D119 EXAM QUESTIONS WITH |\ |\ |\
CORRECT ANSWERS
|\ |\
As you begin a well-child visit on a 12-month-old infant, you observe the child
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
pull himself up using the chair for support and to "cruise." You note the child has
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
a stepping gait in which the whole leg is raised at the hip to ensure adequate
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
ground clearance.
|\ |\
What is the appropriate course of action for you to take?
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\
A. Send the infant to the ER for immediate evaluation.
|\ |\ |\ |\ |\ |\ |\ |\ |\
B. Continue the well visit because most infants outgrow this gait pattern.
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
C. Perform a comprehensive history and physical, with special attention to
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\
musculoskeletal and neurologic systems.
|\ |\ |\ |\
D. Refer the infant to a pediatric orthopedist. - CORRECT ANSWERS ✔✔C. When
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
evaluating an abnormal gait pattern, you should first perform a comprehensive
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
history and physical with special attention to musculoskeletal and neurologic
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\
systems. A stepping gait may be a symptom of peripheral neuropathies, spina
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
bifida, or polio.
|\ |\ |\
It is important for you to assess a family's beliefs on infant sleeping habits. Doing
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
so will help ensure the family heeds your direction regarding a patient's sleep.
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
What are some families' erroneous beliefs about infant sleeping?
|\ |\ |\ |\ |\ |\ |\ |\ |\
A. Using a family bed
|\ |\ |\ |\
B. Using a new crib
|\ |\ |\ |\
,C. Providing a safe sleep environment
|\ |\ |\ |\ |\
D. Placing children on their back to sleep - CORRECT ANSWERS ✔✔D. In some
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
cultures, a family bed is the norm. Ensure parents understand the importance of
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
infants sleeping in their own beds to help prevent injury and death from parents
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
rolling onto or smothering the child during sleep. Providing a safe area for
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
children to sleep and avoiding a family bed entirely improves sleeping safety for
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
children.
|\
The parent of a newborn infant asks you when the parent should intervene to
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
help the infant's future intellectual growth.
|\ |\ |\ |\ |\ |\
What should you tell the parent?
|\ |\ |\ |\ |\
A. Intellectual growth begins when speech develops.
|\ |\ |\ |\ |\ |\
B. Language and literacy skills begin at birth.
|\ |\ |\ |\ |\ |\ |\
C. Cognitive learning begins during the toddler years.
|\ |\ |\ |\ |\ |\ |\
D. Preschool is an optimal time to begin general learning. - CORRECT ANSWERS
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
✔✔B. Talking to, reading to, playing with, and interacting with a child are some of
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
the most important things a parent can do to enhance and stimulate intellectual
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
growth. Intellectual learning begins long before preschool. Waiting until preschool
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\
may produce a delay in the child's development. Children absorb information
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
from birth, and learning occurs before speech. Intellectual development begins at
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
birth and long before toddler years.
|\ |\ |\ |\ |\ |\
You are examining a 12-month-old infant who was six weeks premature. You
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
observe that the infant uses a raking motion to pick up small objects. The
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
Parents' Evaluation of Developmental Status (PEDS) questionnaire completed by
|\ |\ |\ |\ |\ |\ |\ |\ |\
the parent did not indicate significant developmental delays.
|\ |\ |\ |\ |\ |\ |\ |\
,What should you do first?
|\ |\ |\ |\
A. Perform an in-depth developmental assessment.
|\ |\ |\ |\ |\
B. Suggest activities to improve fine motor skills.
|\ |\ |\ |\ |\ |\ |\
C. Reassure the parent that this is normal for a premature infant.
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
D. Refer the infant to a developmental specialist. - CORRECT ANSWERS ✔✔D.
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
To fully understand the developmental stage of your patient, you must do a full
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
assessment. This may or may not be normal behavior. You will not know for
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
certain without a full evaluation. If abnormalities are found during the full
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
assessment, a referral would be appropriate. A full assessment may reveal other
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
problems or none at all. If no other problems are revealed, you may suggest
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
activities to improve fine motor skills, as appropriate. A full assessment,
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
however, would be the first step.
|\ |\ |\ |\ |\ |\
During an assessment of a four-week-old infant, you learn that the breastfed
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
infant nurses every two hours during the day but is able to sleep for a four-hour
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
period during the night. The infant has gained 20 grams per day since last seen in
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
the clinic.
