Growth and Development from Book ?s

Question 1

Most stage-based theories of development primarily focus on:

a) The continuity of development
b) The discontinuity of development
c) Persistence of inherent personality characteristics
d) the influence of context on development

Answer 1

b) The discontinuity of development

- -> these theories address deviations from developmental progress norms

Question 2

Using time-outs with kids is an example of:

Answer 2

operant conditioning

–B.F. Skinner’s model of operant conditioning, with a negative consequence for an unacceptable behavior

Question 3

Good communication among families, schools, and primary care providers is an example of which ecological concept?

a) Microsystem
b) Mesosystem
c) Exosystem
d) Macrosystem

Answer 3

b) Mesosystem

a mesosystem = the link or relationship b/t the various settings (microsystems) w/in which a child exists (home, school, day care, etc.)

Question 4

Early reflexive responses that are not related to survival include all but:

a) Babinski
b) Moro
c) Swimming
d) Rooting

Answer 4

d) Rooting

- -> is a key survival reflex!

Question 5

What should a child’s weight at 1 yr be in comparison to birth weight?

Answer 5

At 1 year, weight should be approximately triple the birth weight

Question 6

Which developmental theory best explains the multifactorial etiology of failure to thrive?

Answer 6

Transactional Theory

• -explains risks and protective factors assoc. w/resilience and vulnerability
  
  • -> it may explain some of the environmental factors assoc. w/FTT

Question 7

Most healthy infants are able to reach, grasp, and hold on to a rattle or other small toy by about:

a) 2 mos
b) 6 mos
c) 8 mos
d) 10 mos

Answer 7

b) 6 mos

Question 8

When is pincer grasp mastered?

Answer 8

9 mos

Question 9

Is stuttering with fatigue and excitement okay in a preschooler? 7yo?

Answer 9

–not unusual in a preschooler but may indicate a more pervasive problem in a 7yo

Question 10

The underlying emotion of an insecurely attached (avoidant) relationship is:

a) Ambivalence
b) Deprivation
c) Anger
d) Unconditional Love

Answer 10

c) Anger

- -> underlying anger characterizes avoidance or an insecure bond

Question 11

Piaget’s stage of cognitive development for preschoolers?

Answer 11

preoperational stage

Question 12

Which behavior would you expect to decrease during the preschool years?

a) rough-and-tumble play
b) instrumental aggression
c) hostile aggression
d) cooperative play

Answer 12

b) instrumental aggression
- -> preschoolers strongly define what is “theirs,” be it a toy or a space or a special privilege; this aggression wanes as they begin to understand sharing and appropriate impulse control

Question 13

What is the hallmark of preschoolers?

Answer 13

egocentrism!
there is little they think they do not control; they think the world revolves around them and that everything that happens is bc they did or didn’t do something

Question 14

Which of the following strategies would not be appropriate to include as part of your management of a 9yo boy who is obese?

a) referral to nutritionist for weight reduction plan
b) increase physical exercise
c) behavior modification strategies to deal with stress and/or reinforce tx plan
d) involve family in management program

Answer 14

a) referral to nutritionist for weight reduction plan
- -> tx in a 9yo requires a multifactorial approach, including “eating healthy” and exercise, and needs not necessarily focus on weight reduction…the goal is to prevent wt gain and maintain wt until linear growth catches up

Question 15

First sign of female puberty?

Answer 15

breast buds!

• -followed closely by the development of pubic hair
• -peak height velocity and menarche generally occur at age 12 1/2 yrs

Question 16

Which of the following findings would be most helpful in distinguishing obesity from large body frame in an adolescent who is concerned about her weight?

a) tricep skin fold measurement
b) weight-for-height ratio
c) BMI
d) percent of ideal body weight

Answer 16

c) BMI

- ->BMI is generally considered the best index for evaluation of weight; it correlates weight with height

Question 17

Most common form of abuse seen in peds primary care?

Answer 17

soft tissue injuries

• -such as bruises, abrasions, and lacerations
• -are most common form of abuse in all age groups

Question 18

Which of the following clinical findings would not suggest an eating disorder with a purging component?

a) sore throat
b) brittle nails
c) diarrhea
d) finger calluses

Answer 18

c) diarrhea
- -> eating d/o’s with a purging component are characterized by constipation, rather than diarrhea, resulting from chronic laxative use

Question 19

Effects on pupils: opioids, amphetamines, LSD, nicotine?

