Clinical Management of Pediatric Patients
Exam Solutions
Course Introduction
This course offers a comprehensive overview of the principles and practices involved in the clinical management of pediatric patients. Students will examine unique aspects of pediatric assessment, diagnosis, and therapeutic interventions across a range of common and complex medical conditions. Emphasis is placed on age-appropriate communication, growth and development considerations, pharmacological and non-pharmacological treatments, and family-centered care. Through case studies and evidence-based guidelines, students will develop critical thinking skills necessary for effective, safe, and ethical management of infants, children, and adolescents in various healthcare settings.
Recommended Textbook
Meeting the Physical Therapy Needs of Children 1st Edition by Susan K. Effgen PhD PT
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25 Chapters
400 Verified Questions
400 Flashcards
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Chapter 1: Serving the Needs of Children and Their Families
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25 Verified Questions
25 Flashcards
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Sample Questions
Q1) A task analysis includes
A) determining the prerequisite body functions.
B) the activities required to perform the task.
C) the cognitive requirements to perform the task.
D) understanding the motor planning requirements of the task.
E) All of the above
Answer: E
Q2) According to the ICF-CY, impairments are
A) problems in functional activities.
B) restrictions in activities.
C) problems in physiological functions of body systems.
D) limitations in functional skills.
E) limitations in participation.
Answer: C
Q3) Chaining techniques work best
A) with those with a cognitive impairment.
B) as negative reinforcement.
C) as continuous reinforcement.
D) with discrete tasks having a clear beginning and end.
Answer: D
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Chapter 2: Child Development
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41 Verified Questions
41 Flashcards
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Sample Questions
Q1) Your best friend from college expresses concern that there is something wrong with her 4-month-old son. At this age, a typical 4-month-old can
A) roll over independently.
B) change from sitting to crawling independently.
C) drink from a cup.
D) pulls to standing at furniture.
E) rakes or scoops tiny objects using ulnar grasp.
Answer: A
Q2) When working with a teenager having a developmental disability, which theory would probably guide your work today as a physical therapist?
A) Dynamic systems
B) Genetic-oriented view
C) Cognitive view
D) Maturational view
Answer: A
Q3) What factors have been shown to correlate with positive child development?
Answer: Adequate socioeconomic status, higher parent educational level, and availability of play toys.
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Chapter 3: Child Appraisal: Examination and Evaluation
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22 Flashcards
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Sample Questions
Q1) Confidence intervals
A) give a range of expected scores.
B) are set ranges of acceptable performance.
C) indicate item response theory.
D) are best when there is a wide interval of scores.
Answer: A
Q2) When documenting services for children,
A) the term "patient" or "client" should be used.
B) the Health Insurance Portability and Accountability Act does not apply.
C) the term "infant" or "child" should be used.
D) there is no need to document physical therapy services because the team writes a joint report.
Answer: C
Q3) Interviewing families and listening to their priorities for their children is an integral part of the
A) Canadian Occupational Performance Measure.
B) School Function Assessment.
C) Bayley Scales of Infant and Toddler Development.
D) Activities Scale for Kids.
Answer: A
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Chapter 4: Family-Centered Care
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Sample Questions
Q1) It is appropriate for the physical, occupational, and speech therapists to collaboratively decide on the child's mode of communication.
A)True
B)False
Q2) What are three common stresses associated with raising a child with a disability?
Q3) Which of the following approaches is not representative of family-centered care?
A) Strength based
B) Directive
C) Supportive
D) Responsive
Q4) Family-centered care precludes providing direct service in a hospital-based clinic.
A)True
B)False
Q5) What is the key element defining family-centered care?
A) Holistic care
B) Evidence-based practices
C) Collaborative partnership
D) Quality service
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Chapter 5: Musculoskeletal System: Structure, Function, and
Evaluation
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19 Verified Questions
19 Flashcards
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Sample Questions
Q1) Measuring a child's thigh-foot angle gives you an indication of the amount of A) twisting of the long axis of the tibia (version).
B) hamstring limitation.
C) genu valgum.
D) metatarsus adductus.
Q2) The spine of a newborn infant is initially in a A) scolotic position.
B) kyphotic position.
C) straight position.
D) lordotic position.
