Pediatrics Proctored Exam New 2024 Version with All Questions from Actual Past Exam a, Exams of Nursing

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ATI Pediatrics Proctored Exam New 2024 Version with All

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A Nurse is teaching the guardian of a preschooler. The guardian states that the preschooler has had an imaginary playmate for about 3 months. which of the following pieces of information should the nurse give to guardian?

• children commonly begin having imaginary friends when they reach school age
• Notify your provider if the imaginary friend persists longer than 6 months
• Have your child take responsibility for actions if he tries to blame the imaginary friend
• Set limits by not allowing your child to have the imaginary friend present during family meals --------- Correct Answer ------------ Have your child take responsibility or actions if he tries to blame the imaginary friend (the nurse should inform the guardian that imaginary playmates are common during the preschool years due to the high level of imagination among this age group. Although having an imaginary friend is considered healthy, the preschooler might try to use this imaginary friend as a means of avoiding responsibility or punishment for unacceptable behavior. the nurse should inform the guardian of the need to have the preschooler take responsibility for his actions) A nurse is assessing a 6-month-old infant who had a cardiac catheterization with right femoral entry to diagnose a possible congenital heart defect. Which of the following findings should the nurse report to the provider? ---------- Correct Answer --------- Cool toes on the right foot A nurse is teaching the parents of a child who has rheumatic fever. Which of the following statements by a parent indicates an understanding of the teaching? ---------- Correct Answer --------- My child may take aspirin for his joint pain A nurse is caring for an infant who is experiencing dehydration. Which of the following assessments is the nurse's priority? ---------- Correct Answer --------- Measure the client's weight daily A nurse is assessing a school-age child who reports horseback riding 3 times per week and has injuries reportedly related to a fall from a horse. Which of the following findings should the nurse investigate further as an indication of child maltreatment? - --------- Correct Answer --------- Thin, frail extremities A nurse in a providers office enters an examination room to assess an 8 month old infant for the first time. which of the following reactions by the infant should the nurse expect.
• The infant gives the nurse a social smile
• the infant turns away when the nurse approaches

• The infant reaches out to the nurse to be held
• The infant is responsive and alert as the nurse comes closer --------- Correct Answer --- --------- the infant turns away when the nurse approaches (the nurse should expect an 8 month old infant to have a heightened fear of strangers. the infant is expected to cling to her parent and turn away when approached by a stranger.) A nurse is caring for a toddler who has gastroenteritis caused by salmonella. which of the following is the priority action for the nurse?
• Weigh the child
• Initiate contact precautions
• Establish a skin care routine
• Obtain a recent food history --------- Correct Answer ------------ Initiate contact precautions (Salmonella is a type of bacteria that is transmitted via contaminated feces, making contact precautions essential for preventing transmission. This client is at great risk for transmission of salmonella to others; therefore, contact precautions are the nurse's priority) A nurse is caring for a 4 month old child who is hospitalized. which f the following toys hsould the nurse provide for the child?
• A board book with large pictures
• A toy with movable parts
• A plastic mirror
• Push pull toy --------- Correct Answer ------------ A plastic mirror (A 4 month old infant can recognize herself and will also attempt to play with the baby in the mirror. a mirror is a bright object that provides appropriate visual stimulation for this age group. For the infants safety, however, the mirror must be unbreakable) A nurse is planning care for an adolescent who has sickle cell anemia and is experiencing a vaso occlusive crisis. which of the following interventions should the nurse include in the plan?
• Apply cold compresses to the child's extremities
• Administer meperidine every 4 hr until the crisis has resolved
• Maintain the child on bed rest
• Decrease the child's fluid intake for 8 hours --------- Correct Answer ------------ Maintain the child on bed rest (The nurse should maintain bed rest for this child who is experiencing a vaso occlusive crisis to minimize energy expenditure and avoid additional oxygen needs A nurse is planning care for a 3 month old infant who has an ileostomy. which of the following interventions should the nurse include in the plan?

• Avoid laying the infant on his abdomen
• avoid tucking the appliance into the infants diaper
• check the bag for stool every 4 hours
• Replace the appliance every 3 days --------- Correct Answer ------------ Check the bag for stool every 4 hours (the nurse should check the bag for stool every 4 hours or less to prevent the bag from overfilling and leaking stool from an ileostomy is acidic and can cause excoriation of the skin) A nurse is caring for an infant who has gastroenteritis and is dehydrated. which of the following characteristics places the infant at a higher risk of electrolyte imbalances compared to an adult client?
• Less extracellular fluid
• Reduced body surface area
• Longer intestinal tract
• Decreased rate of metabolism --------- Correct Answer ------------ Longer intestinal tract (Compared to adults or older children, infants have a longer intestinal tract. this results in greater fluid losses, especially through diarrhea) a nurse is caring for a child who has tetralogy of Fallot. which of the following laboratory values should the nurse expect to find?
• Platelet count of 20,000/mm^
• WBC 4,000/mm^
• Thyroid stimulating hormone 7.0 microunits/mL
• RBC 6.8 million/uL --------- Correct Answer ------------ RBC 6.8 million/uL (A child who has tetralogy of Fallot experiences cyanosis; therefore, the body responds by increasing RBC production (polycythemia) in an attempt to supply oxygen to all body parts) A nurse is teaching an adolescent about various strategies for chironic pain management. which of the following activities should the nurse use as an example of the nonpharmacological strategy of thought stopping?
• Assemble a puzzle
• Discuss a recent pleasurable event
• Tighten and then relax each body part
• Repeat memorized facts about the painful event --------- Correct Answer ------------ Repeat memorized facts about the painful event (Having the adolescent repeat memorized facts about the painful event is an example of the non pharmacological pain management strategy of thought stopping. Thoughts such as the pain will be gone soon or ill be home by this time tomorrow can help the adolescent control the pain. after listing the facts, the nurse should then have the adolescent condense and memorize the facts to repeat them whenever pain occurs.

A nurse is reviewing recommended immunizations with the guardian of a 2 month old infant. which of the following statements should the nurse make?

