Extensive Test Bank for Nelson Pediatrics Review MCQs – 19th Edition | Clinical Knowledge Assessment | Exam Prep| and Pediatric Case-Based Learning Resource

Test bank for MCQs in Pediatrics Review of Nelson T
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extbook of Pediatrics 20 Edition
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, Nelson Pediatrics Review(MCQs) 19 Edition Ws Ws Ws Ws




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 Ws Ws




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




□Isolate the parents and child Ws Ws Ws Ws




□Determine W s von Willebrand factor levels
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, □Measure Ws fibronectin in the vagina Ws Ws Ws




description Consideration of factitious disorder by proxy should be triggered when the reported symptoms are repeate
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dly noted by only one parent, appropriate testing fails to confirm a diagnosis, and seemingly appropriate treatment is ineff
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ective. At times, the child's symptoms, their course, or the response to treatment may be incompatible with any recognize
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d disease. Preverbal children are usually involved. Bleeding is a particularly common presentation. This may be caused
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by adding dyes to samples, adding blood (e.g., from the mother) to the child's sample, or giving the child an anticoagul
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ant (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 of care team
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□Multiple Ws hospitalizations and investigations without diagnosis Ws Ws Ws Ws




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




■ 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. T
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he mother may present as a devoted or even model parent who forms close relationships with members of the healt
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h care team. While appearing very interested in her child's condition, she may be relatively distant emotionally. (See Ch
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apter 37, page 146.)Ws Ws Ws




4. Which statement is false? Ws Ws Ws




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




□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 i
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mmunodeficiency and the major underlying factor for morbidity and mortality globally for children <5 yr of age. Zinc is a
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micronutrient that supports multiple metabolic functions in the body, is essential for normal immune functioning, and is r
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equired 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 i
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n theWs

, developing world from traditional diets to the Western diet has been associated with increases in noncommunicable dis
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eases, often coexisting with undernutrition and malnutrition, observed sometimes in the same communities or even the sa
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me families. (See e41-1.)
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5. Components of energy expenditure in children include: Ws Ws Ws Ws Ws Ws




□Thermal effect of food Ws Ws Ws




□Basal metabolic rate Ws Ws




□Energy for physical activity Ws Ws Ws




□Energy to Ws Ws support growth Ws




■ All of the above
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description The 3 components of energy expenditure in adults are the basal metabolic rate, the thermal effect of fo
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od (energy required for digestion and absorption), and energy for physical activity. Additional energy intake and expend
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iture 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 Ws




□Chronic Ws intestinal disorders Ws




□Zinc Ws deficiency


■ B and CWs Ws




□All of the above Ws Ws Ws




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-
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A carotenoids. In the USA, grains and vegetables supply approximately 55% and dairy and meat products supply ap
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proximately 30% of vitamin A intake from food. Vitamin A and the provitamins-
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A are fat soluble, and their absorption depends on the presence of adequate lipid and protein within the meal. Chronic
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intestinal disorders or lipid malabsorption syndromes can result in vitamin A deficiency. In developing countries, subclini
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cal or clinical zinc deficiency can increase the risk of vitamin A deficiency. There is also some evidence of marginal zin
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c 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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