[PEDIA1] LE2 Flashcards

Question

10. The first visible sign of puberty among girls and boys is: * A. Thelarche and penile growth B. Thelarche and testicular enlargement C. Menarche and testicular enlargement D. Menarche and penile growth

Answer 1

B. Thelarche and testicular enlargement Explanation: The first visible sign of puberty in girls is thelarche (the onset of breast development), and in boys, it is testicular enlargement. These signs indicate the beginning of puberty.

Answer 2

A. Testicular development, pubic hair, peak height velocity Explanation: The typical sequence of puberty in males starts with testicular development, followed by the appearance of pubic hair, and then reaches the peak height velocity. This sequence reflects the general pattern of changes during male puberty.

Answer 3

C. Thelarche, growth spurt, menarche Explanation: In females, the usual sequence of puberty begins with thelarche (breast development), followed by a growth spurt, and finally menarche (the onset of menstruation). This sequence outlines the standard progression of female pubertal development.

Answer 4

D. Deciduous teeth Explanation: During adolescence, individuals do not experience an increase in deciduous (baby) teeth. Instead, these teeth are replaced by permanent teeth. Increases in laryngeal and pharyngeal size, aerobic capacity, and hematocrit are typical physiological changes that occur during adolescence.

Answer 5

D. Between SMR 2 and SMR 3 Explanation: In females, peak height velocity typically occurs between Tanner stages 2 and 3 (SMR 2 and SMR 3), which is before the onset of menstruation. Tanner stages are used to describe the physical development in children, adolescents, and adults.

Answer 6

b. Two years later than female's height spurt This option correctly reflects the general pattern that males experience their peak height velocity approximately two years later than females. This delay is due to the later onset of puberty in males compared to females. While peak height velocity in males does occur in the context of Tanner stages (often between SMR 3 and 4 for males), emphasizing the relative timing to females provides a clear comparison of developmental timelines between the genders.

Answer 7

B. Psychosocial development closely correlates with pubertal status Explanation: Psychosocial development during adolescence can be closely correlated with pubertal status, as the physical changes of puberty often influence an individual's self-perception and social interactions. Cognitive development and its correlation with physical maturation vary widely among individuals, and teens typically move from concrete to formal operational thinking, not the other way around.

Answer 8

B. Decrease in white matter Explanation: During adolescence and into the third decade of life, the brain experiences an increase in white matter, not a decrease. This increase in white matter is associated with increased myelination, which improves the efficiency of nerve impulse transmission. There is a decrease in gray matter due to synaptic pruning, and there is an increase in efficient communication and connectivity between different brain regions.

Answer 9

B. It occurs mostly in the frontal lobe Explanation: Synaptic pruning is a process that refines brain function by reducing the number of synapses, making neural networks more efficient. It occurs throughout the brain but is particularly significant in the frontal lobe, which is involved in higher-order functions such as decision-making, planning, and social behavior. The process follows the principle of "use it or lose it," meaning synapses that are not frequently used are more likely to be pruned away.

Answer 10

d. Impulse control and Planning Explanation: The pre-frontal cortex is responsible for higher-order cognitive functions such as impulse control, planning, decision-making, and moderating social behavior. Its later development in adolescents compared to other brain areas contributes to their characteristic impulsivity, thrill-seeking behaviors, and challenges in planning and controlling impulses.

Answer 11

a. Development of abstract thinking Explanation: Development of abstract thinking is a hallmark of cognitive development in adolescence but tends to fully crystallize later in the adolescent years. This cognitive milestone allows for the appreciation of complex concepts and hypothetical situations.

Answer 12

d. Concerned about future career, intimate relationships, accepts family's values Explanation: Individuals in late adolescence are typically more focused on their future, including career planning and developing intimate relationships. They also begin to integrate and accept their family's values as they form their own identity and prepare for adulthood.

Answer 13

c. Adolescent's decision making and subsequent behavior are large determinants of their morbidity and mortality. Explanation: This statement is true across the adolescent period. Adolescents' decision-making and behaviors significantly impact their health and safety, contributing to morbidity and mortality rates. This includes behaviors related to driving, substance use, and sexual activity.