• your baby can receive the varicella vaccine at 6 months of age
• your baby can start the pneumococcal vaccine now
• Your baby should receive the flu vaccine before 6 months of age
• you baby can start eh measles, mumps, and rubella vaccine --------- Correct Answer ---- -------- Your baby can start eh pneumococcal vaccine now (The infant can receive the first dose of the pneumococcal vaccine now, with 2 additional doses at 4 months and 12 months of age) A nurse is caring for an adolescent following a lumbar puncture. which of the following actions should the nurse take?
• initiate NPO status for the adolescent
• place the adolescent in a supine position
• place a moist, warm pack on the adolescents lower back
• apply a eutectic mixture of local anesthetics to the adolescent's puncture site --------- Correct Answer ------------ Place the adolescent in supine position (The nurse should place the adolescent in a supine position for 30 minutes to an 1 hour following a lumbar puncture to decrease the risk of a post Dural puncture headache) A nurse is assessing a child who is receiving IV chemotherapy. assessment findings include extravasation of the tissues surrounding the IV insertion site. In which order should the nurse take the following actions?
• Remove IV line
• Elevate the extremity
• Stop the infusion
• Notify the provider --------- Correct Answer ------------ Stop the infusion Elevate the extremity Notify the provider Remove the IV line A nurse is discussing the causes of chronic diarrhea with a client. which of the following conditions is caused by malabsorption
• Celiac disease
• Ulcerative colitis
• Hirschsprung's disease
• Crohn's disease --------- Correct Answer ------------ Celiac Disease (the nurse should recognize that celiac disease causes chronic diarrhea due to malabsorption. other malabsorption conditions include short bowel syndrome, lactose intolerance, and congenital enzyme deficiency)

A nurse is caring for an 8 year old child who has sickle cell anemia. which of the following actions should the nurse take?

• Apply cool compresses to the painful area
• Initiate contact isolation precautions
• Give the child flavored popsicles
• Administer phytonadione --------- Correct Answer ------------ Give the child flavored popsicles (Maintaining hydration with a child who has sickle cell anemia is important to prevent sickling. children often accept flavored popsicles as a source of fluid A nurse is caring for a toddler who has a fever, a high pitched cry, irritability, and vomiting. which of the following actions should the nurse take?
• Administer 81 mg of aspirin to the toddler
• Give the toddler a cold bath
• Place the toddler in a supine position
• Pad the rails of the toddler's bed --------- Correct Answer ------------ Pad the rails of the toddler's bed (When caring for a toddler who has manifestations of bacterial meningitis, the nurse should implement seizure precautions, which includes padding the side rails of the bed) A nurse is caring for an infant who has pertussis. which of the following actions should the nurse take?
• assess for edema of the extremities
• apply warm compresses to the neck area
• initiate airborne precautions
• maintain a cardiorespiratory monitor --------- Correct Answer ------------ Maintain a cardiorespiratory monitor (Infants with pertussis typically present with apnea in response to coughing spasms and mucus plugs. Humidified oxygen and suction equipment should be used as needed) A nurse is caring for a 7 year old child who is in skeletal traction following a complete fracture of the femur. which of he following diversional activities should the nurse offer the child?
• Puzzle with large pieces
• Building blocks
• Finger paints
• Chapter books --------- Correct Answer ------------ Chapter books (the nurse should offer chapter books as an appropriate diversional activity for a school age child who has limited movement due to skeletal traction) A nurse is creating a plan of care for a 6 month old infant who requires continuous pulse oximetry monitoring. Which of the following interventions should the nurse include.

• Reposition the sensor to a new site once every 24 hr
• Secure the oximetry sensor to the infant's wrist
• apply conduction gel to the skin before attaching the sensor
• Cover the oximetry sensor with clothing --------- Correct Answer ------------ Cover the oximetry sensor with clothing (the nurse should cover the sensor with clothing to prevent outside light from causing an altered or false reading) A nurse is caring for a toddler who has otitis media and a temperature of 39.1 (102.4F). Which of the following actions should the nurse take first?
• Reduce the temperature of the Childs room
• redress the child in minimal clothing
• apply cool compresses to the Childs forehead
• administer an antipyretic to the child --------- Correct Answer ------------ Administer an antipyretic to the child (when using the urgent vs. nonurgent approach to client care, the nurse should first administer an antipyretic to decrease the toddler's body temperature) A nurse is providing teaching to a 12 y3ear old client who is recovering from an acute episode of hemophilia A. which of the following statements should the nurse include in the teaching?
• have your parent stretch and mover your legs for you
• apply heat to joints that become painful, stiff, and swollen.
• take aspirin at the first sign of a headache
• you will be able to participate in physical exercises --------- Correct Answer ------------ You will be able to participate in physical exercises (physical exercise is important for the maintenance of joint mobility and muscle strengthen. participation in non contact sports and the use of protective equipment such as knee pads are encouraged, although high impact athletic activities such as karate should be avoided) A school nurse is assessing a child who has been stung by a bee. the childes hand is swelling and the nurse notes that the child is allergic to insect stings. which of the following findings should the nurse expect if the child develops anaphylaxis
• Bradycardia
• Nausea
• Hypertension
• Urticaria
• Stridor --------- Correct Answer ------------ Nausea, Urticaria, and stridor (A common gastrointestinal response to excessive histamine release is nausea. A common skin manifestation of excessive histamine release is hives, also known as

urticaria. A serious, life threatening response to excessive histamine release is airway narrowing, which presents as dyspnea and stridor) A nurse is developing a health education program for the parents of school aged females. which of the following pieces of information regarding sexual maturation should the nurse include

