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CPN CPE MMT practice questions

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Question 1Pediatric Nutrition Assessment

A 4-year-old child is being screened for malnutrition. Which single measurement is the most appropriate index of acute (wasting) malnutrition in this age group?

  1. Head circumference-for-age z-score
  2. Mid-upper arm circumference-for-age percentile only
  3. Weight-for-height or BMI-for-age z-score Correct answer.
  4. Height-for-age z-score

Explanation

Weight-for-height (or BMI-for-age in children over 2 years) reflects current body mass relative to stature, so it falls when weight is lost acutely. Height-for-age is a cumulative index that reflects chronic stunting rather than recent wasting.

Question 2Pediatric Nutrition Assessment

A pediatric dietitian plots a 7-year-old's weight and height on a WHO/CDC growth chart. The BMI-for-age z-score is +3.2. Using WHO classification, how is this best described?

  1. Thinness
  2. Overweight
  3. Obesity Correct answer.
  4. Normal weight

Explanation

For children aged 5-19 years, WHO defines overweight as BMI-for-age above +1 SD and obesity as above +2 SD. A z-score of +3.2 therefore falls clearly in the obesity category.

Question 3Pediatric Nutrition Assessment

Which laboratory marker is most commonly used to screen for iron deficiency in a young child before anemia develops?

  1. Hemoglobin concentration
  2. Serum folate
  3. Serum ferritin Correct answer.
  4. Mean corpuscular volume

Explanation

Serum ferritin reflects body iron stores and falls before hemoglobin drops, making it the preferred early screen for iron depletion. Hemoglobin and MCV change later, once iron deficiency has progressed to anemia.

Question 4Pediatric Nutrition Assessment

A nurse measures a 2-year-old's length using a recumbent board. Which practice best ensures an accurate measurement?

  1. Measure the child in a seated position on a standard scale
  2. One person holds the child upright and marks the wall
  3. The child stands against a wall-mounted stadiometer
  4. Two trained people hold the child's head against the fixed board and extend the legs Correct answer.

Explanation

Recumbent length requires two trained measurers: one holds the head against the fixed headboard while the other extends the legs and brings the footboard to the heels. Standing measurements are inaccurate under age 2 because children cannot stand fully erect.

Question 5Pediatric Nutrition Assessment

A 6-month-old exclusively breastfed infant has not received iron-rich complementary foods. Which finding most strongly suggests depleted iron stores?

  1. Low serum ferritin with normal hemoglobin Correct answer.
  2. Elevated serum ferritin
  3. Elevated mean corpuscular volume
  4. Low serum folate

Explanation

Breast milk is low in iron, and stores from the mother are largely depleted by around 6 months. A low ferritin with normal hemoglobin indicates iron depletion before anemia, which is the expected early finding.

Question 6Pediatric Nutrition Assessment

Which growth reference is recommended by WHO for assessing children from birth to 5 years?

  1. National reference charts for term infants
  2. WHO Child Growth Standards Correct answer.
  3. CDC 2000 growth charts
  4. Fenton preterm charts

Explanation

WHO recommends its Child Growth Standards for children from birth to 5 years because they describe how healthy children should grow under optimal conditions. CDC 2000 charts are used for children aged 2 years and older in some settings but are not the WHO standard for under-fives.

Question 7Pediatric Nutrition Assessment

A 3-year-old presents with pitting edema of both feet, a distended abdomen, and a low serum albumin. Which form of severe acute malnutrition does this most likely represent?

  1. Marasmus
  2. Stunting
  3. Moderate acute malnutrition
  4. Kwashiorkor Correct answer.

Explanation

Bilateral pitting edema with hypoalbuminemia is the defining feature of kwashiorkor, a form of edematous severe acute malnutrition. Marasmus is characterized by severe wasting without edema.

Question 8Pediatric Nutrition Assessment

Which of the following is an appropriate screening tool for identifying children at risk of malnutrition in a hospital setting?

  1. The Glasgow Coma Scale
  2. The Braden Scale
  3. The Mini Nutritional Assessment (MNA)
  4. STAMP (Screening Tool for the Assessment of Malnutrition in Paediatrics) Correct answer.

Explanation

STAMP is a validated pediatric malnutrition screening tool designed for hospitalized children. The MNA is for older adults, and the Braden and Glasgow scales assess pressure injury risk and consciousness, respectively.