Answer 14

d. Altruistic Explanation: While adolescents can demonstrate altruistic behavior, this option is not characteristic of adolescent thinking in general, especially when compared to the other options. Adolescence is often marked by egocentrism, which can manifest as self-centeredness, a sense of invincibility, and prone to exaggeration, rather than a focus on altruism.

Answer 15

b. Effect on schooling / vocation As the most likely psychosocial concern, it reflects the importance of how the diagnosis might impact her educational and vocational aspirations. At this age, individuals are often making critical decisions about their future career paths, and managing a chronic illness like diabetes could introduce challenges in navigating these decisions. Concerns might include managing diabetes care alongside school or work responsibilities, potential limitations on career choices depending on the severity of the condition, and the need for accommodations at school or work.

Answer 16

a. Separation from parents Explanation: Separation from parents is a key developmental task during adolescence as individuals seek to establish their own identity and autonomy. This process involves both physical and emotional aspects and is crucial for the transition to independent adulthood.

Answer 17

d. Economic independence Explanation: While achieving economic independence is an important milestone, it is not typically considered a central developmental task of adolescence. The primary tasks during this period focus more on establishing identity, achieving emotional and psychological independence, and accepting one's sexuality.

Answer 18

c. B4 Explanation: Tanner stage B4 for breast development is characterized by the secondary mound formation where the areola and papilla form a secondary mound above the level of the breast.

Answer 19

c. G4 Explanation: Tanner stage G4 for genital development in males includes further enlargement of the penis with development of the glans, darkening of the scrotal skin, and increased scrotal size.

Answer 20

b. PH 3 Explanation: Tanner stage PH3 for pubic hair development is characterized by a moderate amount of darker, coarser, and more curled hair, extending laterally.

Answer 21

b. Socializes with same sex peers Explanation: In early adolescence, teens often socialize more with same-sex peers as they begin navigating the complexities of social relationships and developing their social identity. This stage is marked by a strong inclination towards forming friendships and social networks with peers of the same sex.

Answer 22

c. Psychosocial If we're emphasizing psychosocial development in the context of environmental and cultural influences, it's true that these factors profoundly impact adolescents' psychosocial development. Cultural norms, societal expectations, and the environment in which an adolescent grows up can significantly shape their social interactions, identity formation, self-esteem, and relationships with peers and family. While physical and cognitive developments are also influenced by these factors, psychosocial development is particularly sensitive to the social context, including cultural and environmental influences. This aspect of development encompasses the changes in relationships, emotions, and social skills that occur during adolescence.

Answer 23

D. Peak of Parent-child conflict Explanation: Middle adolescence is often characterized by the peak of parent-child conflict. This period is marked by teens seeking independence, questioning authority, and testing boundaries, which can lead to increased conflicts with parents.

Answer 24

C. Development of emotional intimacy Explanation: In late adolescence, individuals start to develop deeper emotional intimacies in their relationships. This period is characterized by more mature relational dynamics compared to earlier stages of adolescence.

Answer 25

B. Middle adolescence Explanation: Preoccupation with body image and appearance is common in middle adolescence. Teens at this stage are highly concerned with how they are perceived by others and often spend considerable time on their appearance.

Answer 26

A. Breast stage 2, pubic hair stage 2 Explanation: The description matches Tanner stage 2 for both breast and pubic hair development. Breast stage 2 is characterized by a small mound of breast and papilla elevation, and pubic hair stage 2 involves sparse, lightly pigmented, straight hair, primarily along the labia.

Answer 27

A. A boy wanting his own room and not interested in family activities This choice specifically highlights the aspect of seeking more privacy at home and beginning to reject parental advice and involvement in their decision-making, which is a key characteristic of early adolescence as it relates to the theme of separation from parents.

Answer 28

B. Middle Explanation: The sense of immortality and immunity, often referred to as the "personal fable," is most pronounced during middle adolescence. Teens at this stage tend to feel invincible and may engage in riskier behaviors due to a belief in their own uniqueness and invulnerability.

