NU 665 MIDTERM EXAM – QUESTIONS & CORRECT
SOLUTIONS
PCP cas ccare ccoordinators c- ANSWER c -These cchildren crequire cheath
cmaintenance, cillness cprevention, cand cdevelopmental csurveillance
-Traditional cprimary ccare cneeds c- cneeded cfor croutine cvaccinations,
ccommon cdisease cmanagement, cand cfamily csupport cand cguidance
-Collaboration camong cclinicians, ccase cmanagers, cfamily cmembers,
chome ccare cand cschool cprofessionals, cclinics, chospitals, cand
ccommunity-based cservices
-Gatekeeper cand ccare ccoordinator c- ccollaboration cfor call cneeds
-PCHH c- cpatient-centered chealth chome c- cideal cmodel cfor cmanaging
ccomplex chealth ccare cneeds
Differences cbetween cCSHCN c(children cwith cspecial chealth ccare
cneeds) cand cwithout cspecial cneeds c- ANSWER c Table c7.1
-Mental chealth cproblems c- cADD, cmood cdisorders, cautism, ctic cdisorders
-Atopic cand crheumatic cdisorders c- casthma, cJRA, clupus
-Endocrine cand cmetabolic cdiseases c- cgrowth cdisorders, cadrenal
cdisorders, cdisorders cof csex cdevelopment, cthyroid cdisorders, cinborn
cerrors cof cmetabolism, cDM, cpituitary cdisorders
-Congenital, cgenetic, cor cchromosomal cdefects c- crare cgenetic
cdiseases/syndrome
-Premature cand/or cvery clow cbirth cweight cinfants
-Severe cinjuries cor cburns
-Static cor cprogressive cneurologic cand cneuromuscular cdisorders c- cCP,
cglobal cdevelopmental cdelays, cmuscular cdystrophy, cspina cbifida,
cseizure cdisorders
-Respiratory cdisorders c- ccystic cfibrosis
-CV cdisorders c- ccardiac cdefects, clong-term ceffects cof cacquired cCV
cdisease
-GI cdisorders c- cIBD
-Childhood ccancers
-Family cpsychosocial cconcerns c- ctrauma/abuse, chomelessness,
cundocumented cimmigration cstatus, coverwhelming cneeds cwith climited
cresources
Subspecialty ccare c- ANSWER c -PCPs creview cnotes cand
crecommendations, clooking cfor cmissing cor cduplicate citems
-May chave can cinterdisciplinary cclinic cavailable
Tertiary ccare c- c ANSWER c -PCP cmakes csure cfamily chas cdocumentation
,cof cchild's ccondition, cmedications, cetc. cand cknowledge cof cwhen cto cgo
cto ca chigher clevel cof ccare
Homecare cand ccommunity cservices c- c ANSWER c -PCP cin ccharge cof
carranging cand crecognizing cthe cneed cfor cservices
Technology cdependence cand cmedication c- ANSWER c -Complex
cequipment csuch cas chome cventilators, centeral cfeeding cpumps,
cwheelchairs, chospital cbeds, cand cnerve cstimulations cmay cbe cneeded
,-Low-tech csupplies cmay cinclude crespiratory cor cfeeding ctubing, cspecial
cformulas cor cdiets, curinary ccatheters, cand costomy cbags
-Ongoing cfamily ceducation cis cessential cto censure cthe csafe cand
ceffective cuse cor call cdevices cand cto cmake csure cthat cfamilies cknow
chow cto cfix ccommon ccomplications cwithout cseeking curgent ccare
-Medications c- cbe caware cof cpolypharmacy c- cthis cleads cto can cincreased
crisk cof cdrug cinteractions cand cconfusion cabout cdosing cand
cadministration
-Ongoing creview cof cmedication cnecessity cand climiting cthe cuse cof
cmedication cto ccompounding cpharmacies; cPCPs ccan chelp cfind
ccompounding cpharmacies cas cmany cof cthese ckids crequire cliquid
cmedications cand ccannot cswallow cpills
Costs cand cfamily cburden c- ANSWER c -Out-of-pocket ccosts cand ctime
cspent ccaring cfor cCSHCN ccan cbe csignificant cand cmay clead cto chigher
clevel ccare cwhen ccare cneeds care cnot cmet
