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A female athlete experiences anaphylaxis during a soccer game. The only significant history is
that she had lunch about 1 hour before the incident. Food-dependent exercise-induced
anaphylaxis is diagnosed. Of the following, the MOST likely cause is:
chocolate milkshake
pineapple
tomatoes
whole wheat bread
whole wheat bread
Exercise is a known co-factor in some children who experience anaphylaxis. Food-dependent
exercise-induced anaphylaxis (FDEIA) is defined as a food induced allergic reaction that occurs
during or soon after exercise. Children should not exercise within 2-3 hours of ingesting the
triggering food. Nuts, wheat, apples, bananas, kiwi, peaches and eggs frequently are the cause for
anaphylaxis.
A healthy 24 month old can be expected to have achieved which of the following language
milestones?
counts three objects correctly
speaks using 30 - 50 words
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states full name
tells a story
speaks using 30 - 50 words
Utilizing the Early Language Milestone Scale, beginning at the age of 11 months and continuing
to 24 months of age, the child should have a vocabulary of 50 words. This child should be able to
put words together in short, 2 - 3 word sentences and name at least one object in a picture. The
child at age 3 - 4 years will be able to tell a short story and begin to count. A 2 year old may
know his first name, but usually cannot state full name until he/she is older.
Which is the MOST important safety question to ask a 17 year old?
"Are you aware of ways to avoid accidents?"
"Do you play violent video games more than 2 hours a day?"
"Do you always wear a seat belt when driving or riding in a car?"
"Is there a gun anywhere in your house?"
"Do you always wear a seat belt when driving or riding in a car?"
Motor vehicle accidents are the leading cause of death among children in the United States, with
78% of all unintentional injury deaths related to MVA among adolescents. When correctly used,
restraint systems can prevent fatalities and reduce the number and severity of injuries to children
and adolescents. As adolescents begin to drive and carry peer passengers, it is especially
important to remind them of basic safety issues, including the use of seat belts, emphasizing the
danger of driving, drinking and drug use as well as appropriate behavior while in the car.
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Reinforcing pedestrian safety is another important issue with adolescents. Firearm injuries have
decreased over recent years, especially among older children, and there is no link between
violent video games and increased accidents.
The parent of an 8 month old, reports switching the baby's formula to cow's milk due to the
continued expense of formula. Which is the BEST response?
Cow's milk does not contain adequate nutrition, and poses a higher risk for allergy.
Cow's milk has a lower protein and fat content, which will impede growth of the baby.
Switching to cow's milk sooner than 1 year will not cause any harm.
There is no need to continue formula as long as the child is receiving other baby foods.
Cow's milk does not contain adequate nutrition, and poses a higher risk for allergy.
During the first year of life, infants should receive only formula or breast milk. The use of cow's
milk is contraindicated because of its high protein content, inappropriate nutrition composition,
especially lack of iron sources, and the risk of gastrointestinal bleeding and allergic reactions. If
an infant is switched sooner than one year, the practitioner should encourage the family to
resume use of formula or breast milk until the one year birthday. Despite the addition of table
foods or baby solid foods, formula and breast milk are still the dietary mainstay.
A 10 month old has had apparent abdominal pain for the past 4 hours. During episodes of pain,
the infant screams inconsolably and draws his legs towards the abdomen, has vomited twice, but
has had no diarrhea. Between episodes the infant is calm and quiet. The MOST likely diagnosis
is:
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Meckel's adiverticulum
intussusception
acute aappendicitis
acute agastroenteritis
a intussusception
Acute aonset aof aabdominal apain arequires aimmediate ainvestigation. aThe anurse apractitioner amust abe
aable ato adistinguish abetween aconditions athat acan asafely abe amanaged aat ahome aand athose arequiring
immediate areferral. aMeckel's adiverticulum ausually ainvolves apainless arectal ableeding. aAcute
appendicitis acan aoccur ain ainfants aand amust abe aconsidered ain athe adifferential adiagnosis. aThe apain
ahistory aof aacute aappendicitis ais ausually amore acontinuous, aand athere ais ano apalpable amass. aAcute
gastroenteritis amay ainvolve aintermittent apain aand acramping, abut amore atypically athe achild aappears
aill, aand avomiting aand adiarrhea aplay aa amore aprominent arole. aThe apain aof aintussusception ais avery
severe, awith aperiods aof awell-being ain abetween. aThere ais afrequently avomiting, ahowever astools
initially aare anormal. aLater astools acan abe alike ared ajelly ain aappearance. aA asausage ashaped amass ais
afrequently apalpable ain athe aright aupper aquadrant aand aaids ain adiagnosis.
For athe aparents aof aan a8 amonth aold, athe aMOST aappropriate aage-related aanticipatory aguidance
aregarding asafety aincludes awhich aof athe afollowing?
cover aelectrical aoutlets, akeep asmall aobjects aout aof areach, aturn acar aseat ato aforward-facing aposition
keep amedications aout aof areach, acontinue ato ause acar aseat ain arear-facing aposition, acover aelectrical
aoutlets