PED EXAM FNP QUESTIONS AND
ANSWERS
Agwellg12-year-
oldgchildgrecentlygarrivedgfromgSouthgAfricagpresentsgforgagschoolgphysical.gShe
greceivedgBCGgimmunizationgshortlygaftergbirthgandgisgupgtogdategwithgrequired
gimmunizations.gAgPPDgisgplacedgandgreadgatg48ghours.gLikelygfindingsginclude
gwhichgofgthegfollowing?g-gans-PositivegPPD,gchildgrequiresgagfollow-
upgchestgX-ray
ThegBCG,gorgbacilligCalmette-Guérin,gisgagvaccinegforgTB.gManygforeign-
borngpersonsghavegbeengvaccinatedgwithgthegBCGgvaccine,gespeciallygingcountri
esgwheregtheregisgaghighgincidencegofgTB.gItgisglikelygthatgthisgchildgwillghaveg
agpositivegPPDgtest.gItgisgnotgpossiblegtogdeterminegingthisgcase,ghowever,gifgt
hegchildghasgactivegTBgwithoutgagchestgX-ray.
Whatgbehaviorgingag2-year-oldgwouldgbegconsideredgworrisome?g-gans-
Unablegtogwalkgdownstairsgholdinggagrail:
Thegnursegpractitionergshouldgalwaysgbegawaregofgtypicalgexpectedggrowthgand
gdevelopmentgparameters.gAtgtwogyearsgofgage,gnormalgexpectedggrossgmotorg
skillsgincludeghavinggthegabilitygtogwalkgupgandgdowngstairsgwithoutgdifficulty.gT
hegchildgshouldgbegevaluatedgfurthergforgothergdelaysginggrossgmotor,gfinegmoto
r,gorglanguage/socialgskills.
BabygSabrinagpresentsgforgherg6gmonthgwellgchildgcheck-
up.gAtg40gweeksggestationghergdocumentedgbirthgweightgwasg6glbsg6goz,gandg
lengthgofg20ginches.gCurrentlyghergweightgisg10glbs,g4gozgandglengthgisg24ginc
hes.gThegnursegpractitionergconcludesgthegfollowing:g-gans-
Theginfantgisgfailinggtogmeetgexpectedggainsgingbothgweightgandglength.:
Infantsgageg0-
3gmonthsggaingapproximatelyg1.4ginchesgingheightgpergmonth.gBabygSabrinagwo
uldgbegexpectedgtoghavegachievedg24ginchesgingheightgbyg3gmonthsgofgage.gA
tg5-6gmonthsgofgage,ginfantsghavegusuallygdoubledgtheirgbirthgweight.
Duringgagsportsgphysicalgforgang18-year-
oldgmaleghighgschoolgstudent,gwhichgfindinggwouldgrequiregfurthergfollow-up?g-
gans-Tannergstagegofg4:
,Typically,gmalesgageg13-18gwillghavegdevelopedgtogTannergstageg5.gAng18-
year-
oldgmalegthatgisgingTannergstageg4gshouldgbegevaluatedgforgfurtherggrowthgand
gdevelopmentgdeficits.gScoliosisgofgthegspinegofg10-
15gdegreesgisggenerallygnotgconsideredgtogbegagproblemgunlessgthegpatientgex
pressedgconcerngorgdiscomfort.
Ag7-year-
oldgmalegchildgisgbroughtgtogthegclinicgbyghisgparentsgforgevaluation.gThegchild
ghasgnogsignificantgPMH.gApproximatelygsevengdaysgagoghegdevelopedgagcoldg
andgsincegthenghasghadgagpersistentgcoughgandgfever.gHisgoldergsistergwasgal
sogillgwithgcoldgsymptomsgatgthegsamegtime.gThegNPgperformsgagphysicalgexa
mgandgnotesgthatgthegchildghasgmildgtachypnea,gwithgcracklesgingbothgbasesga
ndgagpulsegoximetergofg90%.gHisgtemperaturegisg100.8g°F.gTheregaregnogwhee
zesgauscultated.gThegNPgsuspectsgthatgthegchildghasgwhichgofgthegfollowing?g-
gans-
Viralgpneumonia:gThegchildgpresentsgclinicallygwithgpneumonia.gViralgpneumoniag
generallyghasgaggradualgonsetgwithglessgacutegsymptomsgandgaglow-
gradegfever.gItgisgusuallygprecededgbyganguppergrespiratoryginfection.gWheezesg
aregnotgpresentgingchildrengwithgpneumonia.