-CSHCN care cat crisk cfor cfragmented ccare, cwith cpoor cteam
ccommunication, ccrisis-driven chealth ccare, cand cinsufficient ccaregiver
csupport
Government cresources cfor cCSHCN c- ANSWER c -Medicaid c- cmany
crely con cthis cas ctheir csole chealth ccare ccoverage
-SSI c- cprovides cfinancial chelp cwith ccare ccosts cif cthe cchild chas csevere
cfunctional climitations ccaused cby ca cphysical cand/or ccognitive
cimpairment clikely cto clast clonger cthan ca cyear cor cto cresult cin cthe
cchild's cdeath
-Durable cMedical cequipment c(DME) cand creimbursement c- cessential cto
cfill cout cpaperwork cproperly
Community cand cschool-based cservices c- c ANSWER c -Early
cintervention, cpublic cschool cservices, cfinancial cassistance cprograms,
crespite ccare cservices, cand csupport cgroups
-Many cdevelopmental, ceducational, cand cpsychosocial csupport cservices
care cprovided cin cschool csettings cby cgovernment cand ccommunity
-Smaller cschool cdistricts clack cresources cto cprovide cthese cservices
Early cintervention c- ANSWER c -From cbirth cto cage c3
-May cinclude cdevelopmental, cspeech, cphysical, cand coccupational
ctherapy, caudiology, cassistive cmedical ctechnology, cfamily ctraining
cassistance, csocial cwork cservices cand cservice ccoordination
-PCPs cshould crefer cany cchild cwith csuspected cdisabilities cor
cdevelopmental cdelays cto cEI cservices cfor cevaluation cand ctherapy
-Services care cgenerally cfree, cbut cother cservices cmay cbe cbilled cso
creferral cto csocial cwork cmay cbe cneeded
-After cage c3, cCSHCN ctransition cto cservices cthrough cthe cpublic cschool
csystem c- cIDEA cand csection c504 censures cfree, cappropriate ceducation
cin cthe cleast crestrictive cenvironment cpossible cfor call cchildren
-Children cwith cdisabilities creceive ceducational csupport cin ceither cgeneral
cor cspecial ceducation cclassrooms, ctherapies cincluding cspeech cand cOT,
chealth ccare cservices cneeded cduring cthe cschool cday, cand cemotional,
cbehavioral, cand cpsychologic cservices
-PCPs cshould cencourage cparents cof cchildren creceiving cEI cto ccontact
ctheir cschool cbefore cthird cbirthday c- cthey cmay cbe celigible cfor ca c504
cor cIEP
, IEP cand c504 cplans c- c ANSWER c -Children cwho cdo cnot cmeet ccriteria
cfor can cIEP cmay cbe celigible cfor c504 cplan cif cthey cfollow cthe
ccurriculum cwithout cmodification cbut crequire cadditional cassistance cin
cschool csettings csuch cas cphysical, csensory, cor cmental csupport
1. 504 cplan
-Simple caccommodations cor cminor cchanges; ceasier, cfaster, cmore
cflexible
-Eligibility c- cbased con cidentification cof cpsychologic cor cphysical cdisorder
cthat climits ca cmajor clife cactivity c(learning cor cbehavior)
-Evaluation c- ccompiled cby cthe cschool cfrom ca cvariety cof csources cto
cconfirm cassumption; cno cmoney cto ccover cevaluation cor csupport; ccan
coccur cwithout cparental cknowledge cor cparticipation
-Provisions c- cextra ctime cto ccomplete cassignments, ca ccopy cof cnotes,
cproviding ca cquiet cplace cto ctake ctests, cor cassistive ctechnologies; cno
clegal crequirements cfor cwhat cis cincluded, cfor cparent cinvolvement, cor
cmandated creevaluation
2. IEP
-Needs ca cwide crange cof cservices cor cprotections
-More cinvolved cwith cmandated cparental cparticipation
-Eligibility c- cmeet ccriteria cof cqualified cdisability c- cADHD cnot cincluded c-