• hgihe4r body fat content is associated with earlier onset of menarche
• pubic hair is typically present prior to breast development
• ovulation begins after sexual maturation is complete
• menarche signals the beginning of puberty --------- Correct Answer ------------ higher body fat content is associated with earlier onset of menarche (the nurse should inform the parents that the onset of menarche is expected to occur around 10.5 to 15.5 years of age. females who have a higher body fat content have been shown to have earlier onset of menarche) A nurse is teaching the parents of a toddler who has enterobiasis about managing this parasitic disease. Which of the following pieces of information should the nurse include in the teaching? ---------- Correct Answer --------- You should keep your child's fingernails trimmed short. A nurse on a pediatric unit is admitting a 4-year-old child. Which of the following toys should the nurse plan to provide for the child to engage in independent play? ---------- Correct Answer --------- Plastic stethoscope A nurse is reviewing the risk factors for the development of congenital heart disease with a client who is planning to conceive. Which of the following conditions should the nurse include as a maternal risk factor? ---------- Correct Answer --------- Alcohol consumption A nurse is providing preoperative education for an 8-year-old child prior to cardiac surgery. Which of the following actions should the nurse take? ---------- Correct Answer - -------- Use a doll with tubes and an incision to explain the surgery A nurse in a provider's office is observing children playing in the waiting room. The nurse should expect to identify parallel behavior in which of the following age groups? -- -------- Correct Answer --------- Toddlers A nurse is performing a physical assessment on a 12-month-old infant. Which of the following findings should the nurse report to the provider? ---------- Correct Answer ------- -- The infant's current weight is double his birth weight A nurse is assessing a toddler who has gastroenteritis. Which of the following findings indicates the toddler is experiencing severe dehydration? ---------- Correct Answer --------
• Deep, rapid respirations

A charge nurse is providing education about child maltreatment to a group of newly licensed nurses. Which of the following pieces of information should the charge nurse include in the teaching? ---------- Correct Answer --------- Children who were born prematurely are more likely to be maltreated A nurse is caring for a child who has paralytic poliomyelitis. Which of the following actions should the nurse take? ---------- Correct Answer --------- Administer oral analgesics prior to exercises A nurse is planning care for a 4-year-old child who has nephrotic syndrome. Which of the following actions should the nurse take? ---------- Correct Answer --------- Provide thorough skin care A nurse is caring for a child who received penicillin IM 15 minutes ago. The child is now irritable and restless. Which of the following actions should the nurse take first? ---------- Correct Answer --------- Assess for laryngeal edema A nurse is caring for a child with a vesicular rash that has been present for 6 days. The nurse should expect that the child has which of the following conditions? ---------- Correct Answer --------- Varicella A nurse is providing teaching to the parent of a toddler who has bacterial conjunctivitis. Which of the following instructions should the nurse include? ---------- Correct Answer --- ------ Notify the provider immediately if the sclera becomes inflamed A nurse is planning care for a preschooler who is immediately postoperative following the placement of a ventriculoperitoneal shunt. Which of the following interventions should the nurse include in the plan? ---------- Correct Answer --------- Lay the preschooler on the nonoperative side A nurse is teaching a school-age child who has a new diagnosis of type 1 diabetes mellitus. Which of the following statements should the nurse make? ---------- Correct Answer --------- You can use a vial of insulin for up to 30 days. A nurse is assessing a 6-month-old infant who was recently admitted with acute vomiting and diarrhea. Which of the following findings indicates the infant has moderate dehydration? ---------- Correct Answer --------- Tachypnea A nurse is assessing a 3-year-old preschooler. Which of the following developmental milestones should the nurse expect the preschooler to demonstrate? ---------- Correct Answer --------- Stacking 10 blocks A nurse is assessing a 30-month-old toddler during a well-child visit. Which of the following findings requires further assessment by the nurse? ---------- Correct Answer --- ------ The toddler's birth weight is tripled.

A nurse is caring for a child who has a ruptured appendix. Which of the following positions should the nurse encourage the child to maintain? ---------- Correct Answer ---- ----- Semi-Fowler's A nurse is providing teaching to the parent of a 2-year-old toddler about nutrition. Which of the following statements by the parent indicates an understanding of the teaching? --- ------- Correct Answer --------- My child should consume 1000 calories per day A nurse is conducting a health assessment for a 24-month-old toddler at the local health department. The nurse should expect which of the following findings? ---------- Correct Answer --------- Ability to build a tower of 6 blocks Slightly bowed or curved leg appearance A nurse is caring for an infant who is preoperative for the treatment of an intact myelomeningocele sac. In which of the following positions should the nurse place the infant? ---------- Correct Answer --------- Prone A nurse is assessing an 18-month-old toddler during a well-child examination. Which of the following findings should the nurse report to the provider? ---------- Correct Answer -- ------- The toddler is unable to remove his shoes A nurse is caring for a child who is receiving treatment for diabetic ketoacidosis and has a current blood glucose level of 250mg/dL. Which of the following actions should the nurse take? ---------- Correct Answer --------- Administer 5% dextrose in 0.9% sodium chloride by continuous IV infusion A nurse in a pediatric clinic is caring for a 3-year-old child who has a blood lead level of 3 mcg/dL. When teaching the toddler's parent about the correlation of nutrition with lead poisoning, which of the following pieces of information is appropriate for the nurse to include? ---------- Correct Answer --------- Ensure the child's dietary intake of calcium and iron is adequate A nurse is caring for a preschooler who was brought to an outpatient clinic with a 2-day history of vesicular, honey-colored crusty region around the nose and mouth. If the provider determines the lesion to be impetigo contagiosa, what should the nurse anticipate teaching the child's parent about the illness? ---------- Correct Answer --------- Apply a topical antibacterial ointment to the lesions Wash the child's bed linens daily with hot water Wash hands before and after contact with the affected area A nurse is assessing a newborn at birth to assign Apgar scores. At 1 min of age, the newborn is crying vigorously with limbs flexed and has a heart rate of 120/min. The newborn's trunk is pink, but his hands and feet are cyanotic, and he cries when the soles of his feet are stimulated. Which of the following Apgar scores should the nurse assign this infant? ---------- Correct Answer --------- 9