"g7-year-
oldgmalegchildgisgbroughtgtogthegclinicgbyghisgparentsgforgevaluation.gThegchild
ghasgnogsignificantgPMH.gApproximatelygsevengdaysgagoghegdevelopedgagcoldg
andgsincegthenghasghadgagpersistentgcoughgandgfever.gHisgoldergsistergwasgal
sogillgwithgcoldgsymptomsgatgthegsamegtime.gThegNPgperformsgagphysicalgexa
mgandgnotesgthatgthegchildghasgmildgtachypnea,gwithgcracklesgingbothgbasesga
ndgagpulsegoximetergofg90%.gHisgtemperaturegisg100.8g°F.gTheregaregnogwhee
zesgauscultated."
WhatgdoesgthegFNPgexpectgtogfindgongauscultationgofgtheglungs?g-gans-
Cracklesgingagportiongofgaglunggfield,gnogwheezing:
gThegabsencegofgwheezinggisgagpositivegpredictorgforgchildrengwithgpneumonia.
"g7-year-
oldgmalegchildgisgbroughtgtogthegclinicgbyghisgparentsgforgevaluation.gThegchild
ghasgnogsignificantgPMH.gApproximatelygsevengdaysgagoghegdevelopedgagcoldg
andgsincegthenghasghadgagpersistentgcoughgandgfever.gHisgoldergsistergwasgal
sogillgwithgcoldgsymptomsgatgthegsamegtime.gThegNPgperformsgagphysicalgexa
mgandgnotesgthatgthegchildghasgmildgtachypnea,gwithgcracklesgingbothgbasesga
ndgagpulsegoximetergofg90%.gHisgtemperaturegisg100.8g°F.g
TheregaregnogwheezesgauscultatedgwhatgwillgthegFNPghavegasgpartgofgthegpla
ngofgcare?g-gans-
CXRgnow,gsupportivegcaregatghome;gcallgingonegdaygorgifganygworseninggofgsy
mptoms;greturngtogofficeging2gdaysgforgfollow-upgevaluation
,Allgchildrengwithgagdiagnosisgofgpneumoniagshouldgbegcarefullygmonitored.gTheg
childghasgagclassicgviralgpneumoniagpresentation,gwhichgtendsgtogbeglessgsever
egandgcangbegcaredgforgatghome.
Ag6-month-
oldgmalegisgbeinggseengwithghisgcaretakergforgagbarkinggcoughgwhichgisgmakin
ggthegcaretakerganxious.gThegbabygseemsgtoghavegmildgrespiratorygdistressgand
gthegoximetrygreadsgatg94%.gThegFNPgsendsgthegbabygforg-gans-Steeple-
shapedgappearancegwithgnarrowingginguppergairway
Childrengwithgcroupgwillgusuallygpresentgwithgagbrassygbarkgsoundinggcough,gin
spiratorygstridor,gandgagsteeplegsigng(orgwineglass)gappearancegongagchestgX-
ray.
thegmostgcommongorganismgresponsiblegforgotitisgmediagisgwhichgofgthegfollowi
ng?g-gans-Streptococcusgpneumonia
Streptococcusgpneumoniagisgthegmostgcommongorganismgresponsiblegforgotitisg
media.gAmoxicillin
remainsgthegfirstgchoicegofgtreatmentgforgotitisgmediagwithgagsuspectedgbacterial
getiology.
