Chapter 8 (Cards 35-41 are Nutrition)

Question 1

The Gonads begin to secrete estrogen and testosterone during

a) Infancy
b) Puberty
c) Pregnancy
d) Early childhood
e) Early adulthood

Answer 1

ANS: B At puberty, the gonads secrete testosterone and estrogen. As a result, secondary sex characteristics (e.g., genitalia growth) begin. Maturation occurs at a mean age of 14 years in females and 13 years in males.

Question 2

Developmental changes of puberty are caused mainly by the interaction of the pituitary gland, gonads, and the

a) Hypothalamus
b) Islet cells
c) Thalamus
d) Wernicke area
e) Thymus

Answer 2

ANS: A Under the influence of the hypothalamus, pituitary gland, and gonads, developmental changes of puberty are established. The other choices do not play a part in maturation.

Question 3

After 50 years of age, stature

a) Becomes fixed
b) Begins a barely perceptible secondary increase
c) Increases at a rate of 0.5cm/year
d) Declines
e) Declines and then begins a barely perceptible increase.

Answer 3

ANS: D As an individual reaches 50 years of age, the intervertebral disk begins to thin and become more compressed, which leads to a decline in stature.

Question 4

By 10 to 12 years of age, lymphatic tissues are about _____ adult size

a) 25% of
b) 50% of
c) The same as
d) Twice the size as in
e) five times the size as

Answer 4

ANS: D Lymphatic tissues are small compared to the total body size, but they are almost fully developed at birth. They grow fast and are about twice the adult size by 10 to 12 years of age.

Question 5

Which organ(s) completes physical development more quickly than any other body part?

a. Brain
b. Kidneys
c. Heart
d. Lungs
e. Lymphoid tissue

Answer 5

ANS: A Along with the skull, eyes, and ears, the brain completes development more quickly than any other part of the body; its most rapid growth occurs from conception to age 2 years.

Question 6

During adolescence, the head size normally increases as a result of

a. sinus development.
b. brain mass increase.
c. evolution of lymphatic tissue.
d. hypertrophy of glial cells.
e. hypertrophy of myelin.

Answer 6

ANS: A As the facial sinuses grow, the head size enlarges its surface area to accommodate this growth.

Question 7

Fifty percent of an individual’s ideal weight is gained during

a. pregnancy.
b. preschool years.
c. adolescence.
d. early adulthood.
e. older adulthood.

Answer 7

ANS: C During adolescence, the trunk and legs grow the most, causing organs and the skeletal mass to double in size. During pregnancy, weight gain is accounted for by the growing fetus and pregnancy organs (placenta and uterus). In the preschool years, weight is gained at a steady rate, with fat tissue increasing slowly until about 7 years of age. In early adulthood, there is a reduction in size and weight. A decrease in weight for height and body mass index has been found with increasing age between 70 and 89 years of age.

Question 8

Gender-specific skeletal differences first occur during

a. the second stage of fetal development.
b. late infancy.
c. early childhood.
d. adolescence.
e. early adulthood.

Answer 8

During adolescence, females develop wider pelvises, and males develop broad shoulders. Whereas males transition from a slight increase in body fat to more lean muscle mass in later puberty, females maintain an increase in adipose tissue throughout adolescence.

Question 9

The legs are the fastest growing body part during

a. early infancy.
b. late infancy.
c. childhood.
d. adolescence.
e. early adulthood.

Answer 9

ANS: C
The legs grow the fastest during childhood, the trunk grows fastest in infancy, and the skeletal muscles and organs grow fastest in early adulthood.

Question 10

Skeletal mass and organ systems double in size during

a. infancy.
b. early childhood.

c. adolescence.
d. early adulthood.
e. mid life.

Answer 10

ANS: C
During puberty, sex steroids stimulate secretion of growth hormone, causing the organs and
skeletal mass to double in size.

Question 11

Achieving an optimal infant birth weight is difficult for pregnant adolescents because

a. they have not completed their own growth spurt.
b. there are insufficient uterine supporting structures.
c. the amnionic fluid is variable in adolescents.
d. blood volume has not reached adult proportions.
e. most of the maternal tissue growth occurs in the third trimester.