Q3) You are doing an orthopedic evaluation on a 13-month-old child. The parents are concerned that the child isn't walking. Select the finding that is atypical in a 13-month-old child.
A) The child has no visible longitudinal arch in standing (flat feet).
B) The child has a 3-degree hip flexion contracture.
C) The child has genu valgum.
D) The child has a straight lateral border of the foot.
Q4) Cartilage provides the initial prenatal structure for the development of bone.
A)True
B)False
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Chapter 6: Musculoskeletal System: Considerations and
Interventions for Specific Pediatric Pathologies
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Sample Questions
Q1) Young boys having Duchenne muscular dystrophy tend to use the Gower maneuver to rise from the floor because of weakness in
A) knee extensors and flexors.
B) hip extensors and flexors.
C) distal leg musculature.
D) upper extremity musculature.
Q2) Select the correct statement regarding congenital muscular torticollis.
A) It can be associated with developmental dysplasia of the hip.
B) The muscle tightness will spontaneously resolve by 12 months of age.
C) It is characterized by tightness of the sternocleidomastoid muscle resulting in decreased lateral flexion and rotation to the same side.
D) Torticollis is caused by prematurity.
Q3) Children with cerebral palsy
A) commonly retain neonatal levels of hip retroversion.
B) have atypical muscle composition so strengthening is not advocated.
C) have a higher incidence of scoliosis than the general population.
D) characteristically have intellectual disabilities.
Q4) Name two diagnoses where heightened reaction to trauma is common.
Page 8
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Chapter 7: Neuromuscular System: Examination, Evaluation, and Diagnoses
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23 Verified Questions
23 Flashcards
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Sample Questions
Q1) Which of the following changes in body structures most likely explain the muscle weakness observed in children with cerebral palsy?
A) Decreased type I fast twitch fibers
B) Decreased type II slow twitch fibers
C) Increased number of cross bridges
D) Shortened sarcomeres
Q2) Which of the following diagnostic pediatric standardized tests would be most appropriate to administer to a 7-year-old child to assist in confirming a diagnosis of developmental coordination disorder?
A) Bruininks-Oseretsky Test of Motor Proficiency-2
B) Developmental Coordination Disorder Questionnaire
C) Movement Assessment Battery for Children
D) Peabody Developmental Motor Scales-2
Q3) Which of the following postural strategies would be typically used to maintain balance during a challenging activity?
A) Bilateral ankle dorsiflexion primarily
B) Recruitment of the abdominal muscles prior to that of the tibialis anterior
C) Recruitment of the tibialis anterior prior to that of the abdominal muscles
D) Use of the ankle strategy
Page 9
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Chapter 8: Neuromuscular System: the Plan of Care
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Sample Questions
Q1) You are treating a 13-month-old child who is not yet sitting independently. He requires support at the hips to sit on the floor, and your goal for him is to sit indendently.
Focusing on function, which intervention strageties would be most appropriate?
A) Playing in prone to strengthen his trunk muscles and floor sitting activities while playing with toys with decreasing amounts of physical assistance provided
B) Strengthening activities, such as having the child perform assisted sit-ups and sitting on a therapy ball
C) Using pillows around the hips and trunk to completely prop the child into a supported poistion in sitting to play
D) Reducing tone and active range of motion
Q2) There is emerging evidence that increased intensity of physical therapy interventions can improve physical therapy outcomes.
A)True
B)False
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Chapter 9: Cardiovascular and Pulmonary Systems
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Sample Questions
Q1) Activity-focused interventions for participation should not be integrated with interventions for body functions and structures.
A)True
B)False
Q2) Select the practice scenario that is most likely to facilitate motor learning in a child with a neurological impairment.
A) Promoting error-free practice to avoid learning bad habits.
B) Practicing in the clinic setting to control external stimuli.
C) Varying the practice situation to include several versions of the task.
D) Provide a substantial amount of verbal rationale.
Q3) According to the information processing perspective, memory
A) can interfere with creating new movement patterns.
B) enables a person to benefit from prior experience.
C) must be embedded within a task.
D) does not impact on performance, but is important in learning.
Q4) The difference between learning and changes in performance is that learning is the immediate effect of practice.
