AMA Journal of Ethics®

Illuminating the art of medicine

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AMA Journal of Ethics®

Illuminating the art of medicine

Virtual Mentor. August 2003, Volume 5, Number 8.

Test Questions

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Test Questions: Pediatrics

August 2003, Volume 5, Number 8

1. Most states require physicians to report:

A. Every case in which there are visible signs of physical punishment on a child.
B. Only cases in which repeated injuries or consistent visible signs of corporal punishment lead them to suspect child abuse.
C. Only those cases in which parents, when asked, admit to using physical discipline.

2. As children mature, they should be increasingly involved in making decisions about their health care:

A. Because doing so can confer a sense of control over their illness.
B. Unless they refuse life-sustaining treatment, in which case their decisions must be always overridden.
C. Because involving them recognizes their developing autonomy.
D. Because it is the law in most states.
E. All of the above.
F. A and C.

3. When physicians believe that parents' faith-based decisions are not in their sick child's best interest, the first action the physician should take is:

A. Withdraw from the case before becoming adversaries of the parent and losing the opportunity to provide medical care for the child.
B. Involve a person educated in the parents' faith tradition to ensure that they correctly understand their child's illness and the tenets of their faith.
C. Seek a court order to carry out the proposed treatment in the child's best interest and over the parents' objection.
D. Allow the parents sufficient time to realize that divine intervention is not saving their child.

4. Federal regulations governing children's participation in research specifies that children can:

A. Participate in research with minimal risk if their parents consent and the child assents as appropriate for his or her age.
B. Only participate in research when the risk is minimal and there is a strong possibility that they will benefit directly from the research.
C. Participate in research that exceeds minimal risk if it offers some prospect of direct benefit to the child.
D. A and C.

5. Journal article authors Carl Elliott and Robert Crouch argue that:

A. Young children should not be considered as possible donors of a kidney to a sibling.
B. It is impossible for potential sibling donors to make free, un-coerced decisions regarding the donation.
C. Psychological benefit to the donor is sufficient to balance the risks most healthy children will undergo in donating a kidney to a sibling.
D. The concept of "other-regarding interests" is helpful in assessing a child donor's readiness to decide whether or not to donate.
E. A and B.

6. Current American Academy of Pediatrics and Centers for Disease Control and Prevention guidelines recommend prompt use of an antibiotic (preferably amoxicillin) for treatment of otitis media in children to reduce the risk of mastoiditis secondary to the otitis.

7. The commentary on the clinical case of MD, the 15-year-old boy who is obese, contends that:

A. There are clear cut legal and ethical reasons to report MD's parents to the Department of Social Services for not acting in his best interest.
B. MD's parents undermined his medically necessary weight loss, which makes them, by legal definition, neglectful.
C. MD's parents cannot be held accountable for his behavior because he is 15 years old and a mature adolescent.
D. MD's obesity is largely accounted for by his post-transplant regimen.

8.The Miller v HCA law suit involving hospital staff treatment of a newborn against her parents' instructions, puts the following interests into conflict:

A. Parental right to make decisions for their children, the child's best interest, the state's interest in protecting and preserving life.
B. Physician negligence and malpractice, state's right to set standards for medical practice, child's best interest.
C. Parental right to make decisions for their children, child's best interest, physician negligence and malpractice.
D. Parental right to make decisions for their children, state's right to set standards for medical practice, physician negligence and malpractice.

9. Pitfalls to prescribing behavior-changing drugs for young children (ages 3-10) on the basis of symptoms along include:

A. The medication may mask an underlying diagnosis.
B. Some referrals for behavior problems are really symptoms of overworked, underpaid teachers and child care workers in understaffed settings.
C. No information exists about safe and appropriate dosages of the behavior-changing drugs commonly used in the US and Europe.
D. Doing so perpetuates the myth that medication alone will take care of all problems between children, parents, and their teachers.
E. All of the above.
F. A, B, and D.

10. When parents want "everything done," in the case of a terminally ill infant with many co-morbid conditions:

A. Physicians must abide by the parents' preferences at the risk of being sued for negligence.
B. Physicians must adhere to hospital policy, even when doing so contributes to the infant's pain and suffering.
C. Physicians can explain that their professional ethic requires that they not intervene aggressively to prolong the baby's suffering.
D. Physicians must abide by the 1984 Baby Doe Regulations that require that newborns receive maximal life-prolonging treatment under all circumstances.
E. B and D.

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