Peds Exam 1 study guide questions and answers

You advise an 18 year old female student who has been given a booster dose of MMR at the college health clinic: A. She might have a low grade fever during the first 24 to 48 hours B. She should not get pregnant within the next 4 weeks C. Her arm will be very sore at the injection site for 24 to 48 hours D. Her arm will have some induration at the injection site in 24 to 48 hours B. She should not get pregnant within the next 4 weeks The mother of a 4 wk old is concerned that her infant's eyes are crossed for a few seconds occasionally. The NP would: A. Recommend a referral to a pediatric ophthalmologist B. Advise the mother that this is a normal finding in infant up to 2 months of age C. Recommend a multivitamin supplements be given to the infant daily D. Educate her on how to patch the infant's eye every 4 hrs. B. Advise the mother that this is a normal finding in infant up to 2 months of age 00:36 01:14 Which of the following statements is false regarding physiological jaundice in newborns? A. Physiological jaundice is the most common type of jaundice in infants B. The level of unconjugated bilirubin is increased in the newborn's body C. Phototherapy is usually indicated for these infants D. It starts on the second to fourth day of life C. Phototherapy is usually indicated for these infants The majority of infants with physiological jaundice do not need phototherapy. This form of jaundice is caused by the buildup of unconjugated bilirubin because the infant's immature liver cannot metabolize and excrete it quickly enough A 15 year old boy has just moved into the community and is staying in a foster home temporarily. There is no record of his immunizations. His foster mother wants him to be checked before he enters the local high school. Which of the following immunization does this patient need? A. Meningococcal vaccine B. MMR vaccine C. Tdap vaccine D. All of the above D. All of the above This patient also needs hepatitis B vaccine, HPV vaccine, varicella vaccine (no history of chickenpox) A new mother is breastfeeding her full-term 4 week old infant. She wants to know whether she should give the infant vitamin supplements. The best advise is: A. Because she is breastfeeding, the infant does not need any vitamin supplements B. Breast milk give the infant all the vitamins he needs until 12 months of age C. Breastfed infants require vitamin D supplementation beginning in the first few days of life D. Infant formula can be used to supplement breastfeed as needed C. Breastfed infants require vitamin D supplementation beginning in the first few days of life Recommends vitamin D 400 IU/day supplementation starting at the first few days of life for all breastfed infants to decrease the risk of rickets Which of the following foods would you advise a new mother to introduce to her 6-month-old infant first? A. Iron fortified rice cereal B. Plain rice cereal C. Iron fortified pureed chicken meat D. Plain pureed carrots A. Iron fortified rice cereal The NP examines a 4-week-old boy whose mother reports that he has cried at least 3 hours a day at the same time of day since birth. What is the main goal in the clinical evaluation of this infant? A. Rule out any physiological cause for the crying spells B. Make sure the infant is well clothed C. Evaluate the environment D. Order laboratory and diagnostic testing A. Rule out any physiological cause for the crying spells The mother of a 16 y/o boy is concerned that her son is not developing normally. On physical exam, the patient is noted to have small testes with no pubic or facial hair. What is the most appropriate statement to the mother? A. Her son is developing normally B. Her son's physical development is delayed and should be evaluated by a pediatric endocrinologist C. Her son should be rechecked in 3 months, if he still does not have secondary sexual characteristics, a thorough hormonal workup should be imitated D. Her son's physiological development is slower than normal but is within the lower limit of normal for his age group B. Her son's physical development is delayed and should be evaluated by a pediatric endocrinologist If there is no testicular development by 14 y/o, an endocrinology consult is warranted At what age can a child ride a tricycle? 3 A new mother reports that her 6-mo-old infant has a cold and has a fever of 99.8. The infant is not irritable and is feeding well without problems. The mother wants to know whether it is okay for him to be immunized at this time. Which of the following statements is true? a. The infant should not be immunized until he is afebrile b. An infant with a cold can be immunized at any time. c. An infant with a cold can be immunized as long as the infant's temp is no higher than 100.4 d. Because immunization is so important, it should be given to the infant as scheduled c. An infant with a cold can be immunized as long as the infant's temp is no higher than 100.4 The mother of a 4-month-old girl calls your office and reports that the infant has a fever of 101.4. The infant received her immunizations