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PEDIATRICS CLINICAL EXAM 1: CHILD DEVELOPMENT & CARE QUESTIONS WITH CORRECT AND VERIFIED ANSWERS
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Infant - correct answers birth - 12 months Toddler - correct answers 1 - 3 Preschooler - correct answers 3 - 5 Grade school - correct answers 6 - 11 Adolescence - correct answers 11+ Communicating with Parents - correct answers Introduce yourself; establish parental roles; ask how to address the parents (Mrs., their name, etc.). Ensure privacy and confidentiality. Encourage talking - correct answers Use open-ended questions. Listen and observe - correct answers With cultural awareness. Use silence and empathy - correct answers To avoid communication blocks.
Provide anticipatory guidance - correct answers Tell the parents what the child should be doing at this time and what's coming next (health promotion activities). Consider the need for a professional interpreter - correct answers Establish a setting. Child plays while the nurse interviews parents - correct answers Never talk down to your patients and families. Commit to sit and have a conversation - correct answers With them. Developmentally Appropriate Communication - correct answers Make communication developmentally appropriate. Get on the child's eye level - correct answers Bend down to talk to them. Approach the child gently and quietly - correct answers While involving the parent or caregiver. Always be truthful - correct answers In communication. Give the child choices - correct answers As appropriate.
Types of cries - correct answers Crying as communication. Early childhood (preschoolers and toddlers) (1-5) - correct answers Do not refer to a child or baby as it. School-age children (6-11) - correct answers 'Why about everything stage'; explain what, how, and why (using concrete terms). Adolescent (teenagers) (12-19) - correct answers Be honest with the patient; the patient may require a detailed explanation of treatments. Importance of peers - correct answers Adolescents may want to socialize with other hospitalized teens. Play - correct answers It is how children learn and mature. Types of play - correct answers Infancy (solitary play) - birth to 1; Toddlers (parallel play) - 1 to 3; Preschool (associative play) - 3 to 5; School-age (cooperative play and team play) - 6 to 11. Pediatric Assessment Sequence - correct answers The sequence for pediatric assessment is generally altered from the typical head-to-toe assessment of adults, to accommodate the child's developmental needs.
Area of Injury Focus - correct answers Whatever is wrong, focus on their area of injury. Best Time for Assessment - correct answers Best time is when sleeping or watching TV. Communication Techniques - correct answers Use communication techniques, play, and parental assistance to complete the examination. Goals of Pediatric Assessment - correct answers Minimize the stress and anxiety associated with the assessment of various body parts. Trusting Relationships - correct answers Foster trusting nurse-child-parent relationships. Child Preparation - correct answers Allow for maximum preparation of the child. Parent-Child Relationship Security - correct answers Preserve the security of the parent-child relationship. Accuracy of Assessment Findings - correct answers Maximize the accuracy of assessment findings.
School-Age Stressors - correct answers Stressors for school-age children include fear of loss of control, pain, needles, shots, and being away from family. Decreasing School-Age Stressors - correct answers Decrease stressors by explaining why the procedure is necessary, touring the facility, acknowledging fear, and explaining in their terms. Adolescent Stressors - correct answers Stressors for adolescents include change in appearance, fear of dying, pain, fear of the unknown, and concern with body image disturbances. Decreasing Adolescent Stressors - correct answers Decrease stressors by respecting privacy, talking openly, being truthful, and touring the facility. Growth Measurements - correct answers Growth measurements include recumbent length for infants up to age 36 months plus weight and head circumference. Head Circumference Measurement - correct answers In order to obtain a correct measurement of the head circumference, measurements must be made above the eyebrows and above the ear pinnae to the occiput. Measurement Technique - correct answers Use paper or non-stretchable tape and more than one measurement is necessary.
Quadriplegic Measurement - correct answers For a quadriplegic 17-year-old, go recumbent. Circumference Comparison - correct answers Head and chest circumference are equal at 1-2 years old; in childhood, chest circumference exceeds head by 5-7 cm. Assessment Recommendations - correct answers Height and weight are assessed from birth to 18+, head circumference from birth to 24 months, BMI from 24 months to 18+, vision and hearing from birth to 18+, developmental assessments at 9, 18, and 30 months (2 years) or if autism is suspected. Lead Screening Schedule - correct answers Lead screening is conducted at 6, 9, 12, 18, 24 months and at 3, 4, 5, and 6 years. Body Mass Index (BMI) - correct answers A measurement that combines height and weight to assess body fat. Growth Chart Percentiles - correct answers Values less than the 5th percentile or more than the 95th percentile are considered outside the expected parameters for height, weight, and head circumference. Vital Sign Assessment - correct answers Includes temperature (T), heart rate (HR), respiratory rate (RR), blood pressure (BP), and pain.
NUMERIC Pain Scale - correct answers Used for children aged 5 years and older who understand the concept of numbers. Generalized Response to Pain in Infants - correct answers Includes rigidity, thrashing, loud crying, and facial expressions of pain. Older Infants Response to Pain - correct answers Includes withdrawal from painful stimuli, loud crying, facial grimacing, and physical resistance. Young Child's Response to Pain - correct answers Includes loud crying, verbalizations like 'Ow!' and 'It hurts!', thrashing limbs, and clinging to parents. School-aged Child's Response to Pain - correct answers Includes stalling behavior, muscle rigidity, and may use behaviors of a young child. Adolescent's Response to Pain - correct answers Includes less vocal protest, increased muscle tension, and more verbalizations about pain. Assessment of Chronic Pain in Children - correct answers Includes establishing a trusting relationship, assessing onset, duration, pattern, and effectiveness of treatment.