Question 9Pediatric Nutrition Assessment

A 10-year-old is being assessed for malnutrition. Which combination of measurements best allows calculation of weight-for-height z-score?

  1. Height and mid-upper arm circumference
  2. Weight and height Correct answer.
  3. Weight and head circumference
  4. Weight and triceps skinfold

Explanation

Weight-for-height requires both weight and height to express body mass relative to stature. The other combinations do not yield a weight-for-height index.

Question 10Pediatric Nutrition Assessment

A 5-year-old's height-for-age z-score is -2.6, while weight-for-height is within normal limits. Which interpretation is most appropriate?

  1. Chronic malnutrition (stunting) with preserved current weight Correct answer.
  2. Normal growth
  3. Acute wasting with preserved height
  4. Obesity

Explanation

A low height-for-age with normal weight-for-height indicates chronic or past undernutrition (stunting) while current weight relative to height is preserved. Acute wasting would show a low weight-for-height.

Question 11Pediatric Nutrition Assessment

A child's mid-upper arm circumference is 12.5 cm. According to WHO/UNICEF guidance for children aged 6-59 months, how should this be classified?

  1. Normal nutritional status
  2. Moderate acute malnutrition
  3. Severe acute malnutrition Correct answer.
  4. At risk of overweight

Explanation

A MUAC below 115 mm in children aged 6-59 months indicates severe acute malnutrition. Values from 115 to 125 mm indicate moderate acute malnutrition, and above 125 mm is generally normal.

Question 12Pediatric Nutrition Assessment

A 9-month-old with severe acute malnutrition is admitted. Which initial assessment finding most strongly predicts increased mortality risk?

  1. Temporary refusal of feeds
  2. Presence of bilateral pitting edema Correct answer.
  3. Moderate anemia
  4. Mild dehydration

Explanation

Edematous malnutrition (kwashiorkor) carries a higher mortality risk than non-edematous severe wasting. Edema signals severe protein-energy imbalance and metabolic derangement requiring careful management.

Question 13Pediatric Nutrition Assessment

A dietitian is interpreting a child's BMI-for-age. Which statement about BMI-for-age in children is correct?

  1. It uses the same fixed cut-offs as adults at all ages
  2. It replaces weight-for-height at all ages
  3. It is unaffected by pubertal stage
  4. It must be interpreted against age- and sex-specific reference data Correct answer.

Explanation

In children, BMI changes with age and sex, so it must be plotted against age- and sex-specific references rather than fixed adult cut-offs. Puberty also alters body composition and BMI trajectory.

Question 14Pediatric Nutrition Assessment

A 12-month-old is being assessed. Which measurement is most useful for detecting failure to thrive related to chronic undernutrition?

  1. A single head circumference measurement
  2. A single mid-upper arm circumference measurement
  3. Serial weight-for-age and length-for-age measurements over time Correct answer.
  4. A single triceps skinfold measurement

Explanation

Failure to thrive is identified by a fall in growth trajectory, so serial weight and length measurements plotted over time are essential. Single measurements cannot reveal a change in growth velocity.

Question 15Pediatric Nutrition Assessment

Which laboratory finding is most consistent with iron deficiency anemia in a young child?

  1. Low hemoglobin, low MCV, low ferritin Correct answer.
  2. Low hemoglobin, high MCV, normal ferritin
  3. Normal hemoglobin, low MCV, high ferritin
  4. High hemoglobin, high MCV, high ferritin

Explanation

Iron deficiency anemia produces microcytic, hypochromic red cells with depleted stores, so hemoglobin and MCV are low and ferritin is low. High ferritin would suggest adequate or excess iron stores.

Question 16Pediatric Nutrition Assessment

A 2-year-old is measured standing for the first time. The recorded height is 1.5 cm shorter than the recumbent length taken the previous month. What is the most likely explanation?

  1. The child has a growth disorder
  2. Standing height is normally lower than recumbent length in young children Correct answer.
  3. The child has lost height due to malnutrition
  4. The scale is miscalibrated

Explanation

Recumbent length is typically about 0.7-1.5 cm greater than standing height in young children. Switching measurement methods can therefore create an apparent drop in height without any true growth faltering.

Question 17Pediatric Nutrition Assessment

A child with severe acute malnutrition is being assessed for hypoglycemia on admission. Which threshold is used to define hypoglycemia in this context?