Answer 11

ANS: A

Pregnant adolescents younger than 16 years of age, or less than 2 years from menarche, may still be in their growth spurt. They may require higher weight gains during pregnancy to achieve an optimal infant birth weight. Maternal tissue growth accounts for most of the weight gain in the
first and second trimesters.

Question 12

How much of the weight gained during a normal pregnancy is accounted for by an increase in blood volume?

a. Less than 1 pound
b. 1 to 2 pounds
c. 3 to 4 pounds
d. 4 to 6 pounds
e. 6 to 8 pounds

Answer 12

ANS: C
An increase in blood volume usually accounts for 3-4 pounds of the weight gained during
pregnancy. The remainder is due to the fetus and increases in maternal tissues (fluid volume,
breasts, uterus, amniotic fluid, and increases in maternal fat and protein stores).

Question 13

During a preventive health care visit, Ms. G, an older patient, states that she is getting shorter. She says that her son mentioned that her change in stature became noticeable to him during his last visit with her. Her posture appears straight and aligned. When addressing Ms. G’s present concerns, it is most important to inquire about

a. number of pregnancies.
b. parents’ height.
c. history of scoliosis.
d. approximate height at menarche.
e. usual height and weight.

Answer 13

ANS: E

Stature declines after 50 years of age because of progressive thinning of intervertebral disks, so it
is important to determine the patient’s height and weight at this age as a baseline for future
trends.

Question 14

Over the past 2 decades, there has been a trend toward

a. preservation of weight.
b. preservation of height.
c. obesity in older adults.

d. preservation of muscle mass.
e. increase in size and weight of various organs in older adults.

Answer 14

ANS: C
An increase in overweight and obese older adults has been documented over the past 15 to 20 years. A decrease in weight for height and body mass index has been found with increasing age in patients from 70 to 89 years of age. An age-associated reduction in size and weight of various organs has been identified, especially of the liver, lungs, and kidneys.

Question 15

Milestone achievements are data most likely to appear in the history of

a. adolescents.
b. infants.
c. school-age children.
d. young adults.
e. older adults.

Answer 15

ANS: B
As part of the developmental assessment in infants, milestone achievements at certain ages, such as crawling, laughing, picking up the head, and turning over, are recorded.

Question 16

Infants normally increase their birth length by ____% during the first year of life.

a. 10
b. 25
c. 50
d. 100
e. 200

Answer 16

ANS: C
Infant length generally increases by 50% in the first year of life.

Question 17

Healthy term babies generally double their birth weight by what age?

a. 1 month
b. 3 months
c. 5 months
d. 9 months
e. 12 months

Answer 17

ANS: C
In general, healthy infants double their birth weight by 4 to 5 months of age and triple their birth weight by 12 months of age. Formula-fed infants are heavier after the first 6 months of life than breastfed infants; they grow faster in the first 6 months of life and experience slower growth in the second 6 months of the first year.

Question 18

Infants born to the same parents are normally within which range of weight of each other?

a. 1 ounce
b. 6 ounces
c. 12 ounces
d. 1 pound
e. 2 pounds

Answer 18

ANS: B
Siblings born at term to the same parents usually weigh within 6 ounces of each other.

Question 19

You should measure the child’s head circumference at every health visit until at least age _____ months.

a. 3
b. 8
c. 12

d. 18
e. 24

Answer 19

ANS: E
Head circumference should be measured at every visit until 2 to 3 years of age.

Question 20

To measure head circumference, the tape is wrapped snugly around the child’s head at the

occipital protuberance and the

a. supraorbital prominence.
b. brow line.
c. nasal bridge.
d. chin.
e. hairline.

Answer 20

ANS: A
The measuring tape should be snugly wrapped around the child’s head at the occipital
protuberance and the supraorbital prominence, thereby documenting the largest circumference.
Care should be taken to ensure that the tape does not cut the skin. Make the reading to the nearest 0.5 cm or inch; remember to remeasure the head circumference at least once to check the accuracy of your measurement.

