Week/Quiz 1

Question 1

Lymph system is fully developed at age __, increases in size beyond that between age _____ and ___ and then decreases back down to normal size at the end of adolescence.

Answer 1

6 years, 10-12

Question 2

Neonates have a small stomach with a capacity of about ___ ml

Answer 2

60

Question 3

Gastric pH is alkalotic at birth, acid production slowly increases to adult level by age ___.

Answer 3

2

Question 4

L ventricular muscle is underdeveloped until age ___. Which means the radial pulse may not be palpable until this age.

Answer 4

6

Question 5

Infants have a poor response to hypotension via vasoconstriction; hypotension without tachycardia is seen with hypovolemia in neos and infants because the ______ reflexes are immature.

Answer 5

Baroreceptors

Question 6

_____ closes within the first hour of life. This opening ___________ and closes by ___.

Answer 6

Forman ovale, allows blood to shunt through the atriums from the R to the Left, closes by mechanical pressure from the change in cirulation after delivery.

Question 7

___ closes within the first 10-15 hours after birth. This opening ___ and closes by

Answer 7

Ductus artirioses, allows blood to shunt from the Pulmonary arteries to the aortas, bypassing the lungs which are not yet functioning, closed by oxygenating the lungs, which releases bradykinin and then causes the closure of the DA.

Question 8

____ and ____ are the first sinuses to develop (present at birth). Others are developing at age ___

Answer 8

Ethmoid and maxillary, 3 years

Question 9

Infants are ____ breathers until about age _____.

Answer 9

Nose, 4-5 months

Question 10

Saliva is minimal at birth, and increases by age ____.

Answer 10

3 months

Question 11

Sebaceous glands are active in neonatal because of ______. This causes ____ called ____.

Answer 11

Maternal androgens, baby acne, milia.

Question 12

Teeth should erupt between ages ___ and ____. Delayed if patient is what?

Answer 12

6 and 24 months, Malnutrition or hypothyroidism

Question 13

____ circumferences exceed ____ circumferences from age ____ to ____.

Answer 13

Head, chest, birth-2years

Question 14

___ glands are functional at birth with full function reached at age ___-___. these glands are all over the scin but most concentrated where?

Answer 14

Eccrine, 2-3, palsm, soles of feet and forhead

Question 15

_____ glands are nonfunctional until puberty which is what causes ____

Answer 15

Aprocrine, body odor

Question 16

Fontanells that close at 2 months

Answer 16

posterior

Question 17

fontanelle that closes by 12-18 months

Answer 17

anterior

Question 18

pupils are small with poor reflexes until ___ months. nystagmis and esotropia are common in neos younger than ___ months. Irisis have little pigment until age ___-___ months

Answer 18

5, 6, 6-12

Question 19

at age ___ months infants can fixate both eyes on same image. they can distinguish color by ___ months and are farsighted until ____.

Answer 19

4, 8, 6-7 years

Question 20

EAC is short and straight with upward curve and is horizontal until age ___. to do an otoscopic exam on a 3 years or less child, what should be done?

Answer 20

2 years, pinna should be pulled DOWN and back

Question 21

EAC continues to shorten and straighten as the child grows. to do an otoscopic exam on a 3 years or older child, what should be done?

Answer 21

Pinna should be pulled UP and back

Question 22

maternal iron stores in liver of baby but is depleted by age ____ which is why introducing other foods is important at this age.

Answer 22

6 months

Question 23

infants fight infections primarily by _____ immunity. immunity is not yet developed until ___ years which means younger than this age, children will be prone to sickness as they build their immunity

Answer 23

passive, 6years

Question 24

urinary bladder lies between the ____ and the ___ in infants and toddlers. bladder decends into pelvis by age __.

Answer 24

symphysis and the umbillicus

Question 25

testicles enlarge between age ____ and ___. early puberty is present if the testicles enlarge before then.

Answer 25

9.5-13.5

Question 26

abdominal distention in infants and toddlers is normal and can be caused by lumbar curvature called ____.

Answer 26

Lordosis

Question 27

neuro system is complete but not fully myelinated at birth. myelination is rapid in the first __ years of life and is complete by age __years.