A nurse in the emergency department is reviewing laboratory results for several children who have manifestations of influenza. Which of the following children should the nurse report to the provider immediately? ---------- Correct Answer --------- An infant with a WBC count of 24,000/mm A nurse is teaching the parent of a child who has ADHD and a new prescription for methylphenidate sustained-release tablets. Which of the following pieces of information should the nurse include in the teaching? ---------- Correct Answer --------- Weigh your child twice per week while he is taking this medication The nurse is providing teaching to the parent of a 4-year-old child who stutters. Which of the following statements by the parent indicates an understanding of the teaching? ------ ---- Correct Answer --------- I should ignore the stuttering and not interrupt her A nurse is providing teaching to a 12-year-old client who is recovering from an acute episode of hemophilia A. Which of the following statements should the nurse include in the teaching? ---------- Correct Answer --------- You will be able to participate in physical exercises A nurse is planning care for a 10-month-old infant who has suspected failure to thrive. Which of the following interventions should the nurse include in the plan of care? ---------

• Correct Answer --------- Observe the parents' actions when feeding the child Maintain a detailed record of food and fluid intake A charge nurse is reviewing the expected growth and development of school-aged children with a group of staff nurses. Which of the following should the nurse include? -- -------- Correct Answer --------- A 6-year-old child should be able to count 13 coins A school nurse is providing care to a child who has a nosebleed. Which of the following actions should the nurse perform? ---------- Correct Answer --------- Apply pressure to the child's nose using the thumb and forefinger Keep the child calm A nurse is providing teaching to the guardians of a 4-month-old infant on how to play with the infant. Which of the following play activities should the nurse suggest for this infant? ---------- Correct Answer --------- Allow the infant to splash in the bathtub A nurse is caring for a child who has suspected nephrotic syndrome. Which of the following laboratory values should the nurse expect? ---------- Correct Answer --------- Serum cholesterol 700 mg/dL A nurse is creating a plan of care for a 6-month-old infant who requires continuous pulse oximetry monitoring. Which of the following interventions should the nurse include? ---------- Correct Answer --------- Cover the oximetry sensor with clothing

Describe major developmental and occupational milestones for children ages 5- 12 years old: Sleeping Hours --------- Correct Answer --------- 9 - 11 hours recommended each night Describe major developmental and occupational milestones for children ages 5- 12 years old: Chores for Children --------- Correct Answer --------- Children capable of complex chores like laundry, cooking, cleaning & High degree of variability depending on family and cultural factors Describe major developmental and occupational milestones for children ages 5- 12 years old: Play (5-6 yr) --------- Correct Answer --------- Games with rules, dramatic play, organized sports Describe major developmental and occupational milestones for children ages 5- 12 years old :Play (7-12 yr) --------- Correct Answer --------- Strategy-based games, competitive sports, crafts, hobbies Describe major developmental and occupational milestones for children ages 5- 12 years old: ADLs --------- Correct Answer --------- Activities like dressing, toileting, feeding & Children are IND around age 5 Describe major developmental and occupational milestones for children ages 5- 12 years old: Cognitive Development (5-6 yr) --------- Correct Answer --------- Simple reasoning, play grounded in reality, building/creating with objects Describe major developmental and occupational milestones for children ages 5- 12 years old: Cognitive Development (7-12 yr) --------- Correct Answer --------- Abstract reasoning, cognitive flexibility, more robust executive functioning Describe major developmental and occupational milestones for children ages 5- 12 years old: Fine Motor Development (5-6 yr) --------- Correct Answer --------- Proficient with school tools, writes letters, complex bilateral skills Describe major developmental and occupational milestones for children ages 5- 12 years old: Fine Motor Development (7-12 yr) --------- Correct Answer --------- Dexterity and fine manipulation allow for crafts, music, instruments, etc Describe major developmental and occupational milestones for children ages 5- 12 years old: Gross Motor Development (5-6 yr) --------- Correct Answer --------- Fluid hops/skips/jumps/runs, emerging ball skills, body control, and balance Describe major developmental and occupational milestones for children ages 5- 12 years old: Gross Motor Development (7-12 yr) --------- Correct Answer --------- Endurance for running and other sports, athleticism emerging

Describe major developmental and occupational milestones for children ages 5- 12 years old: Social Relationships (5-6 yr) --------- Correct Answer --------- Helpful and thoughtful interactions, perspective taking Describe major developmental and occupational milestones for children ages 5- 12 years old: Social Relationships (7-10 yr) --------- Correct Answer --------- Plays fair and follows the rules, tight social connections, sharing of inner self, forming social groups Plays fair and follows the rules, tight social connections, sharing of inner self, forming social groups: Social Relationships (11-12 yr) --------- Correct Answer --------- Trustworthy, empathetic, interest in romantic relationships Analyze factors supporting effective interprofessional collaborations among occupational therapists and teachers: Clear Role Delineation --------- Correct Answer ---- ----- SBOT assists children towards greater participation in daily occupations at school Enacted via embedded, classroom-specific service delivery Related service vs. instructional support specialist Analyze factors supporting effective interprofessional collaborations among occupational therapists and teachers: Shared values/Respect --------- Correct Answer --- ------ Tensions arise when collaboration and communication is inadequate Logistical, interpersonal, and professional conflict Analyze factors supporting effective interprofessional collaborations among occupational therapists and teachers: Responsible Communication --------- Correct Answer --------- Effective and mutual conflict management Understanding of educational law and practices Respectful advocacy Services align with the values and culture of the teacher and classroom Communication, Role perception, Conflict resolution Analyze factors supporting effective interprofessional collaborations among occupational therapists and teacher: --------- Correct Answer --------- Feedback is perspective: Constructive feedback <- criticism - > verbal abuse Critical Aspects of Effective OT-Teacher Collaboration: Role Delineation ● Grounding in an educational context ● Respect for professional differences ● Establishing shared goals and a team approach ● Situating OT role within the classroom ● Effective conflict resolution and honest communication Examples of exemplary services: Tier 1 Services --------- Correct Answer --------- Everyone, embedded programs Social Skills: Mental health promotion, coping skills, anti-bullying Health Promotion: Stress and health management Play, leisure, and recreation: Performing arts, recreation facilitators, self-concept