Answer 29

A. Early Explanation: Sexual interest and awareness typically begin in early adolescence. This is when puberty starts, leading to an increase in hormones and the beginning of sexual maturation, which sparks an increased interest in sexual matters.

Answer 30

B. Middle Explanation: Preoccupation with appearance is especially common in middle adolescence. During this stage, teens become more concerned with how they are perceived by others and begin to place a greater emphasis on their physical appearance and attractiveness.

Answer 31

C. Late Explanation: While peer groups are crucial throughout adolescence, their importance tends to diminish in late adolescence. As teens mature and develop a stronger sense of individual identity, they begin to prioritize personal goals and intimate relationships over peer group conformity.

Answer 32

A. Early Explanation: Being highly conscious about looks and doubting if bodily changes are normal are characteristic concerns of early adolescence. This stage marks the onset of puberty, bringing about rapid physical changes that can lead to self-consciousness and uncertainty.

Answer 33

A. Peer pressure may be positive pressure for the teen Explanation: Peer pressure can indeed have positive effects, such as encouraging academic achievement, involvement in community or extracurricular activities, and adopting healthy habits. While peer groups can influence teens in various ways, not all peer pressure is negative, and teens do not necessarily maintain the same identity across different groups or limit their peer interactions to same-sex peers.

Answer 34

C. Boy's group are centered on a particular activity Explanation: During early adolescence, boys' social groups often revolve around specific activities or interests, such as sports or video games. Girls' groups during early adolescence tend to be more relationship-oriented, although this isn't an option provided here.

Answer 35

C. Late Explanation: In late adolescence, as individuals mature and gain a better understanding of their identity and others', they often re-establish closer relationships with their parents, moving towards an adult-like relationship.

Answer 36

b. Middle This reflects the stage when many teens start to show a significant interest in romantic and sexual relationships, aligning with the developmental changes and social dynamics characteristic of middle adolescence.

Answer 37

B. Basis for predicting the final size of the breast, testes, penis, scrotum

Answer 38

B. SMR 3 Explanation: Spermarche (the first ejaculation), the appearance of acne, and the onset of axillary perspiration typically occur around Tanner stage 3, as these are signs of advancing puberty in boys.

Answer 39

C. 12 yrs old Explanation: The mean age for peak height velocity in girls is around 12 years old. This is the period during which girls experience their fastest rate of growth in height during puberty.

Answer 40

c. The growth spurt occurs 18-24 months in females than in males Explanation: This statement is inaccurately phrased. The growth spurt actually occurs earlier in females than in males, typically around 2 years earlier, not 18-24 months in females than in males. The onset of puberty and the associated growth spurt begin earlier in girls than in boys.

Answer 41

b. 3-4 years

Answer 42

c. Two fingers The two-finger technique is specifically designed for use in neonates and infants, as it allows for effective compression of the chest with appropriate depth and control, ensuring sufficient blood flow to sustain vital organs during periods of inadequate cardiac output.

Answer 43

c. It remains patent or retains the catheter for about 10 days Explanation: The statement that the catheter remains patent or is retained for about 10 days is not accurate. Umbilical catheters, whether for venous or arterial access, are typically not intended to be left in place for such a long duration due to the risk of infection and other complications. The duration for which an umbilical catheter is left in place can vary, but it is generally used for a shorter term, and its use is closely monitored.

Answer 44

b. Backward and upward Explanation: For adults and older children, the pinna should be pulled backward and upward to straighten the external auditory canal for better visualization during otoscopy. For infants, the pinna is pulled downward and backward.

Answer 45

d. Saphenous vein Explanation: The saphenous vein at the ankle is the preferred site for venous cutdown in children with difficult vascular access. This site is chosen due to its accessibility and the lower risk of complications compared to other sites.

Answer 46

C. Finger prick or heelstick Explanation: The finger prick or heelstick method is commonly used for blood collection in newborns and infants to test for various parameters, including hematocrit, bilirubin, and glucose levels. This method is preferred due to its minimal invasiveness and suitability for the small blood volume required for these tests.