cdevelopmental cdelays, cemotional cdisturbances, cor cSLD cthat caffects
clearning cor cbehavior
-Evaluation c- ca ccomplete cevaluation ccompiled cby ca cteam cof
cprofessionals cincluding ctesting cand cinformation cfrom ca cvariety cof
csources; cfederally cfunded; cmust chave cwritten cconsent cto cperform
-Provisions c- cit cdescribes cthe cchild's clearning cproblems, cdetails
cservices cto cbe cprovided, csets cannual cgoals, cand cdefines chow
cprogress cwill cbe cmeasured; cchanges cmade conly cin cmeeting cand cin
ccollaboration cwith cteam; cspecial cprovisions cif csuspected cor cexpelled;
creevaluation cevery c3 cyears
Care ccoordination c- ANSWER c -PCPs care cideal c- cwhen cthey cact
cas ccare ccoordinators, cthis ceases cthe cburden con cfamilies, cimproves
csatisfaction, ccan chelp cto cimprove chealth ccare coutcomes cand
cminimize chealth ccare cexpenditures
-ideal cbecause cof ctheir clong-standing crelationships cwith cCHSCN cand
ctheir cability cto chelp cfamilies cnavigate cthe ccomplicated cand coften
cintimidating chealth ccare csystem
Health ccare cissues cfor cPCPs c- ANSWER c -Time cconsuming
cwith cbeing con cthe cphone, cpaperwork, creviewing cmedical
crecords, cand ccounseling cparents
-Many cproviders chave cdiscomfort cin ccaring cfor cthese cchildren cbecause
cof ca clack cof cknowledge cof crare cconditions cor chealth ccare cservice
crequirements cthat cmay cbe cbeyond cthe cscope cof cmost cPCPs
-Poorly creimbursed
Patient-Centered cHealthCare chome cplan c- c ANSWER c -The cideal ccare
cmodel cfor cCSHCN
-Provides caccessible, ccontinuous, ccomprehensive, ccoordinated,
ccompassionate, cculturally ccompetent, cand cfamily ccentered ccare
c(parent cknows ctheir cchild cbest cand cnotice cwhen cissues carise; cyou
SOLUTIONS
PCP cas ccare ccoordinators c- ANSWER c -These cchildren crequire cheath
cmaintenance, cillness cprevention, cand cdevelopmental csurveillance
-Traditional cprimary ccare cneeds c- cneeded cfor croutine cvaccinations,
ccommon cdisease cmanagement, cand cfamily csupport cand cguidance
-Collaboration camong cclinicians, ccase cmanagers, cfamily cmembers,
chome ccare cand cschool cprofessionals, cclinics, chospitals, cand
ccommunity-based cservices
-Gatekeeper cand ccare ccoordinator c- ccollaboration cfor call cneeds
-PCHH c- cpatient-centered chealth chome c- cideal cmodel cfor cmanaging
ccomplex chealth ccare cneeds
Differences cbetween cCSHCN c(children cwith cspecial chealth ccare
cneeds) cand cwithout cspecial cneeds c- ANSWER c Table c7.1
-Mental chealth cproblems c- cADD, cmood cdisorders, cautism, ctic cdisorders
-Atopic cand crheumatic cdisorders c- casthma, cJRA, clupus
-Endocrine cand cmetabolic cdiseases c- cgrowth cdisorders, cadrenal
cdisorders, cdisorders cof csex cdevelopment, cthyroid cdisorders, cinborn
cerrors cof cmetabolism, cDM, cpituitary cdisorders
-Congenital, cgenetic, cor cchromosomal cdefects c- crare cgenetic
cdiseases/syndrome
-Premature cand/or cvery clow cbirth cweight cinfants
-Severe cinjuries cor cburns
-Static cor cprogressive cneurologic cand cneuromuscular cdisorders c- cCP,
cglobal cdevelopmental cdelays, cmuscular cdystrophy, cspina cbifida,
cseizure cdisorders
-Respiratory cdisorders c- ccystic cfibrosis
-CV cdisorders c- ccardiac cdefects, clong-term ceffects cof cacquired cCV
cdisease
-GI cdisorders c- cIBD
-Childhood ccancers
-Family cpsychosocial cconcerns c- ctrauma/abuse, chomelessness,
cundocumented cimmigration cstatus, coverwhelming cneeds cwith climited
