Which of the following classifications of Protein-Energy Malnutrition classifies a weight of more than 90% of the expected weight for that age as normal?

Appeared in: DSSSB -28 August 2019 (Shift-2)

Explanation

The Gomez classification is a system used to grade Protein-Energy Malnutrition (PEM) based on a child's weight-for-age.
It calculates the child's current weight as a percentage of the median (50th percentile) weight for a healthy child of the same age.
According to this system, a weight greater than 90% of the expected weight is classified as 'Normal' nutritional status.
Malnutrition is then graded as Mild (Grade I: 76-90%), Moderate (Grade II: 61-75%), and Severe (Grade III: <60%).

Option A: Syndromal classification is based on the presence of specific clinical signs and symptoms, such as edema (Kwashiorkor) or severe wasting (Marasmus), not on a percentage of expected weight.
Option B: The WHO classification, which is the current standard, uses Z-scores (standard deviations from the median) for weight-for-height, height-for-age, and weight-for-age. It does not use a simple percentage cut-off like >90%.
Option D: The Indian Academy of Paediatrics (IAP) classification also uses weight-for-age percentages, but it sets the cut-off for 'normal' at greater than 80% of the expected weight, not 90%.

Clinical Relevance

Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Classification systems for Protein-Energy Malnutrition (PEM) as background academic context rather than a clinical decision trigger.
Accurate classification of malnutrition is crucial for determining the severity of the condition, planning appropriate nutritional intervention, and monitoring the child's response to treatment.
While Gomez and IAP classifications are historically significant and easy to use for community-level screening, the WHO Z-score system is preferred in clinical settings for its higher accuracy and ability to differentiate between acute (wasting) and chronic (stunting) malnutrition.
A nurse must be familiar with all these classifications, as they may be used in different healthcare settings or appear in examinations. Understanding the basis of each (weight-for-age %, Z-score, clinical signs) is key.

How to Approach the Question

First, identify the core components of the question: it's asking for a specific classification of Protein-Energy Malnutrition.
Note the key criterion given: 'weight of more than 90% of the expected weight for that age as normal'.
This is a factual recall question. You need to access your knowledge of the different PEM classification systems.
Systematically review each option:
Recall or deduce that Syndromal classification is based on clinical signs, not percentages.
Recall that the modern WHO classification uses Z-scores, not simple percentages.

Concept Tested & Keywords

Concept Tested: Classification systems for Protein-Energy Malnutrition (PEM)
Stem keywords: Protein-Energy Malnutrition, classification, weight, 90%, expected weight, normal
Lead-in keywords: Which of the following

Q1niKKF5eE3i_WJUs9NBrP

E6 Nutrition Monika Sharma 3e p. 222-224

E6 Text Book Of Pediatric Nursing 3rd Panchali Pal — Part 3 (pp 477-702 of 713) p. 37-39

E6 Nelson Textbook of Pediatrics(2024) — Volume 1 p. 468-470

Practise the full DSSSB -28 August 2019 (Shift-2)

Attempt every question from this paper in a timed mock, then review the full solution for each one.