve reunification. In the
b b b b b b b b b b b b b b b b b b b b b
USA, the Adoption and Safe Families Act (P.L. 105-89) passed in 1997 requires that a permanency plan be made for
b b b b b b b b b b b b b b b b b b b b
each child no later than 12 mo after entry to foster care and that a petition to terminate parental rights typically must be filed
b b b b b b b b b b b b b b b b b b b b b b b b
when a child has been in foster care for at least 15 of the previous 22 mo. (See Chapter 35, page 134, and e35-1.)
b b b b b b b b b b b b b b b b b b b b b b b b
2. A 4 yr old girl is admitted to the hospital for her third evaluation for vaginal bleeding. The
b b b b b b b b b b b b b b b b b
mother noted bright red blood on the child's underwear. Previous examinations revealed a
b b b b b b b b b b b b
normal 4 yr old girl, Tanner stage 1, with normal external genitalia. Pelvic ultrasound results
b b b b b b b b b b b b b b b
were normal, as was the serum estradiol level. The hemoglobin and platelet counts were
b b b b b b b b b b b b b b
normal, as were the bleeding time and coagulation studies. Findings on pelvic examination
b b b b b b b b b b b b b
conducted under anesthesia also were normal. The next step in the examination is to:
b b b b b b b b b b b b b b
■ Determine the blood type of the blood on the underwear
b b b b b b b b b
□Interrogate the father b b
□Isolate the parents and child b b b b
□Determine b von Willebrand factor levels
b b b
, □Measure fibronectin in the vagina b b b b
description Consideration of factitious disorder by proxy should be triggered when the reported symptoms are repeatedly
b b b b b b b b b b b b b b b
noted by only one parent, appropriate testing fails to confirm a diagnosis, and seemingly appropriate treatment is ineffective.
b b b b b b b b b b b b b b b b b b
bAt times, the child's symptoms, their course, or the response to treatment may be incompatible with any recognized disease.
b b b b b b b b b b b b b b b b b b
b Preverbal children are usually involved. Bleeding is a particularly common presentation. This may be caused by adding dyes
b b b b b b b b b b b b b b b b b
bto samples, adding blood (e.g., from the mother) to the child's sample, or giving the child an anticoagulant (e.g., warfarin).
b b b b b b b b b b b b b b b b b b b
(See Chapter 37, page 146.)
b b b b b
3. Munchausen syndrome by proxy is characterized by all of the following EXCEPT:
b b b b b b b b b b b
□Mother who appears devoted and wins over members of care team
b b b b b b b b b b
□Multiple hospitalizations and investigations without diagnosis
b b b b b
□Symptoms on history but not witnessed by medical team
b b b b b b b b
■ Symptoms occurring in presence of different caregivers (e.g., while mother is out of town)
b b b b b b b b b b b b b
□Use of medications or toxins
b b b b
description Symptoms in young children are mostly associated with proximity of the offending caregiver to the child. The
b b b b b b b b b b b b b b b b b
mother may present as a devoted or even model parent who forms close relationships with members of the health care
b b b b b b b b b b b b b b b b b b b b
team. While appearing very interested in her child's condition, she may be relatively distant emotionally. (See Chapter 37,
b b b b b b b b b b b b b b b b b b
page 146.)
b b
4. Which statement is false? b b b
■ Malnutrition is the second leading cause of acquired immune deficiency worldwide behind HIV infection
b b b b b b b b b b b b b
□Zinc is important in immune function and linear growth
b b b b b b b b
□Kwashiorkor and marasmus are rare in developed countries b b b b b b b
□The Western diet is associated with increased noncommunicable disease
b b b b b b b b
description The significant global burden of malnutrition and undernutrition is the leading worldwide cause of acquired
b b b b b b b b b b b b b b b
immunodeficiency and the major underlying factor for morbidity and mortality globally for children <5 yr of age. Zinc is a
b b b b b b b b b b b b b b b b b b b b
micronutrient that supports multiple metabolic functions in the body, is essential for normal immune functioning, and is
b b b b b b b b b b b b b b b b b
required to support linear growth; zinc deficiency is associated with impaired immune functioning and poor linear growth. In
b b b b b b b b b b b b b b b b b b
parallel to the risk for nutrient and energy deficiencies, issues relating to excesses pose important challenges because of their
b b b b b b b b b b b b b b b b b b b
negative health effects, such as obesity or cardiovascular disease risk factors. The nutrition transition under way in the
b b b b b b b b b b b b b b b b b b
, developing world from traditional diets to the Western diet has been associated with increases in noncommunicable
b b b b b b b b b b b b b b b
diseases, often coexisting with undernutrition and malnutrition, observed sometimes in the same communities or even the
b b b b b b b b b b b b b b b b
same families. (See e41-1.)
b b b b
5. Components of energy expenditure in children include: b b b b b b
□Thermal effect of food b b b
□Basal metabolic rateb b
□Energy for physical activityb b b
□Energy to support growth b b b
■ All of the above
b b b
description The 3 components of energy expenditure in adults are the basal metabolic rate, the thermal effect of food
b b b b b b b b b b b b b b b b b b
(energy required for digestion and absorption), and energy for physical activity. Additional energy intake and expenditure
b b b b b b b b b b b b b b b b
are required to support growth and development for children. (See e41-4.)
b b b b b b b b b b b
6. Which of the following clinical scenarios increases the risk of vitamin A deficiency?
b b b b b b b b b b b b
□Vegetarian diet b
□Chronic intestinal disorders b b
□Zinc deficiency b
■ B and C
b b
□All of the above
b b b
description Vitamin A is an essential micronutrient because it cannot be biogenerated de novo by animals. It must be
b b b b b b b b b b b b b b b b b b
obtained from plants in the form of provitamin-A carotenoids. In the USA, grains and vegetables supply approximately
b b b b b b b b b b b b b b b b b
55% and dairy and meat products supply approximately 30% of vitamin A intake from food. Vitamin A and the
b b b b b b b b b b b b b b b b b b b
provitamins-A are fat soluble, and their absorption depends on the presence of adequate lipid and protein within the meal.
b b b b b b b b b b b b b b b b b b b
bChronic intestinal disorders or lipid malabsorption syndromes can result in vitamin A deficiency. In developing countries,
b b b b b b b b b b b b b b b
subclinical or clinical zinc deficiency can increase the risk of vitamin A deficiency. There is also some evidence of marginal
b b b b b b b b b b b b b b b b b b b b
zinc intakes in children in the USA. (See Chapter 45, page 188.)
b b b b b b b b b b b b
7. Which statement about vitamin A toxicity is NOT true?
b b b b b b b b
