TEST BANK FOR NELSON PEDIATRICS REVIEW(MCQS) 19 EDITION - Copy (1).pdf

, Nelson Pediatrics Review(MCQs) 19 Edition w w w w




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 w mission of foster care is to safely care for children while providing services to families to promote reunification
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□Most w (>70%) of children in foster care are reunited with their families
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■ A and C
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description The mission of foster care is to provide for the health, safety, and well-being of children while
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wassisting their families with services to promote reunification. Children entering foster care have frequently
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wexperienced early childhood trauma. More than 70% have a history of abuse, neglect, or both. Only about
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w50% of children achieve reunification. In the USA, the Adoption and Safe Families Act (P.L. 105-89)
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wpassed in 1997 requires that a permanency plan be made for each child no later than 12 mo after entry to
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wfoster care and that a petition to terminate parental rights typically must be filedwhen a child has been in
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wfoster care for at least 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
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wrevealed a normal 4 yr old girl, Tanner stage 1, with normal external genitalia.
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wPelvic ultrasound resultswere normal, as was the serum estradiol level. The hemoglobin
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wand platelet counts were normal, as were the bleeding time and coagulation studies.
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wFindings on pelvic examination conducted under anesthesia also were normal. The
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wnext 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 the father w w




□Isolate the parents and child
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□Determine von Willebrand factor levels w w w w

, □Measure fibronectin in the vagina
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description Consideration of factitious disorder by proxy should be triggered when the reported symptoms are
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wrepeatedly noted by only one parent, appropriate testing fails to confirm a diagnosis, and seemingly
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wappropriate treatment is ineffective. At times, the child's symptoms, their course, or the response to
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wtreatment may be incompatible with any recognized disease.Preverbal children are usually involved. Bleeding
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wis a particularly common presentation. This may be caused by adding dyes to samples, adding blood (e.g.,
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wfrom the mother) to the child's sample, or giving the child an anticoagulant (e.g., warfarin). (See Chapter
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w37, 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 w hospitalizations and investigations without diagnosis w w w w




□Symptoms w on history but not witnessed by medical team
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■ 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
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wchild. The mother may present as a devoted or even model parent who forms close relationships with
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wmembers of the health care team. While appearing very interested in her child's condition, she may be relatively
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wdistant emotionally. (See Chapter 37, page 146.)
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4. Which statement is false?w w w




■ Malnutrition is the second leading cause of acquired immune deficiency worldwide behind HIV infection
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□Zinc is w w important in immune function and linear growth w w w w w w




□Kwashiorkor w and marasmus are rare in developed countries
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□The w 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
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wacquired immunodeficiency and the major underlying factor for morbidity and mortality globally for children <5 yr
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wof age. Zinc is a micronutrient that supports multiple metabolic functions in the body, is essential for normal
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wimmune functioning, and is required to support linear growth; zinc deficiency is associated with impaired
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wimmune functioning and poor linear growth. In parallel to the risk for nutrient and energy deficiencies, issues
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wrelating to excesses pose important challenges because of theirjnegative health effects, such as obesity or
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, cardiovascular disease risk factors. The nutrition transition under way in the
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