yesterday. Which of the follow is correct? A. The fever is most likely due to the combination of the MMR and polio vaccine B. The fever is most likely due to the pertussis component of the DTap C. The infant is starting to get a viral URI D. The infant had an allergic reaction to one of the vaccines given and should be brought to the ED B. The fever is most likely due to the pertussis component of the DTap Precocious puberty is defined as the onset of secondary sexual characteristics before the age of: A. 7 y/o in girls, 8 y/o in boys B. 8 y/o in girls, 9 y/o in boys C. 9 y/o in girls, 10 y/o in boys D. 9 y/o in girls and boys B. 8 y/o in girls, 9 y/o in boys At what tanner stage does puberty start? A. TS 1 B. TS 2 C. TS 3 D. TS 4 B. TS 2 The earliest age at which the MMR vaccine can be administered is: A. 4 months B. 6 months C. 8 months D. 12 months D. 12 months A 16-year-old complains of a severe sore throat for 3 days along with a generalized rash and fever. The skin has the texture of sandpaper. This constellation of findings best describes: A. Kawasaki's disease B. Scarlet Fever C. German measles D. Rubeola B. Scarlet Fever Rash first appears on the neck and chest, then spreads over the body. Described as "sandpapery" in feel, can last for more than a week. A 15-month-old who is eating and behaving normally is found to have a high fever. After a few days, the fever resolves and the child breaks out in a maculopapular rash. This is a description of which of the following conditions? A. Erythema infectiosum B. Roseola infantum C. Fifth disease D. Scarlet fever B. Roseola infantum Caused by HHV-6, s/s include high fever for a few days with a maculopapular rash occurring after the fever breaks. Erythema infectiosum (Fifth disease) caused by parvovirus B19, s/s include "slapped cheek" appearance, in a few day lacy-appearing rash on trunk, arms, legs One of the developmental milestones for this age group is the ability to draw a stick figure "person" with six separate body parts. What is the age group that this finding is associated with? A. 3 y/o B. 4 y/o C. 5 y/o D. 6 y/o C. 5 y/o A 8 year-old child is seen by the NP. The mother reports that the child has been febrile for 2 days and is not eating well due to painful sores inside the mouth. The child's temperature is 101, HR 88 BPM, RR 14. During the physical exam, the NP notices several small blisters and shallow ulcers on the child's pharynx and the oral mucosa. The child has small round red rashes on both palms and soles. Which of the following conditions is most likely? A. Herpes simplex infection B. Hand, foot, mouth disease C. Varicella infection D. Secondary syphilis infection B. Hand, foot, mouth disease Caused by coxsackievirus, virus is found in saliva, sputum, nasal mucus, feces, blister fluid. What type of infection is caused by the human parvovirus B19? A. Fifth disease B. Roseola infantum C. Condyloma acuminata D. Scarlet fever A. Fifth disease, erythema infectiosum Caused by parvovirus. Most common 5 - 15 y/o. 3 stages: First stage characterized by a bright-red rash on the cheeks/face with slight fever and coldlike symptoms. Second stage the rash become lace like, third stage rash disappears but reoccurs when the child is exposed to sunlight, heat or exercise A preschool girl who is homeschooled is brought by her mother to the walk-in clinic because of acute onset of fever, runny nose, cough, sore throat, red eyes with morbilliform rash. Mother reports that her daughter has never been immunized. The family recently returned from a vacation. Which of the following conditions is most likely? A. Rubella B. Varicella C. Fifth disease D. Rubeola D. Rubeola, measles Caused by rubeola virus A healthy full-term infant at age 3 to 5 months should be able to: A. Gesture to an object B. Bring hands together C. Reach for an object with one hand D. Feed self a teething biscuit B. Bring hands together A healthy 2 y/o child is able to: A. speak in phrases of two or more words B. throw a ball at a target C. scribble spontaneously D. ride a tricycle A. speak in phrases of two or more words A healthy infant at age 9 to 11 months is expected to: A. roll from back to stomach B. imitate bye-bye C. play peek a boo D. hand toy on request C. play peek a boo At which age would a child likely start to imitate housework? A. 18 months B. 24 months C. 30 months D. 36 months A. 18 months A healthy 3 year old child is expected to Give his or her first and last name A healthy 6 to 7 month old is able to a. roll from back to stomach b. confidently feed self a cracker c. reach for an object d. crawl on abdomen a. roll from back to stomach You examine a healthy 9 moth old infant from a full term pregnant and expect to find that the infant: A. Sits without support B. Cruises C. Has the ability to recognize his or her own name D. Imitates a dazzling noise C. Has the ability to recognize his or her own name Which of the following would not be found in newborns? A. best vision at a range of 8 to 12 inches B. presence of red reflex C. light-sensitive eyes D. lack of defensive blink D. lack of defensive blink