Ag19-year-oldgmothergbringsgherg2g1/2-month-old-
boygtogyourgclinicgwithgagconcerngthatgthegbabyghasgbecomeglessginterestedgin
ghisgfeedingsgovergthegpastg2gorg3gdays,gtakinggingonlygaboutghalfgthegnormal
gamountgofgformulagbeforegbecominggtiredgandgfallinggasleep.gHisgbirthghistorygi
sgnormalgandgheghasgnormalgdevelopmentgandgweightggain.gHisgtemperaturegis
g100.2g°Fg(axillary)gnow.gHeghasgnogrespiratorygsymptomsgandgyourgphysicalge
xaminationgrevealsgnogidentifiablegsourcegofgfever.gWhichgofgthegfollowinggquesti
ons/observationsgwouldgbegMOSTghelpfulgingestablishinggagdiagnosis?g-
gans-"Isganyonegelsegatghomegillgatgthisgtime?"
Thegchild'sgsymptomsgaregconsistentgwithgthegprodromalgphasegofgagviralgorgba
cterialginfection.gAskinggifgtheregaregsickgcontactsgwouldgprovidegthegmostgvalua
bleginformationgatgthisgpointgingtime.
Whichgofgthegfollowingginfantsgaregsusceptiblegtogrespiratorygsyncytialgvirusg(RS
V)gandgbronchitisgingthegfirstgyeargofglife?g-gans-Veryglowgbirthgweightginfants
AlthoughgallginfantsgaregatgriskgforgRSV,glowgbirthgweightginfants,ginfantsgyoung
ergthang6gmonthsgofgage,gprematureginfants,gandginfantsgwithgangunderlyinggco
nditiongsuchgasgheartgorglunggdiseasegaregatghighestgrisk.gBygtwogyearsgofgag
e,galmostgallgchildrengwillghaveghadgRSV.
Ag4-week-oldginfantgpresentsgtogthegofficegingmid-Januarygwithgagone-
weekghistorygofgnasalgcongestiongandgoccasionalgcough.gOngthegeveninggpriorgt
ogthisgvisit,gshegdevelopedgagtemperaturegofg102g°F,grefusedgtogbreastgfeed,gh
adgparoxysmalgcoughing,gandgnoisy,glaboredgbreathing.gPatientgisgangill-
appearingginfantgwhogisglethargicgwithgtachypneagandgintercostalgretractions.gShe
, ghasgag4-year-
oldgsiblinggwhogisgingdaygcaregandgwhogrecentlyghadgag"cold."gConsideringgthe
gclinicalgpresentation,gwhatgisgthegmostglikelygcausegofgthisginfant'sgillness?g-
gans-RSVgbronchiolitis
ThegchildghasgmanygriskgfactorsgassociatedgwithgRSV,gincludinggagsiblinggingda
ygcare,galonggwithgthegtimegofgyear.gThegchild'sgclinicalgpresentationgisgconsiste
ntgwithgRSVgbronchiolitis.
Ag9-year-
oldgchild'sgsymptomsgoccurgfourgtimesgagweekgduringgthegdaygandgthreegtimes
gduringgthegnight,gwithgangFEV1gofg80%.gWhatgwouldgbegthegseveritygclassifica
tiongpergthegNationalgAsthmagEducationgandgPreventiongProgram?g-gans-
Moderategpersistent
Thegchild'sgsymptomsgaregconsistentgwithgthegdiagnosisgofgmoderategpersistentg
asthmagpergthegGINAg(GlobalgInitiativegforgAsthma)gguidelines.
Ang8-year-
oldgmaleghasgmildgpersistentgasthma.gAppropriategdailygmedicationgshouldginclud
egwhichgofgthegfollowing?g-gans-Anginhaledglow-dosegcorticosteroid
gAgchildgwithgmildgpersistentgasthmagshouldgbegusinggthegstepwisegapproachgto
gmanagement.gPergGINAgguidelines,gthegchildgwithgmildgpersistentgasthmagshoul
dgbegusingganginhaledglow-dosegcorticosteroidgtogcontrolgsymptoms.
