NELSON PEDIATRICS MCQ PDF

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MCQs in Pediatrics Review of Nelson Textbook of Pediatrics – 20th edition. This is question bank based on textbook Nelson Pediatrics. It helps. Nelson Pediatrics Review (MCQs) 19ed. for a late-component or alternative pathway deficiency with CH50 and AP50 Nelson pediatrics review (mcqs) 19ed Watch This Video ○○○ raudone.info LATEST nelson PEDIATRICS review MCQs 19 ed pdf pdf free download for freshers experienced students objective books interview questions mcqs lab viva.


Nelson Pediatrics Mcq Pdf

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Nelson Pediatrics Review(MCQs)17ed - Ebook download as PDF File .pdf), Text File .txt) or read book online. MCQs in Pediatrics Review of Nelson Textbook of Pediatrics 20th Edition PDF - If you found this book helpful then please like, subscribe and. Nelson Pediatrics Review raudone.info Kaplan Step 2 Kaplan USMLE Ped 05 First Aid First Aid Full First Aid Flashcards Med-Ped Peds Ped PAEDIATRICS.

Special transports ECMO are not common and are used for only unusual circumstances.

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The mother of a 5-yr-old near-drowning victim arrives at the pediatric intensive care unit PICU. She is highly upset and emotional, and forcefully demands to see her child. The best response of the PICU staff to the mother would be: To sit with her and explain the procedures of the PICU, including times permitted for visitation, the number of visitors permitted To direct her to a social worker who would provide a description of the rules for visitation in the PICU To require that she speak with the child's physician before being permitted to visit the bedside To direct her to the parents' waiting area, and inform her that she will be summoned when the time is right To take her as soon as possible to the bedside, after having provided a brief description of what the room might look like, what medical devices will be present, and what level of response she might expect from her child Explanation: It is not always possible for a parent to immediately be brought into a child's PICU room.

A health care provider should be there for the parent to explain the patient's condition and facilitate ongoing communication. Nonetheless, this process should be brief, as any delay increases anxiety and possibly mistrust. See Chapter 54 in Nelson Textbook of Pediatrics, 17th edition. A child has been in the PICU for 10 days and still faces at least a week of further treatment.

Which of the following features of the physical examination is most strongly

Various family members have consulted with a variety of treating medical staff about prognosis. As a result, the family has heard several contradictory versions of what the treatment plan will be. You should now: Advise the family to speak only to you in the future Explanation: All of these answers have been suggested except the letter to the administrator and depend on the circumstances in the PICU and the patient.

Although "B" has value, once confusion has taken over it is important for one person to communicate with the family. Practically, this is not always possible.

Schedule regular meetings where representatives of the different services are present and consensus can be reached Advise the family to write a letter to the hospital administrator Advise the family not to speak to consulting physicians Advise the family that this degree of ambiguity is unavoidable in this setting Question.

A 2-yr-old child arrives in the PICU in respiratory distress and soon requires intubation and mechanical support.

MCQs in Pediatrics Review of Nelson Textbook of Pediatrics – 20th edition

Because of a heart murmur detected 2 days later, a cardiology consultation is requested, and the fellow performing the consultation speaks with the family, indicating the need for immediate heart surgery. The family is distressed at this news, and wonders why you have not mentioned the possibility of surgery. The most appropriate next step in management is to: Ask the family to discuss the matter further with the cardiology service Contact the chief of cardiology and lodge a complaint about the actions of the fellow Convene a meeting with representatives from your service and the cardiology service, develop a plan, and then meet with the family to present recommendations Explanation: When such communication catches you off guard, regroup the team and family and discuss the events that led to the diagnosis and surgery.

Never forget the best interest of the patient despite less-than-optimal communication. The mother of one of your PICU patients regularly looks through the bedside medical chart of her child. Bedside nurses report this to you and express their discomfort with the practice. Your most appropriate response would be to: Advise the nurses that it is the mother's right to view the chart and nothing should be done Report the matter to the hospital authorities Suggest to the mother that you or your representative would like to go through the chart with her on a regular basis to clarify the jargon and explain the content more fully Explanation: Charts should not be read in isolation.

Notes or laboratory data are easily misinterpreted and require a health care worker to help communicate their meaning and significance. Instruct the mother that she may not view the chart since it contains the writings of several different health care providers who have not consented to her viewing it Enlist the help of a social worker to persuade her that viewing the chart is not appropriate Question. You inform the family of a gravely ill child in the PICU that she is very likely to die soon.