Answer 47

A. Have the patient in a standing position Explanation: For accurate blood pressure measurement, especially in children, it is recommended to have the patient seated or lying down, not standing. The standing position can affect blood pressure readings due to the effects of gravity and may not provide the most accurate assessment of resting blood pressure.

Answer 48

D. Laceration of tongue or gums Explanation: While orotracheal intubation can lead to several complications, laceration of the tongue or gums is less common compared to other complications like broken teeth, bronchospasm, and hypoxemia. The procedure is performed with care to avoid damage to oral structures, though minor injuries can occur.

Answer 49

E. AOTA Explanation: All provided options (A, B, C, D) are correct practices for measuring growth in children and adolescents. Height is accurately measured in a standing position; the lower segment measurement and arm span length measurement descriptions are accurate; and weighing a child indirectly by having a parent hold the child is a common practice when direct weighing is not feasible.

Answer 50

b. Use of one, two or three fingers is preferred to palpate precordial pulsation

Answer 51

D. Rectal Explanation: The rectal temperature measurement is considered the gold standard for assessing core body temperature, especially in infants and young children. It is more accurate than axillary, oral, and ear (tympanic) measurements, though it is invasive compared to the other methods.

Answer 52

D. Subglottic stenosis Explanation: Subglottic stenosis is a potential long-term or late complication of intubation, not typically an immediate one. Immediate complications can include esophageal intubation, right mainstem intubation, and barotrauma.

Answer 53

A. Proximal tibia Explanation: The proximal tibia is the preferred site for intraosseous (IO) infusion in children, including those with difficult venous access. It is easily accessible and provides a reliable entry point for the administration of fluids and medications.

Answer 54

C. Chest thrusts or back blows Explanation: For infants under 1 year old, the recommended approach for relieving airway obstruction due to foreign body aspiration involves the use of back blows and chest thrusts, not the Heimlich maneuver.

Answer 55

D. Heimlich maneuver Explanation: For children older than 1 year, the Heimlich maneuver (abdominal thrusts) is the recommended procedure to relieve airway obstruction caused by foreign body aspiration.

Answer 56

D. Oxygen saturation Explanation: Oxygen saturation is often considered the "sixth vital sign" in pediatric patients, reflecting its importance in assessing the respiratory and circulatory status of children.

Answer 57

A. Vastus lateralis muscle Explanation: For infants, including a 2-month-old baby receiving DPT immunization, the vastus lateralis muscle in the thigh is the preferred and safe site for intramuscular injections. This site is recommended due to its large muscle mass and distance from major nerves and blood vessels.

Answer 58

d. Midstream collection Explanation: Midstream urine collection is the most practical and non-invasive method for obtaining a urine sample from school-age children. It involves collecting urine 'midstream' during urination, which helps reduce contamination from the skin and genital area.

Answer 59

a. Radial artery The radial artery, located on the ventral surface of the wrist, is often the preferred site for obtaining arterial blood specimens in infants and young children, especially for arterial blood gas (ABG) analysis. The detailed procedure for collecting blood from the radial artery, including the use of a 25 to 23-gauge butterfly needle and performing Allen's test to ensure collateral perfusion, highlights its suitability and common use for this purpose.

Answer 60

b. Left hand and wrist Explanation: The most commonly used method for determining bone age is based on a single X-ray of the left hand and wrist. This method allows healthcare providers to compare the maturity of the child's bones to standard age norms.

Answer 61

b. 2-3 cm Explanation: The tip of the endotracheal tube (ETT) should ideally be positioned approximately 2-3 cm below the vocal cords (glottis) into the trachea to ensure proper ventilation and to avoid accidental extubation or intubation of the right main bronchus.

Answer 62

c. sensitivity to tuberculin protein of the bacteria due to a past or present infection Explanation: The accelerated response to the BCG vaccine, characterized by rapid induration, pustule formation, and scabbing and healing, indicates sensitivity to the tuberculin protein. This response suggests a past or present infection with Mycobacterium tuberculosis, as the immune system reacts more vigorously due to previous exposure to similar antigens.

