PSYCHOSOCIAL ISSUES AND CHILD ABUSE

Question 1

Factors that determine the understanding of death and expression of grief

Answer 1

Chronologic age and levels of cognitive
development

Question 2

What are the most helpful measures for children in cases of divorce?

Answer 2

Regular schedule with flexibility
Consistency with structure and routine
Cooperative co-parenting

Question 2

What does exposure to high levels of parental
conflict lead to?

Answer 2

Predictive of poor emotional adjustment by the
child regardless of the parents’ marital status

Question 3

Consequences of divorce on a child’s emotional
adjustment

Answer 3

May affect his/her subsequent intimate
relationships

Question 4

Consequences of adoption on children from
institutional or orphanage care

Answer 4

A higher risk of medical and developmental
problems than their counterparts who have
resided in foster care

Question 5

TV watching is not recommended at what age?

Answer 5

Children younger than 2 years of age

Question 6

Child is being placed in foster care; how soon
should this child be evaluated by a provider?

Answer 6

Initial visit should take place within 72 h after
placement in the foster care system

Question 7

How long should children 2 years and older be
allowed to watch TV?

Answer 7

2 h/day or less for all children, including other
forms of screen (solitary TV watching is highly
discouraged)

Question 8

One of the most common causes of school refusal in children

Answer 8

Separation anxiety disorder

Question 9

Increased aggressive behavior and acceptance of violence, obscuring of the distinction between fantasy and reality, trivialization of sexuality are effects of

Answer 9

Excessive media time

Question 10

A set of clinical features in which unfounded
parental anxiety about the health of a child results in disturbances of the parent–child interaction

Answer 10

Vulnerable child syndrome

Question 11

At what age should discussions start regarding
transition of care for adolescents and young adults with chronic medical conditions?

Answer 11

Around 12 years of age

Question 11

A child tends to have asynchronous developmental patterns, very advanced in one domain area compared to the rest

Answer 11

Gifted child

Question 12

Maternal depression, substance use/abuse, and
physical injuries

Answer 12

May indicate intimate partner violence

Question 13

A frequent risk factor for child abuse

Answer 13

Intimate partner violence

Question 14

Consequences of children who are exposed to
corporal punishment and intimate partner violence

Answer 14

More likely to exhibit aggressive/violent
behaviors than other children

Question 15

What is the most common form of child abuse?

Answer 15

Neglect

Question 16

What is the most common presentation in an
abused child?

Answer 16

Asymptomatic—just because there are no
physical signs does not mean that the child has
not been abused

Question 17

What is the most common cause of head injury in a child less than 1 year of age?

Answer 17

Child abuse

Question 18

A 3-week-old girl presents to ER with lethargy,
poor sucking, and retinal hemorrhages; mother
stated the child rolled over and fell from the bed. What is the most likely cause?

Answer 18

Abusive head trauma (shaken baby syndrome)

Question 19

Parents or guardians who failed to provide
adequate medical care for a child, e.g., refused to administer medications for a serious medical
condition

Answer 19

Medical neglect

Question 19

What are the consequences of child abuse during early development?

Answer 19

Physiologic and anatomic changes in the brain,
increased risk of physical and behavioral
problems

Question 20

Parents or guardian fail to provide basic needs
(nutrition, shelter, clothes) or who abandon the
child

Answer 20

Physical neglect

Question 21

Parents or guardian fail to enroll the child in school or provide homeschooling, allow frequent absenteeism, or ignore special education needs

Answer 21

Educational neglect

Question 22

Parents or guardian isolate the child, withhold emotional support, expose the child to interpersonal violence or substance abuse, e.g., fight or engage in sex in front of the child

Answer 22

Emotional neglect

Question 22

Parents or guardian leave the child alone or improperly supervised, fail to keep the child from safety hazards, e.g., leaving strong chemicals open and not safely secured in the house

Answer 22

Supervision neglect

Question 22

Posterior rib fracture, bucket handle fracture, femur fracture in child less than 1 year old, distal humeral physeal fracture, and humeral shaft fracture in child less than 3 years old are high suspicion of

Answer 22

Child abuse

Question 23

Bucket handle fracture (also known as a classic metaphyseal fracture or metaphyseal corner fracture) in infants

Answer 23

High specificity for child abuse. It may occur with shaking, vigorous pulling or twisting of an infant’s extremity

Question 24

What is the next best step with any suspicion of child abuse in a child less than 2 years of age?

Answer 24

Skeletal survey

Question 25

Difference between bucket handle fractures and buckle fractures

Answer 25

Fracture of the distal radius (buckle fracture) is common and is not associated with child abuse

Question 26

A 7-month-old healthy infant with a few bruises on arms and legs

Answer 26

Must be evaluated for child abuse and reported to child protective services

Question 27

A 7-year-old healthy child with multiple bruises on both tibial shins and elbows

Answer 27

Reassurance

Question 28

Entire foot is burned, with a well-demarcated line of injury around the leg and absence of splash marks (stocking distribution)

Answer 28

Child abuse (possible forced immersion into hot water)

Question 29

Entire hand is burned, with a well-demarcated line of injury around the forearm and absence of splash marks (glove distribution)

Answer 29

Child abuse (possible forced immersion into hot water)

Question 30

What is the most common physical examination finding in a child with sexual abuse?

Answer 30

Normal examination

Question 31

Physical contact between the victim and the perpetrator, with or without oral, anal, or vaginal penetration

Answer 31

Child sexual abuse

Question 32

Which gender is less likely to disclose sexual abuse and might be victimized more often than the reported ratio

Answer 32

Boys

Question 33

A 16-year-old adolescent presents to the ER due to a sexual assault that occurred 1 day ago, what should be done?

Answer 33

SANE exam—should be done by a specialized nurse. The cutoff for exam 72–120 h (within 5 days)

Question 34

What is the SANE exam?

Answer 34

Exam performed by a Sexual Assault Nurse Examiner who examines the victim of sexual assault and collects all forensic evidence

Question 35

A healthy child with multiple recurrent ER visits; the mother is a healthcare professional who demands tests and imaging with each visit; before discharge patient’s blood glucose is 40 mg/ dL. Further evaluation shows high serum insulin level and absence of serum C-peptide level

Answer 35

Caregiver-fabricated illness