Download GNRS 5670 Exam 1: Pediatric Primary Care Study Guide and more Exams Nursing in PDF only on Docsity!
GNRS 5670 exam 1 questions and
answers graded a+
Enlarged lymph nodes greater than 1cm... - ANSWERS>>>>>need to be measured and documented normal for child to have palpable lymph nodes
How do you assess thyroid on a child? - ANSWERS>>>>>-have child hyper-extend the neck and drink water -observe movement
Pediatric visual development: 2mos - ANSWERS>>>>>tears
Pediatric visual development: 3 mos - ANSWERS>>>>>focus on simple colors, mouth, and eyes eye movement becomes regular
Pediatric visual development: 4mos - ANSWERS>>>>>color vision
Pediatric visual development: toddler - ANSWERS>>>>>50% of adult vision
Pediatric visual development: preschool - ANSWERS>>>>>visual acuity improves
Pediatric visual development: 3yrs - ANSWERS>>>>>visual acuity is 20/
Pediatric visual development: school age - ANSWERS>>>>>visual acuity in 20/
Assessing visual acuity in a newborn: - ANSWERS>>>>>use black and white chart
Assessing visual acuity in young children: - ANSWERS>>>>>pictorial snellen or E chart
Peripheral cyanosis: - ANSWERS>>>>>-normal in newborns -involves hands and feet appearing blue -resolves in 3 days
Central cyanosis: - ANSWERS>>>>>-involves lips, trunk, nose, and earlobes -indicates a cardiovascular problem
What can a child squatting indicate? - ANSWERS>>>>>a cyanotic heart defect
How should you assess a child who is ticklish? - ANSWERS>>>>>- have them bend their knees and place feet on exam table -have them place their hand over yours during palpation
Newborn motor skills: - ANSWERS>>>>>primary reflexes present and symmetric sucking, rooting, moro, grasp arm and leg recoil knee flexibility
Newborn psychological development: - ANSWERS>>>>>-erickson: trust v mistrust -piaget: sensorimotor (coordination between self and environment) -assess parent child interaction, oral gratification, stimulating environment -assess mental health -screen for signs of abuse
Anticipatory guidance for newborns: - ANSWERS>>>>>-consistent routines -ppd -accept help -avoid crowds -skin, circ, umbilical care -vitamin D- need 400 iu if they are exclusively bf, until formula is introduced
Safety for newborns: - ANSWERS>>>>>-safe sleep
-no shaking -crib slats >>>>-can only focus on face or bright object within 8-12in -at 2 wk visit do penlight exam (for nystagmus and red reflex)
Physical development 1-3mo: - ANSWERS>>>>>length increases 3.5cm/mo FOC 1.5cm/mo Weight 0.5-1 oz/day growth spurt at 6-8wks
Motor skills 1-3mo: - ANSWERS>>>>>attempt to grasp sit with support roll over
Communication 1-3mo: - ANSWERS>>>>>-encourage parents to speak to their child with simple words -social smile appears by 3mo
Anticipatory guidance 1-3mo: - ANSWERS>>>>>-sleep on back (15-16 hrs/day), same room, own crib
can pull to sit can keep back straight
Communication 4-5mo:q - ANSWERS>>>>>babbles, coos increased awareness of environment
Anticipatory guidance 4-5mo: - ANSWERS>>>>>-encourage parents to let child put themselves back to sleep when awake at night -night time rituals -consistent prompt response to infant crying -hand on baby on the changing table -childproofing -floor play time, reading, reciprocal talking -no bottle in bed, no bottle propping, no microwave to heat milk -clean mouth/teeth with soft cloth 2 x day, teething begins -drooling begins at 4mo
4mo immunizations: - ANSWERS>>>>>Rotavirus # Dtap # Hib # PCV 13 # IPV #
Physical development 6-8mo: - ANSWERS>>>>>Weight 1lb/mo
Length 1.2cm-1.5cm/mo FOC 0.5 /mo
Motor skills 6-8mo: - ANSWERS>>>>>sits with support crawls
Communication 6-8mo: - ANSWERS>>>>>-articulates single sounds and progress to double consonant sounds -social play -stranger anxiety
Anticipatory guidance 6mo: - ANSWERS>>>>>-introduce solid foods slowly and one at a time, mash up table foods -clean mouth with soft cloth 2x day -teething begins -dental referral -promote language using simple words -read books, talk about pictures
6mo vision screening: - ANSWERS>>>>>fixation corneal light reflex cover/uncover (for strabismus) red reflex
Motor skills 9-12mo: - ANSWERS>>>>>-hold and pick up objects of various sizes -sit and crawl for prolonged periods -push to stand -walking holding onto furniature
Communication 9-12mo: - ANSWERS>>>>>-says 3-4 words -stranger anxiety -love to explore
Anticipatory guidance 9-12mo: - ANSWERS>>>>>-establish consistent bedtime routine -no bottle in bed -slowly increase solids -offer juice in a cup -do not leave alone in bath water -remove samll toys/plastic pieces -lock up guns -no more bottles at 12mo -separation anxiety begins
9mo immunizations: - ANSWERS>>>>>none catch up if needed
BF babies stool vs formula fed: - ANSWERS>>>>>BF: soft, sour/sweet smelling, often or rarely Formula: hard, smellier, 2-4x day
How many times a day should a baby void? - ANSWERS>>>>>min 6 x day up to 15-20x day