Answer 63

a. birth Explanation: The first dose of the Hepatitis B vaccine is recommended to be given at birth as part of the standard immunization schedule. This early vaccination helps prevent vertical transmission of Hepatitis B from mother to child.

Answer 64

d. over 7 years old Explanation: The pertussis vaccine is typically not recommended for individuals over 7 years old in its pediatric form (DTaP). For older children and adults, a different formulation called Tdap (tetanus, diphtheria, and acellular pertussis) is used to provide protection against pertussis.

Answer 65

a. Influenza vaccine Explanation: The influenza vaccine comes in both inactivated (killed virus) and live attenuated forms. The most commonly administered influenza vaccine is the inactivated form, especially for the annual flu shots. The live attenuated influenza vaccine (LAIV) is a nasal spray, but when referring to the influenza vaccine broadly, it includes forms that are not live attenuated.

Answer 66

b. DTaP Explanation: DTaP (Diphtheria, Tetanus, and acellular Pertussis) vaccine is important because natural infection with these bacteria does not confer lifelong immunity, making vaccination essential for continued protection.

Answer 67

d. DTaP The DTaP vaccine includes diphtheria and tetanus toxoids and acellular pertussis components, none of which are live agents. The pertussis component is made from acellular parts of the pertussis bacteria, and the diphtheria and tetanus components are toxoids (inactivated toxins). This makes DTaP an example of a vaccine that contains heat-killed organisms or their components, fitting the description provided in the question.

Answer 68

d. All of the above Explanation: Preventive pediatrics encompasses the supervision of physical growth and development from fetal life to adolescence, early detection of congenital anomalies, and periodic health supervision visits to ensure the overall health and well-being of children and adolescents.

Answer 69

b. Tyrosinemia Explanation: As of the last update, Tyrosinemia was not included in the standard newborn screening panel in the Philippines. The Philippine Newborn Screening includes tests for conditions such as Congenital Hypothyroidism, Congenital Adrenal Hyperplasia, Phenylketonuria, Galactosemia, and Maple Syrup Urine Disease, among others.

Answer 70

B. Varicella vaccine Explanation: The Varicella vaccine is a live attenuated vaccine and is generally contraindicated in individuals who are immunocompromised or on immunosuppressive therapy due to the increased risk of vaccine-induced disease.

Answer 71

A. Measles Explanation: The Measles vaccine is not administered at birth. It is typically given at a later stage, usually around 12-15 months of age as part of the routine childhood vaccination schedule. In contrast, OPV (Oral Polio Vaccine), Hepatitis B, and BCG (Bacille Calmette-Guérin for tuberculosis) can be administered at birth.

Answer 72

D. Infants with Vitamin B deficiency Explanation: While premature infants, infants with metabolic disorders, and those with a family history of congenital cataracts are at increased risk for eye and visual defects and thus recommended for screening, there is no specific recommendation for universal eye and visual defect screening solely based on Vitamin B deficiency.

Answer 73

A. < 6 months Explanation: Early intervention for hearing-impaired infants is most effective when started before 6 months of age. Early detection and intervention can significantly improve outcomes in speech, language, and cognitive development.

Answer 74

A. Fever Explanation: Fever is a common and generally mild adverse reaction following vaccination, reflecting the body's immune response to the vaccine.

Answer 75

C. Hepatitis B immune globulin Explanation: Hepatitis B immune globulin provides passive immunity by supplying ready-made antibodies to the hepatitis B virus, offering immediate but temporary protection. Vaccines like Hepatitis B vaccine and MMR confer active immunity by stimulating the body's immune system to produce its own antibodies, and infection with measles virus also leads to active immunity through natural infection.

Answer 76

C. Both A and B Explanation: Infants born to HepB Ag-positive mothers should receive both the Hepatitis B vaccine and Hepatitis B immunoglobulin (HepB Ig) shortly after birth to provide both immediate and long-term protection against hepatitis B infection.