A)True
B)False
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Chapter 10: Integumentary System
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16 Flashcards
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Sample Questions
Q1) Skin necrosis from chronic pressure is likely to occur after _____hours of continuous pressure.
Q2) In young children and adults, the body area for estimation of burns is relativity similar except for significant differences in the__________area.
Q3) ____________are the cells responsible for pulling the epidermal layer toward the center of the wound.
Q4) A child with an upper extremity burn that crosses the anterior aspect of the antecubital fossa should
A) be splinted in flexion.
B) be splinted in extension.
C) not be splinted and should perform PROM only.
D) be measured for a compression garment.
Q5) Wound drainage that is infected and malodorous is called _____________.
Q6) ___________is the process of laying down of collagen matrix.
Q7) The prognosis for a wound for a specific child will depend on what factors?
Q8) A pressure ulcer that presents as a partial-thickness skin loss and can be a blister or shallow crater is a stage ________ulcer.
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Chapter 11: Early Intervention
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Sample Questions
Q1) Which technique(s) assist the therapist and family in integrating therapeutic objectives into the family's daily lives?
A) Intervention in the child's natural environment
B) Activity-based instruction
C) Use of catalogs and matrixes
D) All of the above
Q2) What is the optimal team formation for early intervention?
A) An interdisciplinary team
B) A multidisciplinary team
C) A transdisciplinary team
D) None of the above
Q3) Cataloguing is useful to
A) see whether the therapeutic activities can be embedded into the family's existing schedule.
B) make a log of the baby's daily activities from morning to night.
C) add therapeutic interventions into the child's activities.
D) avoid having to make a matrix.
Q4) Role release allows all therapists to complete the duties of all disciplines.
A)True
B)False
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Chapter 12: Schools
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Sample Questions
Q1) A transition planning individualized education program meeting for a student with autism must occur by the time the student is
A) 14 years old.
B) 16 years old.
C) 18 years old.
D) 21 years old.
Q2) A common problem of working in school-based settings is
A) working school hours.
B) that pediatric clinical specialization PCS is required.
C) working with a team of professionals.
D) professional isolation.
Q3) School-based physical therapy started
A) with the Education of All Handicapped Children Act.
B) with the Individuals with Disabilities Education Act.
C) in special schools in the first half of the 20th century.
D) with the Americans with Disabilities Act.
E) in special schools in the second half of the 20th century.
Q4) List at least four themes/issues that should be included in "best" practice in transition.
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Chapter 13: Sports Settings for the School-Aged Child
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Sample Questions
Q1) Indicate which of the following constitutes the greatest medical issue in children.
A) Fractures
B) Sprains and strains
C) Concussion and second impact syndrome
D) Spinal injuries
Q2) Which of the following has become a public health issue?
A) Children playing sports without proper supervision
B) Parental interference with sport
C) Lack of good coaching of children
D) Pediatric use of drugs
Q3) What should be the emphasis of training programs for children?
A) Cooperation, fun, team play, and learning
B) Competitive spirit
C) Improvement of aerobic ability
D) All of the above
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Chapter 14: Pediatric Acute Care Hospital
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Sample Questions
Q1) A 15-year-old male adolescent is admitted to the emergency room with a head trauma. He now presents with an external ventriculostomy to monitor intracranial pressure. When working on bed mobility, what should the position of the drain be in relationship to the patient?
A) Above the level of the patient's head
B) Below the level of the patient's head
C) Even with the patient's head
D) The position of the drain does not impact patient care
Q2) A 2-year-old toddler with an extensive past medical history including prematurity (33-week gestation), feeding intolerance, and global delays is admitted to the acute care setting for revision of a g-tube. The family is currently followed at home by early intervention one time a week for physical therapy services. What factors play a role in your consideration for determining acute-care physical therapy treatment frequency?
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Chapter 15: Neonatal Intensive Care Unit
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Sample Questions
Q1) Physiological signs of stress in a neonate include
A) increased heart rate and skin color changes.
B) gaze aversion and leg extension.
C) increased respiration and oxygen saturation.
D) facial grimace and finger splays.
Q2) When making recommendations about the infant's active movement, the physical therapist should generally recommend
A) encouraging the infant to have several periods of active movement during the day to build body strength and endurance.
