Clinical Practice in Pediatrics
Final Exam
Course Introduction
Clinical Practice in Pediatrics is designed to immerse students in the practical aspects of pediatric healthcare, focusing on the diagnosis, management, and prevention of diseases in infants, children, and adolescents. This course combines supervised clinical rotations with hands-on patient care, emphasizing the development of clinical reasoning, physical examination skills, communication with both pediatric patients and their families, and interdisciplinary collaboration. Students are exposed to a range of pediatric subspecialties, including neonatology, general pediatrics, and pediatric emergencies, while also addressing ethical, developmental, and psychosocial considerations unique to pediatric populations.
Recommended Textbook
Pediatric Skills for Occupational Therapy Assistants 4th Edition by Jean W. Solomon
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29 Chapters
434 Verified Questions
434 Flashcards
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2
Chapter 1: Scope of Practice
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Sample Questions
Q1) In what year will the OT profession turn 100 years old?
A) 2017
B) 2020
C) 2027
D) 2035
Answer: A
Q2) The OTA works to improve a child's sitting posture so the child can write more clearly.How is the practitioner viewing occupation?
A) Occupation is the means to strengthen the child's hands.
B) Occupation is the end product-to help the child perform in school.
C) Occupation is not considered in this scenario.
D) Occupation is being used to help the child deal with frustration.
Answer: B
Q3) Evaluation, intervention planning, and discharge planning are all part of: A) assessment.
B) OT process.
C) referral process.
D) screening process.
Answer: B
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Page 3
Chapter 2: Family Systems
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Q1) What type of role is the OT practitioner using when developing a schedule for wearing a splint that incorporates the natural family routines?
A) Prescriptive
B) Consultative
C) Adaptive
D) Resourceful
Answer: B
Q2) Which statement is true concerning working with families according to family systems theory?
A) Families with children with disabilities have lots of problems and cannot rely on their instincts and natural abilities to parent their children.
B) The practitioner is always right when there is a disagreement with the family.
C) There is always one correct way or set of procedures that works with all families.
D) None of the above is true.
Answer: D
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Chapter 3: Medical Systems
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Sample Questions
Q1) What are the proper infection control measures for contact precautions?
A) Wash hands when entering and leaving room.
B) Wash hands when entering and leaving room; wear gown and gloves.
C) Wash hands when entering and leaving room; wear gown, gloves, and mask.
D) Wash hands when entering and leaving room; wear gown, gloves, and fit tested respirator or special protective mask.
Answer: B
Q2) Which medical team member specializes in lung development?
A) Cardiologist
B) Gastroenterologist
C) Pulmonologist
D) Neurologist
Answer: C
Q3) What type of care is it called when the OT practitioner and team provide comfort care to the dying child and family?
A) Early intervention
B) Medical management
C) Palliative care
D) Rehabilitative care
Answer: C
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Chapter 4: Educational Systems
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Q1) What are special services such as occupational therapy (OT), physical therapy (PT), speech therapy (ST), school health, and social work required for a child to benefit from a special education program called?
A) Related services
B) Resource room services
C) Self-contained services
D) Special education services
Q2) Which tip would help the occupational therapist work best with the teacher?
A) Provide the teacher with a comprehensive list of research advocating for OT.
B) Spend time in the classroom before making any suggestions.
C) Schedule hourly meetings over lunch on a weekly basis.
D) Discuss the intervention plan and how the teacher may assist the occupational therapist.
Q3) Who determines if a child has an exceptional educational need and requires special services?
A) The classroom teacher.
B) The individualized education program (IEP) team.
C) The occupational therapist.
D) The parents.
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Page 6
Chapter 5: Community Systems
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Sample Questions
Q1) What are the goals of Healthy People 2020?
A) Document the need for OT services.
B) Develop national health priorities.
C) Increase life quality.
D) Document health disparities.
Q2) Jeannie, the Certified Occupational Therapy Assistant (COTA), is responsible for planning and implementing an after-school exercise program for children in the second and third grades.In which of the following systems is Jeannie working?
A) Family
B) Community
C) Educational
D) Medical
Q3) Which of the following is not considered necessary for a practitioner to be culturally competent?
A) Awareness
B) Knowledge
C) Personal values
D) Skills
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Chapter 6: Principles of Normal Development
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Q1) In which context can the OT practitioner have the greatest impact?
A) Chronologic age
B) Environmental
C) Social
D) Cultural
Q2) Which of the following is true about normal development?