Painful and Invasive Procedures - correct answers Includes postoperative pain, burn pain, recurrent headaches, abdominal pain, and cancer pain. Catabolic State from Surgery - correct answers Surgery and traumatic injury generate a catabolic state, altering blood flow, coagulation, metabolism, and electrolyte balance. Nonpharmacologic management - correct answers Techniques used to manage pain without medication. Pharmacologic management - correct answers Use of medications to alleviate pain. Nonopioids - correct answers Medications that relieve pain without the use of opioids. Opioids - correct answers Powerful pain-relieving medications that include substances like morphine and oxycodone. Nonnutritive sucking - correct answers A method used to soothe infants by allowing them to suck on non-food items. Kangaroo care - correct answers A practice where a parent holds their baby close to their chest to promote bonding and comfort.
Protest phase - correct answers The initial phase of separation anxiety characterized by crying and clinging to the parent. Despair phase - correct answers The phase of separation anxiety where the child stops crying and shows signs of depression. Detachment (denial) phase - correct answers The final phase of separation anxiety where the child appears to adjust but may not truly be content. Trust vs Mistrust (Infant) - correct answers A developmental stage where infants learn to trust caregivers based on the consistency of care. Autonomy (Toddler) - correct answers The developmental stage where toddlers seek independence and control over their environment. Egocentric/ Magical Thinking (Preschooler) - correct answers A cognitive stage where preschoolers believe their thoughts can influence the world around them. Limiting Loss of Control - correct answers Strategies to help children maintain a sense of control during hospitalization.
Family Centered Care/Collaboration - correct answers An approach that involves families in the care process to improve outcomes for children. Child life specialist - correct answers A professional who helps children cope with hospitalization through play and education. Daily routines - correct answers Consistent activities that help provide structure and security for children. Security objects - correct answers Items that provide comfort and a sense of security to children during stressful situations. Encourage independence for older children - correct answers Promoting self- sufficiency in older children to help them cope with hospitalization. Fears of Bodily Injury and Pain - correct answers Persists to Adulthood if not addressed Infant Indicators - correct answers Inconsolable crying, thrashing, withdrawing Toddler Indicators - correct answers Verbal indicators, crying, 'clingy'
Limit Confined Child - correct answers Be honest Caregiver Presence - correct answers Permit caregiver to be present Opportunities for Play - correct answers Developmentally appropriate Diversion Activities - correct answers Developmentally appropriate toys Expressive & Creative Activities - correct answers Therapeutic play Encouraging Parent Participation - correct answers Provide information- keep informed Discharge Planning - correct answers Limiting these Fears Minimize Threats - correct answers Prepare before procedures Creative Play - correct answers Art Dramatic Play - correct answers Puppets, dolls
Touching Equipment - correct answers Permit touching of equipment Demonstration - correct answers Demonstrate on doll/security object Individual Risk Factors - correct answers Difficult temperament, lack of fit between a child and a parent, age (especially age 6 months to 5 years), male gender, below- average intelligence, multiple and continuing stressors (e.g., frequent hospitalizations) Sibling Reactions - correct answers Loneliness, fear, worry, anger, resentment, jealousy, guilt Effects of Hospitalization on the Child - correct answers Effects may be seen before admission, during hospitalization, or after discharge Child's Concept of Illness - correct answers More important than intellectual maturity in predicting anxiety Beneficial Effects of Hospitalization - correct answers Recovery from illness, increased coping skills, mastering of stress and feelings of being competent in coping, new socialization experiences
Child Life Specialists - correct answers Extensive knowledge of child growth and developmental and psychosocial needs of children Objectives of Child Life Specialists - correct answers Reduce stress and anxiety related to the hospitalization or health-care-related experiences, promote normal growth and development in the healthcare setting and at home Guidelines for Admission - correct answers Preadmission, assign room based on developmental age, seriousness of dx., and length of stay Admission Process - correct answers Introduce patient to nurse and PCP, introduce to roommate / parent, take vitals, etc. Call light - correct answers A device used by patients to alert staff for assistance. Bed control - correct answers A mechanism for adjusting the position of a patient's bed. Television - correct answers An entertainment device provided in patient rooms. ID band - correct answers A wristband applied to patients for identification purposes.
Hospital regulations - correct answers Rules and guidelines governing patient care and conduct within the hospital. Specimen and lab work - correct answers Samples collected for diagnostic testing as needed. Discharge - correct answers The process of releasing a patient from the hospital. Vomit basin - correct answers A container provided for patients to use in case of vomiting. Cup with a cap and straw - correct answers A drinking cup designed for children to prevent spills. Verbal and written instructions - correct answers Information provided to parents regarding care after discharge. National children's study - correct answers The largest prospective, long-term study of children's health and development in the U.S. Obesity - correct answers Defined as BMI greater than 95th percentile for youth of the same age and gender.