Answer 19

opioids: constricted pupils

amphetamines & LSD: dilated pupils

nicotine: generally no effect on pupils

Question 20

Which of the following dx’s is not more common among males?

a) ADHD
b) conduct d/o’s
c) Suicide
d) FTT

Answer 20

d) FTT

- -> FTT has no predominance in males or females

Question 21

In addition to specific academic skill deficits, learning disabilities are commonly associated with which of the following characteristics?

a) Perceptual-motor impairments, normal motor function
b) Perceptual-motor impairments, impulsiveness
c) Perceptual-motor impairments, Down syndrome
d) Lack of impulsiveness, perceptual-motor impairment

Answer 21

b) Perceptual-motor impairments, impulsiveness

- -> children w/LD may demonstrate impulsive behaviors as attention-getting behaviors

Question 22

What is somnambulism? Favor nocturnus?

Answer 22

somnambulism = sleepwalking
–> can occur in school-aged children

Favor nocturnes = night terrors
–> can occur in preschool-aged children

Question 23

By the time a child enters 1st grade, he/she should be able to draw a person with ___ parts and count to ___ or more.

Answer 23

• -draw a person with at least 6 parts

- -count to 10 or more

Question 24

While examining a 10yo’s teeth, you note that the upper incisors slightly overlap the lower incisors. The second and lower first molars are absent. Your assessment is:

a) Malocclusion
b) Delayed mandibular dentition
c) Normal dentition
d) Hyperdontia

Answer 24

b) Delayed mandibular dentition
- -> the mandibular (lower) molars often erupt b/t ages 6-7…even allowing for individual variation, this is a considerable delay

hyperdontia = supeernumerary teeth

Question 25

Developmentally, when would the concept of cheating be understood?

Answer 25

not until 7yo
–idea of playing fairly to ensure everyone an equal chance occurs with maturity and the ability to differentiate among moral choices

Question 26

Which of the following physical findings in a 2yo warrants an immediate referral to a neurologist/neurosurgeon?

a) Head circumference growing faster than ht and wt
b) Unresolved cephalhematoma
c) Rigid and immobile sagittal suture
d) snapping sensation when pressure is applied to parietal bone

Answer 26

c) Rigid and immobile sagittal suture
- -> indicates premature fusing resulting in craniosynostosis
- -> for proper brain growth, sutures need to approximate each other yet remain mobile

Question 27

You would expect a school-aged child to grow how much and gain how much wt per year?

Answer 27

• -grow about 2.5 inches/yr

- -gain 5-7 lbs/yr

Question 28

Why is handedness before 1 year a concern?

Answer 28

• -may indicate cerebral palsy

- -> should carefully assess for increase in deep tendon reflexes and tone

Question 29

Which of the following best describes behavior associated with Piaget’s concrete operational phase?

a) Learning primarily by trial and error
b) Interpreting events in relationships to themselves
c) Categorizing information into lower or higher classes
d) Drawing logical conclusions from observations

Answer 29

c) Categorizing information into lower or higher classes

• -concrete operations occur during the school-age years as children begin to understand the characteristics of things and objects
• -classification is a thought process that develops during this time

Question 30

The principle that growth and development becomes increasingly integrated is best demonstrated by:

a) Gaining head control before raising the chest
b) Bringing cup to mouth, tipping, and swallowing
c) Rolling over before sitting
d) Grasping with fist before using fingers

Answer 30

b) Bringing cup to mouth, tipping, and swallowing
- -> infants must first develop hand-mouth coordination before incorporating tipping and swallowing, which is a more integrated function

–head control before raising the chest: demonstrates the principle of cephalocaudal progression

–Rolling over before sitting/Grasping with fist before using fingers: suggest proximal-distal progression

Question 31

In which male tanner stage does fine, downy pubic hair appear?

Answer 31

Tanner II

Question 32

In which male Tanner stage do you see adult-like appearance?

Answer 32

Tanner IV

Question 33

What Tanner stage would support a dx of physiologic gynecomastia?

Answer 33

Tanner III
–> physiologic gynecomastia is a common clinical finding in young adolescent males and usually presents during Tanner stage III

Question 34

During a PE of 10 1/2yo girl, you note the appearance of breast buds. You tell her that she can expect which of the following in approximately 2 years?

a) Growth of pubic hair
b) Peak height velocity
c) Onset of menses
d) Axillary hair

Answer 34

c) Onset of menses

–individual timing may differ, but in the female pt, pubic hair, axillary hair, and peak height velocity generally occur before menarche

Question 35

Adolescents who engage in risky behavior, such as driving without a seatbelt, are displaying:

a) A type of egocentrism
b) A need for independence
c) Role experimentation
d) Low self-esteem

Answer 35

a) A type of egocentrism
- -> the belief that one is immune to poor or bad outcomes (death,disease…) is a form of egocentrism known as personal fable in which adolescents believe that the laws of nature do not apply to them

Question 36

Late adolescence is characterized by…?

Answer 36

increased autonomy and beginning to appreciate the complexities and motivations of other people’s behaviors