Ag3-month-
oldgfemalegisgbroughtgtogthegofficegforgagroutinegexaminationgandgnumerousgbr
uisesgingvaryinggstagesgaregnotedgongtheginfant'sgbackgandglegs.gThegmotherg
getsgverygupsetgwhengaskedgaboutgthegbruisesgandgstartsgtogcry.gShegrefusesg
togtalkganygmoregaboutgthegbruisesgorghowgthisgmayghaveghappened.gAgneces
sarygnextgstepgforgthisgscenariogisgwhichgofgthegfollowing?g-gans-
Explaingtogthegmothergthatgbruisesgsuchgasgthesegareguncommongingag4-
month-old,gandgfurthergassessment,gincludinggagskeletalgbodygscan,gisgrequired.
gAnygchildgwithgunexplainedgbruisesg(especiallygingchildrengwhogaregnotgyetgmo
bile)gisgrequiredgtoghavegagfullgskeletalgbodygscan.
AccordinggtogthegdevelopmentalgtheorygofgErikson,gifgthegneedsgofgtheginfantgar
egmetgingagconsistentgmanner,gtheginfantgwillgdevelopgwhichgofgthegfollowing?g-
gans-TRUST
Accordinggtogthegdevelopmentalgtheorist,gErikson,gitgisgessentialgforganginfant'sg
needsgtogbegmetgsogtheygmaygdevelopgtrustgingthegworldgaroundgthemg(Trustg
vs.gMistrustgstage).
Thegabilitygofganginfantgtogturnghisgheadgtogthegsidegwhenglyinggpronegoccursg
duringgtheg_______gmonthgofglife.g-gans-1st
gAgneonate'sgnormalggrossgmotorgskillgdevelopmentgshouldgincludegthegabilitygto
gturnghis/
hergheadgduringgthegfirstgmonthgofglifegwhengplacedgingagpronegposition.
ANSWERS
Agwellg12-year-
oldgchildgrecentlygarrivedgfromgSouthgAfricagpresentsgforgagschoolgphysical.gShe
greceivedgBCGgimmunizationgshortlygaftergbirthgandgisgupgtogdategwithgrequired
gimmunizations.gAgPPDgisgplacedgandgreadgatg48ghours.gLikelygfindingsginclude
gwhichgofgthegfollowing?g-gans-PositivegPPD,gchildgrequiresgagfollow-
upgchestgX-ray
ThegBCG,gorgbacilligCalmette-Guérin,gisgagvaccinegforgTB.gManygforeign-
borngpersonsghavegbeengvaccinatedgwithgthegBCGgvaccine,gespeciallygingcountri
esgwheregtheregisgaghighgincidencegofgTB.gItgisglikelygthatgthisgchildgwillghaveg
agpositivegPPDgtest.gItgisgnotgpossiblegtogdeterminegingthisgcase,ghowever,gifgt
hegchildghasgactivegTBgwithoutgagchestgX-ray.
Whatgbehaviorgingag2-year-oldgwouldgbegconsideredgworrisome?g-gans-
Unablegtogwalkgdownstairsgholdinggagrail:
Thegnursegpractitionergshouldgalwaysgbegawaregofgtypicalgexpectedggrowthgand
gdevelopmentgparameters.gAtgtwogyearsgofgage,gnormalgexpectedggrossgmotorg
skillsgincludeghavinggthegabilitygtogwalkgupgandgdowngstairsgwithoutgdifficulty.gT
hegchildgshouldgbegevaluatedgfurthergforgothergdelaysginggrossgmotor,gfinegmoto
r,gorglanguage/socialgskills.