Answer 77

D. MMR Explanation: The MMR vaccine, which is a live attenuated vaccine, is generally not contraindicated in all HIV-positive patients. It can be administered to HIV-positive patients who do not have evidence of severe immunosuppression. However, caution and medical guidance are advised, making it a more complex choice compared to the other options listed, which are not live vaccines or are less likely to be contraindicated in HIV-positive individuals.

Answer 78

C. At 15 months Explanation: The first dose of the MMR vaccine is typically given at 12-15 months of age, with a second dose usually administered at 4-6 years of age, making 15 months an ideal time for the first dose.

Answer 79

A. IgA Explanation: Oral vaccines like the Oral Polio Vaccine (OPV) stimulate the production of IgA antibodies in the gastrointestinal tract, providing localized immunity.

Answer 80

C. Is the procedure of choice for immunization of normal children Explanation: The combined DPT vaccine is the procedure of choice for the primary immunization of normal children, as it efficiently provides protection against three significant diseases with a single injection, simplifying the vaccination schedule and improving compliance.

Answer 81

D. Acute illness with an oral temperature over 38C Explanation: A moderate or severe acute illness with or without fever is a precaution to the administration of most vaccines. An oral temperature over 38°C (100.4°F) is considered a contraindication for routine immunization until the illness resolves, to avoid complicating the diagnosis of the illness or attributing a reaction incorrectly to the vaccine.

Answer 82

c. At 9 months of age Explanation: The first dose of the live attenuated measles vaccine is typically administered at 9 months of age in many immunization schedules, including those in countries with high measles transmission rates.

Answer 83

b. Less risk of vaccine-associated paralytic polio Explanation: The primary advantage of IPV over OPV is the elimination of the risk of vaccine-associated paralytic poliomyelitis (VAPP), a rare but serious adverse event associated with the oral polio vaccine.

Answer 84

b. +2 to +8 degrees Centigrade Explanation: Vaccines are typically required to be stored within a temperature range of +2 to +8 degrees Centigrade to ensure their potency and effectiveness. This is a standard guideline for vaccine storage in the cold chain.

Answer 85

B. Passive immunization provides permanent protection through administration of antibodies Explanation: Passive immunization, through the administration of antibodies, provides immediate but temporary protection against infectious diseases. It does not provide permanent protection, unlike active immunization, which stimulates the body's own immune response.

Answer 86

a. Diphtheria immune globulin Explanation: Diphtheria immune globulin provides passive immunity by supplying ready-made antibodies to the body, unlike vaccines such as DT (Diphtheria and Tetanus toxoid), MMR (Measles, Mumps, and Rubella), and the Influenza vaccine, which stimulate the body's immune system to produce its own antibodies, providing active immunity.

Answer 87

a. Newborn period Explanation: Developmental screening can and should start from the newborn period to identify any early signs of developmental delays or disorders. Regular screenings continue throughout childhood at various well-child visits.

Answer 88

c. 3 years old Explanation: Routine blood pressure screening for well children is recommended to start at 3 years old, according to the American Academy of Pediatrics guidelines, and should continue at every health care visit thereafter.

Answer 89

d. 18 months old Explanation: The American Academy of Pediatrics recommends that all children be screened for autism spectrum disorders (ASD) at 18 months and 24 months, or whenever a parent or provider has a concern.

Answer 90

b. 1 month old Explanation: A tuberculin skin test (TST) can be administered to an at-risk child as early as 1 month old if there is a concern about exposure to tuberculosis or if the child is considered to be at high risk for TB.

Answer 91

d. Dyslipidemia screening Explanation: Dyslipidemia screening is not routinely performed for all 2-year-olds but is recommended for children at risk of heart disease or with a strong family history of cardiovascular disease or dyslipidemia. For a general population of 2-year-olds, including those with obesity, dyslipidemia screening might not be included unless there are specific risk factors present.

Answer 92

D. Good nutrition is directly related to an improved infant and child health. Nutrition is a fundamental aspect of health and development, especially in infants and children.

Answer 93

B. 45-60% Carbohydrates, 30-40% Fats, 10-25% Proteins

Answer 94

A. Vitamin A. The body can convert beta-carotene, found in plant foods, into vitamin A.

Answer 95

C. Facilitates absorption of Vitamin D. Proteins have many functions, including balancing fluids, providing energy, and acting as chemical messengers, but they do not directly facilitate the absorption of vitamin D.

