Growth & Development

Question 1

Development is -1- and -2-

Answer 1

1. cephalocaudal

2. proximodistal

Question 2

Breastfeeding protects infants from different diseases, such as -1-; and decreases -2-, and -3-

Answer 2

1. GERD in premies
2. Pain, anxiety
3. Obesity

Question 3

For sore nipples, our reponse should be…

Answer 3

…assessing latch

Question 4

Concerns for frequent breastfeeding:

Answer 4

reassure

Question 5

Vit D supplementation?

Answer 5

400IU Vit D @ 2 months*

Question 6

plant-based diet in breastfeeding mother

Answer 6

Vit B12 supplement

Question 7

iron and fluoride supplementation from -1-; -2- mg/kg/day of iron - -3- or -4- are other sources

Answer 7

1. 6 mo.
2. 1
3. formula
4. cereal

Question 8

Growth Trend:

14 days of age

Answer 8

back at their birthweight

Question 9

Teeth:
First: -1-
First molars -2-
Second molars -3-

• 4-: start losing teeth, and first permanent molars come in
• 5-: second permanent molars/wisdom teeth

Answer 9

1. 8-12 months - central incisors
2. 12 months
3. 24 months
4. 6 years
5. 11-13 years

Question 10

Piaget -1- Birth to 24 months
> -2-: environmental
> 6 mo: -3-
> -4-: dropping objects

Answer 10

1. Sensorimotor
2. Startle reflex
3. object permanence
4. Empirical problem solving

Question 11

Piaget - - toddlers 2-6 years old

-1&2-

Answer 11

Preoperational/preconceptual

1. self-oriented/centered
2. magical thinking
   a. animism - humanizing toys; imaginary friends

Question 12

Piaget, 7-11 year olds: -1-

Affinity for: -2-, and -3-

Answer 12

1. Concrete operational
2. logic, math, geography
3. puzzles

Question 13

Piaget - - 12+ years old

Answer 13

(Formal) Operational

abstract problems,

Question 14

Erikson 
Infant - 0-1 year -
Toddlers - 1-3 - 
Preschoolers - 3-6 - 
School age - 6-11 - 
Adolescents - 12 - 18 -

Answer 14

- viking - "vs"
 trust vs. mistrust
autonomy vs. shame & doubt
initiative vs. guilt
industry vs. inferiority
 identity vs. confusion

Question 15

Freud
0-6 mo.- - 
7-18 mo. - 
12-35 mo. - 
3-6 y - 
6-12 y - 
13+ -

Answer 15

oral
orally aggressive
anal stage
phallic/yonic stage; oedipal complex
puberty - sexual (gender) stage
genital (sexuality) stage

Question 16

Corrected gestational age important in -1-
Healthy baby born at 32 weeks
6-month well check: rolling, or lifting head well, but not babbling, crawling, or transferring objects - concerned? -2-
Correction is no longer done at -3-

Answer 16

1. premies
2. No, this is appropriate for a 4-month-old
3. 24 months

Question 17

Bone age

Answer 17

found by hand x-ray; describes degree of growth retardation

Question 18

Gross motor milestones

Sitting alone
Pulling to stand
Standing alone by
Walking

Answer 18

7-9 months
9-10 months
12 months
12-14 months

Question 19

*Fine Motor Milestones, Starting ages*
Reach - 
transfer -
rake - 
finger grasp - 
pincer -

Answer 19

3/4 months
7 months (5/6)
6/7
> 9 months (7/9)
8/10

Question 20

*Language/Social Dev*
 8/9 months - -1-
9/10 months - -4-
10-12 months - -5-
15/18 - -2-
18/22 - -3-

Answer 20

8/9 months - -1. mama, dada; waving bye-bye (to themselves, first); stranger anxiety (6-8 months)
9/10 months - 4. responding to name; separation anxiety (8 or 9 months)
10-12 months - 5. simple pretend play-
15/18 - -2. 1-2 body parts (finding, and speaking)
18/22 - -3. 2-word phrases

Question 21

Development Overall

2-5 months - -1- 
6-9 months - -2-
10-12 months - -3-
13-18 months - -4-
19-24 months - -5-

Answer 21

1. smiling/cooing/laughing aloud; lifting chest while prone; grasping rattle
2. babbling/mama-dada/turning to sound/name; crawling, high-chair; transferring
3. purposeful names/recognizing people; pulling up/cruising; pincer grasp, pointing/gesturing/ambidexterity (through 18 months)
4. simple standalone words; walking alone (no babinski); purposeful coloring/ball-throwing
5. 2-word phrases; steps, jumping (both feet); 4-block tower/lines & circles

Question 22

Health promotion

blood pressure & snellen chart at age -1-
PHQ-2/9 - -2-

Answer 22

1. 3

2. 12+ yo

Question 23

Lead screening ages

Answer 23

6 mo. - 6 years

Question 24

Car seats: rear-facing to age -1-
> The retainer clip should be at -2- to help hold the upper body in place in the event of a collision. Harness straps should be inserted into the slots that are -3- the level the infants’ shoulders.
-4- needs at least a booster until they weigh -5-

Answer 24

1. 12 months
2. the armpit level
3. at or below
4. 4 years/40 lb
5. 100 lb

Question 25

Growth Trend: | 4 months -

Answer 25

double BW

Question 26

Growth Trend: | 1 year -

Answer 26

triple BW

Question 27

GT: 2.5 years -

Answer 27

quadruple BW

Question 28

GT: | 3 years to school-age -

Answer 28

4-6 lb a year

Question 29

GT: school-age -

Answer 29

5-7 lb a year

Question 30

Developmental surveillance occurs at -1- and includes listening to -2- and the provider’s observations of the child’s development. -3- such as the ASQ are formal, -4- that score the child’s abilities and are used by the healthcare provider to -5-.