cresources
Subspecialty ccare c- ANSWER c -PCPs creview cnotes cand
crecommendations, clooking cfor cmissing cor cduplicate citems
-May chave can cinterdisciplinary cclinic cavailable
Tertiary ccare c- c ANSWER c -PCP cmakes csure cfamily chas cdocumentation
,cof cchild's ccondition, cmedications, cetc. cand cknowledge cof cwhen cto cgo
cto ca chigher clevel cof ccare
Homecare cand ccommunity cservices c- c ANSWER c -PCP cin ccharge cof
carranging cand crecognizing cthe cneed cfor cservices
Technology cdependence cand cmedication c- ANSWER c -Complex
cequipment csuch cas chome cventilators, centeral cfeeding cpumps,
cwheelchairs, chospital cbeds, cand cnerve cstimulations cmay cbe cneeded
,-Low-tech csupplies cmay cinclude crespiratory cor cfeeding ctubing, cspecial
cformulas cor cdiets, curinary ccatheters, cand costomy cbags
-Ongoing cfamily ceducation cis cessential cto censure cthe csafe cand
ceffective cuse cor call cdevices cand cto cmake csure cthat cfamilies cknow
chow cto cfix ccommon ccomplications cwithout cseeking curgent ccare
-Medications c- cbe caware cof cpolypharmacy c- cthis cleads cto can cincreased
crisk cof cdrug cinteractions cand cconfusion cabout cdosing cand
cadministration
-Ongoing creview cof cmedication cnecessity cand climiting cthe cuse cof
cmedication cto ccompounding cpharmacies; cPCPs ccan chelp cfind
ccompounding cpharmacies cas cmany cof cthese ckids crequire cliquid
cmedications cand ccannot cswallow cpills
Costs cand cfamily cburden c- ANSWER c -Out-of-pocket ccosts cand ctime
cspent ccaring cfor cCSHCN ccan cbe csignificant cand cmay clead cto chigher
clevel ccare cwhen ccare cneeds care cnot cmet
-CSHCN care cat crisk cfor cfragmented ccare, cwith cpoor cteam
ccommunication, ccrisis-driven chealth ccare, cand cinsufficient ccaregiver
csupport
Government cresources cfor cCSHCN c- ANSWER c -Medicaid c- cmany
crely con cthis cas ctheir csole chealth ccare ccoverage
-SSI c- cprovides cfinancial chelp cwith ccare ccosts cif cthe cchild chas csevere
cfunctional climitations ccaused cby ca cphysical cand/or ccognitive
cimpairment clikely cto clast clonger cthan ca cyear cor cto cresult cin cthe
cchild's cdeath
-Durable cMedical cequipment c(DME) cand creimbursement c- cessential cto
cfill cout cpaperwork cproperly
Community cand cschool-based cservices c- c ANSWER c -Early
cintervention, cpublic cschool cservices, cfinancial cassistance cprograms,
crespite ccare cservices, cand csupport cgroups
-Many cdevelopmental, ceducational, cand cpsychosocial csupport cservices
care cprovided cin cschool csettings cby cgovernment cand ccommunity
-Smaller cschool cdistricts clack cresources cto cprovide cthese cservices
Early cintervention c- ANSWER c -From cbirth cto cage c3
-May cinclude cdevelopmental, cspeech, cphysical, cand coccupational
ctherapy, caudiology, cassistive cmedical ctechnology, cfamily ctraining
cassistance, csocial cwork cservices cand cservice ccoordination
-PCPs cshould crefer cany cchild cwith csuspected cdisabilities cor
cdevelopmental cdelays cto cEI cservices cfor cevaluation cand ctherapy
-Services care cgenerally cfree, cbut cother cservices cmay cbe cbilled cso
creferral cto csocial cwork cmay cbe cneeded
-After cage c3, cCSHCN ctransition cto cservices cthrough cthe cpublic cschool
csystem c- cIDEA cand csection c504 censures cfree, cappropriate ceducation
cin cthe cleast crestrictive cenvironment cpossible cfor call cchildren
