An -year-old child has excellent ideas in a class discussion, but what she records on paper is primitive and unsophisticated. She can spell well in isolation and understands rules of punctuation and capitalization, but in her own writing she makes multiple errors and mistakes in punctuation and capitalization. Her handwriting is legible, but writing is painfully slow. This girl most likely is having problems with

Correct Answer: B

Rationale: The issue described points to graphomotor difficulties, where fine motor skills required for writing lag behind cognitive abilities. While ideation and expressive language seem intact, the slow and error-prone writing process suggests a motor-related challenge.

Correct Answer: D

Rationale: Bacterial tracheitis is most commonly caused by Staphylococcus aureus, leading to severe airway obstruction.

Correct Answer: D

Rationale: Alkali therapy can cause hypernatremia and skin slough but not hyperkalemia. The other options are potential side effects.

Correct Answer: C

Rationale: Galactosemia does not typically cause hyperinsulinemic hypoglycemia

Correct Answer: C

Rationale: Alcohol consumption significantly increases the risk of drowning in adolescents by impairing judgment and motor coordination, which increases the likelihood of water-related accidents.