PEDS MIDTERM 6541
Appropriate advice for a mother of a 2-week-old child here for a "well child" visit
includes which of the following? - ANSWER Answers:
Sleep in the supine position is recommended
Parents bring their 6-month-old son to see you. He is symmetrically less than the 5th
percentile for height, weight and head circumference. He was born at 30 weeks'
gestation and weighed 1000g. He was a planned pregnancy, and his mother's
prenatal course was uneventful until an automobile accident initiated the labor. He
was ventilated for 3 days in the intensive care unit but otherwise did well without
ongoing problems. He was discharged at 8 weeks of life. Which of the following is
the most likely explanation for his small size? - ANSWER Normal ex-preemie infant
growth
A Mantoux test in a child with no risk factors is considered positive with a reaction of
- ANSWER at least 15 mm induration
A 4-year-old believes there is more juice in a tall, thin glass than a shorter, wider
one. The child has not yet achieved which of the principles of Piaget? - ANSWER
Conservation
I can roll over, grasp a rattle, and reach for things and have begun feeding myself
finger foods, but I can't wave bye-bye yet. How old am I? - ANSWER 6 months
A 4-month-old child has poor weight gain. Her current weight is less than the 5th
percentile, height about the 10th percentile, and head circumference at the 50th
percentile. The planned pregnancy resulted in a normal, spontaneous, vaginal
delivery; mother and child were discharged after a 48-hour hospitalization. Feeding
is via breast and bottle; the quantity seems sufficient. The child has had no illness.
The examination is unremarkable except for the child's small size. Screening
laboratory shows the hemoglobin and hematocrit are 11 mg/dL and 33%
respectively, with a platelet count of 198,000/mm3. Serum electrolyte levels are
sodium 140, chloride 105, potassium 3.5, bicarbonate 17, blood urea nitrogen 15,
and creatinine 0.3. Liver function tests are normal. Urinalysis reveals a pH of 8 with
occasional epithelial cells but no white blood cells, bacteria, protein, ketones, or
reducing substances. Which of the follow - ANSWER Oral supplementation with
bicarbonate
Which of the following vaccines is routinely recommended at 4 months of age? -
ANSWER Diphtheria, tetanus, acellular pertussis (DTaP)
I can walk well on tiptoes, my speech is 50% understandable, I know six body parts,
but I cannot balance on one foot for 1 second. I am - ANSWER 2-1/2 years old (30
months)
, You see a healthy 18-month-old for a well-child visit. At the 12-month visit he
received the diphtheria, tetanus, and acellular pertussis (DTaP) third dose; hepatitis
B second dose; measles, mumps, and rubella (MMR) first dose; injected poliovirus
(IPV) second dose; pneumococcal conjugate (PCV13) fourth dose; and Haemophilus
influenzae type B (Hib) fourth dose. Which of the following do you order today? -
ANSWER DTaP, varicella, hepatitis A, and hepatitis B
Which is the correct order for introduction of solid foods to an infant? - ANSWER
Cereal, vegetables, fruits, and meats
I like to use my pincer grasp that involves the ability to pick up a small object such as
a raisin or piece of cereal with the thumb and forefinger, and that is mastered around
what age? - ANSWER 9 months
The first sign of the onset of female puberty is usually - ANSWER Breast buds
A mother of a 6-month-old asks you about normal sleep patterns for an infant this
age. The best response is: - ANSWER 10 hours at night and 3-4 hours during the
day
Medicaid provides health insurance coverage to - ANSWER Certain categories of
people whose personal income falls below a certain percentage of the federal
poverty level.
You see a 5-month-old who is fussy, has interrupted sleep, and is drooling. You note
large lower lateral incisor bulges. You recommend: - ANSWER A and D
You see a young child who has tripled her birth weight and looks for hidden objects.
When given blocks, she places one in each hand. She has a fine pincer grasp. On
the floor, she walks around holding objects and is trying to take independent steps.
This child is most likely how old? - ANSWER 12 months
Sally, age 4, presents to the office with her mother for a well-child visit. To assess for
age-appropriate fine motor skills, what activity would you ask her to perform? -
ANSWER Cut on a line with scissors
Which adolescent would be at greatest risk for developing anorexia nervosa? -
ANSWER 14-year-old female gymnast
Which of the following injuries is most likely to be caused by abuse of a toddler? -
ANSWER A displaced posterior rib fracture.
You see a 3-year-old for a well-child visit. His mother informs you that potty training
has been very easy because he "has an amazing internal clock. He falls asleep, gets
hungry, and has bowel movements at the same time every day." This describes
which aspect of temperament? - ANSWER Rhythmicity
Which of the following statements regarding adolescent substance use is true? -
ANSWER Tobacco is the most commonly abused substance during adolescence.