Question 21

Between 5 and 24 months of life, the infant’s chest circumference is normally

a. about equal to the head circumference.
b. greater than the head circumference by 2 inches.

c. smaller than the head circumference by about 4 inches.
d. at least 2 inches smaller than head circumference.

e. none of the above; there is no relation between head and chest circumference
during this period.

Answer 21

ANS: A
Between the ages of 5 months and 2 years, the infant’s chest circumference should closely approximate the head circumference; the ratio should be monitored so that microcephaly can be identified, if present.

Question 22

In clinical practice, the Ballard Assessment Tool is used to assess a newborn’s

a. length.
b. weight.
c. lung maturity.
d. gestational age.
e. future IQ.

Answer 22

ANS: D

The Ballard Assessment Tool assesses six physical and six neuromuscular characteristics,
administered within 36 hours of birth, to confirm the newborn’s gestational age.

Question 23

The term large for gestational age (LGA) indicates that an infant is larger than ____% of infants born at the same number of weeks’ gestation.

a. 10
b. 25
c. 50
d. 75
e. 90

Answer 23

ANS: E
LGA corresponds to an infant who is in the greater than 90th weight percentile.

Question 24

The upper-to-lower segment ratio should be calculated

a. bimonthly for the first year of life.
b. annually for the first 5 years.
c. only when a child is suspected of having a growth problem or unusual body proportions.

d. in children of first-generation immigrants.
e. every 6 months for the first 24 months.

Answer 24

ANS: C
The upper-to-lower ratio is assessed when a child is suspected of having a growth problem or unusual body proportions.

Question 25

An 11-year-old boy is brought in for an annual physical examination by his mother. You suspect _____ when you measure his arm span at 65 inches and his height at 60 inches.

a. premature pubarche
b. hypothyroidism
c. scoliosis
d. Marfan syndrome
e. dwarfism

Answer 25

ANS: D
Arm span that is greater than a child’s height is associated with Marfan syndrome. These children can have cardiovascular problems and should be thoroughly evaluated.

Question 26

Which of the following statements regarding female pubertal changes is true?

a. Most adolescent girls develop breasts before pubic hair.
b. Peak height velocity should occur after menarche.

c. Breast asymmetry is an abnormal finding.
d. Menarche should occur by Tanner breast stage B.

e. Sexual maturation begins later in taller and heavier girls.

Answer 26

ANS: A
In two-thirds of girls, breasts begin to develop before pubic hair. Peak height velocity actually occurs about 1 year before menarche, breast asymmetry is common, and menarche occurs after Tanner breast stage B. Sexual maturation begins earlier in taller and heavier girls.

Question 27

At what age does peak height growth velocity occur in boys?

a. 6 years
b. 10 years
c. 12 years
d. 13 years
e. 15 years

Answer 27

ANS: D
Peak height velocity occurs at an average age of 13 years.

Question 28

What is the youngest age at which pubic hair growth in a boy may be considered normal?

a. 7 years
b. 8 years

c. 9 years
d. 10 years
e. 11 years

Answer 28

ANS: C
In boys, sexual development before 9 years of age is precocious puberty and is considered an abnormal finding.

Question 29

Which Tanner stage is marked by the most significant growth in penis length?

a. Stage 1
b. Stage 2
c. Stage 3
d. Stage 4
e. Stage 5

Answer 29

ANS: C
Tanner stage 3 is marked by enlargement of the penis, especially in length.

Question 30

Which breast Tanner stage corresponds to a secondary areola mound development above the breast?

a. Stage 1
b. Stage 2
c. Stage 3
d. Stage 4
e. Stage 5

Answer 30

ANS: D
Tanner stage 4 depicts the stage in which the areola forms a second mound above the breast.

Question 31

A woman with a normal prepregnancy body mass index (BMI) should gain approximately _____ pounds during pregnancy.

a. 10
b. 15
c. 20
d. 30
e. 40

Answer 31

ANS: D

Women of normal BMI should expect to gain between 25 and 35 pounds during pregnancy.