BabygSabrinagpresentsgforgherg6gmonthgwellgchildgcheck-
up.gAtg40gweeksggestationghergdocumentedgbirthgweightgwasg6glbsg6goz,gandg
lengthgofg20ginches.gCurrentlyghergweightgisg10glbs,g4gozgandglengthgisg24ginc
hes.gThegnursegpractitionergconcludesgthegfollowing:g-gans-
Theginfantgisgfailinggtogmeetgexpectedggainsgingbothgweightgandglength.:
Infantsgageg0-
3gmonthsggaingapproximatelyg1.4ginchesgingheightgpergmonth.gBabygSabrinagwo
uldgbegexpectedgtoghavegachievedg24ginchesgingheightgbyg3gmonthsgofgage.gA
tg5-6gmonthsgofgage,ginfantsghavegusuallygdoubledgtheirgbirthgweight.
Duringgagsportsgphysicalgforgang18-year-
oldgmaleghighgschoolgstudent,gwhichgfindinggwouldgrequiregfurthergfollow-up?g-
gans-Tannergstagegofg4:
,Typically,gmalesgageg13-18gwillghavegdevelopedgtogTannergstageg5.gAng18-
year-
oldgmalegthatgisgingTannergstageg4gshouldgbegevaluatedgforgfurtherggrowthgand
gdevelopmentgdeficits.gScoliosisgofgthegspinegofg10-
15gdegreesgisggenerallygnotgconsideredgtogbegagproblemgunlessgthegpatientgex
pressedgconcerngorgdiscomfort.
Ag7-year-
oldgmalegchildgisgbroughtgtogthegclinicgbyghisgparentsgforgevaluation.gThegchild
ghasgnogsignificantgPMH.gApproximatelygsevengdaysgagoghegdevelopedgagcoldg
andgsincegthenghasghadgagpersistentgcoughgandgfever.gHisgoldergsistergwasgal
sogillgwithgcoldgsymptomsgatgthegsamegtime.gThegNPgperformsgagphysicalgexa
mgandgnotesgthatgthegchildghasgmildgtachypnea,gwithgcracklesgingbothgbasesga
ndgagpulsegoximetergofg90%.gHisgtemperaturegisg100.8g°F.gTheregaregnogwhee
zesgauscultated.gThegNPgsuspectsgthatgthegchildghasgwhichgofgthegfollowing?g-
gans-
Viralgpneumonia:gThegchildgpresentsgclinicallygwithgpneumonia.gViralgpneumoniag
generallyghasgaggradualgonsetgwithglessgacutegsymptomsgandgaglow-
gradegfever.gItgisgusuallygprecededgbyganguppergrespiratoryginfection.gWheezesg
aregnotgpresentgingchildrengwithgpneumonia.
"g7-year-
oldgmalegchildgisgbroughtgtogthegclinicgbyghisgparentsgforgevaluation.gThegchild
ghasgnogsignificantgPMH.gApproximatelygsevengdaysgagoghegdevelopedgagcoldg
andgsincegthenghasghadgagpersistentgcoughgandgfever.gHisgoldergsistergwasgal
sogillgwithgcoldgsymptomsgatgthegsamegtime.gThegNPgperformsgagphysicalgexa
mgandgnotesgthatgthegchildghasgmildgtachypnea,gwithgcracklesgingbothgbasesga
ndgagpulsegoximetergofg90%.gHisgtemperaturegisg100.8g°F.gTheregaregnogwhee
zesgauscultated."
WhatgdoesgthegFNPgexpectgtogfindgongauscultationgofgtheglungs?g-gans-
Cracklesgingagportiongofgaglunggfield,gnogwheezing:
gThegabsencegofgwheezinggisgagpositivegpredictorgforgchildrengwithgpneumonia.
