Chapter 01: Health Status of Children: Global and National Perspectives
Garzon Maaks: Burns’ Pediatric Primary Care, 7th Edition

MULTIPLE CHOICE

	1.	Which region globally has the highest infant mortality rate?
a.	Indonesia	
b.	Southern Asia	
c.	Sub-Saharan Africa	
d.	Syria	

ANS:	B
Although Sub-Saharan Africa and Southern Asia together account for 77% of the infant mortality rate globally, Southern Asia has the highest infant mortality rate (39%) in the world followed closely by Sub-Saharan Africa (38%).

	2.	The primary care pediatric nurse practitioner understands that, to achieve the greatest world-wide reduction in child mortality from pneumonia and diarrhea, which intervention is most effective?
a.	Antibiotics	
b.	Optimal nutrition	
c.	Vaccinations	
d.	Water purification	

ANS:	C
Rotavirus is the most common cause of diarrhea globally and Strep pneumonia is the leading cause of pneumonia, and together these are the leading infectious causes of childhood morbidity and mortality globally. Both are vaccine-preventable diseases. Antibiotics to treat pneumonia, optimal nutrition, and clean water all help to reduce morbidity and mortality, but vaccination prevents the diseases from occurring.

	3.	Which statement correctly reflects the health status of children in the United States?
a.	Globalism has relatively little impact on child health measures in the U.S.	
b.	Obesity rates among 2- to 5-year-olds have stabilized below Health People 2020 goal of 9.4%.	
c.	The rate of household poverty is lower than in other economically developed nations.	
d.	Young children who attend preschool or day care have higher food insecurity.	

ANS:	B
Obesity rates are a major concern for child health in the U.S. but recently have stabilized at 8.9%. Globalism has an increasing effect on child health in the U.S. The rate of household poverty in the U.S. is higher than in other economically developed nations. Young children who attend preschool or day care have lower food insecurity.

	4.	The primary care pediatric nurse practitioner understands that what major child health outcome is dramatically associated with worldwide climate change?
a.	Housing	
b.	Education	
c.	Nutrition	
d.	Pollution	

ANS:	C
There is growing evidence that climate change is having a dramatic effect on food crops that leads to food distribution issues and food insecurity among families.

	5.	When providing well child care for an infant in the first year of life, the primary care pediatric nurse practitioner demonstrates an understanding of current guidelines when taking what action?
a.	Focusing less on development and more on illness prevention and nutrition.	
b.	Following guidelines established by the Bright Futures publication.	
c.	Scheduling well-baby visits to coincide with key developmental milestones.	
d.	Seeing the infant at ages 2, 4, 6, and 12 months when immunizations are due.	

ANS:	C
In the most recent AAP Recommendations for Preventive Pediatric Health Care, there is a greater emphasis on behavioral and developmental issues and a recommendation that well child care be based on child and family development rather than the periodicity of immunization schedules.