Examples of exemplary services: Tier 2 Services --------- Correct Answer --------- at-risk, marginalized, vulnerable groups Social skills: Rejected/disliked children, Behavioral incidents with at-risk, Children with learning disabilities, intellectual impairment, DD Health promotion: Yoga-based interventions, Children with asthma Play, leisure, and recreation: Children experiencing abuse and neglect, Intellectual and language impairment RTI (Response to Intervention) --------- Correct Answer --------- Used to provide Early Intervention Services and support students who are not eligible for special education or found to have an educational disability but need additional academic and behavioral supports to succeed in school. Makes decisions regarding the level of support or services a student needs to be successful Tier 1 Services --------- Correct Answer --------- for all students; the largest % of services in this model Tier 2 Services --------- Correct Answer --------- for more vulnerable students; addressing risk factors in order to avoid an IEP; specific to the exact needs of the school (we only know this if we are embedded) IDEA (Individuals with Disabilities Education Act (2004) --------- Correct Answer --------- free and appropriate public education (FAPE) least restrictive environment (LRE) ESSA (Every Student Succeeds Act, focuses on instructional support) 2015 --------- Correct Answer --------- switched to instructional support personnel we are responsible for the health of all members of the school community use our expertise to impact this Models of Service Delivery in SBOT --------- Correct Answer --------- Direct services - 1: (pull out or push in), can be small groups (reading, writing, etc.) Indirect services - consulting with teachers/other professionals, meeting times, professional collaboration specific to a certain child Co-teaching Occupational performance coaching - parent/caregiver focused Integrated services - embedded within routines, but still going in and out Embedded programs (workload models) - universal support to all children: Can help offset bias and stigma from pull out services and Normalizes asking for help Embedded Support Benefits: Best Practice in SBOT --------- Correct Answer --------- Natural environment, universal access, incorporates existing classroom structure and culture, reinforces learning in context Children's literacy development supported through visual motor, visual perceptual and in hand manipulation --------- Correct Answer --------- Efficiency and speed of writing Cognitive demands of advanced learning Systems work in cohorts to yield efficient writing Specific grasp pattern, not a factor with typically developing children

Grasp is not a good predictor or indicator of writing efficiency NOT about handwriting, it's about LITERACY Intellectual disability (ID) --------- Correct Answer --------- Significant intellectual deficits: IQ scored btw 65-85, intellectual capacity/function Significant adaptive functioning deficits: language/literacy, interpersonal and group norms, self-care/safety Global developmental delay (GDD) --------- Correct Answer --------- Neurodevelopmental disability Significant delay in 2 or more major developmental areas: motor, language, social, cognition, daily living skills Self-injurious behaviors (SIB) --------- Correct Answer --------- Behaviors trying to communicate: connection seeking, expressing frustration, self-regulation Functional needs of children affected by ID --------- Correct Answer --------- Challenges with ADLs, poor hygiene, and limited participation in social and recreational activities, extended time spent time at home or alone Goals of OTs working with children with ID --------- Correct Answer --------- Thorough occ.profile, family-centered care, emphasize beliefs, habits and routines, participation in meaningful activity appropriate for the child's age and developmental level, specific areas (time management, self-care, simple task completion, classroom participation, work, and leisure) Somatosensory System --------- Correct Answer --------- Tactile and Propriception Dorsal Column Medial Lemniscal Pathway (DCML) --------- Correct Answer --------- Conveys sensory information related to vibration, discriminatory touch(size, form, contour, teture, and movement across the skin), touch-pressure, and proprioceptive information Anterolateral System (AL) --------- Correct Answer --------- Spinothalamic: pain(sharp), temperature Spinoreticular: pain (dull, burning), temperature (collaterals from the spinothalamic tract), pressure and non-discriminative touch) collateral from the spintothalamic tract) Spinocerebellar --------- Correct Answer --------- Spinocerebellar pathway provides proprioceptive input to the cerebellum, body and limb position, timing and movement Sensory systems critical to children's functioning --------- Correct Answer --------- Proprioception (muscles and joints), vestibular (gravity and mvt), and tactile (touch) systems

Dyspraxia --------- Correct Answer --------- Poor coordination; difficulites in generating for planning and organizing movements, deficits in ideation, somatodysprazia, and bilateral integration and sequencing (not detected until age 3) Modulation --------- Correct Answer --------- Ability to integrate input so that behavior remains adaptive if not, then the child struggles to process info and inputs from the environment Key assumptions of Ayers SI: Neuroplasticity --------- Correct Answer --------- Children's brain processing changes over time Structure and function of the CNS changes in response to the environment (repeated exposure over time) Miller Nosology of Sensory Processing Disorder (SPD) --------- Correct Answer --------- Adds sensory seeking as an distinct manifestation compared to AYERS. SPD into sensory modulation disorder (SMD), sensory-based motor disorder (SBMD), and sensory discrimination disorder (SDD) Developmental coordination disorder (DCD) --------- Correct Answer --------- Neurodevelopmental disorder characterized by motor performance substantially below expected levels for developmental age (won't see until 2.5-3 yrs) coordination problems, and difficulties with basic motor skills Planning Treatment for Dyspraxia Using an SI Approach --------- Correct Answer --------- Consider evaluations (BOT, SIPT, SPM), performance/participation in context, routines and habits in comparison with environmental demands, and parent and teacher observations Motor Delay --------- Correct Answer --------- Specific delay (e.g., fine motor) not generalized, skills later than peers but still have skills Tactile Defensiveness --------- Correct Answer --------- Heightened sensitivity to touch stimuli Gravitational Insecurity --------- Correct Answer --------- Fear or discomfort related to changes in head position or movement Sensory Processing Measure (SPM) --------- Correct Answer --------- Assesses sensory issues, praxis, and social participation in elementary school children aged 5-12; viewed at home, school, and in the community, raters of the SPM have to observe the child in the environment being rated for at least one month; but the child does not need to be present Sensory Profile (SP) --------- Correct Answer --------- Ages 3-10; categories: sensation seeking, sensory sensitivity, sensation avoiding, low registration; subscales (auditory,