"g7-year-
oldgmalegchildgisgbroughtgtogthegclinicgbyghisgparentsgforgevaluation.gThegchild
ghasgnogsignificantgPMH.gApproximatelygsevengdaysgagoghegdevelopedgagcoldg
andgsincegthenghasghadgagpersistentgcoughgandgfever.gHisgoldergsistergwasgal
sogillgwithgcoldgsymptomsgatgthegsamegtime.gThegNPgperformsgagphysicalgexa
mgandgnotesgthatgthegchildghasgmildgtachypnea,gwithgcracklesgingbothgbasesga
ndgagpulsegoximetergofg90%.gHisgtemperaturegisg100.8g°F.g
TheregaregnogwheezesgauscultatedgwhatgwillgthegFNPghavegasgpartgofgthegpla
ngofgcare?g-gans-
CXRgnow,gsupportivegcaregatghome;gcallgingonegdaygorgifganygworseninggofgsy
mptoms;greturngtogofficeging2gdaysgforgfollow-upgevaluation
,Allgchildrengwithgagdiagnosisgofgpneumoniagshouldgbegcarefullygmonitored.gTheg
childghasgagclassicgviralgpneumoniagpresentation,gwhichgtendsgtogbeglessgsever
egandgcangbegcaredgforgatghome.
Ag6-month-
oldgmalegisgbeinggseengwithghisgcaretakergforgagbarkinggcoughgwhichgisgmakin
ggthegcaretakerganxious.gThegbabygseemsgtoghavegmildgrespiratorygdistressgand
gthegoximetrygreadsgatg94%.gThegFNPgsendsgthegbabygforg-gans-Steeple-
shapedgappearancegwithgnarrowingginguppergairway
Childrengwithgcroupgwillgusuallygpresentgwithgagbrassygbarkgsoundinggcough,gin
spiratorygstridor,gandgagsteeplegsigng(orgwineglass)gappearancegongagchestgX-
ray.
thegmostgcommongorganismgresponsiblegforgotitisgmediagisgwhichgofgthegfollowi
ng?g-gans-Streptococcusgpneumonia
Streptococcusgpneumoniagisgthegmostgcommongorganismgresponsiblegforgotitisg
media.gAmoxicillin
remainsgthegfirstgchoicegofgtreatmentgforgotitisgmediagwithgagsuspectedgbacterial
getiology.
Ag19-year-oldgmothergbringsgherg2g1/2-month-old-
boygtogyourgclinicgwithgagconcerngthatgthegbabyghasgbecomeglessginterestedgin
ghisgfeedingsgovergthegpastg2gorg3gdays,gtakinggingonlygaboutghalfgthegnormal
gamountgofgformulagbeforegbecominggtiredgandgfallinggasleep.gHisgbirthghistorygi
sgnormalgandgheghasgnormalgdevelopmentgandgweightggain.gHisgtemperaturegis
g100.2g°Fg(axillary)gnow.gHeghasgnogrespiratorygsymptomsgandgyourgphysicalge
xaminationgrevealsgnogidentifiablegsourcegofgfever.gWhichgofgthegfollowinggquesti
ons/observationsgwouldgbegMOSTghelpfulgingestablishinggagdiagnosis?g-
gans-"Isganyonegelsegatghomegillgatgthisgtime?"
Thegchild'sgsymptomsgaregconsistentgwithgthegprodromalgphasegofgagviralgorgba
cterialginfection.gAskinggifgtheregaregsickgcontactsgwouldgprovidegthegmostgvalua
bleginformationgatgthisgpointgingtime.
Whichgofgthegfollowingginfantsgaregsusceptiblegtogrespiratorygsyncytialgvirusg(RS
V)gandgbronchitisgingthegfirstgyeargofglife?g-gans-Veryglowgbirthgweightginfants
AlthoughgallginfantsgaregatgriskgforgRSV,glowgbirthgweightginfants,ginfantsgyoung
ergthang6gmonthsgofgage,gprematureginfants,gandginfantsgwithgangunderlyinggco
nditiongsuchgasgheartgorglunggdiseasegaregatghighestgrisk.gBygtwogyearsgofgag
e,galmostgallgchildrengwillghaveghadgRSV.