  1. Blood glucose below 3 mmol/L (54 mg/dL) Correct answer.
  2. Blood glucose below 10 mmol/L (180 mg/dL)
  3. Blood glucose below 7 mmol/L (126 mg/dL)
  4. Blood glucose below 1 mmol/L (18 mg/dL)

Explanation

In severe acute malnutrition, hypoglycemia is defined as blood glucose below 3 mmol/L (54 mg/dL) and requires prompt treatment. Higher thresholds would misclassify many children, while the very low threshold would miss treatable cases.

Question 18Pediatric Nutrition Assessment

Which of the following best describes the purpose of a 24-hour dietary recall in pediatric nutrition assessment?

  1. To measure body composition directly
  2. To assess growth velocity over a year
  3. To diagnose micronutrient deficiency biochemically
  4. To estimate recent nutrient intake from a detailed report of foods consumed Correct answer.

Explanation

A 24-hour recall collects a detailed account of all foods and drinks consumed in the previous day to estimate nutrient intake. It does not measure body composition, diagnose deficiency, or assess long-term growth velocity.

Question 19Pediatric Nutrition Assessment

A 4-year-old is being screened with weight-for-age. The child's weight-for-age z-score is -1.0, but weight-for-height is -2.5. Which conclusion is most appropriate?

  1. The child has acute wasting despite a near-normal weight-for-age Correct answer.
  2. The child is overweight
  3. The child is stunted
  4. The child has no nutritional problem

Explanation

Weight-for-age can mask wasting when height is also reduced, so a low weight-for-height z-score indicates acute wasting even with a near-normal weight-for-age. This is why weight-for-height or BMI-for-age is preferred for detecting wasting.

Question 20Pediatric Nutrition Assessment

A 6-year-old refugee child is being assessed. Which finding best supports a diagnosis of stunting?

  1. Height-for-age z-score below -2 with normal weight-for-height Correct answer.
  2. BMI-for-age z-score above +2
  3. MUAC above 135 mm
  4. Weight-for-height z-score below -2 with normal height-for-age

Explanation

Stunting is defined by a height-for-age z-score below -2, reflecting chronic undernutrition, and it can coexist with normal current weight-for-height. Wasting would instead show a low weight-for-height.

Question 21Pediatric Nutrition Assessment

A 3-year-old is being assessed for edema. Which finding is required to confirm nutritional edema in severe acute malnutrition?

  1. Unilateral swelling of one ankle
  2. Facial puffiness only in the morning
  3. Bilateral pitting edema of both feet present for at least 3 days Correct answer.
  4. Edema that resolves with diuretics

Explanation

Nutritional edema in severe acute malnutrition is bilateral pitting edema of both feet that persists for at least 3 days. Unilateral or transient swelling suggests other causes.

Question 22Pediatric Nutrition Assessment

A 15-year-old presents with a BMI-for-age z-score of +2.6 and a waist-to-height ratio of 0.62. Which interpretation is most appropriate?

  1. Thinness requiring nutritional supplementation
  2. Normal growth with a muscular build
  3. Obesity with central adiposity conferring metabolic risk Correct answer.
  4. Stunting due to chronic undernutrition

Explanation

A BMI-for-age z-score above +2 indicates obesity, and a waist-to-height ratio above 0.5 signals central adiposity associated with metabolic risk. Together these findings support increased cardiometabolic risk.

Question 23Pediatric Nutrition Assessment

A 10-month-old with severe acute malnutrition has a MUAC of 11.0 cm and no edema. Which classification is correct?

  1. Normal nutritional status
  2. Edematous severe acute malnutrition
  3. Severe acute malnutrition, non-edematous (marasmus) Correct answer.
  4. Moderate acute malnutrition

Explanation

A MUAC below 115 mm with no edema defines non-edematous severe acute malnutrition, or marasmus. Edematous severe acute malnutrition would require bilateral pitting edema.

Question 24Pediatric Nutrition Assessment

A 2-year-old with severe acute malnutrition is being assessed. Which combination of findings best indicates a high risk of refeeding syndrome?

  1. Isolated mild anemia
  2. Elevated serum albumin
  3. Low serum phosphate, low potassium, and low magnesium after feeding begins Correct answer.
  4. High serum phosphate and high potassium

Explanation

Refeeding syndrome is characterized by a fall in phosphate, potassium, and magnesium as insulin drives intracellular uptake after feeding resumes. Monitoring and correcting these electrolytes before and during refeeding is essential.