visual, touch, movement, body position, oral sensory, conduct, social emotional and attentional) Interoception --------- Correct Answer --------- System regulating internal body states and emotions Behavioral Manifestations Central Auditory Processing Disorder (CAPD) --------- Correct Answer --------- Normal or above average hearing on auditory tests; Auditory attention and figure ground processing; Auditory discrimination, auditory sequential processing, auditory memory, auditory sensitivity Behavioral Measures of Interoception --------- Correct Answer --------- Assessment using biofeedback metrics, self-report measures, correlation with SPM-2 Social participation, vision, touch (higher scores correlated w/concerns about interoception) Metacognition --------- Correct Answer --------- able to evaluate own cognitive process & products, problem-solving and at age 2 metacognition emerging (contemplating own actions) Cognitive-Based Approaches in OT --------- Correct Answer --------- Specific mental functions and higher order functions Cognition --------- Correct Answer --------- ability to acquire & use info, highly dependent on environment, faciltated by uninterrupted exploration in the outdoor and natural world, language facilitates this (social, physical, sensory, and language info), becomes more comples as you age Scaffolding --------- Correct Answer --------- Matching child's ability with the task demand (ex: scissors) CO-OP (Cognitive Orientation to Daily Occupational Performance) --------- Correct Answer --------- Four stages: 1) acquire skill, 2) apply cognitive strategy (scaffold, coach, discovery, schedule, etc.), 3) generalize skill, 4) transfer learning OT Application on Behavioral theories --------- Correct Answer --------- Behavior is part of the client's performance pattern, learned in context and reflects family, social and cultural roles, situate behavior (what means to you & occupation) ADHD --------- Correct Answer --------- Involves problems with EF, emotional functioning, emotional regulation, trouble adapting to cognitive, emotional and behavioral demands ODD --------- Correct Answer --------- Often have disobedient, hostile, and defiant behavior; may be argumentative and have frequent tantrums

Anxiety --------- Correct Answer --------- Persistent and excessive worry or fear; restlessness or feeling on edge, easily fatigued, irritability, muscle tension, sleep disturbance MTSS ( multi-tier system of supports) --------- Correct Answer --------- The purpose of prevention and early intervention - to identify and address student problems early to reduce the need for more intensive services later: ● High-quality general education instruction based on scientific evidence ● Continuous progress monitoring of student performance ● Universal screening of academics and behavior ● The use of multiple tiers of instruction that are progressively more intense, based on the student's response to intervention Tier 3 Services --------- Correct Answer --------- Failed Tier 1&2; IEP and special education track; disability severe enough to qualify for IEP Early Intervening services (EIS) --------- Correct Answer --------- Help students in Gen ED who are not eligible for services but who need additional support Challenges to embedded support implementation --------- Correct Answer --------- Time Strategies to promote success with embedded support --------- Correct Answer --------- Administrative support, dedicated co-planning time, professional commitment Ocular motor system --------- Correct Answer --------- controlled by skeletal muscles Lazy Eye --------- Correct Answer --------- laxity or damage to the oculomotor muscles External eye- cornea --------- Correct Answer --------- not impermeable, can get conjunctivitis Pupil --------- Correct Answer --------- lets light in by contracting or dilating Optic nerve --------- Correct Answer --------- visual cortex where images are interpreted by the brain Lens --------- Correct Answer --------- Focuses light onto retina Visual perceptual fields --------- Correct Answer --------- Extent to which your eyes work together to make sense of the 3D world: roughly 180 with peripheral vision, both eyes have shared responsibility for both visual fields Visual perceptual fields: Binocular function --------- Correct Answer --------- both eyes work together

Visual perceptual fields: Optic chiasm --------- Correct Answer --------- Part of the brain where the optic nerves cross and is therefore or primary importance to the visual pathway Fixation point --------- Correct Answer --------- where both eyes are in alignment perceiving their respective fields Accommodation: --------- Correct Answer --------- the ability of the eye to adjust its focus in order to see objects clearly at different distances Binocular vision --------- Correct Answer --------- relies on the alignment of both eyes, allowing them to point at the same object of interest. Convergence insufficiency: --------- Correct Answer --------- a common binocular vision disorder characterized by difficulty converging or bringing the eyes together to maintain single binocular vision, especially when focusing on nearby objects Near point convergence: --------- Correct Answer --------- a measure of the closest distance at which an individual can maintain single binocular vision when focusing on a near object. Pursuits --------- Correct Answer --------- smooth eye movements that track or follow a moving object as it moves across the visual field. Saccades --------- Correct Answer --------- rapid eye movements that allow us to quickly shift our gaze from on object or point of interest to another Visual acuity --------- Correct Answer --------- the clarity or sharpness of vision, typically measured by the ability to discern details of objects at a specific distance Visual analytics skills --------- Correct Answer --------- the ability to interpret, analyze, and derive meaning from visual information effectively. Visual efficiency --------- Correct Answer --------- the ability of the visual system to efficiently process and interpret visual information, enabling individuals to perform various visual tasks accurately and effectively Visual information processing: --------- Correct Answer --------- refers to the complex cognitive and neural processes involved in perceiving, interpreting, and making sense of visual stimuli from the environment Visual-spatial skills --------- Correct Answer --------- also known as spatial perception or spatial awareness, refer to the ability to perceive, interpret, and mentally manipulate spatial relationships between objects and within three-dimensional space Understanding the behavior --------- Correct Answer --------- What are the patterns?