B) allowing active movement when the infant is awake and quietly alert, but helping the infant to avoid excessive, frequent movements.
C) avoiding all active movement to conserve energy, including using restraints if needed.
D) encouraging any active movement as long as the infant is not crying.
Q3) Full-term infants are born
A) between 37 and 42 weeks gestation.
B) at 9 months gestation.
C) at 40 weeks gestation.
D) between 35 and 40 weeks gestation.
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Page 17
Chapter 16: Rehabilitation Settings
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Sample Questions
Q1) In planning for transition to school, which of the following statements is true?
A) School therapists can continue to provide the same level of rehabilitation therapy when the child is back in school.
B) School therapists provide therapy deemed necessary for the child's educational goals as outlined on the IEP.
C) Children should return to school when they no longer have any rehabilitation therapy needs.
D) Coordination between school and rehabilitation therapists is not necessary if the family is able to relay information.
Q2) For a child with a brain injury, the rehabilitation team should consider which of the following when planning a transition back to school?
A) The child will not be able to return to school and will need to be home schooled.
B) The child will need a Section 504 plan or individualized education program.
C) The child will need to go to a different school.
D) The child will return to the same classroom without accommodations.
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Chapter 17: Assistive Technology: Positioning and Mobility
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Sample Questions
Q1) You are evaluating a child with myelodysplasia (spina bifida) whose lesion is at L1-2. His parents are concerned that he is not able to keep up with his peers, even though he can walk with support of orthoses and forearm crutches. Your recommendation for mobility would include
A) continuing use of orthoses and forearm crutches in all environments so that he does not lose any additional abilities.
B) continued use of orthoses and forearm crutches indoors and a manual wheelchair that he can propel outdoors or over longer distances.
C) discontinuing use of orthoses and forearm crutches and using a manual wheelchair in all environments.
D) discontinuing use of orthoses and forearm crutches, using a manual wheelchair indoors, and using a power wheelchair outdoors.
Q2) Assistive technology involves
A) the assistive technology device only.
B) the services necessary to obtain assistive technology devices only.
C) both the assistive technology device and services.
D) the assistive technology device and the acquisition of the device.
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Page 19
Chapter 18: Assistive Technology: Augmentative
Communication and Other Technologies
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Sample Questions
Q1) Which of the following most accurately describes a physical therapist's role in assessing a child for assistive technology, including augmentative communication and computer access?
A) Physical therapists are only involved in positioning and mobility assessments.
B) Physical therapists identify the best position to promote optimal motor control and match features of devices to the motor abilities of the child.
C) Physical therapists are only involved in training the child to use devices once they have been purchased.
D) Physical therapists identify abnormal movement patterns and design intervention strategies to promote use of those movement patterns to access the devices.
Q2) The following are all examples of rate enhancement strategies for text to speech devices, except
A) Word prediction
B) Abbreviation/expansion
C) Letter prediction
D) Voice-over Internet protocol
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Chapter 19: Cerebral Palsy
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Sample Questions
Q1) A 6-year-old child with cerebral palsy who walks independently in the school environment using a wheeled, rear walker, would be classified in the Gross Motor Function Classification System as
A) Level I.
B) Level II.
C) Level III.
D) Level IV.
Q2) A 13-year-old child with spastic diplegic cerebral palsy has decreased dorsiflexion range of motion bilaterally. An appropriate activity to include in his home program to increase dorsiflexion range of motion is
A) passive range of motion of the ankle.
B) wear orthotics for at least 3 to 4 hrs daily.
C) strength training of the dorsiflexors.
D) heel lift exercises.
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21
Chapter 20: Cystic Fibrosis
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Sample Questions
Q1) A child can have cystic fibrosis and have no pulmonary symptoms.
A)True
B)False
Q2) You are examining a 12-year-old with cystic fibrosis. His resting vitals are HR = 90 bpm; RR = 20 bpm; and SpO<sub>2</sub> = 98%. You start your exercise testing. As the test continues, the child is walking on the treadmill at 2.5 mph 2% grade for 5 min. His vital signs are as follows: HR = 120 bpm, RR = 22 bpm, SpO<sub>2</sub>, 90%; and an RPE of 14. You would
A) continue the test with the same mph and grade.
