New nelson chapters 1 -80. Chapts 1-20

New nelson chapters 1 -80

Chapts 1-20

2. Which of the following interventions have significantly lowered the pediatric mortality rate in developing countries?

A. Vaccination programs

B. Oral rehydration therapy

C. Treated mosquito nets

D. Early diagnosis and treatment of pneumonia

E. All of the above

3. Per the IOM, high-quality health care by definition must be:

A. Timely and effective

B. Equitable and efficient

C. Safe and patient centered

D. A and C

E. All of the above

4 Which of the following is a step in the rapid cycle of improvement (PDSA)?

A. Perform

B. Define

C. Study

D. Attend

5 Developing a culture of safety relies on all of the following concepts EXCEPT:

A. De-emphasizing hierarchy and encouraging contributions of all members of the health care team

B. Excellent communication including patient hand-outs

C. Application of human factors engineering to systems and processes

D. Discouraging anonymity in the reporting of adverse events

8. The " doctrine of double effect" supports the following use of opioids and benzodiazepines at the end of life:

A. Using morphine to hasten the last breath of a suffering infant removed from the ventilator

B. Giving a 3 times normal dose of morphine IV to treat possible pain in a patient removed from an oscillator

C. Giving small doses of morphine and lorazepam (Ativan) to an infant to reduce discomfort before removing from ventilator and placing in mother's arms

D. All of the above

9. Many health care institutions have established ethics committees made up of a diverse membership. Of the following, which is generally NOT a function of the ethics committee?

A. Drafting a review of institutional policy

B. Educating health care professionals, patients, and families

C. Case consulting

D. Triage of scarce hospital resources

13. Which of the following strategies would be most likely to succeed in reducing the risk of poisoning among young children?

A. Counseling parents at the 9-mo well visit to lock up medicines

B. Enacting legislation to require childproof caps on hazardous household cleaners and medicines

C. Educating daycare providers on poisoning risks

D. Giving out " Lock it up! " promotional flyers to parents at grocery stores

14. Teenage drivers experience a high rate of motor vehicle collisions. All of the following factors increase the risk of motor vehicle deaths EXCEPT:

A. Alcohol use

B. Night driving

C. High rate of speed

D. Presence of more than two occupants in the car

E. Larger vehicle

19. The parents of a 3 yr old girl report that " she ran before she walked, " " she is never hungry at the same time, " and " she goes from toy to toy. " This child is best described as:

A. Autistic

B. Having a specific temperament

C. Having attention-deficit/hyperactivity disorder

D. Having developmental pervasive disorder

E. Being deaf

22. A newborn infant spends about 40 min with the mother but then falls asleep and does not respond to the mother's voice. Which of the following statements regarding this lack of activity is true?

A. It is suggestive of sepsis

B. It is suggestive of sedation

C. It is normal

D. It represents a seizure

E. It is due to apnea

46. Daily television viewing should be limited in middle childhood to:

A. 2 hours or less, with no TV in bedroom

B. 3 hours, with no TV in bedroom

C. 2 hours or less, TV in room okay

D. No TV watching acceptable

47. Word-finding difficulties may result in:

A. Difficulty in expressing feelings

B. Difficulty in verbal self-defense

C. Frustration

D. Difficulty in English class

E. All of the above

48 The ratio of upper body segment to lower body segment changes from 1. 7 at birth to 1. 0 by what age?

A. 2 years

B. 4 years

C. 7 years

D. 10 years

E. Puberty

49 In which of the following causes of short stature is bone age consistent with a patient's actual age?

A. Familial short stature

B. Constitutional delay

C. Endocrinologic short stature

D. Undernutrition

50 At what age would a child with no teeth be considered to have delayed eruption?

A. 9 months

B. 13 months

C. 15 months

D. 18 months

51 Which of the following is not a risk factor for school failure?

A. Foster placement

B. Parents without high school education

C. Parental depression

D. Overly laidback parenting style

E. Ethnic minority

54. Pediatricians can help improve child care options for their patients by:

A. Advising parents on characteristics of high quality child care centers

B. Advising child care centers on how to reduce rates of SIDS and infectious illness

C. Directing parents to appropriate web resources regarding child care

D. Telling working parents to stay at home with their children

E. A, B, and C

65. You suspect narcolepsy in an adolescent patient who complains of persistent daytime sleepiness and who is noted by his teacher to " stare off" in class periodically. A polysomnogram is normal. What is the next step in diagnosis?

A. Multiple sleep latency test

B. EEG

C. Iron studies

D. HLA testing

66. The appropriate therapy for severe obstructive sleep apnea syndrome is:

A. Adenotonsillectomy

B. Tracheostomy

C. Parapharyngeal muscle surgery

D. Theophylline

E. Bilevel positive airway pressure

67 Risk factors for obstructive sleep apnea syndrome include all of the following EXCEPT:

A. Retroposition of the mandible

B. Trisomy 21

C. Prader-Willi syndrome

D. Cleft palate repair

E. Chronic rhinitis

F. All of the above

68 Which of the following is NOT a true statement about childhood mental illness?

A. 1 in 10 youth suffer from a significant psychiatric disorder

B. Over 75% of children suffering from mental illness do not receive treatment

C. More money is spent in the USA on mental illness than on asthma or infectious diseases

D. Psychiatric disorders do not routinely affect the treatment of physical disorders

E. Lack of proper treatment of pediatric psychiatric disorders contributes to cross-generational transmission of disadvantage

69 A psychosocial history during an adolescent visit should encompass all of all of the following domains except:

A. Drug use

B. Family medical history

C. Home environment

D. Sexuality

E. Education

70 A full psychiatric diagnostic evaluation covers all of the following components EXCEPT:

A. Explication of the presenting problem

B. Developmental history

C. Physical examination

D. Mental status examination

E. Treatment plan

71 Which of the following is not a valid reason to start a psychotropic medication?

A. Child requests a medicine to feel better

B. A patient has not responded to psychosocial intervention

C. Patient's aggressive behavior is a threat to safety of others

D. Anxiety symptoms are interfering with school performance

73. Which clinical situation does not pose a high risk for adverse medication effects?

A. Teenager on venlafaxine for anxiety is prescribed linezolid for MRSA pustules

B. Patient with Wolff-Parkinson-White syndrome is prescribed fluoxetine for depression

C. Teenager with history of seizures is prescribed bupropion for smoking cessation and depressive symptoms

D. A patient with heart failure is prescribed trazodone for difficulty sleeping

E. A bipolar patient on lithium undergoes kidney transplant with subsequent cyclosporine treatment

74 What is a correct description of primary gain in somatoform disorders?

A. Avoidance of psychic conflict

B. Being able to avoid responsibilities

C. Staying home from school

D. Undergoing medical procedures

E. All of the above

75 Conversion reactions are best characterized by:

A. Sudden onset

B. Traceability to a precipitating event

C. Involvement of special senses

D. Pseudoseizures

E. Abrupt end

F. All of the above

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