Question 25Pediatric Nutrition Assessment

A 5-year-old's growth data show a height-for-age z-score of -1.0, weight-for-height z-score of -2.8, and MUAC of 12.0 cm. Which statement best summarizes the nutritional diagnosis?

  1. Acute wasting with relatively preserved linear growth Correct answer.
  2. Overweight with short stature
  3. Chronic stunting with preserved weight
  4. Normal growth with measurement error

Explanation

A low weight-for-height and low MUAC indicate acute wasting, while a height-for-age z-score of -1.0 is within the normal range, indicating relatively preserved linear growth. This pattern suggests recent rather than chronic undernutrition.

Question 26Pediatric Nutrition Assessment

A 6-month-old infant is brought to a nutrition clinic. The dietitian plots the infant's weight-for-length on the WHO growth standards. Which growth chart set is appropriate for this child?

  1. WHO weight-for-length charts for children under 2 years Correct answer.
  2. CDC BMI-for-age charts for children over 2 years
  3. CDC weight-for-length charts for children under 2 years
  4. WHO weight-for-height charts for children over 2 years

Explanation

WHO recommends its growth standards for children from birth to 5 years, including weight-for-length for children under 2 years. CDC charts are recommended for children aged 2 years and older in the United States. Using the correct chart set ensures accurate classification of nutritional status.

Question 27Pediatric Nutrition Assessment

A 2-year-old child is being assessed for nutritional edema. Which clinical finding is most consistent with bilateral pitting edema?

  1. Swelling that is limited to one ankle and resolves with elevation
  2. Swelling that is present only around the eyes upon waking
  3. Swelling that is warm, red, and painful to touch
  4. Swelling that is present on both feet and leaves a persistent indentation after firm pressure Correct answer.

Explanation

Nutritional edema in severe acute malnutrition is bilateral, pitting, and typically affects the feet and lower legs. The pitting nature means that firm pressure leaves an indentation. Unilateral, inflammatory, or periorbital swelling suggests other causes.

Question 28Pediatric Nutrition Assessment

A 4-year-old child is seen in a clinic. The dietitian calculates a mid-upper arm circumference (MUAC) of 13.0 cm. According to WHO/UNICEF guidance for children aged 6–59 months, how should this MUAC be classified?

  1. Normal nutritional status
  2. Moderate acute malnutrition Correct answer.
  3. At risk of malnutrition
  4. Severe acute malnutrition

Explanation

For children aged 6–59 months, a MUAC between 11.5 cm and 12.5 cm indicates moderate acute malnutrition, while a MUAC below 11.5 cm indicates severe acute malnutrition. A MUAC of 13.0 cm falls just above the moderate cutoff but below the normal threshold of 13.5 cm, so it is classified as moderate acute malnutrition.

Question 29Pediatric Nutrition Assessment

A 10-year-old child is being evaluated for obesity. The dietitian calculates a BMI-for-age z-score of +2.5. According to WHO classification, which category does this z-score represent?

  1. Underweight
  2. Normal weight
  3. Obesity Correct answer.
  4. Overweight

Explanation

WHO defines obesity in children aged 5–19 years as a BMI-for-age z-score greater than +2 standard deviations. A z-score of +2.5 therefore indicates obesity. Overweight is defined as a z-score between +1 and +2.

Question 30Pediatric Nutrition Assessment

A 3-year-old child is admitted with severe acute malnutrition. The child has a history of diarrhea and is lethargic. Which laboratory finding is most consistent with dehydration in this child?

  1. Elevated serum sodium Correct answer.
  2. Elevated serum potassium
  3. Low hematocrit
  4. Low blood urea nitrogen

Explanation

Dehydration in severe acute malnutrition often presents with hypernatremia due to water loss exceeding sodium loss, especially with diarrhea. Serum potassium may be low or normal, and hemoconcentration typically raises hematocrit and blood urea nitrogen. Therefore, elevated serum sodium supports dehydration.

Question 31Pediatric Nutrition Assessment

A 7-year-old child presents with poor growth. The dietitian plots height-for-age and weight-for-age. The height-for-age z-score is -2.8 and weight-for-age z-score is -1.5. Which interpretation best describes the child's growth pattern?