A) Development is linear.
B) Development is static.
C) Development is dynamic.
D) Development is vertical.
Q3) Which period is characterized by rapid growth, spending much time in educational settings, and shifting of the child's major influences from parents to peers?
A) Infancy
B) Early childhood
C) Middle childhood
D) Adolescence
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8
Chapter 7: Development of Performance Skills
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Q1) Kelly is a 3-month-old infant.As you observe her, you notice that her eyes are open, they are bright and shining, and she can track moving objects with her eyes.You would likely classify Kelly into which of the following infant states?
A) Alert, active, and awake
B) Drowsy
C) Light sleep
D) Equilibrium
Q2) Which statement is not true concerning primitive reflexes?
A) Reflexes provide the first movement out of physiological flexion.
B) Reflexes are integrated as the infant learns about the environment.
C) Reflexes persist throughout childhood.
D) Reflexes are genetically carried survival mechanisms.
Q3) In which matter do peers influence adolescents more than parents?
A) Academic choices
B) Career
C) Future aspirations
D) Trying out new roles
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Chapter 8: Development of Occupations
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Sample Questions
Q1) What does the age at which children develop independent self-care skills depend on?
A) Family's cultural expectations
B) Opportunities for practice
C) The child's motivation to be independent
D) Both A and C
E) All of the above
Q2) What factor(s) influences a child's participation in home management activities?
A) Age
B) Social environment
C) Culture
D) Both A and C
E) All of the above
Q3) What can be expected of a 4-year-old?
A) Ability to put on clothing; generally knowing the right and wrong side.
B) Ability to tie his or her shoes.
C) Ability to zip pants and buckle belts.
D) Both A and C.
E) All of the above.
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Page 10
Chapter 9: Adolescent Development: Becoming an Adult
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Q1) Which statement(s) best reflects the cognitive development of adolescents?
A) Thinking becomes abstract, creative, and complex.
B) Adolescents have difficulty with problem solving.
C) Adolescents learn the consequences of their actions.
D) Both A and C are correct.
E) All of the above are correct.
Q2) What is generally true of the photographs of adolescents in teen magazines, television, and media?
A) Adolescents are generally shown as overweight.
B) Media do not show a diversity of types.
C) Media present a realistic body type.
D) Media present an ethnic variety.
Q3) Which stage of adolescent development involves the teen being engrossed with self (e.g., interested in personal appearance), decreased compliance with parents' rules, questioning of adults, and changing moods and behaviors?
A) Early adolescence
B) Middle adolescence
C) Late adolescence
D) All stages
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Page 11
Chapter 10: The Occupational Therapy Process
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Q1) Which statement best represents a top-down approach toward intervention?
A) Haley will bring both hands together during play.
B) Haley will pick up a Cheerio with a neat pincer grasp.
C) Haley will play with a variety of toys using two hands.
D) Haley will stack four cubes using both hands.
Q2) Which of the following statements is not true about short-term objectives?
A) They are all the things the client needs to be able to do to meet long-term goals.
B) They are the statements that describe the terminal functional skills the clients should achieve after intervention.
C) They are interim steps that are used to reach long-term goals.
D) They describe skills that should be mastered in a relatively short time period.
Q3) Which frame of reference targets the child's range of motion, strength, and endurance for occupations?
A) Biomechanical
B) Developmental
C) Motor control
D) Sensory integration
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Chapter 11: Anatomy and Physiology for the Pediatric
Practitioner
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Q1) Which statement describes the autonomic nervous system?
A) It consists of the brain and spinal cord.
B) It consists of a network of peripheral nerves.
C) It consists of the "fight-or-flight" and "rest-and-digest" nerves.
D) It controls movement only.
Q2) What is homeostasis?
A) Balancing water and electrolytes.
B) Maintaining a steady heart rate and blood pressure.
C) Maintaining a stable internal body temperature.
D) Creating an external barrier to microbes.
Q3) How many thoracic vertebrae are there?
A) 1
B) 5
C) 7
D) 12
Q4) A physiologist is a biologist who studies
A) function.
B) structure.
C) evolution.
D) genetics.
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Chapter 12: Neuroscience for the Pediatric Practitioner
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Q1) Which statement reflects what occurs in therapy in regard to neurons?
A) Brain neurons do not change over time.
B) Damaged neurons can be repaired.
C) Destroyed neurons are replaced with new ones.
