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PNP Certification Exam > Age groups and milestones > Flashcards

Age groups and milestones Flashcards

1
Q

Caloric requirements: birth to 6 months–

A

120 kcal/kg/day

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2
Q

Caloric requirements: 7 mo to 1 year–

A

100 kcal/kg/day

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3
Q

Caloric requirements: 2 yo to 10 yo:

A

70 to 100 kcal/kg/day

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4
Q

Caloric requirements: Adolescents (greater than 10)

A

45 kcal/kg/day

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5
Q

Breastfeeding during painful procedures provides _______

A

analgesia

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6
Q

The longer the mother breastfeeds, the ____ chance of the child to be overweight independent of education and socioeconomic status.

A

Less

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7
Q

How is adequate nutrition confirmed in infants?

A

Weight gain

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8
Q

Within the first three months of life, there should be weight gain of __ g/day

A

30 grams/day equivalant to 1 oz/day

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9
Q

After the first three months, the NEXT three months should have weight gain of __ to __ g/day

A

15 to 20 grams/day

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10
Q

For infants that are exclusively breast fed, when should you start Vitamin D supplementation? What is the dose?

A

Should start at 2 months and continue throughout adolescence. The does is 400 IU/day

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11
Q

For exclusively breastfed infants, when should iron supplementation be started? What is the dose? Where does the iron typically come from?

A

Iron is started after 6 months of age. The dose is 1 mg/kg/day. The iron typically comes from fortified cereals.

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12
Q

What is the accepted amount of initial weight loss following birth?

A

10%

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13
Q

The first initial weight loss is typically regained within __ to __ days?

A

7 to 14 days

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14
Q

The infants weight should double by ___ months

A

Five

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15
Q

The infants weight should triple by ___ months

A

12

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16
Q

The infants weight should quadruple by ___ years of age

A

2

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17
Q

How much weight should three-year-olds through school-aged children gain?

A

4 to 6 pounds a year

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18
Q

School aged children should gain how many pounds annually?

A

5-7 lbs./year

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19
Q

Primary teeth eruption begins at ___ months and lasts until ___ months:

A

6 months

24 months

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20
Q

Permanent tooth eruption begins at __ years and ends at __ years

A

6 years

13 years

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21
Q

Tooth eruption mnemonic: Come Little Children Munch Meat — is used for primary teething. What is the order at which you would expect to see tooth eruption?

A 
Central Incisor
Lateral Incisor
Cuspid
First Molar
Second Molar
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22
Q

What is the order in which the permanent teeth erupt?

A 
Central Incisor (6 to 8 years)
Lateral Incisor (7-9 years)
Cuspid (9-12 years)
First Bicuspid (10-12 years)
Second Bicuspid (10-12 years) 
First Molar (6 to 7 year)
Second Molar (11-13 years)
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23
Q

What nursing theorists concentrated on sensorimotor stages and what the brain knows?

A

Jean Piaget

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24
Q

Sensorimotor stage: ____ to __ years

A

Birth to 2 years

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25
Q

In the sensorimotor stage, infants rely on their _______ _______.

A

Primitive reflexes

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26
Q

Preoperational/Preconceptual Stage: Ages __ years to __ years. This phase focuses on ________.

A

2 years to 4 years old

Fantasy

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27
Q

Piaget: Intuitive/Preoperational thinking: ___ years to __ years. This is the beginning of __________.

A

4 - 7 years

Causation

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28
Q

Concrete thinking (Piaget) is ages ___ to ___. Provide an example of concrete thinking.

A

7 to 11 years

Memorization

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29
Q

Formal operational thought (Piaget) is ages __ to __ years. Children in this stage are capable of _____ conclusions.

A

11 - 15 years

Logical

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30
Q

Erikson’s stages: infancy

A

birth to 1 year

Trust vs. Mistrust

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31
Q

Erikson’s stages: Toddler

A

1 - 3 years

Autonomy vs. Shame/doubt

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32
Q

Erikson’s stages: Preschool

A

3 to 6 years

Initiative vs. Guilt

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33
Q

Erikson’s stages: School age

A

6 to 12 years

Industry vs. Inferiority

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34
Q

Erikson’s stages: Adolescence

A

12 to 18 years

Identity vs. Role confusion

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35
Q

Freud: Principle of pleasure:

A

Id

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36
Q

Freud: Principle of reality/self-interest

A

Ego

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37
Q

Freud: Principle of morality/conscience

A

Superego

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38
Q

According to Freud, what stage are infants in?