The family, consistent with their faith, wishes to apply oils to her body and place various amulets on the bed. Your reaction should be to: Refer the matter to the hospital attorney Refer the matter to the chaplain Persuade them that the application of oils and the presence of amulets cannot possibly influence the child's health status Inform them that so long as what they wish to do does not pose immediate threat to their child's health, you support their wishes Explanation: This is a most important example of understanding cultural issues in health, life, and dying.

To this family, not performing the ritual may prevent the child from dying peacefully. A chaplain familiar with the family's faith is also useful, whether employed by the hospital or present as the family's personal spiritual advisor. Inform them that hospital policies forbid applying the oil because it is an unauthorized form of medical treatment Question.

Proper use of the PRISM scoring system would include: Decision-making in end-of-life issues for a chronically ill child Withdrawal of support decisions for a child with multiple organ failure Comparison of level of disease severity between treatment and control groups Explanation: The Pediatric Risk of Mortality score is based on 17 physiologic variables vital and neurologic signs, acid-base, blood chemistries, hematologic parameters subdivided into 26 ranges and taking into consideration age neonate, infant, child, adolescent.

It is best in predicting mortality for populations of patients and not for an individual PICU patient. Decision- making at the end of life should never be based on an acute PRISM score, especially in a chronically ill child. It has no relevance or reliability in non-PICU patients, such as those receiving chemotherapy. See Chapter 56 in Nelson Textbook of Pediatrics, 17th edition. Assessment of performance of a chemotherapy regimen Question.

Which of the following scoring systems is useful for triage decisions? The other scores are most useful in assessing physiologic instability resource utilization in an acute PICU setting. Regarding resuscitative efforts, the most important goal is: Restoration of age-appropriate heart rate Appropriate movement of the chest wall Auscultation of equal breath sounds in both lung fields Adequate oxygen delivery and utilization for the body tissues Explanation: Although all of these goals are important, they all reflect the rescuer's ability to restore perfusion and oxygen delivery to vital tissues.

The effectiveness of resuscitation can be assessed by visualizing good chest rise and palpating good pulses during rescue breathing and chest compressions, respectively. See Chapter Palpation of equal pulses in all four extremities Question. A 9-mo-old boy is brought to the emergency room in a limp and unresponsive state.

After initiation of CPR including tracheal intubation , delivery of oxygen via positive-pressure breaths, and chest compressions, multiple attempts to insert an IV line fail. The transferring hospital must provide an appropriate medical screening to assess if the patient has an emergency condition If an emergency condition exists, the patient's condition must be stabilized, or if stabilization measures exceed that hospital's expertise, the patient must be transferred to a hospital capable of such measures Transfer of unstable patients is permitted under limited circumstances The law does not apply to pediatricians who are on call for consultation to the emergency department Explanation: This law is meant to benefit patients and includes patients of all ages and their doctors.

All patients must be stabilized to the best of the ability of the emergency room staff. All pertinent data must also be transferred with the patient to the most appropriate hospital capable of caring for the patient's condition.

There are several requirements in preparing a child for transfer to a higher level of care e. In preparing for transfer of a child, which of the following is not recommended? Obtaining written consent for transfer from the patient's parent or guardian Copying diagnostic tests, radiographs and the child's medical record Calling and giving report to the appropriate transport agency Instructing transport agency to call receiving physician to secure acceptance for transfer Explanation: Doctor-to-doctor communication is essential when transferring a critically ill patient.

This is not the responsibility of an ambulance company. See Chapter 51 in Nelson Textbook of Pediatrics, 17th edition. Documenting name of transport agency and the time that the transport occurred Question.

Emergencies involving children are stressful for the child, parent, and EMS-C providers. All of the following are useful in decreasing stress to children and their families in emergency settings except: Keeping the parents away during procedures or resuscitation Explanation: Indeed, most parents can provide additional calming and distraction during procedures, and their presence should be encouraged.

The question of parents being present during resuscitation is controversial, but most physicians find that it usually does no harm and may be of value later to grieving parents. See Chapter 51 in Nelson Textbook of th Training staff in calming and distraction techniques Separating the child from other frightening sights and sounds in the treatment area Communicating clearly, with written instructions accompanying verbal information whenever possible Screening for mental health needs Question.

MCQs in Pediatrics Review of Nelson Textbook of Pediatrics

The safest and quickest manner to transport a critically ill child from a community hospital to the regional pediatric center is: Have the parents drive the child from their local hospital Request that the local paramedics transport the child Accompany the child in the ambulance with the local paramedics Request that the tertiary pediatric facility assist and transport the patient Explanation: The care and transport of a critically ill child requires staff with specific experience and knowledge of the pediatric population and the illnesses necessitating transportation.