Answer 96

C. Facilitates absorption of Vitamin D as the function not attributed to proteins.

Answer 97

A. no TV Rationale: For children under 2 years old, it is recommended to avoid screen time, including watching TV, to promote healthy physical and cognitive development.

Answer 98

C. rate of weight gain

Answer 99

B. 4 oz. The American Academy of Pediatrics recommends not exceeding this amount to prevent excessive calorie intake and dental problems.

Answer 100

C. Increase the frequency and duration of breastfeeding

Answer 101

C. 320 kcal 1. Determine the total grams of carbohydrates consumed daily: 5 grams/kg x 16 kg = 80 grams. 2. Calculate the total caloric intake from carbohydrates: 80 grams x 4 kcal/gram = 320 kcal. CALORIC VALUES OF THREE MAIN COMPONENTS OF FOODS ● Dietary nutrients that provide energy o 1g carbohydrates = 4Kcal o 1g protein = 4 Kcal o 1g fats = 9 Kcal o 1oz of milk = 20 Kcal o 1oz = 30m

Answer 102

A. Increases risk of allergies among infants

Answer 103

12: C. The baby's chin is not touching the breast Rationale: Proper latching, where the baby’s chin touches the breast, is crucial for effective breastfeeding and to prevent nipple soreness. Incorrect latching can cause persistent nipple pain.

Answer 104

C. Protein Hydrolysate formula. These formulas are designed for infants at risk of allergies and are easier to digest.

Answer 105

C. Fiber slows gastric empty time and promotes satiety Rationale: Fiber can help in weight management by slowing gastric emptying, which promotes a feeling of fullness (satiety) and can lead to reduced calorie intake.

Answer 106

A. 25-(OH)-D Rationale: The best measure of vitamin D status is the level of 25-hydroxyvitamin D (25-(OH)-D) in the blood, as it reflects the total vitamin D stores in the body.

Answer 107

C. Calcium Rationale: Calcium plays a critical role in muscle and nerve function, blood coagulation, and milk production, among other physiological processes.

Answer 108

D. 6 months Rationale: Iron supplements are typically recommended for healthy, exclusively breastfed infants starting at around 6 months of age to prevent iron deficiency.

Answer 109

D. Assure the mother and continue with the usual diet of the child Rationale: If the child is asymptomatic, feeding well, and has no history of hospitalization or chronic illness, reassurance and continuing with the usual diet may be appropriate, while monitoring for any symptoms.

Answer 110

A. Colostrum Rationale: Colostrum, the first milk produced after birth, has the highest concentration of secretory IgA and macrophages, which are important for the newborn's immune system.

Answer 111

A. Presence of wet diapers, 8-10x/day Rationale: A good indicator of adequate breastfeeding is the presence of wet diapers (8-10 times per day), reflecting sufficient milk intake.

Answer 112

B. Breast are painful with tight nipples

Answer 113

D. Soy milk formula Rationale: An infant with complete lactose intolerance may benefit from a soy milk formula, which does not contain lactose and is suitable for infants with lactose intolerance.

Answer 114

C. 6-9 months Rationale: Complementary foods should be introduced around 6-9 months of age to ensure proper nutrition and development, alongside continued breastfeeding.

Answer 115

D. Cyanocobalamin (B12) Rationale: Vitamin B12 (Cyanocobalamin) is primarily found in animal products, and its dietary sources are almost exclusively from these sources.

Answer 116

C. One-handed cup holding Rationale: By 24-36 months of age, children typically develop the skill to hold a cup with one hand and drink from it independently.

Answer 117

D. 480 kcal. CALORIC VALUES OF THREE MAIN COMPONENTS OF FOODS ● Dietary nutrients that provide energy o 1g carbohydrates = 4Kcal o 1g protein = 4 Kcal o 1g fats = 9 Kcal o 1oz of milk = 20 Kcal o 1oz = 30m

Answer 118

B. Sucrose The primary carbohydrate in soy-based milk formula is B. Sucrose. Soy formulas are often sweetened with sucrose to improve taste and mimic the lactose content's energy in cow's milk-based formulas.

