Pediatricians may receive three credit hours in Category I for the Physician's Recognition Award of the American Medical Association by reading the material in this issue and successfully answering the questions in the quiz below. To obtain credits, follow these instructions
1. Read each of the articles carefully
Do not neglect the tables and other illustrative materials, as they have been selected to enhance your knowledge and understanding.
2. The following questions have been designed to provide a useful link between the articles in the issue and your everyday practice Read each question, choose the correct answer, and record your answer on the CME Registration Form at the end of the quiz. Retain a copy of your answers so that they can be compared with the correct answers that will be sent to you later.
3. Type or print your full name and address and your Social Security number in the spaces provided on the CME Registration Form.
4. Send the completed form, with your check or money order for S 1 8 made out to PEDIATRIC ANNALS CME CENTER, 6900 Grove Road, Thorofare, NJ 08080.
5. Your answers will be graded, and you will be advised that you have passed (or failed). An answer sheet containing all correct answers will be mailed to you. Review the parts of the articles dealing with any questions you have missed, and read the supplemental material on this aspect of the subject listed in the references in this issue.
6. Be sure to mail the form on or before the deadline listed on the CME Registration Form so that credit can be awarded. [After that date, the quiz will close, and correct answers will appear in the magazine.) Unanswered questions will be considered incorrect and so scored. A minimum score of 70 must be obtained in order for credits to be awarded.
As an organization accredited for continuing medical education, [he Lena* Hill Hospital of New York designares this continuing medical education activity as meeting the criteria for three credit hours in Category 1 for Educational Materials for the Physician's Recognition Award of the American Medical Association, provided it has been completed according to instructions
1. The process of falling asleep in infancy is now thought to come primarily from:
A. The stomach.
B. The brain.
C. Infant reflexes and instincts.
D. The expected sleep cycle,
2. Of the following, which should be of most consideration in discussing an infant's sleep patterns with the parent?
A. The baby's gestational age.
B. The baby's actual age.
3. All of the following are factors that help a baby to sleep well during the day except:
B. Motionless sleep.
C. Consistency in soothing style.
D. Amount and schedule of feedings.
4. Of the following, which is not one of the most common mistakes parents make in teaching their infants to sleep better?
A. Using music or nursery rhythms to soothe the baby.
B. Keeping the intervals of wakefulness too long.
C. Using swings during sleeping.
D. Being inconsistent in methods used to soothe a baby.
5. Of the following, which is not included by Azrin and Foxx as "readiness criteria" for toilet training?
A. Bladder maturation.
B. Physical readiness.
C. Neurological readiness.
D. Instructional readiness.
6. The typical age to encounter "toileting refusal" is generally about: A. 12 months.
B. 18 months.
C. 25 months.
D. 36 months.
7. The most common factor in encopresis is:
C. Psychological problems.
D. Dysfunctional families.
8. Basic strategies in the management of encopresis include all of the following except:
A. Treating existing constipation.
B. Beginning dietary management.
C. Keeping bowel motility functioning properly.
D. Using antidiarrheal agents to control the leakage.
9. Of the following factors, which is now thought not to be related to the development of nocturnal enuresis?
A. Impaired arousal.
B. Sleep stage.
C. Small functional bladder capacity.
D. Relative vasopressin deficiency.
10. An important component of any treatment regimen for nocturnal enuresis should include:
A. Biofeedback techniques.
B. The provision of reassurance and positive support by the family and health care provider.
C. Regular and consistent mild shaming by the parents for wet nights.
D. Education of the parents as to the possible long-term manifestations of en uresis.
11. The highest and most sustained long-term success rate for nocturnal enuresis includes use of:
C. Signal alarm device.
D. Elimination diet.
12. Desmopressin (DDAVP), the newest pharmacologie agent for the treatment of nocturnal enuresis, is characterized by all of the following except:
A. It is an analogue of the antidiuretic hormone, vasopressin.
B. Clincal complications have included epistaxis, nasal congestion, and rarely, water intoxication.
C. Medication usage is associated with successful control of bed-wetting in as many as 70% of patients that are continuously maintained on the drug.
D. The therapeutic program consists of twice a day nasal spray usage.
13. ADHD is now considered a true developmental disability requiring long-term systematic treatment if any impact on later outcome is to be achieved.
14. The stimulant drugs for treating ADHD have:
A. Demonstrated promise in managing adolescents and adults with ADHD1 as well as usefulness in early schoolaged children.
B. Approximately a 90% likelihood of success in managing children with significant ADHD.
C. A high likelihood of producing tic disorders orTourette's syndrome.
D. A very low likelihood of causing appetite loss or insomnia.
15. All of the following parenting skills are recommended to parents for managing the behavior of their ADHD child except:
A. Increase the frequency and immediacy of rewards for compliance to rules and instructions.
B. Use immediate response and consequences, and the use of short-term "time out" for unacceptable behavior.
C. Learning to deliver commands rapidly and without repetition, with frowns and increased interaction for noncompliance with requests.
D. Anticipate potential problem situations and make a plan with the child for avoidance of these potential problems if possible, and for behavior management if problems do occur.
16. In determining a starting dosage of a stimulant drug for treating ADHD:
A. One should always use the child's body weight and height.
B. Body weight is no longer a useful reference point, as recent statistics indicate the behavioral effects of stimulants are highly idiosyncratic.
C. The presence of a tic disorder in the child is irrelevant.
D. The same dose can be used regardless of which type of stimulant drug is to be prescribed.
17. Most researchers consider oppositions I, argumentative behavior in children to be:
A. Organically based.
B. Part of a larger constellation of instinctive behaviors.
C. The cornerstone of later conduct problems.
D. Amenable to pharmacological intervention.
18. Major skills taught early to children that have been shown to reduce the need for later discipline and negative child interaction include all of the following except:
A. Independent play.
B. Thinking positively.
C. Verbai communication with all physical contacts.
19. The notion of enhanced time-in refers to:
A. Making the routine interaction more enjoyable.
B. Paying a child an allowance.
C. The amount of time devoted to seeing families for behavior modification.
D. Decreasing the periods and length of time-in and time-out.
20. Independent play skills are best encouraged by providing substantial verbal instructions and avoiding physical contact with an infant who is playing quietly alone.
Answers to the February Quiz