Situate the behavior as happening over the course of time (day/week) Maybe a cumulative effect of many stressors Zoom in and out on the behaviors - does the child live a life with purpose and meaning in their day? Undiagnosed pain/seizures/allergies? Other physical conditions? Central Nervous System (CNS) --------- Correct Answer --------- Brain, spinal cord, meninges Peripheral nervous system (PNS) --------- Correct Answer --------- Body's way to communicate with the brain Somatic --------- Correct Answer --------- Voluntary actions (in your control) Sympathetic System --------- Correct Answer --------- Involuntary actions- flight or fight: "kiddos who are here often tend to compound throughout the day & not come back to baseline" Parasympathetic --------- Correct Answer --------- rest and digest Trigeminal nerve facial) --------- Correct Answer --------- Pain, temperature, light touch and pressure Tactile System (Receptors in the skin) --------- Correct Answer --------- Meisner's corpuscles - fast adapting Pacinian corpuscles - fast adapting Merkel's disks - slow adapting Free nerve endings - slow adapting Proprioception (receptors in deep tissue) --------- Correct Answer --------- Golgi tendon organs Muscle spindle (tonic and phasic) Most impactful for SI/SPD: Stimulus reception --------- Correct Answer --------- density of the sensory receptors (certain parts of the body have more sensory receptors), responsiveness to sensation; some areas are more sensitive such as more protective/defensive Transduction --------- Correct Answer --------- Mechanical signal → electrical signal; the conversion of sensory stimuli into neuronal activity Most impactful for SI/SPD: Receptor adaptation --------- Correct Answer --------- two types of reactions (fast start and end of a sensation, and slow give ongoing info); graded exposure and positive experiences of sensory input changes over time of more/less responsiveness fast adapting cue to onset of stimulation, slow is new, changes over time with supportive sensory feedback

Most impactful for SI/SPD: Lateral inhibition --------- Correct Answer --------- one system can dampen another system; light tough can lead to deep touch vice versa Most impactful for SI/SPD: Habituation --------- Correct Answer --------- how the nervous system changes over time in response to supportive sensory input, threshold and setpoint can become more aligned Most impactful for SI/SPD: Sensitization --------- Correct Answer --------- "heightened awareness/responsiveness to a stimulus or class of stimuli for a period of time" - children make associations Limbic system (fear response); --------- Correct Answer --------- children start to make associations based on previous experiences children start to make associations based on previous experiences Threshold+set point --------- Correct Answer --------- sensory reactivity Set point --------- Correct Answer --------- the degree to which something has to be novel to garner attention; at what point do I engage my cognitive (upstairs) brain? (upstairs brain = thinking vs. downstairs brain = reactive) pay attention to sensory input to determine if threat or not Threshold --------- Correct Answer --------- amplitude of input Indicators of modulation: Over Responsive --------- Correct Answer --------- Highly distractible: change in activity pattern, change in affect avoidant behaviors: can lead to even more sensitivity in hands and feet if they avoid sensory things Indicators of modulation: Under Responsive --------- Correct Answer --------- Things that feel normal to us feel not enough for them High threshold for registering sensory input poor registration: don't map every day sensations very well; do things really intensely Key assumptions of Ayers SI: Integrated whole --------- Correct Answer --------- Upstairs = (explicit cognitive thinking) and downstairs brain = (reactive) All areas of the brain are involved in supporting sensory processing Integrate through own narrative, self talk, and lived experience Key assumptions of Ayers SI: Adaptive interactions --------- Correct Answer --------- Challenging children within their daily environments without pushing them to fight or flight Just right challenge

Key assumptions of Ayers SI: Inner Drive --------- Correct Answer --------- Create environments that are safe and welcoming to explore and risk WITH US children want to seek and master things that they're interested in motivation AND engagement Sensory Modulation Disorder (SMD:) --------- Correct Answer --------- Disorganized response to sensory input: Sensory over responsivity (SOR), Sensory Under Responsivity (SUR), Sensory seeking/craving (SS) Sensory-Based Motor Disorder (SBMD) --------- Correct Answer --------- Postural disorders (grounded in muscle tone): dyspraxia (poor coordination with movement) Sensory Discriminative Disorder (SDD) --------- Correct Answer --------- Visual, auditory, tactile, vestibular, proprioception, taste/sound Clinical Indicators of Sensory Modulation Disorder --------- Correct Answer --------- experiencing a disorganized response to sensory input across multiple sensory systems sensory over responsiveness sensory-under-responsiveness, tactile defensiveness gravitational insecurity defensiveness to smell, taste, sound, or light. Interoception and Daily Life --------- Correct Answer --------- Awareness of: internal body states, own feelings/emotions, impact of external stimuli. Interoceptive skills required for self-regulation Auditory System --------- Correct Answer --------- Tympanic membrane: Ossicles, tensor tympani, stapedius (Cochlea), auditory nerve, auditory cortex Hearing: Peripheral auditory system --------- Correct Answer --------- Outer, middle, inner ear; amplitude, frequency of what is being heard, environment is strongly connected to what you hear, use it or lose it Processing: central auditory system --------- Correct Answer --------- Auditory nerve & frontal cortex; How sounds are interpreted and processed; Response to sounds in env.; Extent to which children are exposed to sounds are factors;Natural phases of being sensitive to auditory input (Differentiate between obnoxious and harmful) Interoception as an Emerging Science within OT --------- Correct Answer --------- Know it exists, affecting child's health and well-being; how the Nervous system senses, interprets, and integrates signals originating from within the body, influence w/homestasis Treatments for CAPD (Central Auditory Processing Disorder) --------- Correct Answer --- ------ Modify the environment/task, dampen auditory input via headphones, train auditory