-Children cwith cdisabilities creceive ceducational csupport cin ceither cgeneral
cor cspecial ceducation cclassrooms, ctherapies cincluding cspeech cand cOT,
chealth ccare cservices cneeded cduring cthe cschool cday, cand cemotional,
cbehavioral, cand cpsychologic cservices
-PCPs cshould cencourage cparents cof cchildren creceiving cEI cto ccontact
ctheir cschool cbefore cthird cbirthday c- cthey cmay cbe celigible cfor ca c504
cor cIEP
, IEP cand c504 cplans c- c ANSWER c -Children cwho cdo cnot cmeet ccriteria
cfor can cIEP cmay cbe celigible cfor c504 cplan cif cthey cfollow cthe
ccurriculum cwithout cmodification cbut crequire cadditional cassistance cin
cschool csettings csuch cas cphysical, csensory, cor cmental csupport
1. 504 cplan
-Simple caccommodations cor cminor cchanges; ceasier, cfaster, cmore
cflexible
-Eligibility c- cbased con cidentification cof cpsychologic cor cphysical cdisorder
cthat climits ca cmajor clife cactivity c(learning cor cbehavior)
-Evaluation c- ccompiled cby cthe cschool cfrom ca cvariety cof csources cto
cconfirm cassumption; cno cmoney cto ccover cevaluation cor csupport; ccan
coccur cwithout cparental cknowledge cor cparticipation
-Provisions c- cextra ctime cto ccomplete cassignments, ca ccopy cof cnotes,
cproviding ca cquiet cplace cto ctake ctests, cor cassistive ctechnologies; cno
clegal crequirements cfor cwhat cis cincluded, cfor cparent cinvolvement, cor
cmandated creevaluation
2. IEP
-Needs ca cwide crange cof cservices cor cprotections
-More cinvolved cwith cmandated cparental cparticipation
-Eligibility c- cmeet ccriteria cof cqualified cdisability c- cADHD cnot cincluded c-
cdevelopmental cdelays, cemotional cdisturbances, cor cSLD cthat caffects
clearning cor cbehavior
-Evaluation c- ca ccomplete cevaluation ccompiled cby ca cteam cof
cprofessionals cincluding ctesting cand cinformation cfrom ca cvariety cof
csources; cfederally cfunded; cmust chave cwritten cconsent cto cperform
-Provisions c- cit cdescribes cthe cchild's clearning cproblems, cdetails
cservices cto cbe cprovided, csets cannual cgoals, cand cdefines chow
cprogress cwill cbe cmeasured; cchanges cmade conly cin cmeeting cand cin
ccollaboration cwith cteam; cspecial cprovisions cif csuspected cor cexpelled;
creevaluation cevery c3 cyears
Care ccoordination c- ANSWER c -PCPs care cideal c- cwhen cthey cact
cas ccare ccoordinators, cthis ceases cthe cburden con cfamilies, cimproves
csatisfaction, ccan chelp cto cimprove chealth ccare coutcomes cand
cminimize chealth ccare cexpenditures
-ideal cbecause cof ctheir clong-standing crelationships cwith cCHSCN cand
ctheir cability cto chelp cfamilies cnavigate cthe ccomplicated cand coften
cintimidating chealth ccare csystem
Health ccare cissues cfor cPCPs c- ANSWER c -Time cconsuming
cwith cbeing con cthe cphone, cpaperwork, creviewing cmedical
crecords, cand ccounseling cparents
-Many cproviders chave cdiscomfort cin ccaring cfor cthese cchildren cbecause
cof ca clack cof cknowledge cof crare cconditions cor chealth ccare cservice
crequirements cthat cmay cbe cbeyond cthe cscope cof cmost cPCPs
-Poorly creimbursed
Patient-Centered cHealthCare chome cplan c- c ANSWER c -The cideal ccare
cmodel cfor cCSHCN
-Provides caccessible, ccontinuous, ccomprehensive, ccoordinated,
ccompassionate, cculturally ccompetent, cand cfamily ccentered ccare
c(parent cknows ctheir cchild cbest cand cnotice cwhen cissues carise; cyou
