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