When does TB questionnaire begin? - ANSWERS>>>>>12mo, if pos, obtain skin test HGB and HCT also at 12mo
Physiological development of toddler/preschooler: - ANSWERS>>>>>-kidneys can differentiate/concentrate -GI tract mature -Increased lung capacity -endocrine function mature
Toddler/preschool growth: - ANSWERS>>>>>1-3yrs: 4-6lbs 3-6yrs: 4.5lbs anterior fontanelle closes at 18mo
Psychological development of a preschooler: - ANSWERS>>>>>- Erickson: initiative v self-doubt -Piaget: sensorimotor to preconceptual with symbolic thinking to use language, concrete thinking, and obedience
-diet, exercise, regular toileting hygiene -decrease milk, cheese, rice apples and bananas
Treatment of encopresis WITHOUT constipation: - ANSWERS>>>>>-diet:decrease milk, cheese, rice apples and bananas -avoid laxatives or stool softeners -regular toilet routine -exercise
When do you being audiometry screening? - ANSWERS>>>>>3- 4yo
12-18mo immunizations: - ANSWERS>>>>>MMR Varicella HIB # PCV # Hep A Dtap # Covid
When do you begin assessing BP? - ANSWERS>>>>>3yo
When do you stop measuring head circumference? - ANSWERS>>>>>2 yo
What is the autism assessment and when do you do it? - ANSWERS>>>>>M-CHAT 18-24mo
School readiness check list - ANSWERS>>>>>good health visual acuity normal hearing successful preschool toilet trained self care skills separates from parents follows directions shares/take turns good interpretation skills accepts suppervision tolerates frustration breifly works alone age appropriate language articulates clearly hand-eye coordination visual discrimination auditory discrimination numbers to 10 prints letters and 1st name
may screen from 2 yrs + if family hx of dyslipidemia, MI early in life or if child is obese
Physiological development of adolescent: - ANSWERS>>>>>- physical sexual development -tanner stages: pubic hair and breasts -female menses prior to 16 yo
Psychological development of adolescent: - ANSWERS>>>>>- erickson: indentity v confusion -piaget: formal operations, mature thought process -kholberg: postconventional, question rules, universal principles
Adolescent nutrition: - ANSWERS>>>>>-development of eating disorders in females -male and female obesity issues -ensure adequate vitamin D and calcium
When does the posterior fontanelle close? - ANSWERS>>>>>6- 8wks old -1cm in diameter
When does the anterior fontanelle close? - ANSWERS>>>>>12- 18mo -2-3cm in diameter -during the first 12 mo of life the brain size increases 2.5times
Cephalohematoma: - ANSWERS>>>>>-subperiosteal collection of blood -forms a mass, that does NOT cross suture lines -swelling and bruising
Cephalohematoma tx: - ANSWERS>>>>>no treatment resolves spontaneously in first few days -if there is bruising, observe for jaundice as the blood from bruising is reabsorbed
caput succedaneum: - ANSWERS>>>>>-superficial swelling of the soft tissue of the scalp with underlying bruising -swelling DOES cross suture lines
caput succedaneum tx: - ANSWERS>>>>>none resolves on its own The WHO growth charts are used for what ages? - ANSWERS>>>>>0-2yrs
What is used to track immunizations in the US? - ANSWERS>>>>>Immtrac
Elimination assessment less than 2yrs old: - ANSWERS>>>>>stool pattern, frequency, and consistency
-insert the loop .25-.5 inches into the ear canal along the superior portion of the canal. sweep down and out gently
Newborn nose assessment: - ANSWERS>>>>>-occlude one nostril at a time to assess for choanal atresia, best done by giving child pacifier (this will occlude the mouth) -if they have trouble breathing=Choanal atresia
When do deciduous teeth begin to erupt? - ANSWERS>>>>>- between 6-24 months -if no teeth by 15mo, refer to dentist -all deciduous teeth by 2.5yrs -need to be going to dentist by 3yrs old
When do permanent teeth begin? - ANSWERS>>>>>-6-12yrs old temporary teeth are lost and replaced
What can black lines at the gingival margin indicate? - ANSWERS>>>>>exposure to heavy metals
What could a deviated uvula indicate? - ANSWERS>>>>>neuro defect
Craniotabes: - ANSWERS>>>>>-thinning of the bone of the scalp -common in preterm newborns -can also occur in term infants from position in maternal pelvis or vita D deficiency
Craniotabes tx: - ANSWERS>>>>>none resolves spontaneously -if persistent test for syphlis and rickets
Management of cleft lip/palate: - ANSWERS>>>>>-refer to ENT for sx -special feeding techniques used until sx
Microcephaly: - ANSWERS>>>>>-head circumference 2sd below the mean for age and sex or a head in which the growth in increasingly slower than normal -may be overlapping bones along suture lines
What age does visual acuity screening begin? - ANSWERS>>>>> yo
What age should 20/20 vision be achieved? - ANSWERS>>>>>5 yo
Cover/uncover test: - ANSWERS>>>>>-test first on a near object, and then an object far away (20ft) -ask the child questions about the object in a picture that has been placed on the wall
Strabismus: - ANSWERS>>>>>-test for with corneal light reflection and cover/uncover test
