Peds Midterm 6541 100% Verified Solutions

PEDS MIDTERM 6541 100% VERIFIED SOLUTIONS Appropriate advice for a mother of a 2-week-old child here for a "well child" visit includes which of the following? - ANSWERS Sleep in the supine position is recommended Parents bring their 6-month-old son to see you. He is symmetrically less than the 5th percentile for height, weight and head circumference. He was born at 30 weeks' gestation and weighed 1000g. He was a planned pregnancy, and his mother's prenatal course was uneventful until an automobile accident initiated the labor. He was ventilated for 3 days in the intensive care unit but otherwise did well without ongoing problems. He was discharged at 8 weeks of life. Which of the following is the most likely explanation for his small size? - ANSWERS Normal ex-preemie infant growth A Mantoux test in a child with no risk factors is considered positive with a reaction of - ANSWERS at least 15 mm induration A 4-year-old believes there is more juice in a tall, thin glass than a shorter, wider one. The child has not yet achieved which of the principles of Piaget? - ANSWERS Conservation I can roll over, grasp a rattle, and reach for things and have begun feeding myself finger foods, but I can't wave bye-bye yet. How old am I? - ANSWERS 6 months A 4-month-old child has poor weight gain. Her current weight is less than the 5th percentile, height about the 10th percentile, and head circumference at the 50th percentile. The planned pregnancy resulted in a normal, spontaneous, vaginal delivery; mother and child were discharged after a 48-hour hospitalization. Feeding is via breast and bottle; the quantity seems sufficient. The child has had no illness. The examination is unremarkable except for the child's small size. Screening laboratory shows the hemoglobin and hematocrit are 11 mg/dL and 33% respectively, with a platelet count of 198,000/mm3. Serum electrolyte levels are sodium 140, chloride 105, potassium 3.5, bicarbonate 17, blood urea nitrogen 15, and creatinine 0.3. Liver function tests are normal. Urinalysis reveals a pH of 8 with occasional epithelial cells but no white blood cells, bacteria, protein, ketones, or reducing substances. Which of the following is the most appropriate therapy for this child - ANSWERS Oral supplementation with bicarbonate Which of the following vaccines is routinely recommended at 4 months of age? - ANSWERS Diphtheria, tetanus, acellular pertussis (DTaP) I can walk well on tiptoes, my speech is 50% understandable, I know six body parts, but I cannot balance on one foot for 1 second. I am - ANSWERS 2-1/2 years old (30 months) You see a healthy 18-month-old for a well-child visit. At the 12-month visit he received the diphtheria, tetanus, and acellular pertussis (DTaP) third dose; hepatitis B second dose; measles, mumps, and rubella (MMR) first dose; injected poliovirus (IPV) second dose; pneumococcal conjugate (PCV13) fourth dose; and Haemophilus influenzae type B (Hib) fourth dose. Which of the following do you order today? - ANSWERS DTaP, varicella, hepatitis A, and hepatitis B Which is the correct order for introduction of solid foods to an infant? - ANSWERS Cereal, vegetables, fruits, and meats I like to use my pincer grasp that involves the ability to pick up a small object such as a raisin or piece of cereal with the thumb and forefinger, and that is mastered around what age? - ANSWERS 9 months The first sign of the onset of female puberty is usually - ANSWERS Breast buds A mother of a 6-month-old asks you about normal sleep patterns for an infant this age. The best response is: - ANSWERS 10 hours at night and 3-4 hours during the day Medicaid provides health insurance coverage to - ANSWERS Certain categories of people whose personal income falls below a certain percentage of the federal poverty level. You see a 5-month-old who is fussy, has interrupted sleep, and is drooling. You note large lower lateral incisor bulges. You recommend: - ANSWERS A and D You see a young child who has tripled her birth weight and looks for hidden objects. When given blocks, she places one in each hand. She has a fine pincer grasp. On the floor, she walks around holding objects and is trying to take independent steps. This child is most likely how old? - ANSWERS 12 months Sally, age 4, presents to the office with her mother for a well-child visit. To assess for age-appropriate fine motor skills, what activity would you ask her to perform? - ANSWERS Cut on a line with scissors Which adolescent would be at greatest risk for developing anorexia nervosa? - ANSWERS 14-year-old female gymnast Which of the following injuries is most likely to be caused by abuse of a toddler? - ANSWERS A displaced posterior rib fracture. You see a 3-year-old for a well-child visit. His mother informs you that potty training has been very easy because he "has an amazing internal clock. He falls asleep, gets hungry, and has bowel movements at the same time every day." This describes which aspect of temperament? - ANSWERS Rhythmicity Which of the following statements regarding adolescent substance use is true? - ANSWERS Tobacco is the most commonly abused substance during adolescence. You see a 4-year-old for a well-child visit. He has received four diphtheria, tetanus, and acellular pertussis vaccines (DTaP); three injected polio vaccines (IPV); one measles, mumps, and rubella vaccine (MMR); one varicella vaccine; and two hepatitis B (Hep B) vaccines. What do you order today? - ANSWERS DTaP, IPV, MMR, and Varivax The parents of a 7-year-old are concerned their son does not want to attend school. Which of the historical findings are not usually associated with the diagnosis of school phobia? - ANSWERS Chronic medical illness Chelsea, age 8, complains that she feels as if something is stuck in her ear. What action is contraindicated? - ANSWERS Flushing the ear with water You see a 7-year-old with complaints of "having accidents at night." Physical exam and history are unremarkable. Urinalysis, urine culture, and specific gravity are normal. His parents ask about the best treatment for this problem. The best response is - ANSWERS Fluid restriction and voiding prior to the night may be effective You are doing a kindergarten physical on a 5-year-old girl. Which of the following scenarios would suggest the child is not ready to start kindergarten in the fall? - ANSWERS Counts to 4 and draws a person with three parts. Upon eye examination of a newborn, you note inner canthal folds and Brushfield spots. What do you suspect? - ANSWERS Down syndrome I like to use my pincer grasp that involves the ability to pick up a small object such as a raisin or piece of cereal with the thumb and forefinger, and that is mastered around what age? - ANSWERS 9 months