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NUR 547 PRIMARY CARE MANAGEMENT 1 FINAL EXAM|2025-2026|REAL EXAM|VERIFIED QUESTIONS AND ANSWERS|ALREADY GRADED A+
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What does APGAR stand for? appearance, pulse, grimace, activity, respirations What newborn screening is required by law for all babies? blood screening, hearing screening, pulse ox for Critical Congenital Heart Disease What two reflexes occur from birth to 4 wks? walking reflex and galant reflex What reflex occurs up to 3 months? palmar grasp What reflex occurs up to 8 months? plantar grasp What two reflexes occur up to 4 months? Moro/Startle reflex and tonic neck What reflex occurs up to 12 months? rooting reflex
What Erikson's stage is a newborn in? trust vs mistrust What Piaget's stage is a newborn in? sensorimotor stage What is colic? fussiness for greater than 3 hrs/day for more than 3 days/wk in an infant who is younger than 3 months What anticipatory guidance should be given for a newborn? back to sleep, regular schedule, nighttime routine, rear-facing car seat What immunization is given to a newborn in the hospital? Hep B What milestones should be present at a 2 month old visit? listen actively to sounds, lifts head almost 45 degrees off table when prone, follows moving object with eyes, grasp reflex decreases, recognizes familiar faces, pays attention to speaking
A 2 month old should have hands without fists _______% of the time? 50 Fisted hands after 3 months may indicate what? neuromotor dysfunction What immunizations should be given to a 2 month old? Hep B 2 DTaP 1 HIB 1 PCV 1 IPV 1 Rota 1 What allows an infant to roll at 2 months? absence of asymmetric tonic neck reflex What are 4 month old milestones?
head steady when sitting, NO head lag when pulled into sitting position, rolls from BACK to SIDE and from STOMACH to BACK, plays with hands, pulls clothing/blanket over face, HAND-EYE COORDINATION, bears weight on legs when held upright, REACHES OUT TO PEOPLE, GRASPS WITH 2 HANDS How big is the anterior fontanel? about 2 cm When does the anterior fontanel start closing? 9 months with 1/2 of babies closed by 12 mos When does normal anterior fontanel closure occur? 18 months When should anterior fontanel be close by 100%? 2 years Birth weight will typically __________ by 6 months or a bit sooner. double Extrusion reflex is diminished at what age?
able to lift cup by handle, hitch in locomotion, sits in high chair with straight back, IMITATE SOUNDS, vocalizes to toys and mirror images, RECOGNIZES CAREGIVERS, babbles, PLAYS PEEK-A-BOO, GUH/BAH sounds 6 month developmental milestones: stranger awareness, sleeps through night, PARACHUTE REFLEX, head lag gone, head erect and spine straight when sitting, ROLLS OVER in both directions, GRASPS OBJECTS AND TRANSFERS, bangs/shakes/drops objects, RESPONDS TO NAME, uses SOUND to get attention What immunizations are given to a 6 month old? DTaP 3 IPV 3 HIB 3 Hep B 3 if started in hospital Pneumo 3 Rota 3 What vaccine cannot be given past 32 weeks? rotavirus When does tooth eruption occur?
