,1. Pediatric Examination Approach
Question: A mother brings her 15-month-old toddler to the clinic for his
preventive health care visit. The clinician takes the history and observes the
child's interactions and behaviors and is then ready to begin the rest of the
examination. Which of the following best describes the general approach to
the pediatric examination of the young child?
Answer: Begin with the least invasive parts of the exam.
2. Principles of Child Development
Question: In caring for children, physicians and other clinicians need to
understand child development. Of the following, which is a principle of normal
child development?
Answer: Child development proceeds along a predictable pathway in a healthy
child.
3. Developmental Concerns and Autism
Question: The parents of a 21-month-old child explain that their son used to
speak nearly 50 words and was using 2-word phrases. In the last month or so,
the child has not been using as many words and tends to echo what is being
said to him rather than use language spontaneously. They want to know if this
is normal. After taking a thorough developmental history, the clinician finds
that the child makes poor eye contact and does not play with toys in a
purposeful manner. The physical examination is normal except for the child's
limited social interactions. There is a family history of autism in two first
cousins. Which of the following would be the best response to the parents at
this time?
Answer: Refer the child to a developmental and behavioral pediatrician.
4. Health Promotion in Asthma Management
Question: A clinician is meeting the mother of a 5-year-old with asthma for the
first time. The mother notes that the asthma has been poorly controlled and
that the child has had multiple hospitalizations. The clinician inquires about
family stressors and finds that the parents are divorced, the mother recently
lost her job, and the child spent 2 months living with her grandparents who
both smoke. Which of the following is the best example of the role of health
promotion with this family?
,Answer: Develop a health promotion plan that includes more frequent visits
and guidance to assist the family with stressors and improve the child's
asthma symptoms.
5. APGAR Score Interpretation
Question: A clinician is reading the chart of a full-term newborn whose mother
had an uneventful pregnancy in the hospital for the first time on the day of
birth. In reviewing the infant's chart, the clinician notes that, in the delivery
room, at 5 minutes, the infant had a heart rate >100, strong respiratory effort,
was crying vigorously, moving actively, and had good color except for some
acrocyanosis of the hands and feet. This infant's APGAR score is closest to
which of the following?
Answer: 9.
6. Neonatal Resuscitation
Question: A newborn who is floppy and limp, blue in color, with a heart rate of
60, and minimal respiratory effort has just been delivered. The infant has no
grimace and only a very weak cry. What is the best immediate response to the
infant in this situation?
Answer: Begin neonatal resuscitation.
7. Gestational Age and Birth Weight
Question: An infant is born 4 weeks preterm to a mother with a history of
hypertension, severe diabetes, and alcohol abuse. The infant is noted to be
small for gestational age (SGA), weighing just 1,500 g. Which of the following
is the most important reason for assessing both gestational age and birth
weight for any infant?
Answer: These two factors help to anticipate certain medical and
developmental problems.
8. Newborn Examination
Question: A clinician arrives at the hospital several hours after the birth of a
full-term infant. The infant is rooming in with her parents and appears to be
doing well. There were no problems with the pregnancy, labor, or delivery. The
nurse asks if the baby should be taken back to the nursery for examination.
What is the best response to the nurse?
, Answer: State that the infant should be examined in the presence of the
parents so they can be taught about what their newborn can do.
9. Newborn Tremors
Question: The nurse in the newborn nursery reports that she is concerned
about Baby Boy Jones, who was born full-term by cesarean section for failure
to progress. The pregnancy was complicated only by a maternal urinary tract
infection in the first trimester. He had APGARs of 9 and 10 at 1 and 5 minutes,
respectively, and had been doing well. However, now, on the fourth day of life,
the infant has developed a tremor. Which of the following factors would cause
the most concern about the tremor?
Answer: The infant also has asymmetric limb movements.
10. Developmental Milestones
Question: A mother brings her 9-month-old son to the practice for the first
time, concerned that he is not yet sitting by himself. After taking a careful
history, the physician notes that the infant has good head control and can
grasp a rattle but is unable to roll over, crawl, or pull to stand. What should the
clinician explain to the mother?
Answer: The delay in his physical motor skills is concerning and warrants a
more complete developmental history and possible referral for early
intervention.
11. Gestational Age Calculation
Question: A 42-year-old school teacher with a history of irregular periods who
underwent successful intrauterine insemination (IUI) on January 25th
presents to the clinic for care on March 19th. Her last menstrual period (LMP)
was November 11th of the previous year. Which of the following is true about
the gestational age of her pregnancy?
Answer: It is determined by the date of insemination plus 2 weeks.
