Burns Ch. 4: Developmental Management in Pediatric Primary Care

During a well child exam, you learn that the parents of a young child fight frequently about finances. The parents state they don't fight in front of the child and feel that the situation is temporary and related to the father's job layoff. What will you do? a. Reassure them that the child is too young to understand. b. Recommend that they continue to not argue in front of the child. c. Suggest counseling to learn ways to handle stress. d. Tell them that the conflict will resolve when the situation changes. C You conduct a well baby exam on an infant and note mild gross motor delays but no delays in other areas. Which initial course of action will you recommend? a. Consult a developmental specialist for a more complete eval. b. Prep the parents for a potentially serious developmental disorder. c. Refer the infant to an early intervention program for physical therapy. d. Teach the parents to provide exercises to encourage motor development. D 00:01 01:35 You see a developmentally delayed toddler for an initial visit. The family has just moved to the area and asks you about community services and resources for their child. What should you do initially? a. Ask the parents if they have an individualized family service plan (IFSP). b. Consult with a physician to ensure the child gets appropriate care. c. Inform the family that services are provided when the child begins school. d. Refer the family to a social worker for assistance with referrals and services. A You are examining a newborn recently discharged from the NICU after a premature birth. The parent is upset and expresses worry about whether the infant will be normal. What will you do in this situation? a. Explain to the parent that developmental delays often do not manifest at first. b. Perform a developmental assessment and tell the parent which delays are evident. c. Point out the tasks that the infant can perform while conducting the assessment. d. Refer the infant to a developmental specialist for complete eval. C Which recommendation will you make when parents ask about ways to discipline their 3yo who draws on walls w/crayons? a. Give the child washable markers so the drawings can be removed easily. b. Provide a roll of paper for drawing and teach child to use this. c. Put the child in time out each time the child draws on the walls. d. Take the crayons away to prevent the behavior. B You enter an exam room and find a 2mo in a car seat on the exam table. The mom is playing a game on her smart phone. You interpret this behavior as: a. A sign that the mother has postpartum depression b. Extremely concerning for potential parental neglect. c. Of moderate concern for parenting problems. d. Within the normal range of behavior in early parenthood. C During a well child assessment of an 18mo, you observe the child becoming irritable and uncooperative. The parent tells the child to stop fussing. What will you do? a. Allow the parent to put the child in time out. b. Ask the parent about usual discipline practices. c. Offer the child a book or toy. d. Stop the exam since the child has a reached a meltdown. C You perform an exam on a 9mo and note 2 central incisors in the lower gums. The parent states that the infant nurses, takes solid foods TID, and occasionally takes water from a cup. What will you counsel the parent to promote optimum dental health? a. To begin brushing the infant's teeth w/toothpaste. b. To consider weaning the infant from breastfeeding. c. To d/c giving fluoride supplements. d. To make an appointment for an initial dental exam. D You have a cohort of pts who have special health care needs. Which is an important role for you when caring for these children? a. Care coordination and collaboration. b. Developing protocols for parents to follow. c. Monitoring individual education plans d. Providing lists of resources for families. A A single mom of an infant worries that living in a household w/only one parent will cuase her child to be maladjusted. To help address the mom's concerns, you will suggest: a. developing consistent daily routines for the child. b. exposing her child to extended family members when possible. c. not working outside the home during the first few yrs. d. taking her child to regular play date activities w/other children. A