D) Neurons gain new synapses.
Q2) What is the pattern of cortical representation in the motor homunculus for fine motor skills as compared to the area for gross motor skills?
A) Equal amount of cortical representation
B) Greater amount of cortical representation
C) Smaller amount of cortical representation
D) This has not been calculated.
Q3) What deficits is a child with parietal lobe damage most likely to present?
A) Memory and emotions
B) Personality, judgment, and motor control
C) Touch, pressure, and tactile discrimination
D) Visual and auditory perception
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14
Chapter 13: Pediatric Health Conditions
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Q1) Mira is a 10-year-old with juvenile rheumatoid arthritis (JRA).She has trouble completing her work at school.Which client factors (associated with JRA) may be interfering with her educational work?
A) Decreased ROM.
B) Increased muscle tone.
C) Inability to process sensory information.
D) Poor strength and endurance.
Q2) Kendra, a 7-year-old girl, shows some hand flapping behaviors and some difficulty with expressing herself.She speaks slowly and does not seek out her peers.Although Kendra is able to perform her self-help skills and receives good grades in school, the teacher notices that Kendra is "by herself" frequently.Which developmental disorder do these behaviors describe?
A) Developmental Coordination disorder
B) Attention deficit hyperactivity disorder
C) Autism spectrum disorder
D) Rett syndrome
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Chapter 14: Childhood and Adolescent Psychosocial and
Mental Health Disorders
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Q1) Gerald, a 5-year-old kindergartner, is reluctant to go to sleep without his parents nearby.He clings to his parents each morning when being dropped off at school and spends the first 30 minutes in tears, even after the second month of school.What do these symptoms represent?
A) Normal reactions to new situations
B) Phobic anxiety disorder
C) Separation anxiety
D) Generalized anxiety disorder
Q2) Which statement is not a criterion for substance dependence?
A) The individual does not realize that the use is excessive.
B) Much time is spent in obtaining, using, and recovering from the substance.
C) Withdrawal symptoms occur with attempts to reduce or stop using the substance.
D) Responsibilities are neglected.
Q3) Which statement is true concerning suicide in adolescents?
A) Bringing up suicide may encourage the adolescent to act on it.
B) An adolescent expressing suicidal thoughts will probably not act on them.
C) Adolescents who are preoccupied with death require professional counseling.
D) Suicide is very uncommon in teens.
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Chapter 15: Childhood and Adolescent Obesity
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Q1) What is the recommended physical activity level for children?
A) Vigorous activity for 1 hour daily.
B) Moderate activity for 30 minutes daily.
C) Quiet activity all day long.
D) Outdoor play for at least 20 minutes daily.
Q2) What is the category for a body mass index (BMI) value that falls in the 96th percentile?
A) Healthy weight
B) Overweight
C) Obese
D) Morbidly obese
Q3) What can an occupational therapy (OT) practitioner do to engage the family in establishing health habits?
A) Make complex suggestions that require major life changes.
B) Engage the whole family in simple habit changes.
C) Keep things private and encourage the family not to seek support from others.
D) Make the family members feel guilty about their poor health habits.
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Chapter 16: Intellectual Disabilities
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Q1) Julie is 19 years old and able to accomplish habitual self-care skills, such as feeding.She has been able to participate in some vocational training with supervision.She lives in a group home that provides extensive supervision.In which intellectual disability category would Julie fit?
A) Mild
B) Moderate
C) Severe
D) Profound
Q2) Paul is 10 years old and has noticeable developmental delays.He has been in special education classes and has completed the second grade.Although he can complete most of his activities of daily living (ADLs), he does need supervision.In which intellectual disability category does Paul fit?
A) Mild
B) Moderate
C) Severe
D) Profound
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18
Chapter 17: Cerebral Palsy
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Q1) What is the role of orthoses for children who have cerebral palsy?
A) Improve range of motion
B) Improve overall function
C) Decrease muscle tone
D) Decrease pain
Q2) Why do occupational therapy practitioners use positioning and handling techniques for children with cerebral palsy?
A) Maintain postural alignment.
B) Facilitate improved movement patterns.
C) Facilitate performance of activities of daily living.
D) Both A and C.
E) All of the above.
Q3) Charlie is a 10-month-old with cerebral palsy who has difficulty sitting.With what is he having difficulty?
