Question 1

Adolescence, early, characteristics.

Accepted Answer

Early = 11 - 14 YO - Puberty: girls start 2 years earlier than boys. - Egocentric, moody behavior - it IS all about me. - Eating disorders emerge. - Focus is on concrete and present. - Engage in risk taking behaviors. - COD, most common: secondary to MVA accidents. (Example test question: what would be an important teaching point for a 12 year old in for a school physical? Wear a seat belt.)

Question 2

Adolescent, definition, American Academy of Pediatrics.

Accepted Answer

Anyone between the ages of 11 and 21. They describe three different stages of adolescence, early, middle, and late. ``` Early = 11 - 14 Middle = 15 - 17 Late = 18 -21 ```

Question 3

Adolescence, middle, characteristics

Accepted Answer

Middle = 15 - 17 YO - Peer Groups are very important, most important, more important than family. - Seek privacy while at home. - Transitioning from concrete to operational behavior (planning for future). - Risk taking behavior escalates. (REM, most common cause of death is adolescents is MVA. The middle adolescents 'lead the pack.' :'( ).

Question 4

Adolescence, late, characteristics

Accepted Answer

Late = 18 - 21 YO - Key developmental task is focus on emotional intimacy, they tend to have a best somebody. - Risky behaviors peak secondary to independence an mobility. - Deaths secondary to: MVAs, suicide, homicide.

Question 5

Anticipatory Guidance, adolescence

Accepted Answer

There is a lot to talk to them about, but DO it! - Healthy dietary habits - Reduction of injuries. - Regular exercise. - Responsible sexual behaviors, including abstinence. - Avoidance of tobacco, ETOH, anabolic steroids, and others.

Question 6

Immunizations

Accepted Answer

They might need a lot. Assess at each visit.

Question 7

Question: A 12 YO female visits the NP because she has asymmetry of her breasts. She is in Tanner Stage 3. The NP knows that this: 1. is an ominous finding. 2. represents gynecomastia. 3. is an unusual finding. 4. will probably resolve by Tanner Stage 5

Accepted Answer

4. Tanner Staging, breasts: Stage 1: prepubertal, papilla elevated above chest wall. Stage 2: Breast bud stage (8 - 13): breast and papilla form small mound, areola increase in diameter. Stage 3: Breast and areola enlarge; no separation in contours. Stage 4: Secondary mound formed by areola and papilla about at level of breast. Stage 5: Adult breast. Even if this is a male, asymetrical breasts are not a concern.

Question 8

Question: A 2 week old infant has white pinpoint papules on his face and cheeks. What is this? 1. Mongolian spots. 2. Eczema. 3. Milia 4. Hemangioma.

Accepted Answer

3.

Question 9

Question: In most children, the primary teeth have completely erupted by: 1. 12 months 2. 15 months. 3. 18 months. 4. 24 monhts.

Accepted Answer

4. First teeth at about 6 months. Final primary teeth at about 24 months.

Question 10

Question: Normal vision in a child is expected by: 1. 4 years of age. 2. 5 years of age. 3. 6 years of age. 4. 7 years of age.

Accepted Answer

3. Vision screening at age 3 - 4 years with Snellen chart. Vision at 3: 20/50 Vision at 4: 20/40 Vision at 5: 20/30 Vision at 6: 20/20

Question 11

Gynecomastia, Taber's and APEA

Accepted Answer

Enlargement of breast tissue in the male. This may occur during three distinct age periods: - Birth, transiently - Puberty, declining during the late teen years. Occurs in about 60%, can be unilateral or bilateral and, if bilateral, uneven. Use of ETOH, marijuana, and heroin increase chances of development. - Men over 50. It can be caused by pituitary or testicular tumors, medications such as spironolactone or antiandrogens, or cirrhosis of the liver causing enhanced activity (d/t delayed liver catabolism) of naturally produced estrogens. Risk factors, APEA: - Obesity - Pot - marijuana - Cimetidine (Tagamet) - a histamine H2 antagonist. - Spironolactone (Aldactone)

Question 12

Question: Which finding is abnormal in a 2 month old child? 1. A closed anterior fontanel 2. A palpable posterior fontanel 3. Presence of the stepping reflex. 4. Red reflex.

Accepted Answer

1. 2 - 4 are all normal.

Question 13

Anticipatory Guidance, Birth

Accepted Answer

- Infant will feed every 2 - 3 hours. Awaken to feed if 4 hours have elapsed without feeding. - Supplementation with Vitamin D is usually NOT needed (it is only needed if breastfeeding mother's diet is lacking Vitamin D OR formula is not fortified with Vitamin D and infant does not have adequate exposure to sunlight.) - Place infant on back for sleeping. - Do not use baby powder.

Question 14

Anticipatory Guidance, 1 month of age.

Accepted Answer

- Do not place bottle in bed with baby. - Do not give solids until 4 months of age. - Discuss colic and comfort measures.

Question 15

Development and Anticipatory Guidance, 2 months of age

Accepted Answer

Development: - Infant focuses on face. - Grasps rattle if placed in hand. - Smiles, coos - Able to lift head 45 degrees. Anticipatory Guidance: - No solid foods, no cereal in bottle. - Do not give honey or plain water in bottle.

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Disc 20 - Growth and Development: Adolescent assessment, Infant development, Anticipatory Guidance, 4 - 5 Flashcards

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