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PNP Boards > Growth & Development Questions > Flashcards

Growth & Development Questions Flashcards

1
Q

Most stage-based theories of development focus primarily on:

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

A

b) The discontinuity of development

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2
Q

The common practice of using “time-out” with young children is a direct application of:

a) Operant conditioning
b) Classical conditioning
c) Separation-individualization
d) Maturational reinforcement

A

a) Operant conditioning

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3
Q

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

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

A

b) Mesosystem

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4
Q

Which of the following findings would be most likely associated with asymmetric intrauterine growth retardation?

a) Weight, length, and head circumference ranging from 3rd to 5th percentile
b) Heavy maternal smoking throughout pregnancy
c) Weight at 3rd percentile and length at 25th
d) Gestational diabetes

A

c) Weight at 3rd percentile and length at 25th

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5
Q

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

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

A

d) Rooting

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6
Q

The most likely weight of a one-year-old child whose weight at birth was 6 1/2 pounds would be:

a) 19-20 pounds
b) 13-14 pounds
c) 25-26 pounds
d) impossible to estimate

A

a) 19-20 pounds

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7
Q

One of the major psychosocial tasks of infancy is:

a) Development of secure attachment
b) Separation-individualization
c) Symbiosis
d) Regulation

A

a) Development of secure attachment

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8
Q

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

a) Organismic-maturational theory
b) Social learning theory
c) Transactional theory
d) Psychoanalytic theory

A

c) Transactional theory

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9
Q

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

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

A

b) 6 months

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10
Q

The pincer grasp is a fine motor skill that involves the ability to pick up a small object such as a raisin or piece of cereal with the thumb and forefinger that is usually mastered around:

a) 4 months
b) 6 months
c) 9 months
d) 16 months

A

c) 9 months

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11
Q

You would be concerned about the language development of a child who:

a) Repeats simple phrases at 32 months
b) Stutters when excited or tired at 42 months
c) Has a vocabulary of 10 words at 12 months
d) Pronounces words that are not understandable at 36 months

A

b) stutters when excited or tired at 42 months

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12
Q

The most common temperamental profile is:

a) Easy
b) Difficult
c) Slow-to-warm-up
d) Intermediate

A

a) Easy

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13
Q

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

a) Ambivalence
b) Deprivation
c) Anger
d) Conditional love

A

c) Anger

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14
Q

The stage of cognitive development that Piaget described as characteristic of the way preschoolers think is the:

a) Preoperational stage
b) Mental combinations stage
c) Tertiary circular function stage
d) Sensorimotor stage

A

a) Preoperational stage

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15
Q

A preschool boy whose parents have separated and are beginning divorce procedures:

a) May think that he caused the divorce by misbehaving
b) Should not be told of the impending divorce until the parents are sure of their decision
c) Is likely to experience gender identity confusion
d) Should be able to make a decision about which parent he prefers living with

A

a) May think he caused the divorce by misbehaving

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16
Q

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

A

b) Instrumental aggression

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17
Q

A preschool child who says that the sky is blue because it is his favorite color is illustrating the concept of:

a) Symbolic thinking
b) Egocentrism
c) Centration
d) Imaginary audience

A

b) Egocentrism

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18
Q

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

a) Referral to a nutritionist for weight reduction plan
b) Increase physical exercise
c) Behavior modification strategies to deal with stress and/or reinforce treatment plan
d) involve family in management progream

A

a) Referral to nutritionist for weight reduction plan

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19
Q

Which of the following issues or concepts is relevant to the school-aged child?

a) Operational thinking
b) Initiative
c) Concrete operations
d) Separation-individualism

A

c) Concrete operations

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20
Q

The first physical sign indicating the onset of female puberty is:

a) Sparsely distributed fine, pale pubic hairs
b) Breast buds
c) Menarche
d) Peak height velocity

A

b) Breast buds

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21
Q

Which of the following findings would be helpful in distinguishing obesity vs. large body frame in an adolescent who is concerned with her weight?

a) Tricep skinfold measurement
b) Weight for height ratio
c) Body Mass Index
d) Percent of ideal body weight

A

c) Body Mass Index

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22
Q

The most common form of child abuse seen in pediatric primary care is:

a) Burns
b) Fractures
c) Soft tissue injuries
d) Shaken baby syndrome

A

c) Soft tissue injuries

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23
Q

A differential diagnosis for child abuse would include all of the following except:

a) Birth marks
b) Unintentional injury
c) Inadequate parenting
d) Prader-Willi syndrome

A

d) Prader-Willi syndrome

24
Q

Which of the following symptoms are not typical of a child with ADHD?

a) Easily distracted
b) difficulty playing quietly
c) Doesn’t follow directions
d) Frequently angry and resentful