In addition, the equipment, medications, and means to monitor children require pediatric-specific expertise. Coordinated efforts with a pediatric transport program yield the safest methods of transport. See Chapter 53 in Nelson Textbook of Pediatrics, 17th edition.

The transport team from the tertiary hospital is composed of all of the following except: A parent who can assist in the care of the child Explanation: Parents are not expected to provide care during pediatric transports. Nonetheless, if room is available in the transport vehicle, a parent may accompany the child. Usually this is not possible, and the parent follows the transport van in another vehicle.

Team members skilled in various aspects of pediatric critical care A dispatch service that facilitates communication with the referring hospitals A medical control physician who is available for telephone consultation Question.

Appropriately trained and equipped pediatric transport teams should be able to: Perform major surgical procedures at the referring hospitals Provide appropriate medical care during the transport Explanation: Appropriately trained and prepared based on information from the referring hospital transport staff should be able to care for the patient en route to the PICU.

This does not mean that a patient's condition cannot deteriorate during transport as part of the natural history of the disease. Special transports ECMO are not common and are used for only unusual circumstances. The mother of a 5-yr-old near-drowning victim arrives at the pediatric intensive care unit PICU.

She is highly upset and emotional, and forcefully demands to see her child.

The best response of the PICU staff to the mother would be: To sit with her and explain the procedures of the PICU, including times permitted for visitation, the number of visitors permitted To direct her to a social worker who would provide a description of the rules for visitation in the PICU To require that she speak with the child's physician before being permitted to visit the bedside To direct her to the parents' waiting area, and inform her that she will be summoned when the time is right To take her as soon as possible to the bedside, after having provided a brief description of what the room might look like, what medical devices will be present, and what level of response she might expect from her child Explanation: It is not always possible for a parent to immediately be brought into a child's PICU room.

A health care provider should be there for the parent to explain the patient's condition and facilitate ongoing communication. Nonetheless, this process should be brief, as any delay increases anxiety and possibly mistrust.

See Chapter 54 in Nelson Textbook of Pediatrics, 17th edition. A child has been in the PICU for 10 days and still faces at least a week of further treatment.

Various family members have consulted with a variety of treating medical staff about prognosis. As a result, the family has heard several contradictory versions of what the treatment plan will be. You should now: Advise the family to speak only to you in the future Explanation: All of these answers have been suggested except the letter to the administrator and depend on the circumstances in the PICU and the patient. Although "B" has value, once confusion has taken over it is important for one person to communicate with the family.

Practically, this is not always possible. Schedule regular meetings where representatives of the different services are present and consensus can be reached Advise the family to write a letter to the hospital administrator Advise the family not to speak to consulting physicians Advise the family that this degree of ambiguity is unavoidable in this setting Question.

A 2-yr-old child arrives in the PICU in respiratory distress and soon requires intubation and mechanical support. Because of a heart murmur detected 2 days later, a cardiology consultation is requested, and the fellow performing the consultation speaks with the family, indicating the need for immediate heart surgery.

The family is distressed at this news, and wonders why you have not mentioned the possibility of surgery. The most appropriate next step in management is to: Ask the family to discuss the matter further with the cardiology service Contact the chief of cardiology and lodge a complaint about the actions of the fellow Convene a meeting with representatives from your service and the cardiology service, develop a plan, and then meet with the family to present recommendations Explanation: When such communication catches you off guard, regroup the team and family and discuss the events that led to the diagnosis and surgery.

Never forget the best interest of the patient despite less-than-optimal communication. The mother of one of your PICU patients regularly looks through the bedside medical chart of her child.

Bedside nurses report this to you and express their discomfort with the practice.Which of the following interventions is most likely to improve the patient's neurologic outcome?

Infections include sinusitis, otitis media, pneumonia, or, less often, sepsis or meningitis. The Pediatric Risk of Mortality score is based on 17 physiologic variables vital and neurologic signs, acid-base, blood chemistries, hematologic parameters subdivided into 26 ranges and taking into consideration age neonate, infant, child, adolescent.

This powerful tool is helpful in genetic research and diagnosis. The classic blood gas of salicylate toxicity reveals a primary respiratory alkalosis and a primary, anion gap, metabolic acidosis.

Antidotes are available for relatively few poisons, thus emphasizing the importance of meticulous supportive care and close clinical monitoring.

The chemical classification of antihistamines type I to type VI does not have functional significance. After initiation of CPR including tracheal intubation , delivery of oxygen via positive-pressure breaths, and chest compressions, multiple attempts to insert an IV line fail. She babbles but cannot wave bye-bye nor can she grasp objectives with the finger and thumb.

Theseare the common medications used in Pediatric psychiatric disorders which pediatrician should be familiar with.

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