A) Equilibrium
B) Protective
C) Righting
D) Static balance
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19
Chapter 18: Positioning and Handling: A
Neurodevelopmental Approach
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Q1) The COTA positions her palm on the child's abdomen and back in an effort to help the child move from upright sitting to quadruped.What is the term used for what the practitioner is doing?
A) Handling
B) Intervention
C) Positioning
D) Weight bearing
Q2) What does prone position facilitate in infants?
A) Hand strength and neck and trunk extension
B) Elbow extension and neck flexion
C) Trunk flexion, leg strength, and abdominal strength
D) Trunk extension and leg and hand strength
Q3) The Certified Occupational Therapy Assistant (COTA) observes a 6-year-old child with cerebral palsy and high muscle tone using a W-sitting position on the floor at all times.What does this observation suggest about the child?
A) He is developing normally.
B) He is using a compensatory position to establish stability.
C) He is using a position considered normal for an older child.
D) He is using a compensatory position to establish mobility.
Page 20
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Chapter 19: Activities of Daily Living and Sleeprest
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Q1) The occupational therapy assistant suggests that the school install a gate at the top of the stairs so the child can be safe.What type of effort is this?
A) Reasonable accommodation
B) Least restrictive learning environment
C) Prevention
D) Compensation
Q2) What technique is used when the caregiver takes the child's clothes off, washes the child in a tub, and dries the child off, but the child dresses self and empties the tub water?
A) Adapting the activity
B) Backward chaining
C) Forward chaining
D) Grading the activity
Q3) Suck-swallow-breathe synchrony is not necessary for which of the following?
A) Eating without gasping
B) Smiling and frowning
C) Sleeping without drooling
D) Talking and singing
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21
Chapter 20: Instrumental Activities of Daily Living
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Q1) Marty is unable to distinguish a dime from a nickel.With what client factor is he most likely having difficulty?
A) Figure ground
B) Depth perception
C) Mathematical computation
D) Visual perception
Q2) When discussing sexuality with an adolescent in a school setting, what must the OT practitioner first do?
A) The OT should discuss the topic with the school principal and nurse.
B) It is not appropriate for the OT to address sexuality.
C) The OT should obtain consent from the adolescent's parent or guardian.
D) The OT should get verbal consent from the adolescent.
Q3) A child with autism uses a series of pictures to communicate with you.What type of system is this?
A) Voice Output Communication Aids
B) Picture Exchange Communication System (PECS)
C) Assistive technology
D) Point and speak
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Chapter 21: Play and Playfulness
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Q1) The OT practitioner played a dress-up game in therapy to work on the child's goal to put on a shirt independently.What does this session illustrate?
A) Play as the goal
B) Play as the tool
C) Backward chaining
D) Playfulness as the goal
Q2) Which activity is most suitable to use in OT intervention to help 3-year-olds share?
A) Lecture on sharing.
B) Have only one toy available.
C) Take toys away from the children.
D) Play catch in a small group.
Q3) Which characteristic does not promote play and playfulness in children?
A) Positive reinforcement
B) Patience
C) Rigidity with rules
D) Sense of humor
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Chapter 22: Functional Task at School: Handwriting
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Q1) Which classroom strategy is most helpful to a child with handwriting difficulties?
A) Allow the child to spend recess time writing homework assignments.
B) Do not require the child to write at all.
C) Provide a written list of homework assignments.
D) Require the child to write in neat, full paragraphs.
Q2) Which sitting position is most helpful for writing?
A) Feet on floor, desk resting on lap
B) Feet off floor, desk under armpits
C) Feet on floor, desk slightly above elbow
D) Feet off floor, desk slightly above elbow
Q3) Brigit is an 8-year-old girl who presses hard on the paper and frequently smears her letters and rips the paper.What do you expect to observe with her grasp pattern?
A) Dynamic tripod grasp
B) Grasp by the eraser
C) Loose grasp
D) Tight grasp
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Chapter 23: Therapeutic Media: Activity With Purpose
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Q1) You are trying to increase the social skills of a group of adolescents.Which adaptations to a sponge-painting activity would best meet this goal?
A) Allow them to work in groups of three.
B) Limit talking and encourage independent work.
C) Provide them with simple directions and a time limit.
D) Seat them in desks positioned in a row.
Q2) The OT practitioner noticed the client had a small cut and provided a glove to protect his hand during woodworking.This shows the practitioner was taking into account what client factor?
A) Skin-related structures
B) Sense of self
C) Cardiovascular system
D) Eye-hand coordination
Q3) Which activity would be most suitable for a group of 3-year-old boys and girls?