A

Oral stage

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39
Q

Birth to 6 months, Freud says infants are what?

A

Orally passive

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40
Q

7 to 18 months, Freud says infants are?

A

Orally aggressive (teething, oral satisfaction)

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41
Q

Freud: What stage are toddlers in? (1.5 - 3 years)

A

Anal

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42
Q

Freud: Preschoolers (3 - 6 years old) are in this stage:

A

Phallic stage (love opposite sex, Oedipal complex)

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43
Q

Freud: School age children (6 to 12 years) are in this stage:

A

Latency stage

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44
Q

Freud: Adolescence (12 to 18 years) are in this stage:

A

Genital Stage

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45
Q

What is the adjustment of developmental expectations for premature infants through the age of 2 years?

A

Corrected gestational age (CGA)

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46
Q

Head circumference is measured until what age?

A

2 years old

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47
Q

When do you begin measuring body mass index (BMI)?

A

2 years old

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48
Q

What is the equation for body mass index?

A

weight (kg) / height (m) squared

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49
Q

Generalized assessment tool used from birth to 6 years of age that measures: gross motor development, fine motor development, language, and personal/social development.

A

Denver II

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50
Q

When does the infant have good head control?

A

2-3 months

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51
Q

When does the infant roll back to front?

A

5 to 6 months

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52
Q

When does the infant sit alone?

A

7 months

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53
Q

When does the infant pull to stand?

A

9 to 10 months

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54
Q

When does the infant stand alone?

A

11 to 12 months

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55
Q

When does the infant walk?

A

12 to 14 months

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56
Q

When does the infant walk up and down stairs?

A

22 to 24 months

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57
Q

When does does the infant jump?

A

24 to 48 months

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58
Q

When can the infant grasp and shake a rattle?

A

2 to 3 months

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59
Q

When can the infant reach for objects?

A

3 to 4 months

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60
Q

When can the infant complete hand-to-hand transfer?

A

5 to 6 months

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61
Q

When can the infant perform a raking grasp?

A

6 to 7 months

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62
Q

When can the infant perform a finger grasp?

A

7 to 9 months

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63
Q

When do you see the pincer grasp?

A

8 to 10 months

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64
Q

When can the infant mark on paper?

A

10 to 12 months

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65
Q

When can the infant stack 3 blocks?

A

17 to 18 months

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66
Q

When can the infant stack 6 to 7 blocks?

A

22 to 24 months

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67
Q

When can the infant smile and coo?

A

2 to 3 months

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68
Q

When can the infant laugh?

A

4 to 5 months

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69
Q

When can the infant babble?

A

5 to 6 months

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70
Q

When does the infant say “mama-dada”

A

8 to 9 months

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71
Q

When can the infant wave bye-bye?

A

8 to 9 months

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72
Q

When does the infant understand “No”

A

9 to 10 months

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73
Q

When does the infant point to body parts?

A

15 to 18 months

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74
Q

When can the infant form 2-word sentences?

A

18 to 22 months

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75
Q

When does the infant have a 30 to 50 word vocabularly?

A

22 - 24 months

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76
Q

Children should remain in a backward facing carseat until what age?

A

12 months

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77
Q

All children under the age of __ years or __ pounds must be in a car seat.

A

4 years

40 pounds

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78
Q

What is the dose for IM vaccines typically?

A

0.5 mL

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79
Q

Vaccine intervals need to be at least __ weeks apart?

A

6 weeks

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80
Q

HBV: when is the first dose? Second dose? Third dose?

A

First dose after birth before discharge
Second dose: 2 months
Third dose: 6 months

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81
Q

If an infant is born to a hepatitis B positive mother, what should happen in addition to receiving the HBV?

A

Hepatitis B immunoglobulin within 12 hours of birth

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82
Q

If the mother’s hepatitis status is unknown then what happens?

A

Patient receive hepatitis B within 12 hours of birth, if mom tests positive, HBIG should be given no later than 1 week of age

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83
Q

Rotavirus is a series of __ vaccines given from __ weeks to __ weeks.

A

3

6 to 36 weeks

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84
Q

You do not give Rotavirus after 8 months due to the increased risk of what?