B) increase the mph and grade.
C) decrease the grade but keep the mph the same.
D) stop the test and monitor vitals over the next few minutes.
E) stop the test and call a code.
Q3) You are examining a 2-month-old with cystic fibrosis. The family is meeting with you to learn postural drainage percussion and vibration (PDPV). You would teach them all the PDPV positions except A) left side lying.
B) prone.
C) Trendelenberg.
D) right side lying.
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Chapter 21: Down Syndrome
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Sample Questions
Q1) Which of the following age-related changes are common for individuals with Down syndrome showing signs of dementia?
A) Hypotension
B) Weight loss
C) Hypotonia
D) All of the above
Q2) For a preschool child with Down syndrome, which of the following would the most valid and appropriate tool to monitor the progress of gross motor skills and functional mobility?
A) Alberta Infant Motor Assessment
B) Bayley Scales of Motor Development
C) Bruinink Oseretsky Test of Motor Proficiency
D) Gross Motor Function Measure
Q3) There is evidence to suggest that participation in sensorimotor group sessions improves motor outcomes in young children with Down syndrome.
A)True
B)False
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Chapter 22: Leukemia
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Sample Questions
Q1) Children with acute lymphoblastic leukemia frequently have chemotherapy (Vincristine)-induced peripheral neuropathy, thus causing range of motion limitations in
A) shoulder flexion.
B) neck rotation.
C) spinal flexion.
D) ankle dorsiflexion.
Q2) Intrathecal chemotherapy is administered directly into what area?
A) Muscle
B) Mouth
C) Vein
D) Cerebral spinal fluid
Q3) Common physical therapy interventions for a child with acute lymphoblastic leukemia include A) orthotics.
B) stretching exercises.
C) age-appropriate strengthening exercises.
D) age-appropriate gross motor developmental activities.
E) All of the above.
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Chapter 23: Duchenne Muscular Dystrophy
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Sample Questions
Q1) Duchenne muscular dystrophy is an
A) autosomal recessive disorder.
B) autosomal dominant disorder.
C) X-linked recessive disorder.
D) acquired disorder.
Q2) Boys with Duchenne muscular dystrophy tend to use the Gowers' maneuver to rise from the floor because of weakness in
A) hip flexors, extensors, and abductors.
B) hip flexors and extensors, and knee extensors.
C) hip extensors, knee flexors, and extensors.
D) hip extensors and abductors and knee extensors.
Q3) As Duchenne muscular dystrophy progresses, the greatest life-threatening concerns are
A) cerebral hemorrhage and seizures.
B) pulmonary infections and cardiomyopathy.
C) cerebral thrombosis and seizures.
D) neoplasms and cardiac arrest.
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Chapter 24: Developmental Coordination Disorder
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Sample Questions
Q1) Developmental coordination disorder is a condition occurring in A) less than 5% of grade-school children.
B) predominantly teenage girls.
C) 6% to 13% of grade-school children.
D) children with cerebral palsy.
Q2) A composite score on the Bruininks-Oseretsky Test of Motor Proficiency-2nd Edition that falls within 1 standard deviation below the mean is considered A) below average.
B) average.
C) above average.
D) well below average.
Q3) A standardized assessment commonly used with children who have developmental coordination disorder is the
A) Bruininks-Oseretsky Test of Motor Proficiency-2nd Edition.
B) Peabody Developmental Gross Motor Scales-2nd Edition.
C) Batelle Developmental Inventory.
D) School Function Assessment.
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26
Chapter 25: Myelodysplasia
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Sample Questions
Q1) What happens to the heart rate of children with low- and mid-lumbar myelomeningocele compared to nondisabled peers when walking?
A) Heart rate remains the same
B) Heart rate increases
C) Heart rate decreases
D) Heart rate varies
Q2) All of the following are environmental adaptations that might assist a child with mid-lumbar myelomeningocele in using the bathroom except A) a sliding board.
B) grab bars.
C) a changing table.
D) a rolling stool.
Q3) In the natural school environment, the physical therapist relies on the classroom staff to follow through with mobility and transfer activities on a daily basis for a child with a myelomeningocele.
A)True
B)False
Q4) Discuss what a child must learn when using a manual wheelchair in a natural school environment.
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