6 months Why can honey not be given until after 1 year of age? botulism When can citrus fruits, meat, or eggs be given to an infant? after 6 months What are 9 month old milestones? creeps/crawls, sits alone, responds to adult anger, responds to simple verbal requests, drinks from cup/glass with assistance, PULLS SELF TO STANDING POSITION, begins to show fear, WAVES BYE, PINCER GRASP What should you educate parents on at the 9 month old visit? choking When should a bottle be discontinued? 9 months What forms of discipline should be used in a 9 month old? set limits, be simple and consistent, say no and remove from situation
What should be completed at a 15 month visit? ht/wt measurement, head circ, chest circ, VS, hearing, vision What should be completed at a 18 month visit? ht/wt measurement, head circ, chest circ, VS, hearing, vision, development screen, autism screen What should be completed at a 24 month visit? ht/wt measurement, BMI, head circ, VS, hearing, vision, autism screening What should be completed at a 30 month visit? ht/wt measurement, BMI, VS, hearing, vision, developmental screen What should be completed at a 3 y/o visit? ht/wt measurement, BMI, VS, hearing, vision What stage of Erikson's is a toddler in? autonomy vs shame and doubt When does Piaget's sensorimotor stage end? 2 years
When does object permanence develop in an infant? 7 - 8 months What stage of Piaget's comes after 2 years? preoperational What thought processes occur during the preoperational stage? magical thinking, animism, centration, time What milestones occur at a 15 month visit? BOUNCES TO MUSIC, SCRIBBLE, 3-6 words, COMBINES WORDS at 16-24 months, 2 BLOCK TOWER, POINTS TO BODY PARTS What immunizations should be given at 15 month appointment? include any 12 month vaccines that were not given DTaP Flu
What developmental milestones occur at age 2? walks on steps with both feet, 6-8 BLOCK TOWER, simple puzzles, combines words, names picture, 6 BODY PARTS, social skills grow, puts on clothes, throws ball overhand, jumps If delayed speech is noted at a 2 year old visit what should we suspect? neglect, hearing loss, or mental retardation What should be used as disciple for a 2 year old? time out What are signs of readiness for toilet training? ability to undress self, shows interest in toilet, imitates toileting behaviors, aware of having wet/dirty diaper, increasing periods of dryness during day or night What are some strategies for toilet training? positive reinforcement, do not use punishment or negative reinforcement, may take weeks- months, restart training later if child does not seem ready, stress may cause setbacks, boys may start later and take longer
What are some developmental milestones of a 30 month old? NAME A FRIEND, 8 BLOCK TOWER, wash/dry hands, brush teeth with help, speech intelligible, 1 COLOR, combines words, broad jump, balance on 1 foot for 1 second What are some developmental milestones of a 3 year old? 3600 words, 900 words in simple sentences, more colors, COPIES CIRCLE, 2 BODY PART PERSON When do you start measuring BP in a toddler? 3 y/o When should you measure H/H in a toddler? once between 15 mos and 5 years When should you do a urinalysis in a toddler? once between age 15 mos and 5 years
engages in conversational give/take, knows what to do if cold/tired/hungry, sings songs, talks about day, names 3-4 COLORS, aware of sex, board/card games, 3 BODY PART PERSON, tells what might happen next in book, describes self features, fantasy play What are some developmental milestones of a 5 year old? able to skip, walk on tiptoes, broad jumps, folds paper parallel, colors between vertical lines, TIES KNOT, mature pencil grasp, names 4-5 COLORS, knows coins, tells simple story, knows nursery rhymes, dresses/undresses self, PRINTS LETTERS/NUMBERS, COPY SQUARE/TRIANGLE, draws person with 6 BODY PARTS, begins to understand RIGHT/WRONG, engages in dramatic/make believe play, ASSUMES SPECIFIC ROLE WHEN PLAYING, ENGAGES IN DOMESTIC ROLE PLAY, enjoys companionship of other children, plays cooperatively, has good articulation, uses appropriate tense/pronouns, COUNT TO 10 What are some developmental milestones of a 6 year old? BOUNCES BALL, throws/catches, skates, rides BIKE, TIES SHOES, counts to 10, PRINTS NAME, PRINTS NUMBERS TO 10, UNDERSTANDS L and R, 6 BODY PARTS WITH CLOTHES and FINGERS What discipline is appropriate for a preschool age child? provide clear limits, praise positive actions, time out, give some responsibility for things What immunizations should be give to preschool aged children before kindergarten?
DTaP 5 IPV 4 Varicella 2 MMR 2 When can prevnar be given to previously unvaccinated children? 24 - 59 months - 1 dose, 1 time HIB vaccine is generally not given over _________ months of age. 60 When can varicella be given if previously unvaccinated? any age with booster 4-8 wks after initial When can MMR be given if previously unvaccinated? any age with booster 4-8 weeks after initial dose When should cholesterol be checked for a school-age child?
age 10 When does a growth spurt occur for boys? age 12 What stage of Erikson's development is a school age child in? industry vs inferiority What stage of Piaget's development is a school age child in? concrete operational What ages are considered adolescent? begins with onset of puberty at 11-13, can span from 10-24 years What occurs in the early stage of adolescence? 11 - 13, rapid growth spurt, body changes may cause self-concept issues
What occurs during the middle stage of adolescence? 14 - 16, may still struggle with body image, begin abstract thinking What occurs during the late stage of adolescence? 17+, body more like an adult, start to look outside peer groups to more intimate relationship When are girls usually done growing? 15 - 16 When are boys usually done growing? 18 - 20 What are primary sexual characteristics? reproductive organs What are secondary sexual characteristics? external features