Q.1 Which of the following is the most common cause of protein-energy malnutrition in children?
Inadequate protein intake
Vitamin D deficiency
Excess sugar intake
Iron deficiency
Explanation - Protein-energy malnutrition occurs primarily due to insufficient intake of protein and calories, leading to conditions like marasmus and kwashiorkor.
Correct answer is: Inadequate protein intake
Q.2 A child with kwashiorkor typically presents with which of the following clinical features?
Severe wasting and no edema
Edema, irritability, and fatty liver
Rickets and bowed legs
Hyperactivity and insomnia
Explanation - Kwashiorkor is characterized by protein deficiency leading to edema, irritability, an enlarged fatty liver, and skin changes.
Correct answer is: Edema, irritability, and fatty liver
Q.3 Which vitamin deficiency is associated with night blindness in children?
Vitamin A
Vitamin B12
Vitamin C
Vitamin D
Explanation - Vitamin A deficiency affects the retina and causes night blindness and, in severe cases, xerophthalmia.
Correct answer is: Vitamin A
Q.4 Iron deficiency anemia in children is most commonly caused by:
Excessive cow's milk intake
High protein diet
Lack of vitamin C
Excess sugar intake
Explanation - Cow's milk is low in iron and can interfere with iron absorption, leading to iron deficiency anemia in infants and toddlers.
Correct answer is: Excessive cow's milk intake
Q.5 Which nursing intervention is most appropriate for a child with severe malnutrition?
Provide high-protein, low-calorie diet
Administer intravenous fluids without electrolytes
Gradually reintroduce nutrients with frequent monitoring
Encourage fasting to stimulate appetite
Explanation - In severe malnutrition, refeeding syndrome is a risk; nutrients should be reintroduced gradually with close monitoring of electrolytes.
Correct answer is: Gradually reintroduce nutrients with frequent monitoring
Q.6 Which anthropometric measurement is most useful to assess malnutrition in children under five?
Height-for-age
Weight-for-height
Head circumference
Body mass index
Explanation - Weight-for-height measures acute malnutrition, detecting wasting in children under five.
Correct answer is: Weight-for-height
Q.7 A child with rickets often shows which physical sign?
Bow legs
Blue sclera
Cleft palate
Clubfoot
Explanation - Rickets is caused by vitamin D deficiency and presents with soft, weak bones, often leading to bowing of the legs.
Correct answer is: Bow legs
Q.8 Which nutrient is essential for wound healing and immune function in children?
Vitamin C
Vitamin B1
Folic acid
Selenium
Explanation - Vitamin C is crucial for collagen synthesis, wound healing, and supporting immune function in children.
Correct answer is: Vitamin C
Q.9 Marasmus differs from kwashiorkor primarily in that marasmus:
Causes edema
Is due to carbohydrate deficiency
Causes severe wasting without edema
Is a result of vitamin A deficiency
Explanation - Marasmus is characterized by severe calorie deficiency leading to wasting and loss of muscle mass, without the edema seen in kwashiorkor.
Correct answer is: Causes severe wasting without edema
Q.10 Which of the following is a common complication of prolonged iron deficiency anemia in children?
Delayed cognitive development
Hyperactivity
Increased bone density
Jaundice
Explanation - Iron deficiency anemia can impair oxygen delivery to tissues, affecting brain development and leading to cognitive delays in children.
Correct answer is: Delayed cognitive development
Q.11 Which lab test is most specific for diagnosing vitamin B12 deficiency in children?
Serum B12 levels
Serum ferritin
Serum calcium
Serum albumin
Explanation - Serum vitamin B12 measurement is used to diagnose deficiency, which may present with megaloblastic anemia and neurological symptoms.
Correct answer is: Serum B12 levels
Q.12 Which of the following is a primary prevention strategy for childhood obesity?
Encouraging physical activity and balanced diet
Prescribing weight loss medications
Restricting all fats from diet
Fasting for long periods
Explanation - Lifestyle modification with healthy eating and regular exercise is the cornerstone of preventing childhood obesity.