|\ |\
What should you recommend to the parent?
|\ |\ |\ |\ |\ |\
A. Wake the infant every two hours to nurse during the night
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
B. Continue to nurse the infant using the current pattern
|\ |\ |\ |\ |\ |\ |\ |\ |\
C. Supplement with formula at the last nighttime feeding
|\ |\ |\ |\ |\ |\ |\ |\
D. Nurse the infant for longer periods every four hours - CORRECT ANSWERS
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
✔✔B. Infants who are encouraged to breastfeed every two to three hours may
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
have one longer stretch of four hours at night without a feeding. This infant is
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
, gaining between 0.5 and one gram per day, which is appropriate. It is not
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
necessary to alter the pattern of nursing or to supplement with formula.
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
The mother of a six-week-old breastfeeding infant tells you that her baby, who
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
previously had bowel movements with each feeding, now has a bowel movement
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
only once every third day.
|\ |\ |\ |\ |\
What should you tell her?
|\ |\ |\ |\
A. The baby should consume more water.
|\ |\ |\ |\ |\ |\
B. The baby is probably constipated.
|\ |\ |\ |\ |\
C. This change may be related to the baby's dietary intake.
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\
D. This change may be normal for breastfed babies. - CORRECT ANSWERS
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
✔✔A. The baby should consume more water.
|\ |\ |\ |\ |\ |\ |\
During a well-child assessment of an 18-month-old child, you observe the child
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
becoming irritable and uncooperative. The parent tells the child to stop fussing.
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
What should you do? |\ |\ |\
A. Stop the examination because the child is having a meltdown.
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\
B. Allow the parent to put the child in a time-out.
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\
C. Ask the parent about usual discipline practices.
|\ |\ |\ |\ |\ |\ |\
D. Offer the child a book or toy. - CORRECT ANSWERS ✔✔C. Children of this
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
age require frequent entertainment and interaction. It is normal for a child to
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
become fussy during an assessment that requires the child to remain still for a
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
time, and this is an opportunity for parental education. Educate the parent that
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
providing easy toys for entertainment will be more effective than discipline. The
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
CORRECT ANSWERS
|\ |\
As you begin a well-child visit on a 12-month-old infant, you observe the child
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
pull himself up using the chair for support and to "cruise." You note the child has
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
a stepping gait in which the whole leg is raised at the hip to ensure adequate
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
ground clearance.
|\ |\
What is the appropriate course of action for you to take?
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\
A. Send the infant to the ER for immediate evaluation.
|\ |\ |\ |\ |\ |\ |\ |\ |\
B. Continue the well visit because most infants outgrow this gait pattern.
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
C. Perform a comprehensive history and physical, with special attention to
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\
musculoskeletal and neurologic systems.
|\ |\ |\ |\
D. Refer the infant to a pediatric orthopedist. - CORRECT ANSWERS ✔✔C. When
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
evaluating an abnormal gait pattern, you should first perform a comprehensive
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
history and physical with special attention to musculoskeletal and neurologic
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\
systems. A stepping gait may be a symptom of peripheral neuropathies, spina
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
bifida, or polio.
|\ |\ |\
It is important for you to assess a family's beliefs on infant sleeping habits. Doing
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
so will help ensure the family heeds your direction regarding a patient's sleep.
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
What are some families' erroneous beliefs about infant sleeping?
|\ |\ |\ |\ |\ |\ |\ |\ |\
A. Using a family bed
|\ |\ |\ |\
B. Using a new crib
|\ |\ |\ |\
,C. Providing a safe sleep environment
|\ |\ |\ |\ |\
D. Placing children on their back to sleep - CORRECT ANSWERS ✔✔D. In some
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
cultures, a family bed is the norm. Ensure parents understand the importance of
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
infants sleeping in their own beds to help prevent injury and death from parents
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
rolling onto or smothering the child during sleep. Providing a safe area for
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
children to sleep and avoiding a family bed entirely improves sleeping safety for
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
children.
|\
The parent of a newborn infant asks you when the parent should intervene to
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
help the infant's future intellectual growth.
|\ |\ |\ |\ |\ |\
What should you tell the parent?