A

d) Frequently angry and resentful

25
Q

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

a) Sore throat
b) Brittle nails
c) Constipation
d) Finger calluses

A

b) Brittle nails

26
Q

Which of the following situations does not necessarily warrant immediate mental health assessment and/or referral?

a) 13 yo girl who has been “down” for the last month with varied somatic complaints
b) 9 yo boy whose parents recently separated and filed for a divorce and seems to be doing well
c) 16 yo girl who has a history of long-standing depression but seems to be doing well in school
d) 15 yo boy who expresses suicidal thoughts

A

b) 9 yo boy whose parents recently separated and filed for a divorce and seems to be doing well

27
Q

Which adolescent would be at greatest risk for developing anorexia?

a) 12 yo female who just had her first period
b) 14 yo gymnast
c) 16 yo male runner
d) 18 yo female college student

A

b) 14 yo gymnast

28
Q

Which of the following substances is associated with pupillary constriction?

a) Amphetamines
b) LSD
c) Heroin
d) Nicotine

A

c) Heroin

29
Q

A risk factor that is common to many psychosocial pediatric problems including failure to thrive, conduct or oppositional disorders, and childhood depression is:

a) Maternal depression or other psychiatric disorder
b) Substance abuse
c) Prematurity
d) History of sexual abuse

A

a) Maternal depression or other psychiatric disorder

30
Q

Which of the following diagnoses is not more common among males?

a) ADHD
b) conduct disorders
c) Suicide
d) FTT

A

d) FTT

31
Q

The diagnostic criteria for autistic disorders includes which of the following?

a) Speech delay, ataxia, mental retardation
b) impairments in social interactions, interpersonal communication, and staring spells
c) Mental retardation, impairments in social interactions, and sterotypical restricted patterns of interests and activities
d) Impairments in social interactions, interpersonal communication, and stereotypical restricted pattern of interests and activites

A

d) Impairments in social interactions, interpersonal communication, and stereotypical restricted pattern of interests and activites

32
Q

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

A

b) Perceptual-motor impairments, impulsiveness

33
Q

A 5 yo Vietnamese child has fallen off his growth curve. The best intervention would be:

a) Suggest high-calorie breakfast drinks as supplements
b) Incorporate traditional foods into a management plan that will provide increased calories and nutrients
c) Educate the family on the need for increased calories and nutrients
d) Refer family to growth clinic for evaluation

A

b) Incorporate traditional foods into a management plan that will provide increased calories and nutrients

Understanding cultural norms and perspectives is important

34
Q

While taking the history of a 6 month old you learn that she is not sleeping through the night and will not fall back to sleep without the parents rocking or feeding her. This is an example of:

a) Somnambulism
b) Pavor nocturnus
c) Learned behavior
d) Delayed sleep phase

A

c) Learned behavior (parents interfere with child’s attempts to return to sleep through stimulation of rocking and feeding)

35
Q

Somambulism

A

Sleep walking (occurs in school-age children)

36
Q

Pavor nocturnus

A

Night terrors (occurs in preschool-age children)

37
Q

Which of the following scenarios is suggestive of a child who may not be ready to enter first grade? An inability to:

a) Recognize six colors and remember one’s phone number
b) Accurately use pronouns
c) Emphasize with others
d) Count to five and draw a person with three parts

A

d) Count to five and draw a person with three parts (should be able to count to 10 or higher and draw a person with 6 parts)

38
Q

A 9 week old preterm infant whose birth weight was 2.3kg. Mom was HBsAg negative. He is seen today for the first time since discharge from hospital. He has received no prior immunizations. The appropriate immunizations to give at this time would be:

a) DTaP, Hib, IPV, rotavirus, Hep B-1, pneumococcal
b) DTP, Hib, OPV, rotavirus, Hep B-1
c) DTaP, Hib, rotavirus, IPV, pneumococccal
d) DTaP, Hib, IPV, pneumococcal

A

a) DTaP, Hib, IPV, rotavirus, Hep B-1, pneumococcal

Preterm infants should be immunized at the usual chronologic age with regular doses. IPV should be given to avoid nosocomial transmission of polio virus vaccine strain.

39
Q

While examining a 10 yo’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

A

b) Delayed mandibular dentition

The mandibular (lower) molars usually erupt between ages 6 and 7. Even allowing for individual variation, this is a considerable delay.

40
Q

The mother of a 5 yo is concerned that her son often cheats when playing board games with his older sister. What is the most appropriate response?

a) Encourage the parent to use 5 minute time outs when cheating occurs
b) Explain that he is developmentally unable to comprehend rigid rules
c) Make sure that he understands the rules before starting to play the game
d) Explain to him that cheating is like lying and is not acceptable behavior

A

b) Explain that he is developmentally unable to comprehend rigid rules

Developmentally, the concept of cheating is not well understood until 7 years of age.