Correct answer is: Encouraging physical activity and balanced diet
Q.13 Zinc deficiency in children can lead to:
Growth retardation and impaired wound healing
Night blindness
Rickets
Thrombocytopenia
Explanation - Zinc is essential for growth, immune function, and tissue repair; deficiency can impair these processes in children.
Correct answer is: Growth retardation and impaired wound healing
Q.14 Which clinical feature is more indicative of chronic malnutrition rather than acute malnutrition?
Stunted growth
Rapid weight loss
Edema
Fatigue
Explanation - Stunting reflects long-term nutritional deprivation, whereas acute malnutrition usually presents with wasting and edema.
Correct answer is: Stunted growth
Q.15 A child presents with pale conjunctiva, brittle nails, and fatigue. The most likely nutritional deficiency is:
Iron deficiency
Vitamin D deficiency
Vitamin A deficiency
Folic acid deficiency
Explanation - Iron deficiency anemia presents with pallor, fatigue, and nail changes due to decreased hemoglobin synthesis.
Correct answer is: Iron deficiency
Q.16 Which is the most appropriate nursing care for a child receiving enteral feeding due to severe malnutrition?
Monitor tolerance, maintain hygiene, and assess residuals
Provide unlimited feeding at once
Withhold water during feeding
Avoid monitoring for complications
Explanation - Careful monitoring of enteral feeding is critical to prevent complications like aspiration, diarrhea, and electrolyte imbalance.
Correct answer is: Monitor tolerance, maintain hygiene, and assess residuals
Q.17 Which condition results from vitamin D deficiency in infants and children?
Rickets
Scurvy
Goiter
Marasmus
Explanation - Vitamin D deficiency impairs calcium and phosphate metabolism, leading to weak and deformed bones, known as rickets.
Correct answer is: Rickets
Q.18 Which dietary advice is most appropriate for preventing dental caries in children?
Limit sugary foods and encourage fluoride use
Increase sugary snacks
Avoid all dairy products
Encourage only soft drinks
Explanation - Reducing sugar intake and promoting fluoride exposure helps prevent dental caries in children.
Correct answer is: Limit sugary foods and encourage fluoride use
Q.19 A child with marasmus is likely to exhibit:
Severe muscle wasting and thin extremities
Edema and moon face
Enlarged liver
Hyperpigmented skin lesions
Explanation - Marasmus leads to severe wasting due to total calorie deficiency, with prominent muscle and fat loss but no edema.
Correct answer is: Severe muscle wasting and thin extremities
Q.20 Which is the first sign of vitamin C deficiency in children?
Bleeding gums
Night blindness
Brittle nails
Bone deformities
Explanation - Vitamin C deficiency leads to scurvy, which initially manifests as bleeding gums, petechiae, and delayed wound healing.
Correct answer is: Bleeding gums
Q.21 The most important nursing priority for a child with severe acute malnutrition is:
Preventing infection and providing careful nutritional rehabilitation
Encouraging strict diet restriction
Avoiding fluid intake
Excessive physical activity
Explanation - Children with severe malnutrition are highly susceptible to infections and require careful refeeding to avoid complications.
Correct answer is: Preventing infection and providing careful nutritional rehabilitation
Q.22 Which condition is characterized by edema, irritability, and a distended abdomen due to malnutrition?
Kwashiorkor
Marasmus
Rickets
Scurvy
Explanation - Kwashiorkor results from severe protein deficiency and presents with edema, irritability, a distended abdomen, and skin/hair changes.
Correct answer is: Kwashiorkor
Q.23 Which assessment finding is most likely in a child with vitamin D deficiency?
Delayed closure of fontanelles
Bowed legs and delayed walking
Pale conjunctiva
Dry hair and hair loss
Explanation - Vitamin D deficiency impairs bone mineralization, causing rickets, which presents with bowed legs and delayed milestones.
Correct answer is: Bowed legs and delayed walking
Q.24 Which mineral is critical for cognitive development and immune function in children?
Zinc
Calcium
Sodium
Potassium
Explanation - Zinc deficiency can impair growth, cognitive development, and immune function, making supplementation important in malnourished children.
Correct answer is: Zinc