Answer 119

A. Complete and accurate clinical history Rationale: A complete and accurate clinical history is crucial in assessing a child's nutritional status, as it provides comprehensive information including dietary habits, growth patterns, and health history.

Answer 120

B. Yes, because the baby can move the food from the tongue to teeth

Answer 121

A. It is the main source of energy at 4 kcal/gm

Answer 122

C. Continue breastfeeding day and night and give ORS as often as the child wants. Rationale: According to the Nelson Textbook of Pediatrics, breastfeeding should continue during episodes of diarrhea to prevent dehydration and malnutrition. Oral rehydration solution (ORS) should be given to replace lost fluids.

Answer 123

D. Warm compress and massage may be helpful. Rationale: The symptoms suggest engorgement or possible mastitis. Warm compresses and massage can help alleviate pain and improve milk flow, as recommended in the Nelson Textbook of Pediatrics.

Answer 124

C. Feeding of breastmilk without any additional food or drink for 6 months. Rationale: Exclusive breastfeeding for the first 6 months of life provides all the necessary nutrients for an infant and is recommended for sustaining breastfeeding.

Answer 125

C. Baby is unable to hold head. Rationale: Being able to hold the head up is a sign of readiness for complementary feeding. If the baby cannot hold their head, it is considered not ready for complementary foods.

Answer 126

B. Skim milk. Rationale: Skim milk is not recommended for a 4-year-old due to its low fat content, which is needed for growth and development.

Answer 127

A. Unlimited access of mother to baby. Rationale: Hospital policies that promote breastfeeding often include practices that facilitate skin-to-skin contact and unrestricted access to breastfeeding.

Answer 128

D. Mother whose infant has galactosemia. Rationale: Galactosemia is a metabolic condition where the infant cannot process galactose, a sugar present in milk. Breastfeeding is contraindicated in this case, as per the guidelines in the Nelson Textbook of Pediatrics.

Answer 129

A. The mother should be comfortable, the infant's head and body should be straight. Rationale: Proper breastfeeding technique involves ensuring the mother is comfortable and the baby's head and body are aligned straight to facilitate effective latch and swallowing.

Answer 130

C. Lips widely flanged out, nose and chin touching breast. Rationale: A good attachment for breastfeeding includes the baby's lips widely flanged out, with the nose and chin touching the breast, allowing for efficient and effective nursing.

Answer 131

C. Vitamin D. Rationale: Vitamin D functions similarly to a hormone and is involved in the regulation of calcium and phosphate metabolism in the body.

Answer 132

B. Recommended Dietary Allowance (RDA). Rationale: RDA is the average daily dietary intake level sufficient to meet the nutrient requirements of nearly all (97–98%) healthy individuals in a particular life stage and gender group and is used to guide daily intake to prevent deficiencies.

Answer 133

C. Cognitive Function. Rationale: Recommended dietary intake is typically affected by gender, physical activity, and age, but not directly by cognitive function.

Answer 134

B. Transmission of HIV. Rationale: HIV can be transmitted from mother to infant through breastfeeding. It's one of the known risks, especially if the mother is HIV-positive and not on antiretroviral therapy.

Answer 135

A. Whole cow's milk. Rationale: Whole cow's milk is not recommended for infants under one year of age due to its high protein and electrolyte levels, which can stress the infant’s immature kidneys and lacks the appropriate amounts of iron, vitamin C, and other nutrients.

Answer 136

D. Vitamin D. Rationale: Vitamin D has been studied for its potential benefits in reducing the risk of viral respiratory tract infections, including its role in immune function.

Answer 137

C. Pyridoxine (Vitamin B6). Rationale: Pyridoxine (Vitamin B6) is given alongside isoniazid (INH) to prevent the development of peripheral neuropathy, a side effect of INH therapy in the treatment of tuberculosis.

[PEDIA1] LE2 Flashcards

(162 cards)