41
Q

Which of the following is not a sign of readiness to toilet train?

a) Can sit for extended periods
b) Can follow directions
c) Occasional waking from naps with dry diapers
d) regularity of bowel movements

A

d) regularity of bowel movements

This is established in early infancy and has nothing to do with toilet training.

42
Q

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

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

A

c) Rigid and immobile sagittal suture

Indicate premature fusing resulting in craniosynostosis. For proper brain growth sutures need to approximate each other yet remain mobile.

43
Q

While listening to 2.5 yo talk you note that she frequently omits final consonants and her sentences are two to three words in length. The appropriate plan of care would be:

a) Routine follow up at next well child visit
b) Referring for hearing screen
c) Assessing for developmental delay
d) Referring to a speech pathologist

A

a) Routine follow up at next well child visit

Children 2-3 yo have several articulation disfluencies, among them is dropping the final consonants. 2-3 word sentences are normal for the 24-30 month old child.

44
Q

The mother of a 3 yo reports that he has begun to stutter. Further probing reveals that the stuttering occurs frequently and lasts 1-2 seconds. The child is not bothered by the stuttering. The appropriate management would be:

a) Referral to a speech pathologist
b) Referral for an evaluation for an anxiety disorder
c) Reassuring the mother that this is a mild problem
d) Demonstrating slow, deep breathing before talking

A

c) Reassuring the mother that this is a mild problem

This is a mild stuttering problem that does not warrant immediate referral unless the child or parent are increasingly concerned, or it continues indefinitely.

45
Q

You would expect a school age child to:

a) Grow 1.5 inches per year
b) Grow 0.5 inches per year
c) Gain about 6 pounds per year
d) Gain about 3 pounds per year

A

c) Gain about 6 pounds per year

School age children gain 5-7 pounds per year and grow about 2.5 inches per year.

46
Q

During an 8 month old’s exam the father boasts that he is going to be left handed since he prefers doing everything with his left hand. The appropriate response would be to:

a) Ask if others in the family are left handed
b) Suggest play activities that require using both hands
c) Present toys more often to the right hand
d) Perform a careful neurologic examination

A

d) Perform a careful neurologic examination

Handedness before a year is cause for concern. This child should be evaluated for cerebral palsy. Assess for increased deep tendon reflexes and increased tone.

47
Q

A 12yo has been diagnosed with constitutional growth delay. Appropriate management would include:

a) Starting low dose testosterone therapy now
b) Counseling regarding delayed onset of puberty
c) Thyroxine replacement
d) Nutritional counseling

A

b) Counseling regarding delayed onset of puberty

Constitutional growth delay is considered a variant of normal marked by delayed onset of puberty, that is a delay in maturation. Final growth is achieved later but is consistent with family genetics.

48
Q

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

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

A

c) Categorizing information into lower to 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 happens during this time.

49
Q

An 8 yo boy has been diagnosed with ADHD and is receiving stimulant medication. Which of the following interventions would be least helpful?

a) Monthly height and weight checks
b) Small frequent meals and snacks
c) High-calorie supplemental drinks
d) Elimination of refined sugar from diet

A

d) Elimination of refined sugar from diet

Stimulant medication may decrease the appetite so careful monitoring of growth and a nutritional plan that encourages adequate calories is important. there is no sound evidence that sugar plays a role in ADHD.

50
Q

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

A

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.

51
Q

In males Tanner stage III can be distinguished from Tanner stage II by:

a) Fine, downy pubic hair at the base of penis
b) Adult-like pubic hair not extending to thighs
c) Penile growth in width
d) Penile growth in length

A

d) Penile growth in length

Most penile growth in Tanner stage III is in length rather than width because of underdevelopment of the corpora cavernosa.

52
Q

A 13 yo male shares with you that his chest hurts. On exam you note unilateral breast enlargement which is tender to palpation. You suspect physiologic gynecomastia. Which Tanner stage would support this diagnosis?

a) Tanner stage I
b) Tanner stage III
c) Tanner stage IV
d) Tanner stage V

A

b) Tanner stage III

Physiologic gynecomastia is a common clinical finding in young adolescent males. It is usually present during Tanner stage III.

53
Q

During a physical examination of a 10.5 year old female 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

A

c) Onset of menses

In the female patient pubic hair, axillary hair, and the peak height velocity generally occur before menarche.

54
Q

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

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

A

a) A type of egocentrism

The belief that one is immune from poor or bad outcomes is a form of egocentrism known as personal fable in which adolescents believe the laws of nature do not apply to them.

55
Q

An increase in which of the following behaviors is seen more frequently in late, rather than early adolescence?

a) Value conflict with parents
b) Focus on physical appearance
c) Peer group involvement
d) Understanding inner motivations of others

A

d) Understanding inner motivations of others

Late adolescence is characterized by increased autonomy and beginning to appreciate the complexities and motivations of other people’s behaviors.

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