12. Early Pregnancy Signs
Question: A 32-year-old patient with two prior pregnancies presents to the
clinic concerned that she may be pregnant after missing one cycle of her
menses, which was previously very regular. A urine human chorionic
gonadotropin (HCG) test is positive. Presuming a normal pregnancy, what can
Question: A mother brings her 15-month-old toddler to the clinic for his
preventive health care visit. The clinician takes the history and observes the
child's interactions and behaviors and is then ready to begin the rest of the
examination. Which of the following best describes the general approach to
the pediatric examination of the young child?
Answer: Begin with the least invasive parts of the exam.
2. Principles of Child Development
Question: In caring for children, physicians and other clinicians need to
understand child development. Of the following, which is a principle of normal
child development?
Answer: Child development proceeds along a predictable pathway in a healthy
child.
3. Developmental Concerns and Autism
Question: The parents of a 21-month-old child explain that their son used to
speak nearly 50 words and was using 2-word phrases. In the last month or so,
the child has not been using as many words and tends to echo what is being
said to him rather than use language spontaneously. They want to know if this
is normal. After taking a thorough developmental history, the clinician finds
that the child makes poor eye contact and does not play with toys in a
purposeful manner. The physical examination is normal except for the child's
limited social interactions. There is a family history of autism in two first
cousins. Which of the following would be the best response to the parents at
this time?
Answer: Refer the child to a developmental and behavioral pediatrician.
4. Health Promotion in Asthma Management
Question: A clinician is meeting the mother of a 5-year-old with asthma for the
first time. The mother notes that the asthma has been poorly controlled and
that the child has had multiple hospitalizations. The clinician inquires about
family stressors and finds that the parents are divorced, the mother recently
lost her job, and the child spent 2 months living with her grandparents who
both smoke. Which of the following is the best example of the role of health
promotion with this family?
,Answer: Develop a health promotion plan that includes more frequent visits
and guidance to assist the family with stressors and improve the child's
asthma symptoms.
5. APGAR Score Interpretation
Question: A clinician is reading the chart of a full-term newborn whose mother
had an uneventful pregnancy in the hospital for the first time on the day of
birth. In reviewing the infant's chart, the clinician notes that, in the delivery
room, at 5 minutes, the infant had a heart rate >100, strong respiratory effort,
was crying vigorously, moving actively, and had good color except for some
acrocyanosis of the hands and feet. This infant's APGAR score is closest to
which of the following?
Answer: 9.
6. Neonatal Resuscitation
Question: A newborn who is floppy and limp, blue in color, with a heart rate of
60, and minimal respiratory effort has just been delivered. The infant has no
grimace and only a very weak cry. What is the best immediate response to the
infant in this situation?
Answer: Begin neonatal resuscitation.
7. Gestational Age and Birth Weight
Question: An infant is born 4 weeks preterm to a mother with a history of
hypertension, severe diabetes, and alcohol abuse. The infant is noted to be
small for gestational age (SGA), weighing just 1,500 g. Which of the following
is the most important reason for assessing both gestational age and birth
weight for any infant?
Answer: These two factors help to anticipate certain medical and
developmental problems.
8. Newborn Examination
Question: A clinician arrives at the hospital several hours after the birth of a
full-term infant. The infant is rooming in with her parents and appears to be
doing well. There were no problems with the pregnancy, labor, or delivery. The
nurse asks if the baby should be taken back to the nursery for examination.
What is the best response to the nurse?
, Answer: State that the infant should be examined in the presence of the
parents so they can be taught about what their newborn can do.
9. Newborn Tremors
Question: The nurse in the newborn nursery reports that she is concerned
about Baby Boy Jones, who was born full-term by cesarean section for failure
to progress. The pregnancy was complicated only by a maternal urinary tract
infection in the first trimester. He had APGARs of 9 and 10 at 1 and 5 minutes,
respectively, and had been doing well. However, now, on the fourth day of life,
the infant has developed a tremor. Which of the following factors would cause
the most concern about the tremor?
Answer: The infant also has asymmetric limb movements.
10. Developmental Milestones
Question: A mother brings her 9-month-old son to the practice for the first
time, concerned that he is not yet sitting by himself. After taking a careful
history, the physician notes that the infant has good head control and can
grasp a rattle but is unable to roll over, crawl, or pull to stand. What should the
clinician explain to the mother?
Answer: The delay in his physical motor skills is concerning and warrants a
more complete developmental history and possible referral for early
intervention.
11. Gestational Age Calculation
Question: A 42-year-old school teacher with a history of irregular periods who
underwent successful intrauterine insemination (IUI) on January 25th
presents to the clinic for care on March 19th. Her last menstrual period (LMP)
was November 11th of the previous year. Which of the following is true about
the gestational age of her pregnancy?
Answer: It is determined by the date of insemination plus 2 weeks.
12. Early Pregnancy Signs
Question: A 32-year-old patient with two prior pregnancies presents to the
clinic concerned that she may be pregnant after missing one cycle of her
menses, which was previously very regular. A urine human chorionic
gonadotropin (HCG) test is positive. Presuming a normal pregnancy, what can