Question 32

A pregnant woman of normal prepregnancy weight should be expected to gain how much weight per week during the second and third trimesters of pregnancy?

Don’t really get this one?

a. pound
b. 1 pound
c. 1 pounds
d. 2 pounds
e. 2 pounds

Answer 32

ANS: B
Expected weight gain in the first trimester is variable, between 1 and 2 kg (2 to 4 pounds);
however, in the second and third trimesters, weekly weight gain should be approximately 0.45 kg
(1 pound) per week.

Question 33

Frontal skull bossing, cranial ridges, mandibular overgrowth, and maxillary widening are characteristics of

a. infantile hydrocephalus.
b. acromegaly.
c. Cushing syndrome.
d. achondroplasia.
e. Turner syndrome.

Answer 33

ANS: B
These presenting features are all prominent characteristics of acromegaly; teeth separation and malocclusion can result from the maxillary widening.

Question 34

A round face, preauricular fat, hyperpigmentation, and a buffalo hump in the posterior cervical area are associated with

a. infantile hydrocephalus.
b. hypopituitary dwarfism.
c. Cushing syndrome.
d. achondroplasia.
e. acromegaly.

Answer 34

ANS: C
These are all commonly associated characteristics of Cushing syndrome, with the buffalo hump as a distinguishing feature.

Question 35

What age group should have less than 10% of calories come from saturated fat?

a. Infants
b. Children
c. Adolescents
d. Adults
e. All age groups

Answer 35

E

For all ages, less than 10% of calories should be from saturated fat.

Question 36

Which medication is frequently associated with weight gain?

a. Diuretics
b. Oral hypoglycemics
c. Laxatives
d. Steroids
e. Antibiotics

Answer 36

ANS: D
Medications that contribute to weight gain include steroids, oral contraceptives, antidepressants, and insulin.

Question 37

A major risk factor for developing an eating disorder is having

a. parents who stress academia and social acceptance.
b. a first-degree relative with an eating disorder.

c. siblings who are low academic achievers.
d. parents who stress the importance of the food pyramid.

e. parents in a lower socioeconomic group.

Answer 37

ANS: B
A major risk factor for an eating disorder is having a family history of eating disorders,
especially in a first-degree relative.

Question 38

An extremely obese adult would have a BMI greater than

a. 20.
b. 25.
c. 30.
d. 35.
e. 40.

Answer 38

ANS: E
Adult classification of BMI for obesity is overweight, 25 to 29.9; obesity, 30 to 39.9; and
extreme obesity, above 40.

Question 39

Monitoring a patient’s waist-to-hip ratio provides data concerning:

a. daily caloric requirements.
b. lung capacity.
c. stomach cancer risk.
d. cardiovascular disease risk.
e. developing an eating disorder.

Answer 39

ANS: D
Waist-to-hip ratios may aid in predicting relative disease risk in terms of cardiovascular disease.

Question 40

A 17-year-old girl presents to the clinic for a sport’s physical examination. Physical examination findings reveal salivary gland enlargement , multiple erosions of tooth enamel, and scars on her knuckles. She appears healthy otherwise. You should ask her if she

a. binges and vomits.
b. has regular menstrual periods.
c. has constipation frequently.
d. is cold intolerant.
e. has bloating.

Answer 40

ANS: A
Young adults, usually young women, who have salivary gland enlargement, knuckle scars and tooth decay as a result of chronic self-induced vomiting characterize bulimia. Amenorrhea can be from increased physical activity or anorexia; constipation, bloating, and cold intolerance are usually symptoms of anorexia nervosa.

Question 41

Which of the following characteristics can distinguish patients with anorexia from those with bulimia?

a. Adolescent and young adult women are affected.
b. Patients may exercise excessively to lose weight.
c. Patients become malnourished.
d. Patients may abuse laxatives and diuretics.
e. Patients have amenorrhea.

Answer 41

ANS: C
Bulimic individuals usually do not become malnourished (as occurs with anorexic patients) unless they drop to less than 85% of their weight.