A

Intussusception

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85
Q

DTaP is a series of ___ vaccines

A

3 vaccines

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86
Q

DTaP is not indicated for children greater than __ years old.

A

7

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87
Q

Tdap is a series of _ vaccine(s) given at age __ with recommended boosters every __ years.

A

1 vaccine given at age 11 with booster given every 10 years

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88
Q

Hib is a series of __ vaccines given at what ages?

A

3 vaccine series given at 2, 4, and 6 months

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89
Q

When should you receive a Hib booster?

A

12 months

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90
Q

Hib is not recommended for children greater than __ years old?

A

5 years

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91
Q

Pneumococcal vaccine is a series of __ vaccines, given at what ages? When do you get the booster?

A

3 vaccine series given at 2, 4, and 6 months with 1 booster at 12 months

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92
Q

If a child has special disease processes, such as splenic dysfunction or HIV, they should receive an additional pneumococcal vaccine at ___ months

A

24 months

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93
Q

IPV is a series of __, given at:

A

4

2, 4, 6 months and 6 years

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94
Q

When do you begin the annual flu shot for infants?

A

6 months

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95
Q

What is the dose for influenza vaccine for children aged 6 to 35 months?

A

0.25 ml

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96
Q

When do children get the full 0.5 mL vaccine?

A

3 years

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97
Q

Children younger than __ years receive __ doses 1 month apart

A

9 years receive 2 doses

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98
Q

MMR vaccine: Series of __ given when? What is the EARLIEST age of administering MMR?

A

2 vaccine series
given @ 12 months and 12 years
6 months, but will still need dose @ 12 months

99
Q

Varicella is a series of __ given when?

A

2, 2 doses between 12 months and 12 years

100
Q

What vaccine is typically avoided when giving MMR?

A

Varicella

101
Q

HAV- _ dose series given between __ months and __ months with a minimum interval of __ months.

A

2 dose series given between 12 months and 24 months with a minimum 6 month interval

102
Q

Meningococcal vaccine: series of __ given at age __ with a booster at the age of __.

A

2 vaccine series given at age 11 or 12 with a booster given at age 16.

103
Q

When is the earliest you can receive the HPV vaccine?

A

9 years but recommended at 11 or 12 years

104
Q

If you receive the HPV vaccine before the age of __ it is a 2 dose series, otherwise it is a 3 dose series.

A

15 years

105
Q

What are reportable events that should be reported to the vaccine adverse events reporting system (VAERS)?

A

Anaphylaxis
Encephalitis
Death

106
Q

What percent of genetic defects are identified before the age of 6 months?

A

80%

107
Q

When obtaining a pedigree history (genogram), how many generations should be included?

A

Three

108
Q

This genetic disorder occurs in 1:660 births and has an association with increased maternal/paternal age with retardation ranging from mild to severe.

A

Trisomy 21

109
Q

These findings indicate what genetic disorder: Eyes set wider apart than usual, protruding tongue, single palmar crease, hypotonia, and Brushfield spots?

A

Trisomy 21

110
Q

Klinefelter’s syndrome is seen only is ____ and is caused by an extra ___ chromosome.

A

males

X

111
Q

Klinefelter’s syndrome occurs in every 1: _____ births

A

1:1000

112
Q

Klinefelter’s syndrome is the most common cause of ___________ and _________ in men.

A

Hypogonadism

Infertility

113
Q

These phenotypical manifestations exhibit what genetic disorder? Tall stature, gynecomastia, learning disability, personality impairment

A

Klinefelter’s syndrome

114
Q

_____ Syndrome is the most common sex-chromosome anomaly seen in females.

A

Turner’s Syndrome

115
Q

Turners syndrome occurs in ever 1:_____ births

A

1:2,000

116
Q

These findings indicate what genetic disorder?
Webbed neck, “shield” shaped chest with widely spaced nipples, hypertension, and bicuspid aortic valve/coarctation of the aorta?

A

Turner’s Syndrome

117
Q

Inherited connective tissue disorder affecting skeletal, cardiac, and ophthalmic body systems which occurs in 1:20,000 births.

A

Marfan Syndrome

118
Q

These phenotypical presentations indicate what genetic disorder? Arm span exceeds height, hyperextension of joints, kyphoscoliosis, aortic aneurysms, ectopia lentis and iridonesis

A

Marfan Syndrome

119
Q

This genetic disorder is found in Ashkenazic Jewish population and occurs in 1:2,500 births

A

Tay-Sachs Disease

120
Q

What is the biggest red flag to warrant testing for Tay-Sachs disease?