  1. Normal growth with constitutional short stature
  2. Wasting with a normal height
  3. Acute malnutrition with recent weight loss
  4. Stunting with relatively preserved weight Correct answer.

Explanation

A height-for-age z-score below -2 indicates stunting, reflecting chronic undernutrition. The weight-for-age z-score of -1.5 is above the stunting cutoff and suggests that weight is relatively preserved compared with height. This pattern is consistent with stunting rather than acute wasting.

Question 32Pediatric Nutrition Assessment

A 9-month-old infant is being assessed for failure to thrive. The dietitian plots weight-for-age and length-for-age. The weight-for-age z-score is -2.5 and length-for-age z-score is -1.0. Which pattern is most consistent with acute undernutrition?

  1. Wasting Correct answer.
  2. Underweight
  3. Normal growth
  4. Stunting

Explanation

Wasting is defined by a low weight-for-height or weight-for-length z-score, reflecting acute weight loss. In this infant, weight-for-age is low while length-for-age is relatively preserved, suggesting that weight is affected more than length. This pattern is characteristic of acute undernutrition, or wasting.

Question 33Pediatric Nutrition Assessment

A 12-year-old child is seen for a nutrition assessment. The dietitian measures a mid-upper arm circumference (MUAC) of 15.0 cm. Which statement about MUAC interpretation in this age group is correct?

  1. MUAC is a reliable indicator of nutritional status in children aged 5–18 years, with cutoffs similar to those for younger children. Correct answer.
  2. MUAC is only useful for detecting obesity in adolescents.
  3. MUAC is not recommended for children over 5 years because it does not correlate with BMI.
  4. MUAC should be adjusted for height when used in adolescents.

Explanation

MUAC is a validated anthropometric measure for children aged 5–18 years and correlates well with BMI and fat-free mass. Age-specific cutoffs exist, but the principle of MUAC as a proxy for nutritional status remains. It is not limited to younger children or to obesity screening.

Question 34Pediatric Nutrition Assessment

A 5-year-old child with severe acute malnutrition is being assessed for hypoglycemia. The child's blood glucose is 2.8 mmol/L (50 mg/dL). Which action is most appropriate according to WHO guidelines?

  1. Start a high-protein diet immediately
  2. Administer 10% glucose orally or by nasogastric tube immediately Correct answer.
  3. Give intravenous 50% glucose bolus
  4. Withhold feeds and recheck blood glucose in 2 hours

Explanation

WHO defines hypoglycemia in severe acute malnutrition as blood glucose below 3 mmol/L (54 mg/dL). Immediate treatment with 10% glucose orally or by nasogastric tube is recommended if the child can swallow. Intravenous 50% glucose is not used because it is too concentrated and can cause harm.

Question 35Pediatric Nutrition Assessment

A 2-year-old child is admitted with severe acute malnutrition. The child has a temperature of 35.0°C, lethargy, and a blood glucose of 2.5 mmol/L. Which combination of findings best indicates a high risk of mortality?

  1. Fever, irritability, and hyperglycemia
  2. Hypothermia, lethargy, and hypoglycemia Correct answer.
  3. Mild edema and normal activity
  4. Normal temperature, alertness, and normal glucose

Explanation

In severe acute malnutrition, the presence of hypothermia, lethargy, and hypoglycemia are danger signs that strongly predict mortality. These findings reflect severe metabolic and neurological compromise. Immediate treatment is required.

Question 36Pediatric Nutrition Assessment

A 6-month-old infant is exclusively breastfed. The mother reports that the infant has not gained weight adequately. The dietitian assesses breastfeeding and finds poor attachment. Which additional assessment is most important to identify inadequate milk intake?

  1. Serum albumin measurement
  2. Head circumference measurement
  3. Mid-upper arm circumference
  4. Test weighing before and after feeds Correct answer.

Explanation

Test weighing, which involves weighing the infant before and after breastfeeding, can estimate milk intake and is useful when inadequate intake is suspected. Serum albumin is not a reliable indicator of acute nutritional status, and MUAC and head circumference do not directly assess intake. Therefore, test weighing is the most specific method.

Question 37Pediatric Nutrition Assessment

A 4-year-old child is being assessed for iron deficiency anemia. Which laboratory parameter is most specific for iron deficiency in this age group?

