Free Childhood Nutrition and Malnutrition MCQs with Answers

• A. Exclusive breastfeeding without water or other foods
• B. Breastfeeding with regular diluted fruit juice
• C. Formula feeding with added cereal from birth
• D. Breastfeeding with animal milk after one month

Explanation: Exclusive breastfeeding means giving only breast milk, including no water, for the first 6 months when possible.

• A. Offer thick, mashed foods while continuing breastfeeding
• B. Give only clear soup until the child is one year old
• C. Replace breast milk with diluted cow's milk
• D. Add salt and sugar to every meal for extra energy

Explanation: At about 6 months, breast milk is continued while thick, mashed, nutrient-dense complementary foods are introduced gradually.

• A. Severe wasting with marked loss of subcutaneous fat
• B. Bilateral pitting oedema with a rounded face
• C. Generalised oedema with fatty liver enlargement
• D. Depigmented hair with a flaky skin rash

Explanation: Marasmus is severe energy deficiency causing extreme wasting and loss of fat and muscle, usually without oedema.

• A. Kwashiorkor
• B. Marasmus
• C. Iron deficiency anaemia
• D. Vitamin D deficiency

Explanation: Kwashiorkor is severe protein deficiency and commonly presents with bilateral oedema, hair changes, apathy, and skin abnormalities.

• A. Vitamin A deficiency
• B. Iron deficiency
• C. Vitamin D deficiency
• D. Iodine deficiency

Explanation: Night blindness and xerosis of the conjunctiva are early signs of vitamin A deficiency.

• A. Give iron-rich foods with a source of vitamin C
• B. Give tea with meals to improve iron absorption
• C. Use mainly polished rice and refined flour
• D. Avoid meat, pulses, and green leafy vegetables

Explanation: Meat, pulses, and green leafy vegetables provide iron, while vitamin C improves absorption of non-haem iron.

• A. Vitamin D deficiency
• B. Vitamin A deficiency
• C. Iron deficiency
• D. Iodine deficiency

Explanation: These findings are typical of rickets caused by impaired bone mineralisation, most often related to vitamin D deficiency.

• A. Iodine deficiency
• B. Vitamin C deficiency
• C. Iron deficiency
• D. Vitamin D deficiency

Explanation: Iodine deficiency can enlarge the thyroid, producing goitre, and can impair brain development and learning.

• A. The child is underweight for age
• B. The child has wasting for height
• C. The child has stunting for age
• D. The child has nutritional oedema

Explanation: Weight-for-age below the expected range indicates underweight, but it cannot by itself distinguish wasting from stunting.

• A. Check blood glucose and prevent further heat loss
• B. Start vigorous exercise to improve muscle strength
• C. Give a large high-protein meal immediately
• D. Restrict fluids to prevent nutritional oedema

Explanation: Lethargy and cold skin in severe malnutrition may indicate hypoglycaemia and hypothermia, both life-threatening problems.

• A. Carbohydrate, providing 4 kilocalories per gram
• B. Protein, providing 4 kilocalories per gram
• C. Fat, providing 9 kilocalories per gram
• D. Vitamin, providing 9 kilocalories per gram

Explanation: Fat provides 9 kilocalories per gram, while carbohydrate and protein provide about 4 kilocalories per gram.

• A. It is rich in antibodies and helps protect the newborn
• B. It contains more calories than mature milk
• C. It prevents all newborn infections during the first month
• D. It supplies enough iron for the first year of life

Explanation: Colostrum contains immunoglobulins and other protective factors that support the newborn's immature immune system.

• A. Offer only diluted fruit juice between breastfeeds
• B. Offer soft mashed foods with increasing texture and variety
• C. Offer unmodified cow's milk as the main drink
• D. Offer tea with meals to improve appetite

Explanation: By 10 months, the child should receive varied, energy-dense family foods with gradually increasing texture, while breastfeeding continues.

• A. Only the foods the child likes most
• B. All foods, drinks, portions, and times consumed
• C. Only the number of meals eaten outside the home
• D. Only the family's estimate of the child's appetite

Explanation: A 24-hour recall is useful only when it includes all foods and drinks, approximate amounts, and the time of intake.

• A. Wasting from recent or acute undernutrition
• B. Stunting from long-term undernutrition
• C. Isolated iodine deficiency with goitre
• D. Excess body weight from overnutrition

Explanation: Low weight-for-height indicates wasting, which commonly reflects acute or recent undernutrition.

• A. Reassure the caregiver because the child has no fever
• B. Review feeding, illness history, and the growth trend
• C. Start an iron injection without further assessment
• D. Advise stopping breastfeeding until weight improves

Explanation: A weight plateau requires assessment of the complete growth trend, feeding practices, and recent illness before planning care.

• A. Stop solid foods until the stools become normal
• B. Continue breastfeeding and offer small frequent meals
• C. Give only clear fluids for the next several days
• D. Replace meals with sweetened carbonated drinks

Explanation: Breastfeeding and age-appropriate foods should continue during diarrhoea, with small frequent meals if appetite is reduced.

• A. Bleeding gums and poor wound healing
• B. Night blindness and Bitot spots
• C. Widened wrists and delayed dentition
• D. Neck swelling with reduced thyroid function

Explanation: Vitamin C deficiency can cause bleeding gums, poor wound healing, and increased bruising because collagen formation is impaired.

• A. Serve the meal with tea after eating
• B. Add a vitamin C-rich food such as orange or guava
• C. Give the meal with a large glass of milk
• D. Cook the meal only with extra salt

Explanation: Vitamin C improves absorption of non-haem iron from plant foods, so fruit such as orange or guava can be served with the meal.

• A. Begin large high-calorie meals immediately
• B. Start prescribed feeds cautiously and monitor the child closely
• C. Withhold all feeds for 24 hours to rest the intestine
• D. Give a high-protein diet without checking clinical status

Explanation: Children with severe undernutrition require cautious, prescribed feeding with close monitoring during initial rehabilitation.