A

Decreased muscle tone. Will learn to crawl then stops with arms/legs laid out

121
Q

Tay-Sachs disease is a ______ disease leading to death

A

progressive

122
Q

These are typical manifestations of what genetic disorder? Decreased muscle tone, cherry red macula, blindness, deafness, seizures, dementia, death

A

Tay-Sachs disease

123
Q

Congenital defect of the parathyroid glands, thymus, and the conotruncal region of the heart?

A

DiGeorge (Velocardiofacial) Syndrome

124
Q

In DiGeorge syndrome, there is an increase susceptibility to _______ due to thymus aplasia.

A

Infection

125
Q

DiGeorge syndrome has significant neonatal morbidity and mortality associated with ____ defects.

A

Cardiac

126
Q

DiGeorge syndrome reveals [hypo/hyper] parathyroidism with [hypo/hyper] calcemia

A

hypoparathyroidism

hypocalcemia

127
Q

Low birth weight is defined as:

A

Less than 2,500 g

128
Q

Very low birth weight is defined as :

A

less than 1,500 g

129
Q

Extremely low birth weight (ELBW) is defined as:

A

less than 1,000 g

130
Q

Appropriate for gestational age (AGA): between __ and __ percentile.

A

10-90%ile

131
Q

Large for gestational age (LGA):

A

greater than 90%ile

132
Q

Small for gestational age:

A

less than 10%ile

133
Q

when are APGARs calculated?

A

1 and 5 minutes

134
Q

Prematurity is defined as being born before __ weeks

A

37

135
Q

Congenital growth disorder shown by hemihypertrophy, large organs, and other symptoms

A

Bewith-Wiedemann Syndrome

136
Q

Fatal condition defined as an abnormal accumulation of fluid in two or more fetal compartments

A

Hydrops fetalis

137
Q

Normal newborn heart rate:

A

120 to 170 BPM

138
Q

Normal newborn respiration rate:

A

30-80 breaths per minute

139
Q

Pinpoint white papules on face, prominent on cheeks, nose, chin, and forehead that spontaneously disappear within 3-4 weeks of life

A

Milia

140
Q

Obstructed sweat (eccrine gland) ducts; sometimes referred to as “prickly heat”

A

Miliaria

141
Q

Most common newborn rash; usually appears between days 2 to 5 after birth; characterized by blotchy red spots on the skin with overlaying white or yellow papules or pusutues; resolves by the 14th day

A

Erythema toxicum

142
Q

Typically a subtle shade discoloration located on either flank; may not be present at birth but likely to increase in size with age; suspect neurofibromatosis if there are many large spots or if more than 6 spots in a child older than 5

A

Cafe au lait spots

143
Q

Benign, flat, congenital birthmark with wavy borders and irregular shape; common color is blue; may last up to 3 to 5 years after birth, almost always dissappear by puberty

A

Mongolian spots

144
Q

Vascular birthmark (malformation) consisting of superficial and deep dilated capillaries in the skin; produce a reddish to purplish discoloration of the skin; permantent

A

Port-wine stain

145
Q

Raised, soft red lumps on the skin, more common in premature babies, usually shrinks/fades after 6 months

A

Strawberry mark (hemangiomas)

146
Q

When does rooting disappear

A

3 to 4 months

147
Q

When does sucking disapear

A

3 to 4 months

148
Q

When does Moro disappear

A

3 to 4 months

149
Q

When does palmar grasp disappear

A

3 to 6 months

150
Q

When does plantar grasp disappear

A

4 months

151
Q

When does placing/stepping disappear

A

1 to 2 months

152
Q

When does tonic neck disappear

A

3 months

153
Q

When does babinski disappear

A

12 months or when walking

154
Q

This type of head swelling crosses the midline and usually resolves in 2-3 days

A

Caput succadaneum

155
Q

This does head swelling does not cross the midline, usually requires closer monitoring

A

Cephalohematoma

156
Q

To be categorized as microcephaly or macrocephaly, your head must be smaller or larger than __ standard deviations

A

two

157
Q

More than one hair whorl could indicate what

A

poor brain growth

158
Q

This is the largest fontanel

A

Anterior

159
Q

When does the anterior fontanel close?