  1. High red cell distribution width
  2. Low serum ferritin Correct answer.
  3. Low mean corpuscular volume
  4. Low hemoglobin

Explanation

Serum ferritin is the most specific indicator of iron deficiency because it reflects body iron stores. However, ferritin is an acute-phase reactant and may be elevated in inflammation. Hemoglobin and mean corpuscular volume are less specific because they can be affected by other conditions.

Question 38Pediatric Nutrition Assessment

A 10-year-old child with obesity is being assessed for metabolic syndrome. The dietitian calculates a waist-to-height ratio of 0.55. Which interpretation is most appropriate?

  1. The ratio is within the normal range for children.
  2. The ratio indicates increased central adiposity and cardiometabolic risk. Correct answer.
  3. The ratio suggests undernutrition.
  4. The ratio is not valid in children.

Explanation

A waist-to-height ratio above 0.5 is considered a marker of increased central adiposity and cardiometabolic risk in children and adolescents. A ratio of 0.55 exceeds this threshold, indicating elevated risk. It is a valid and practical screening tool in pediatric populations.

Question 39Pediatric Nutrition Assessment

A 2-year-old child with severe acute malnutrition has a MUAC of 11.0 cm and no edema. According to WHO classification, which category does this child fall into?

  1. Moderate acute malnutrition
  2. Severe acute malnutrition Correct answer.
  3. Normal nutritional status
  4. At risk of malnutrition

Explanation

A MUAC below 11.5 cm in a child aged 6–59 months defines severe acute malnutrition, regardless of the presence of edema. A MUAC of 11.0 cm is below this cutoff, so the child has severe acute malnutrition. Moderate acute malnutrition is defined by a MUAC between 11.5 and 12.5 cm.

Question 40Pediatric Nutrition Assessment

A 3-year-old child is admitted with severe acute malnutrition. The child has a history of poor appetite, and the mother reports that the child has been eating very little for the past week. Which assessment finding is most important for determining the risk of refeeding syndrome?

  1. Low serum potassium
  2. Low serum magnesium
  3. Low serum sodium
  4. Low serum phosphate Correct answer.

Explanation

Refeeding syndrome is characterized by a rapid drop in serum phosphate, potassium, and magnesium after reintroduction of nutrition. Hypophosphatemia is the hallmark and most consistent early indicator. Therefore, monitoring serum phosphate is most important for assessing refeeding risk.

Question 41Nutrition Requirements and Growth

A 6-month-old exclusively breastfed infant is being assessed at a well-child visit. Which statement best reflects current pediatric nutrition guidance regarding iron at this age?

  1. Iron stores are typically depleted, so iron-rich complementary foods or supplementation should be introduced Correct answer.
  2. Iron requirements decrease after 6 months because growth velocity slows
  3. Breast milk supplies adequate iron, so no additional source is needed until 12 months
  4. Iron supplementation should be delayed until the infant begins cow's milk at 12 months

Explanation

Infants are born with iron stores that are largely depleted by about 4 to 6 months, while breast milk is low in iron. Current guidance therefore recommends introducing iron-rich complementary foods around 6 months, with iron supplementation considered in some exclusively breastfed infants. This prevents iron deficiency anemia during a period of rapid growth.

Question 42Nutrition Requirements and Growth

Which energy value is most appropriate for estimating the additional energy needs of a healthy, adequately nourished pregnant woman during the second trimester?

  1. No additional energy above pre-pregnancy requirements
  2. About 1,000 kcal/day above pre-pregnancy requirements
  3. About 340 kcal/day above pre-pregnancy requirements Correct answer.
  4. About 100 kcal/day above pre-pregnancy requirements

Explanation

Second-trimester pregnancy adds roughly 340 kcal/day to pre-pregnancy energy needs in well-nourished women, reflecting fetal growth and maternal tissue accretion. The first trimester adds essentially nothing, while the third trimester adds about 450 kcal/day. Values far outside this range are not consistent with standard pregnancy energy recommendations.

Question 43Nutrition Requirements and Growth

A term newborn weighs 3.3 kg at birth. Using the standard rule that term infants typically regain birth weight by about 2 weeks and lose up to 7-10% initially, what is the most expected weight at 10-14 days of life?

  1. About 3.3 kg, having regained birth weight Correct answer.
  2. About 3.0 kg, still below birth weight
  3. About 4.0 kg, reflecting rapid catch-up growth
  4. About 2.6 kg, reflecting a 20% loss

Explanation

Healthy term infants usually lose up to 7-10% of birth weight in the first days and regain it by roughly 10-14 days. A return to approximately 3.3 kg at this point is the expected pattern. Losses beyond about 10% or failure to regain by 2 weeks warrant feeding assessment.