Answer 27

2,7

Question 28

brain growth is rapid. 50% is completed by age ___. reaches 75% by age ___years, 90% by __ years. 100% by

Answer 28

1,3, 6, 12

Question 29

Age groups Neonate Infants Toddlers preschoolers school age children adolescents

Answer 29

Neonate birth-28 days Infants 1 mo- 1 year Toddlers 1-3 yr preschoolers 3-6 yr school age children 6-12 yr adolescents 12-21

Question 30

cephalocaudal development

Answer 30

head-to-toe development that corresponds to gross motor development and myelination of the spinal cord/ sitting up to walking

Question 31

proximal to distal

Answer 31

near to far corresponds to fine motor development and myelination of the spinal cord/ palmar to fine pincer

Question 32

mass to specific

Answer 32

progresses from simple acts to more complex acts examples: gross motor, fine motor, cognitive (concrete before abstract) speech (receptive before expressive, and then creating words and then sentances), socio-emotional (watching faces to stranger anxiety)

Question 33

definite, predictable sequence

Answer 33

same sequence in EVERY child this is due to myelination of the spinal cord and brain development. (all achieve head control before sitting up, receptive language before expressive language)

Question 34

critical senstive periods

Answer 34

most opportune time for learning or doing something (new language is 0-12 yrs) sensitive periods start and end gradually

Question 35

young infants reflexes

Answer 35

moro, startle, grask, suck, excrusiona and crawling

Question 36

required developmental screenings (ages)

Answer 36

9,18 and 30 months

Question 37

required autism screening

Answer 37

18 and 24 months

Question 38

in child visit- how do you determine who to speak to first?

Answer 38

child first if school age, parent first is younger than school age

Question 39

mandatory reporting laws for:

Answer 39

suicidal ideation, intent to harm others, suspected or documented abuse

Question 40

define culture

Answer 40

the social norms, beliefs, values, sympbols, and language of a group learned through process of socialization

Question 41

race defined

Answer 41

a biological classification reffering to people who share the same genetically inherited distinguished physical characteristics

Question 42

ethnicity defined

Answer 42

refers to a cultural groups identification associated with their common geographic origin, language, religion, traditions, values, music, food, and other cultural ties

Question 43

scientific or biomedical theory

Answer 43

belief that psysiology explains the functioning of the human body; illness is based on bacteria or viruses, envinmental exposure, and bodily trauma (western medancine)

Question 44

holistic and naturalistic perspective

Answer 44

illness is a result of the disruption in the balance of nature

Question 45

magico- religios perspective

Answer 45

heath and illness are determines by supernatural forces as god, gods, voodoo, witchcraft, spirits, fate

Question 46

folk illnesses

Answer 46

or culture-bound syndromes are those that are culturally defined

Question 47

red flags 3 months

Answer 47

- constant fisting - rolling before 3 mo -unable to push up on arms

Question 48

red flags 4-6 mo

Answer 48

head lag after 4 months persistnat primitive reflex failure to reach for objects by 5 months no smile by 4-6 mo poor or no head control by 6 mo stiff limbs

Question 49

12-18 mo red flags

Answer 49

no cooing after 6 mo absent stranger anxiety after 7 mo W sitting at 7 mo rounded back, poor use of arms, stiff legs, pointed toes cannot bear weight when pulled up to stand 8 mo no reciprocal vocilization by 9 mo failure to localize sounds by 10 mo

Question 50

12 - 18 mo red flags

Answer 50

no quadupled crawling, cannot pull to stand, moves one side of body more than other, 12 months toe walking, strong hand prefernce, extremity stifness at 15 mo no imitative play after 18 mo hand dominance before 18 mo

Question 51

18- 24 mo red flags

Answer 51

no first word (besides mama dada) by 18 mo has no more than 10-12 episodes of otits media no two words sentances by age 2 years very clingly to mother at 24 mo

Question 52

3year red flags

Answer 52

speech is lesss than 75% intelligable, does not speak in full sentances incorrect pronoun use cannot feed self indepently with spoon or fork toeing in: trips when running

Question 53

4 years red flags

Answer 53

speech is less than 95% intelligable cannot seperate from parent cannot balance on foot for 2 seconds cannot copy circle or hold pencol correctly cannot name 2-3 colors cannot share with friends agression/ acting out

Question 54

year 5 red flags

Answer 54

excessive fears, night terrors unable to identift colors speech not 100% understandable

Question 55

at any time red flags

Answer 55

parental concerns slow or excessive physical growth child's gait changes child stops walking cruelty to animals fire-setting persistent sleep disturbances bullying or being bullied abusive family or peer relationships difficulty with schoolwork pervasive sad mood

Question 56

integumentary assessment in Von Recklinghausen disease (neurofibromatosis)

Answer 56

auxillary freckling AND/OR more than 6 - 5 mm in greatest diameter safe au lait spots

Question 57

integumentary assessment seen in stuge weber diseases and what is this desease

Answer 57

facial port wine stains. causes seizures and cognitive delays

Question 58

integumentary assessment found in tuberous sclerosis and what is the disease

Answer 58

hypomelanotic macular oval shaped lesions (ash leaf spots) and shagreen patches (firm yellow or red or pink nodules) inheritsed disease that causes seizuers and inullectual disability in 50% affected