A

18 months

160
Q

when does the posterior fontanel close?

A

2 to 3 months

161
Q

Salt and pepper speckling (Brushfield spots of the iris) are associated with:

A

Down Syndrome

162
Q

What should you consider if you note a radio-femoral pulse delay?

A

Coarctation of the aorta

163
Q

What is it called when you cannot retract the foreskin?

A

Phimosis

164
Q

How do you check for developmental dysplasia of the hip?

A

Ortolani’s click and Barlow’s maneuver

165
Q

This occurs 1:10,000 to 25,000 newborns, causing developmental delays, seizures, retardation

A

PKU

166
Q

This occurs in newborns causing liver dysfunction, coagulapothies and occurs every 1:60,000 to 80,000 births

A

Galactosemia

167
Q

Irreversible condition characterized by brain damage and developmental problems resulting from prenatal alcohol exposure

A

Fetal alcohol syndrome

168
Q

How is FAS diagnosed?

A

Physical examination

169
Q

What manifestations does this indicate: birth defects of the heart, bone, kidney, joints, ears/eyes. Abnormal facial features: small eye openings, thin upper lip, smooth philtrum, upturned nose, small head size, poor weight gain, intellectual disability

A

Fetal Alcohol Syndrome

170
Q

The newborn period is from __ to __ months; while infancy is __ to __ months.

A

1 to 2 months

1 to 12 months

171
Q

According to the Bright Futures guidelines, what is the schedule for well-child checks?

A

2 weeks, 2 mo, 4 mo, 6 mo, 9 mo, 12 mo

172
Q

At what well child check would you not expect to provide any vaccines if the child is on time with vaccinations?

A

9 mo visit

173
Q

At what visits would you check a child’s hematocrit?

A

6 mo, 9 mo, and 12 mo

174
Q

What is a vitamin deficiency that causes fissures at the corners of the lips?

A

cheilosis

175
Q

Pigeon chest

A

Pectus carinatum

176
Q

Sunken chest; and the most common congenital deformity of the anterior wall of the chest.

A

Pectus excavatum

177
Q

T or F: Gynecomastia and galactorrhea is a normal finding in males up to 3 months old?

A

True

178
Q

In a toddler, where should the liver edge be palpable?

A

1 to 2 cm below the right costal margin

179
Q

At what age should the testes be fully distended into the scrotum?

A

3 months

180
Q

What is Galeazzi sign and when is it seen?

A

Unequal knee height seen in developmental hip dysplasia

181
Q

What is the most alarming type of enlarged lymph nodes?

A

Supraclavicular

182
Q

At what point is there considered to be hearing loss in an infant?

A

At a loss of 20 to 30 decibels

183
Q

When does “Stranger Danger” develop?

A

6 months

184
Q

When does an infant develop separation anxiety?

A

8 months

185
Q

What is an affective bond that develops over the first year and will differentiate into other emotions later?

A

Attachment

186
Q

When should the infant’s first dental appointment be scheduled?

A

By 1 year old

187
Q

From age two months to 1 year, how much should you expect the infant to sleep?

A

8-12 hours/night

188
Q

What is the recommended screen time for children younger than 18 months?

A

The AAP does not recommend screen time for this age group.

189
Q

Any baby younger than ___ weeks that develops a fever should have a full septic work-up done.

A

4 weeks (30 days)

190
Q

Within the first two months of life, __% of fevers are viral.

A

40%

191
Q

When assessing the degree of illness in an infant, it is important to remember that responses are ________.

A

Behavioral

192
Q

The toddler age group is ages:

A

1 to 3 years

193
Q

The preschool age group is ages:

A

4 to 5 years

194
Q

IF a family has a history of dyslipidemia or CV disease, at what age should you check the child’s cholesterol?

A

2 years

195
Q

Beginning in the toddler age group (age 12 mo), what is the schedule for WCC?

A

12 mo, 15, mo, 18 mo, 24 mo, 30 mo, and 36 mo

196
Q

At what age will the child begin having a WCC annually?

A

Age 3

197
Q

Height and weight should be documented at every well child check until age __, then annually.

A

Age 2

198
Q

Where should you be able to palpate the liver in a toddler/preschool aged child?