A) Blowing bubbles
B) Playing with Barbie dolls
C) Scrapbooking
D) A 20-piece puzzle
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Chapter 24: Motor Control and Motor Learning
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Q1) Glen is a 5-year-old boy who is unable to pick up cereal and small toys.The certified occupational therapy assistant (COTA) engages Glen in a game to pull objects out of Play-Doh and poke his finger in the Play-Doh to make holes.On what skills do these activities work?
A) Balance and range of motion.
B) Endurance and trunk strength.
C) Strength and in-hand manipulation.
D) Timing and sequencing.
Q2) What type of practice is most effective for transfer of learning?
A) Blocked
B) Distributive
C) Variable
D) Repetitive
Q3) What would be the first step when working with a 6-year-old child with poor coordination and timing for handwriting?
A) Games involving running and moving.
B) Using fingers to grasp object.
C) Scooping, using thumb and index finger.
D) Picking up object, using tip of index finger and thumb.
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Page 26
Chapter 25: Sensory Processingintegration and Occupation
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Q1) Why does the COTA provide a new activity on the swing during the treatment session using a sensory integration approach?
A) To facilitate attention to new sensations.
B) To prevent the COTA from becoming bored.
C) To assure the child that the COTA is in charge.
D) To reduce the structure of the session.
Q2) What is SI?
A) The process of receiving, detecting, and making sense of input from the environment.
B) Planning, designing, and executing movements.
C) Discriminating between different textures within the environment.
D) A fear of height, movement, or textures so that the child is unable to make an adaptive response.
Q3) COTAs can become certified in the administration and interpretation of the Sensory Integration and Praxis Tests (SIPT).
A)True
B)False
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Chapter 26: Applying the Model of Human Occupation to
Pediatric Practice
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Q1) A therapist engages in a give-and-take interaction with a child, his parents, and consultants from other disciplines working with the child to gain an agreement about something that the child should do.The goal of this type of therapeutic strategy is to A) validate.
B) advise.
C) negotiate.
D) identify.
Q2) When a child identifies a set of related actions and attitudes that define a familiar status, this is what within the conceptual area of habituation?
A) Habits
B) Social groups
C) Personal causation
D) Roles
Q3) A child's pattern and organization around different occupations is called
A) Volition
B) Performance capacity
C) Habituation
D) Environmental factors
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Chapter 27: Assistive Technology
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Q1) What was the team trying to identify when they observed the child playing to determine what voluntary movement he had before placing the switch on his arm?
A) Indirect selection
B) Direct selection
C) Access
D) Control site
Q2) Which of the following is not a disadvantage of a power wheelchair?
A) Weight
B) Portability
C) Maintenance
D) Speed
Q3) From where would someone seek AT funding for an 8-year-old to perform successfully in school?
A) Medicare
B) Vocational rehabilitation program
C) Individuals with Disabilities Act (IDEA)
D) Birth to three program
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29
Chapter 28: Orthoses, Orthotic Fabrication, and Elastic
Therapeutic Taping for the Pediatric Population
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Q1) What type of protocol is provided with orthosis?
A) Occupational
B) Cleaning
C) Repair and maintenance
D) Wearing
Q2) Which statement shows the responsibility of the certified occupational therapy assistant during the splint fabrication process?
A) Writing down the sequence of when to don or doff the orthosis.
B) Teaching the child how to properly don or doff the orthosis.
C) Instructing parents, teachers, and others involved in donning and doffing the orthosis.
D) Both A and C.
E) All of the above.
Q3) What is the primary goal of Kinesio taping?
A) To help the body in self-healing.
B) To provide stability to muscles.
C) To correct misaligned joints.
D) To normalize muscle tone.
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Chapter 29: Animal-Assisted Activities and Therapy
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Q1) What is the role of the OT practitioner during a hippotherapy session?
A) Help the child successfully ride the horse.
B) Improve the child's communication skills.
C) Improve the child's posture and balance.
D) Teach the child to ride properly.
Q2) Which factor is most important for the occupational therapy (OT) practitioner to consider when using an animal as an occupation for children?
A) Family and child's pets
B) Parental income and educational level
C) Practitioner's comfort with animals
D) Transportability of pet
Q3) What type of animals are frogs and salamanders?
A) Amphibians
B) Invertebrates
C) Mammals
D) Reptiles
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