|\ |\ |\ |\ |\
A. Intellectual growth begins when speech develops.
|\ |\ |\ |\ |\ |\
B. Language and literacy skills begin at birth.
|\ |\ |\ |\ |\ |\ |\
C. Cognitive learning begins during the toddler years.
|\ |\ |\ |\ |\ |\ |\
D. Preschool is an optimal time to begin general learning. - CORRECT ANSWERS
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
✔✔B. Talking to, reading to, playing with, and interacting with a child are some of
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
the most important things a parent can do to enhance and stimulate intellectual
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
growth. Intellectual learning begins long before preschool. Waiting until preschool
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\
may produce a delay in the child's development. Children absorb information
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
from birth, and learning occurs before speech. Intellectual development begins at
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
birth and long before toddler years.
|\ |\ |\ |\ |\ |\
You are examining a 12-month-old infant who was six weeks premature. You
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
observe that the infant uses a raking motion to pick up small objects. The
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
Parents' Evaluation of Developmental Status (PEDS) questionnaire completed by
|\ |\ |\ |\ |\ |\ |\ |\ |\
the parent did not indicate significant developmental delays.
|\ |\ |\ |\ |\ |\ |\ |\
,What should you do first?
|\ |\ |\ |\
A. Perform an in-depth developmental assessment.
|\ |\ |\ |\ |\
B. Suggest activities to improve fine motor skills.
|\ |\ |\ |\ |\ |\ |\
C. Reassure the parent that this is normal for a premature infant.
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
D. Refer the infant to a developmental specialist. - CORRECT ANSWERS ✔✔D.
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
To fully understand the developmental stage of your patient, you must do a full
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
assessment. This may or may not be normal behavior. You will not know for
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
certain without a full evaluation. If abnormalities are found during the full
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
assessment, a referral would be appropriate. A full assessment may reveal other
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
problems or none at all. If no other problems are revealed, you may suggest
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
activities to improve fine motor skills, as appropriate. A full assessment,
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
however, would be the first step.
|\ |\ |\ |\ |\ |\
During an assessment of a four-week-old infant, you learn that the breastfed
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
infant nurses every two hours during the day but is able to sleep for a four-hour
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
period during the night. The infant has gained 20 grams per day since last seen in
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
the clinic.
|\ |\
What should you recommend to the parent?
|\ |\ |\ |\ |\ |\
A. Wake the infant every two hours to nurse during the night
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
B. Continue to nurse the infant using the current pattern
|\ |\ |\ |\ |\ |\ |\ |\ |\
C. Supplement with formula at the last nighttime feeding
|\ |\ |\ |\ |\ |\ |\ |\
D. Nurse the infant for longer periods every four hours - CORRECT ANSWERS
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
✔✔B. Infants who are encouraged to breastfeed every two to three hours may
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
have one longer stretch of four hours at night without a feeding. This infant is
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
, gaining between 0.5 and one gram per day, which is appropriate. It is not
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
necessary to alter the pattern of nursing or to supplement with formula.
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
The mother of a six-week-old breastfeeding infant tells you that her baby, who
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
previously had bowel movements with each feeding, now has a bowel movement
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
only once every third day.
|\ |\ |\ |\ |\
What should you tell her?
|\ |\ |\ |\
A. The baby should consume more water.
|\ |\ |\ |\ |\ |\
B. The baby is probably constipated.
|\ |\ |\ |\ |\
C. This change may be related to the baby's dietary intake.
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\
D. This change may be normal for breastfed babies. - CORRECT ANSWERS
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
✔✔A. The baby should consume more water.
|\ |\ |\ |\ |\ |\ |\
During a well-child assessment of an 18-month-old child, you observe the child
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
becoming irritable and uncooperative. The parent tells the child to stop fussing.
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
What should you do? |\ |\ |\
A. Stop the examination because the child is having a meltdown.
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\
B. Allow the parent to put the child in a time-out.
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\
C. Ask the parent about usual discipline practices.
|\ |\ |\ |\ |\ |\ |\
D. Offer the child a book or toy. - CORRECT ANSWERS ✔✔C. Children of this
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
age require frequent entertainment and interaction. It is normal for a child to
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
become fussy during an assessment that requires the child to remain still for a
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
time, and this is an opportunity for parental education. Educate the parent that
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
providing easy toys for entertainment will be more effective than discipline. The
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