A

1-2 cm below the right costal margin

199
Q

“Bowed legged” (normal variant in toddlerhood)

A

Genu varum

200
Q

“Knock-knees” (normal variant in preschooler)

A

Genu valgum

201
Q

What age does tibial torsion typically resolve?

A

Age 4

202
Q

This is in-toeing, which is normal until adolescent stage

A

Femoral anteversion

203
Q

What age should the toddler be able to run with wide gait, up and down steps, and kick a ball without falling?

A

Age 2

204
Q

When should a child be able to ride a tricycle?

A

Age 3

205
Q

When should the child be able to ride a bicycle without training wheels and go up and down stairs with alternating feet?

A

Age 4

206
Q

When can the child jump rope and skip?

A

Age 5

207
Q

What age can the child turn a doorknob?

A

Age 2

208
Q

At what age can the child copy a circle?

A

Age 3

209
Q

What age can a child: tie their shoes and copy a squate?

A

Age 5

210
Q

The tendency of children to cognize their environment only in terms of their own point of view:

A

Egocentrism (Piaget)

211
Q

What should the visual acuity be by age 5?

A

20/30

212
Q

What age should the hearing test be changed to the pure tone audiometry?

A

Over 3 years

213
Q

What type of play do toddlers involve in?

A

Onlooker and parallel play

214
Q

Preschoolers partake in what type of play?

A

Associative, cooperative, dramatic, and physical play

215
Q

What is the gold standard for the diagnosis of developmental delays in infants/toddlers to 42 months of age with separate mental, motor, and behavioral rating scales?

A

Bayley Scales of Infant and Toddler Development

216
Q

When should the spoon be introduced to the child for use?

A

15-17 months

217
Q

How many hours/night should the toddler sleep?

A

10 to 12 hours with daily naps

218
Q

What age do nightmares begin?

A

Age 3

219
Q

Night terrors typically occur between __ to __ years; most outgrow as they get older

A

2 to 6 years

220
Q

When does physiologic and psychological readiness for toilet training begin?

A

1.5 - 2.5 years

221
Q

What is the AAP recommendation for screen time for children aged 2-5 years?

A

No more than 1 hour per day

222
Q

At what age would there be a concern for a patient not being toilet trained during the day time hours?

A

At age 4

223
Q

Stuttering can be normal and last as long as __ months. If last longer than this, you should refer.

A

6 months

224
Q

What is characterized by altered response to environmental stimuli and impaired social interactions?

A

Autism Spectrum Disorder (ASD)

225
Q

School-aged children is considered what age?

A

6 years to 12 years

226
Q

What is the average growth of weight and height in this age group?

A

Weight: 5 to 7 lbs/year
Height: 2 - 3 inches/year

227
Q

BMI greater than __ percentile is considered obesity

A

95th

228
Q

When should the screening for scoliosis begin?

A

Age 9

229
Q

What stage has the development of self esteem?

A

School-aged group

230
Q

In the school age group, how many hours would they be expected to sleep per night?

A

8-10 hours/night

231
Q

This age group should begin having conversations about sex, STI’s, menarche, hormonal/body changes

A

School-aged group (ages 6-12)

232
Q

What is the AAP recommendation for screen time for the school-age group?

A

PCP/patient/family should develop a Family Media Use Plan

233
Q

What is the most common form of child abuse?

A

Neglect

234
Q

__% of abusers in child abuse are the parents

A

80%

235
Q

Adolescent age group:

A

12 - 20 years

236
Q

When should pelvic exams begin (if sexually active)?

A

Age 21

237
Q

HEADSS format assessment stands for what?

A

Home environment, Employment/education, Activities, Drugs, Social, and Sexuality

238
Q

PACES format for interviewing adolescents:

A

Parents/peers, Accident, alcohol & drugs, Cigarettes, Emotional issues, School/sexuality

239
Q

SAFETEENS format for interviewing adolescents:

A

Sexuality, Accidents/abuse, Firearms/homicide, Emotions, Toxins, Environment, Exercise, Nutrition, Shots

240
Q

Menarche between breast development in stages __ to __; but predominately in stage __.

A

3 to 4; 4

241
Q

At what age is puberty considered precocious for girls? boys?

A

Girls before age 8

Boys before age 9

242
Q

How often should you have dental cleanings?

A

Every 6 months

243
Q

What are the peak ages for anorexia and bulimia?

A

14 to 18 years

PNP Certification Exam (12 decks)

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