CMN 571 Final Exam with Questions and Verified
Answers| Already A+ Passed
What is masked hypertension (MH), what patients are at risk for it and how should patients be
evaluated for it? - ✔✔DEFINITION: When a patient (child) has normal BP in office but
elevated BP on ABPM.
WHO IS AT RISK: Pts with obesity and secondary forms of HTN (such as CKD or repaired aortic
coarctation). It is ESPECIALLY prevalent in pts with CKD and associated with target organ
damage.
HOW TO EVALUATE: Pts with CKD should be monitored with ABPM as part of routine CKD
management.
AAP guidelines, p 22.
A child's brain has reached 90% of its adult weight at age _______. - ✔✔FIVE (5)
Hay p 78
Age at which most children master conservation of *length*? - ✔✔5½
Hay p 78
Age at which most children master conservation of *mass*? - ✔✔6½
Hay p 79
,Age at which most children master conservation of *volume*? - ✔✔8
Hay p 79
Concrete operations (i.e. the ability to order, number and classify) typically begin after what
age? - ✔✔6
Hay p 79
Achievement in school and acceptance by peers first become major developmental tasks for
WHAT age child? - ✔✔7
Hay p 79
Children between ages of 7 - 11 who present with emotional or behavioral problems should be
evaluated for _____________. - ✔✔potential learning disabilities
Hay p 79
Explain concept of "goodness of fit" with regard to a child's temperament and parental
expectations. - ✔✔Coaching parents to understand that a child's behavioral style may reflect
a developmental *variation* and that it does not necessarily mean that the child has a
behavioral *disorder*. Helps parents to understand how to modulate their expectations to
match their child's particular behavioral style and temperament, so that disappointment and
frustration do not result.
Hay p 79-80
,Definition of enuresis - ✔✔Repeated urination into the lcothing during the day and into the
bed at night by a child who is *chronologically and developmentally older than 5 years*.
Pattern must occur at least *twice a week* for *three months*.
Hay p 80
Definition and cause of monosymptomatic enuresis - ✔✔Definition: Uncomplicated
nocturnal enuresis (NE). Must never have been dry at night for over 6 months with no daytime
accidents.
Cause: Maturational disorder of the urologic and neurologic systems, with no underlying
organic problem
Hay p 80
How long must a bedwetting alarm be used consistently to achieve results? - ✔✔At least 3
months, every night.
Most common cause of failure is if the child doesn't wake up and the parents do not wake up
the child.
Hay p 81
Benefits and drawbacks of medication use for nocturnal enuresis - ✔✔Benefits: DDVAP and
imipramine have been shown to be very effective
Drawbacks: Imipramine has a risk of overdose. When either drug is stopped, there is a high
relapse rate.
Hay p 81
, Definition and cause of non-monosymptomatic enuresis - ✔✔Definition: Daytime
incontinence
Cause: Consider underlying pathology, as daytime continence is usually achieved between ages
3 - 6.
Hay p 81
When is daytime continence achieved by most children? - ✔✔70% are continent by age 3
years
90% are continent by age 6 years
Hay p 81
Definition of constipation - ✔✔*≥ TWO* of the following events for *2 months*:
1) < 3 BMs per week
2) > 1 episode of encopresis per week
3) Impaction of rectum with stool
4) Passage of stool so large it obstructs the toilet
5) Retentive posturing and fecal withholding
6) Pain with defecation.
Hay p 81
Definition of encopresis - ✔✔Repeated passage of stool into inappropriate places (such as
the underpants) by a child who is developmentally or chronologically *older than 4 years*. It
occurs *each month* for at least *3 months* and is not due to the physiologic effects of a
substance of medical condition, except for constipation.
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