attention and discrimination to context (know what sounds to ignore), sound-based interventions Internal Dialogue --------- Correct Answer --------- begins at age 4 CBT Approaches: Self-coaching --------- Correct Answer --------- Articulated steps become internal dialogue (why words say to children are so impactful) CBT Approaches: Discovery Learning --------- Correct Answer --------- knowledge construction based on lived experience; make predicitions, create a context for child to learn something new Children with the inattentive subtype ADHD --------- Correct Answer --------- Impaire EF, attention, memory; get injured more than others due to making hasty abrupt decisions, experience social rejection, decreased academic performance, make careless mistakes and pay attention to detail, be forgetful, lose things, have a hard time staying organized Children with the hyperactive subtype ADHD --------- Correct Answer --------- Have difficulty holding still or remaining in seat in class, excessive motor mvt at appropriate times, be excessively talkative and interrupt others or blurt out during class OTs support children who have ADHD by --------- Correct Answer --------- Consider the child's ability to engage in meaningful occupation and how performance skills, performance patterns, client factors, and the environment combine to influence performance OTs support children who have ODD by --------- Correct Answer --------- Interventions often address self-management and problem solving skills Depression --------- Correct Answer --------- Persistent sadness, hopelessness, and loss of interests in activities; according to DSM-5 symptoms must be persistent nearly everyday for the majority of the day for at least 2 weeks Bipolar/Mood Dysregulation --------- Correct Answer --------- Persistent sadness, hopelessness and loss of interests in activities. Results in sadness, sleep disturbance, suicidal ideation, hopelessness OT interventions for children with serious mental illness --------- Correct Answer --------- Administer holistic assessments that address individual occupational strengths and areas of improvement on children, develope skills that improve their ability to cope and participate in daily activities Salient factors contributing to children's overall health and wellbeing --------- Correct Answer --------- Hygiene routines, social participation, contributing to health promotion (educational programs, program/policy development, direct/indirect services)

Activity Chairs --------- Correct Answer --------- Mobility vs static base, hi-lo base to reach various surface heights, participate in eating, classroom and leisure activities Standers --------- Correct Answer --------- static standing w/feet on platforms Gait Trainers --------- Correct Answer --------- Supportive frame to promote ambulation Adaptive Strollers --------- Correct Answer --------- Supportive seating (thigh guides, thoracic laterals, headrest options); Consider medical needs (tilt and recline options, holders for oxygen or IV pole) Manual wheelchairs --------- Correct Answer --------- Folding (can be made more compact for transport), rigid (lighter weight), tilt in space (some folding and non-folding) Power mobility devices --------- Correct Answer --------- Joystick (Placed on either right or left side, can place different handles on the joystick to facilitate patent access), alternative drive controls (Utilizing non-joystick methods for driving the power wheelchair by activating switches placed in the ideal location for the client to activate via hand, foot, chin, head, mouth, etc) Stimulus Encoding --------- Correct Answer --------- Involves your brain perceiving sensory input from the outside world, and then transforming (or "encoding") it into stored information Receptor fields --------- Correct Answer --------- The bodily area where a stimulus can affect a sensory receptor is called a receptive field. Most impactful for SI/SPD: Lateral inhibition --------- Correct Answer --------- one system can dampen another system; light touch can lead to deep touch vice versa Convergence --------- Correct Answer --------- Converging pathways involve impulses from several neurons coming together into one neuron. Converging pathways increase sensitivity to excitatory or inhibitory signals. Divergence --------- Correct Answer --------- Divergence allows one neuron to communicate with many other neurons in a network Serial Processing --------- Correct Answer --------- the sequential or step-by-step processing of information in the brain or nervous system, where each stage of processing is completed before moving on to the next stage Parallel Processing --------- Correct Answer --------- a mode of information processing in which multiple computations or operations are carried out simultaneously, allows for the concurrent execution of multiple tasks, often leading to increased efficiency and speed.

Vestibular-cerebellar connections --------- Correct Answer --------- The cerebellum plays a crucial role in integrating vestibular signals with proprioceptive and visual information to coordinate movements, maintain balance, and adjust posture Vestibulospinal connections: --------- Correct Answer --------- These connections facilitate reflexive adjustments in muscle activity in response to changes in head position or movement to maintain stability and posture Vestibular ocular connections: --------- Correct Answer --------- ensures that visual images remain stable on the retina during head movements, enhancing visual acuity and reducing motion blur. Vestibular thalamic and cortical connections: --------- Correct Answer --------- Integrates vestibular input with other sensory information and higher-order cognitive processes, contributing to spatial perception, self-motion perception, and navigation Pediatric Hand Guest Speaker: --------- Correct Answer --------- Work as part of mulitdiciplinary team, make everything fun, functional and play-based, family centered care and shared decision making CRUCIAL Intervention for Depression --------- Correct Answer --------- GB-CBT = GB-CBT stands for Game-Based Cognitive-Behavioral Therapy, which is a therapeutic package that uses structured games and activities to help children and families affected by sexual abuse. GB-CBT combines cognitive-behavioral therapy and play therapy to teach skills, process trauma, and assist children and their families Pediatric Hand Guest Speaker: Common diagnoses --------- Correct Answer --------- Pediatric trauma (fractures, casting 4-6 weeks); complex injuries, nerve injuries/lacerations (neuropraxis), burns Pediatric Hand Guest Speaker: Camptodactyly --------- Correct Answer --------- Non- traumatic, non painful flexion deformity of proximal interphalangeal joint (typically the little finger) ○ Intervention: serial casting, exercises for finger extension, exercises for intrinsic tightness Pediatric Hand Guest Speaker: Radial Longitudinal deficiency --------- Correct Answer -- ------- Congenital hypoplasia (shortening) of radius or ulna; Thumb hypoplasia common with radial involvement; Interventions: casting/orthoses, surgery Pediatric Hand Guest Speaker: Hyoplastic thumb --------- Correct Answer --------- Pollicization- take index finger and make it a thumb Pediatric Hand Guest Speaker: Trigger finger/thumb --------- Correct Answer --------- Digit gets stuck- "triggers" when in flexion. Palpable nodule at base of thumb/finger; Intervention- casting/orthoses, surgery

Pediatric Hand Guest Speaker: Syndactyly --------- Correct Answer --------- Webbed fingers- lack of differentiation in utero, Often seen in Apert's syndrome, Intervention: orthoses, spacers, scar management, ROM, strength, fxnl use Pediatric Hand Guest Speaker: Arthrogryposis --------- Correct Answer --------- Stiffness in joints of the extremities; Intervention: stretching, casting/orthoses, adaptations for ADLs