Question 44Nutrition Requirements and Growth

Which anthropometric indicator is used to classify acute malnutrition in children aged 6-59 months according to WHO criteria?

  1. Mid-upper arm circumference only in children over 5 years
  2. Head circumference-for-age z-score
  3. Weight-for-height z-score Correct answer.
  4. Height-for-age z-score

Explanation

Weight-for-height reflects current body mass relative to stature and is the standard indicator for acute malnutrition, with z-scores below -3 indicating severe acute malnutrition. Height-for-age instead reflects chronic or past undernutrition (stunting). MUAC is also used for acute malnutrition but is applicable in young children, not only those over 5 years.

Question 45Nutrition Requirements and Growth

A 4-year-old child's weight-for-age is tracking consistently along the 15th percentile from age 1 to age 4. How should this growth pattern be interpreted?

  1. As faltering growth requiring immediate dietary intervention
  2. As evidence of stunting that requires height measurement to confirm
  3. As obesity risk because the percentile is below the 50th
  4. As a normal pattern of growth along a consistent percentile channel Correct answer.

Explanation

Children generally follow a stable percentile channel after the first 1-2 years of life. Consistent tracking along the 15th percentile indicates appropriate growth even though the child is below the median. Concern arises from crossing percentiles downward, not from a stable lower percentile.

Question 46Nutrition Requirements and Growth

Which nutrient is most critical to supplement in exclusively breastfed infants soon after birth to prevent deficiency-related bleeding?

  1. Iron
  2. Vitamin D
  3. Zinc
  4. Vitamin K Correct answer.

Explanation

Newborns have low vitamin K stores and breast milk is a poor source, so intramuscular vitamin K prophylaxis is given at birth to prevent vitamin K deficiency bleeding. Vitamin D supplementation is also recommended for breastfed infants but addresses rickets, not bleeding. Iron and zinc are addressed later through diet or supplementation.

Question 47Nutrition Requirements and Growth

Which statement correctly describes the energy content of human milk compared with standard infant formula?

  1. Human milk provides about 20 kcal/oz, similar to standard term formula Correct answer.
  2. Human milk energy content varies so widely that no average can be stated
  3. Human milk provides about 10 kcal/oz, half that of term formula
  4. Human milk provides about 40 kcal/oz, roughly double term formula

Explanation

Mature human milk and standard term infant formula both supply approximately 20 kcal per ounce (about 67 kcal/100 mL). This similarity allows interchangeable volume-based feeding guidance. Fat content varies within and between feeds, but the average energy density remains close to this value.

Question 48Nutrition Requirements and Growth

A 7-year-old child is being evaluated for obesity. Which measure is recommended for screening in this age group?

  1. Weight-for-length percentile
  2. Body mass index-for-age percentile Correct answer.
  3. Head circumference percentile
  4. Mid-upper arm circumference z-score

Explanation

For children aged 2 years and older, BMI-for-age percentile is the recommended screening tool for overweight and obesity. Weight-for-length is used in children under 2 years. MUAC and head circumference do not classify adiposity in school-aged children.

Question 49Nutrition Requirements and Growth

A 9-month-old infant consumes about 24 oz of formula daily plus complementary foods. Roughly what proportion of energy should complementary foods provide at this age?

  1. About 90%
  2. About 10%
  3. About 50% Correct answer.
  4. About 25%

Explanation

By around 9 months, milk feeds and complementary foods contribute roughly equal shares of energy, so complementary foods supply about half of intake. This reflects the transition from milk-dominant to mixed feeding. By 12 months, solid foods generally dominate.

Question 50Nutrition Requirements and Growth

A 2-year-old is described as having a weight-for-height z-score of -3.2 with no edema. How is this classified?

  1. Stunting
  2. Normal nutritional status
  3. Moderate acute malnutrition
  4. Severe acute malnutrition Correct answer.

Explanation

A weight-for-height z-score below -3 defines severe acute malnutrition in children, and the absence of edema does not change that classification (edema would also qualify as severe). Moderate acute malnutrition corresponds to z-scores between -3 and -2. Stunting is defined by low height-for-age rather than weight-for-height.