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When are the recommended ages for developmental screening to be done according to AAP guidelines?
- A. 6 months, 12 months, and 18 months
- B. 6 months, 18 months, and 36 months
- C. 18 months, 24 months, and 36 months
- D. 9 months, 18 months, and 30 months
Correct Answer: D
Rationale: The American Academy of Pediatrics (AAP) recommends developmental screening at 9, 18, and 30 months during well-child visits to identify developmental delays early.
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A pediatric nurse at the clinic interviews a 14-year-old client who is dressed in baggy clothes and two sweaters on a warm day. The client admits to not having had her period for 4 months. The nurse notes fine downy hair along the client's cheeks. Vital signs are T, 36.6; P, 64; and BP, 84/50. Which additional objective sign would best support the nurse's assessment that the client has anorexia nervosa?
- A. Weight 15% below normal for her height.
- B. Eroded dental enamel.
- C. Parotid gland enlargement.
- D. Dehydration.
Correct Answer: A
Rationale: The correct answer is A: Weight 15% below normal for her height. In anorexia nervosa, individuals have a fear of gaining weight leading to severe weight loss. A weight 15% below normal for her height indicates significant weight loss, a hallmark feature of anorexia nervosa. This is supported by the client's baggy clothes, two sweaters on a warm day, and absence of menstrual periods, which are common signs of anorexia nervosa.
Choice B: Eroded dental enamel is a sign of bulimia nervosa, not anorexia nervosa. Choice C: Parotid gland enlargement is seen in bulimia nervosa due to frequent vomiting, not anorexia nervosa. Choice D: Dehydration is a general sign and not specific to anorexia nervosa.
Obsessive-compulsive disorders involve
- A. loss of contact with reality
- B. unresolved anger
- C. unresolved Oedipal conflict
- D. high levels of anxiety
Correct Answer: D
Rationale: OCD is driven by high anxiety, prompting repetitive thoughts and actions.
Which factor most significantly impacts early mental development?
- A. Nutrition
- B. Sleep
- C. Genetics
- D. Play
Correct Answer: A
Rationale: Nutrition (A) is critical for early brain growth, providing essential nutrients for neural development. Sleep (B), genetics (C), and play (D) are important, but nutrition has the most direct and foundational impact in early years.
People with disabilities (PWD):
- A. Have higher mortality rate due to their underlying bodily impairments
- B. Have a thinner margin of health compared to general population
- C. In the UK had lower infection and mortality rate during the Covid pandemic
- D. Have lesser secondary functional loss when they fall sick
Correct Answer: B
Rationale: PWD have a thinner margin of health, meaning they are more vulnerable to health declines, per global health data.
A primigravida patient at 34 weeks gestation presents with a history of not having felt fetal movements for 24 hours. Which one of the following statements is most appropriate?
- A. She probably has an intra-uterine fetal death.
- B. You should immediately arrange transfer to labour ward for early induction labour, providing the baby is still alive.
- C. She should have urgent antenatal cardiotocography (CTG).
- D. She should have an ultrasound scan.
Correct Answer: C
Rationale: Absent fetal movements at 34 weeks require urgent assessment. CTG (C) is the fastest way to check fetal heart rate and well-being. Presuming death (A), inducing without confirmation (B), or slower methods (D, E) are less appropriate initially.