Answer 30

1. every RHA visit 2. caregiver concerns 3. Standardized development tools 4. validated screening tools 5. identify developmental delays

Question 31

The AAP recommends -1- at 9, 18, and 30 months or when surveillance -2- that warrants more information. -3- may fall into categories such as milestones achieved -4-, -5-, or incorrect completion of the milestone.

Answer 31

1. developmental tool screening 2. reveals a concern 3. Abnormalities in development 4. too early/late 5. persistence of milestones

Question 32

A five month old who pulls to -1- from supine is demonstrating -2- which is a concern for cerebral palsy. A three month old with a -3- when being pulled to sitting is -4- timeframe for performance.

Answer 32

1. to a standing (rather than sitting) position 2. muscle rigidity 3. mild head lag 4. within an expected

Question 33

Normal newborn infants lose -1- of their birth weight in the -2- of life. It is helpful for parents to be aware of both the -3- weights. The minimum expected weight gain is -4-, and thus for five days a -5- gain is minimally expected.

Answer 33

1. 5% to 10% 2. first few days 3. birth and discharge 4. 0.5 oz/day (14.2 g/day) 5. 2.5 oz (71 g)

Question 34

For breastfed infants, once the -1- increases, the infant begins to gain weight in the range of -2- or -3-.

Answer 34

1. maternal milk volume 2. 0.5 to 1 oz/day (14.2 to 28.4 g/day) 3. 4 to 7 oz/week (113.4 to 198.4 g/week)

Question 35

By -1- age, many breastfed infants have regained their -2-, although others may take up to -3- weeks. Any gain less than -4- would signal a concern for poor -5- or the potential for a serious disease process.

Answer 35

1. 2 weeks of 2. birth weight 3. 3 to 4 4. 0.5 oz/day (14.2 g/day) 5. breastfeeding

Question 36

A 6 month old can roll from -1-, will -2- and bring them to his mouth, and -3- in response to familiar faces. The 6 month old will -4- but is not yet adept at -5-.

Answer 36

1. tummy to back 2. reach for objects 3. smiles and laughs 4. sit with support 5. hand-to-hand object transferring

Question 37

The fine pincer grasp is not developed until -1- of age, which is also when the -2- with parents and will recognize when the parents -3-. Infants begin to creep and rock on hands and knees at an age -4- months.

Answer 37

1. beyond 9 months 2. infant becomes familiar 3. leave the room 4. older than 6

Question 38

The physiological and anatomical differences in children should be accounted for in patient care; one such consideration is that a child's -1- by raising the -2- during the early phase of -3-, giving a -4- of -5- that may lead to too little fluid resuscitation.

Answer 38

1. circulatory system compensates 2. heart rate/respirations 3. hypovolemic shock 4. false impression 5. physiologic vitals

Question 39

Child/Adult Anotomic/Physiologic Differences A higher metabolism with a limited store of -1- makes children more susceptible to -2-. The narrow airways lead to difficulties with -3- needs; however, a -4- is not always the first consideration for breathing difficulty.

Answer 39

1. glycogen 2. hypoglycemia 3. intubation 4. tracheotomy

Question 40

Child/Adult Anotomic/Physiologic Differences Lastly, even though children have -1-, they also have higher -2- per kilogram of body weight and can, thus, be exposed to -3- of -4-.

Answer 40

1. smaller lungs 2. minute ventilation 3. larger doses 4. aerosolized biological/chemical agents

Question 41

An adolescent patient's problems adjusting to school assignments are not a -1- sign. It would be in -2-, however. If the patient demonstrates any concurrent -3-, such as Difficulty accepting failure, Apparent -4-, and Withdrawal from -5-; then the patient should be further examined.

Answer 41

1. specifically developmental warning 2. a younger patient 3. developmental warning signs 4. personality change 5. friends and family

Question 42

Children possess the fine motor skills and understanding to draw a person with multiple distinguishable body parts (head, torso, arms, legs) and -1- by -2- of age. At -3- of age, children can draw simple people without detail (head, torso, arms, legs). Younger children are able to grasp and manipulate larger objects, such as blocks and doorknobs, but do not begin basic drawing, such as copying a circle, until -4-. Most -5- children would not be capable of advanced drawing.

Answer 42

1. detailed features (eyes, smile, feet, hands) 2. 5 years 3. 4 years 4. age 3 5. 2- to 3-year-old

Question 43

If an infant is demonstrating growth of thirty grams per day during the first three months of life and fifteen to twenty grams per day over the next three months, then the infant is -1- and needs -2-. -3- is not recommended in breastfed babies until after six months of age. -4- should be added to an infant's formula if the -5- has less than 0.6 ppm thereof, and the infant is at least six months old.

Answer 43

1. receiving adequate nutrition 2. no dietary supplementation 3. Iron supplementation 4. Fluoride supplements 5. drinking water supply