Question 59

trisomy 21 crease in hand

Answer 59

transverse felxion of palmar crease close tot he second and third finger (hockey stick palmar crease)

Question 60

brachmann de lange syndrome hair differences and what is the disease

Answer 60

arched marked eyebrows low front hairline, causes speech behavior and growth abnormalities

Question 61

initial health history- what is it and what is included

Answer 61

- takes place when they are first timer in your care - complete comprehensive health history - allergies reason for seeking care - family history - detailed past medical history - functional assessment - current illnesses and injuries - health knowledge - review of systems - prenatal history, neonatal history, and birth history if less than 3 - er visits - medications - surgeries

Question 62

interval health history

Answer 62

well child visit - updates the status of health - ask about new allergies, meds, surgeries, injuries, - functional assessment (update)

Question 63

focused health history

Answer 63

- episodic "sick" visit - problem-solving - chief complaint - history of present illness (onset, location, duration, characteristics) - OLD CARTS - review the following: allergies, medications (dose and last time given), immunizations, pain assessment, recent illnesses, alternative therapies, review of systems

Question 64

whats included in a functional assessment?

Answer 64

- nutrition - elimination -safety - sleep - social - growth and development milestones - school performance - spiritual assessment

Question 65

what is a follow-up health history

Answer 65

child returns to the clinic after a sick visit to see if the chief complaint has been managed

Question 66

what is an emergency health history

Answer 66

quickly collecting data in an acute situation. resembles a focused history but is done rapidly, usually with simultaneously assessments and interventions such as administering medications or respiratory treatments

Question 67

tips for seeing hearing defcit patients

Answer 67

- talk in a normal tone - avoid noises (knocking on doors, interruptions, typing on comp.) -eye level for lip reading - identify transitions in topics - use amplification devices - write down notes or allow the patient to write down items - give examples of words (M as in Mary)

Question 69

Stranger danger peaks

Answer 69

7-8 months

Question 70

Words for kids: incision

Answer 70

Special opening

Question 71

Words for kids: dye

Answer 71

Special liquid

Question 72

Words for kids: worry

Answer 72

Wonder

Question 73

Words for kids: XRAY

Answer 73

Picture

Question 74

Words for kids: pain

Answer 74

Ouchie, boo boo, sore, scratchy

Question 75

Words for kids: fix

Answer 75

Make it better

Question 76

Words for kids: take your temp

Answer 76

I’m going to see how warm you are

Question 77

Words for kids: electrode

Answer 77

Stickers

Question 78

Words for kids: test

Answer 78

Check to see how your BLANK is working

Question 79

When do you get length on peds patient

Answer 79

<2 years old

Question 80

When do you get a height on a pediatric patient?

Answer 80

> 2 years

Question 81

When do you get a heads circumference on a pediatric patient? 

Answer 81

Ages three years and younger

Question 82

When do you get a BMI on the pediatric patient?

Answer 82

 age 2 years and older

Question 83

An infant double her birthweight by what month , Triple birthweight by what month and quadruple birthweight by what month 

Answer 83

6, 12,24

Question 84

A patient is in your office complaining of a sharp pain in his wrist. The patient's complaint best describes which element of the health assessment? Social History Reason for Seeking Care Past Medical History Review of Systems

Answer 84

Reason for Seeking Care

Question 85

When performing a history and physical assessment, the examiner should develop a sequence of standard observations. change the sequence of observation with each interview. develop a preliminary diagnosis at the onset. direct patient responses to fit the history sequence.

Answer 85

develop a sequence of standard observations. .

Question 86

Which type of speculum should be used to examine a patient’s tympanic membrane? The longest speculum available Any speculum that will fit the otoscope head The smallest speculum that will illuminate the ear The largest speculum that will fit comfortably in the ear The shortest speculum available

Answer 86

The largest speculum that will fit comfortably in the ear

Question 87

What is the purpose of a genogram? To obtain a complete family history. To test for genetic disorders. To record the patient's genetic history. To rule out any diseases.

Answer 87

To obtain a complete family history.

Question 88

An ophthalmoscopic eye exam involves:

Answer 88

lens inspection.

Question 89

The body mass index should be measured in all children beginning at age: 3 years 4 years 2 years 1 year

Answer 89

2 yr

Question 90

The sequence of a physical examination changes to a head-to-toe approach beginning with which age group? Group of answer choices Adolescent School-age child Toddler Preschooler

Answer 90

preschool

Question 91

screeningings for alcoholism

Answer 91

AUDIT-C, TACE, CRAFFT