Ag4-week-oldginfantgpresentsgtogthegofficegingmid-Januarygwithgagone-
weekghistorygofgnasalgcongestiongandgoccasionalgcough.gOngthegeveninggpriorgt
ogthisgvisit,gshegdevelopedgagtemperaturegofg102g°F,grefusedgtogbreastgfeed,gh
adgparoxysmalgcoughing,gandgnoisy,glaboredgbreathing.gPatientgisgangill-
appearingginfantgwhogisglethargicgwithgtachypneagandgintercostalgretractions.gShe
, ghasgag4-year-
oldgsiblinggwhogisgingdaygcaregandgwhogrecentlyghadgag"cold."gConsideringgthe
gclinicalgpresentation,gwhatgisgthegmostglikelygcausegofgthisginfant'sgillness?g-
gans-RSVgbronchiolitis
ThegchildghasgmanygriskgfactorsgassociatedgwithgRSV,gincludinggagsiblinggingda
ygcare,galonggwithgthegtimegofgyear.gThegchild'sgclinicalgpresentationgisgconsiste
ntgwithgRSVgbronchiolitis.
Ag9-year-
oldgchild'sgsymptomsgoccurgfourgtimesgagweekgduringgthegdaygandgthreegtimes
gduringgthegnight,gwithgangFEV1gofg80%.gWhatgwouldgbegthegseveritygclassifica
tiongpergthegNationalgAsthmagEducationgandgPreventiongProgram?g-gans-
Moderategpersistent
Thegchild'sgsymptomsgaregconsistentgwithgthegdiagnosisgofgmoderategpersistentg
asthmagpergthegGINAg(GlobalgInitiativegforgAsthma)gguidelines.
Ang8-year-
oldgmaleghasgmildgpersistentgasthma.gAppropriategdailygmedicationgshouldginclud
egwhichgofgthegfollowing?g-gans-Anginhaledglow-dosegcorticosteroid
gAgchildgwithgmildgpersistentgasthmagshouldgbegusinggthegstepwisegapproachgto
gmanagement.gPergGINAgguidelines,gthegchildgwithgmildgpersistentgasthmagshoul
dgbegusingganginhaledglow-dosegcorticosteroidgtogcontrolgsymptoms.
Ag3-month-
oldgfemalegisgbroughtgtogthegofficegforgagroutinegexaminationgandgnumerousgbr
uisesgingvaryinggstagesgaregnotedgongtheginfant'sgbackgandglegs.gThegmotherg
getsgverygupsetgwhengaskedgaboutgthegbruisesgandgstartsgtogcry.gShegrefusesg
togtalkganygmoregaboutgthegbruisesgorghowgthisgmayghaveghappened.gAgneces
sarygnextgstepgforgthisgscenariogisgwhichgofgthegfollowing?g-gans-
Explaingtogthegmothergthatgbruisesgsuchgasgthesegareguncommongingag4-
month-old,gandgfurthergassessment,gincludinggagskeletalgbodygscan,gisgrequired.
gAnygchildgwithgunexplainedgbruisesg(especiallygingchildrengwhogaregnotgyetgmo
bile)gisgrequiredgtoghavegagfullgskeletalgbodygscan.
AccordinggtogthegdevelopmentalgtheorygofgErikson,gifgthegneedsgofgtheginfantgar
egmetgingagconsistentgmanner,gtheginfantgwillgdevelopgwhichgofgthegfollowing?g-
gans-TRUST
Accordinggtogthegdevelopmentalgtheorist,gErikson,gitgisgessentialgforganginfant'sg
needsgtogbegmetgsogtheygmaygdevelopgtrustgingthegworldgaroundgthemg(Trustg
vs.gMistrustgstage).
Thegabilitygofganginfantgtogturnghisgheadgtogthegsidegwhenglyinggpronegoccursg
duringgtheg_______gmonthgofglife.g-gans-1st
gAgneonate'sgnormalggrossgmotorgskillgdevelopmentgshouldgincludegthegabilitygto
gturnghis/
hergheadgduringgthegfirstgmonthgofglifegwhengplacedgingagpronegposition.
