Chapter 16: Child & Adolescent Health

Which patients does the nurse anticipate would most benefit from a medical home?

8-year-old with seizures 20-month-old with leukemia 11-year-old with Down syndrome 12-year-old with ADHD

A nurse working in a pediatric clinic refers the parents of a newborn to the Early and Periodic Screening, Diagnosis, and Treatment (EPSDT) program. Which response by the nurse is most appropriate to address the parents' concern about affordability?

"This is a federally funded program that is free to you and offers many services."

Which patient requires the nurse's immediate intervention?

15-year-old who says "Life isn't worth living"

Which teen does the nurse identify as being at the highest risk for health deviations?

16-year-old residing in an unsafe inner-city neighborhood

Which student will the school nurse recognize at the highest risk for participating in risky behavior?

A teen boy who has a good relationship with his single father and is friends with a group who routinely engages in poor behavior

Which child born in the United States is statistically twice as likely to die in its first year of life compared to Caucasian infants?

African American

Which social factors affect the health of pregnant women and their children? Select all that apply.

Alcohol Tobacco Marijuana

How does the nurse incorporate a 5-year-old with a respiratory infection into a plan of care?

Allow the child to listen to a stuffed animal's "lungs" with a toy stethoscope.

How does the nurse develop a therapeutic and trusting nurse-patient relationship with a 12-year-old patient?

Ask the patient directly about questions in the health history.

How does the nurse best incorporate a 17-year-old athlete into a plan of care to manage asthma?

Ask the teen to demonstrate how to use a spacer for an inhaler.

What are children living in poverty more likely to experience? Select all that apply.

Asthma Dental decay Learning disabilities

Which are "Safe to Sleep" recommendations that community health nurses will include in expectant and new parent classes? Select all that apply.

Breastfeed the baby. Do not let the baby get too hot during sleep. Always place baby on the back to sleep for naps & at night. Soft objects, toys & loose bedding should be kept out of the baby's sleep area.

How does the nurse act as an advocate for a newborn infant's health when the parents have declined vaccination?

By providing educational materials and supporting the parents' right to decline vaccination

A nurse is working with the parents of an infant born at 35 weeks' gestation. Which complications would the infant be at high risk for in life? Select all that apply.

Cerebral palsy Developmental delay Lack of sensory development

Which is a benchmark of child health that involves maintaining the appropriate immunological protection of all members of the community?

Childhood immunization

According to Bright Futures, which nursing actions should take place at every patient visit from infancy through adolescence?

Collecting a health history and providing anticipatory guidance

Which can best improve the identification and early management of specific treatable causes of infant morbidity and mortality?

Comprehensive prenatal care

Which is an example of a secondary intervention aimed at reducing teen pregnancy?

Creation of a teen pregnancy crisis clinic with free pregnancy tests

Community health nurses have an important responsibility to help prevent teenage pregnancy because teenage mothers pose which risks for the infant? Select all that apply.

Death Prematurity Incarceration Low birth weight Lower school achievement

How does the nurse act as an advocate for a 13-year-old who has started smoking?

Educate the patient about smoking risks

What is the primary reason that many children and adolescents remain under-immunized?

Fear of vaccine-related autism

Newborn screening checks for rare but serious health conditions are performed shortly after birth. All U.S. states and territories currently test for which newborn health conditions? Select all that apply.

Galactosemia Phenylketonuria Sickle cell disease Congenital hypothyroidism

How does the Women, Infants, and Children (WIC) national health program benefit recipients? Select all that apply.

Improves birth outcomes Decreases healthcare costs Lowers rates of childhood obesity

Which nursing action is appropriate if an assessment demonstrates that a teenage patient has not met a development goal?

Initiate early referrals that are appropriate to the developmental goal.

Which parenting technique will the nurse teach the parents of an adolescent?

Initiate open conversations about mental health concerns.

Which benefits of breastfeeding will the nurse share with a mother who is deciding whether to breast or bottle feed her newborn?

Lowers the chance of childhood asthma Passes important antibodies on the baby Decreases development of childhood obesity

The nurse is teaching a pregnant woman and her partner about global health initiatives that address reduction of mortality of children under the age of 5. Which health initiative will the nurse discuss?

MDG 4: Newborn Death & Illness Rationale: This global health initiative is directed at reducing mortality rate of children under the age of 5.

Which factors do community health nurses work to decrease infant mortality during the first year of life? Select all that apply.

Maternal health Socioeconomic status Public health practices Access to medical care

Which predictors of preterm birth and low birth weight should community health nurses screen pregnant women for? Select all that apply.

Multiple births Maternal obesity Lack of prenatal care Elective cesarean birth Low socioeconomic status

What is failure to provide for a child's basic physical, medical, emotional, or educational needs or failure to protect a child from harm or potential harm?

Neglect

For which priority conditions should the nurse assess when caring for an adolescent patient who plays video games 10-12 hours daily?

Obesity Type 2 diabetes

Public health nurses play pivotal roles in improving the health status of children and adolescents through serving which roles in the community? Select all that apply.

Participator in publicly funded programs Researcher for more effective strategies to improve children's health Advocator for increased individual & community response to children's needs Promoter of social interventions that enhance the living situations of high-risk families

The community health nurse teaches a pregnant woman about the importance of consuming foods high in folic acid. The nurse knows the educational session is successful when the patient chooses which foods for lunch? Select all that apply.

Pasta Beans Bananas Green leafy vegetables

Which finding causes a nurse the most concern when reviewing the medical record of a patient who is 5 months pregnant?

Positive drug test for opiates

The nurse teaches a child's legal guardian that Bright Futures provides a foundation for which types of health components?

Sensory screenings Consistent physical examinations Tracking of measurements associated with growth

The community health nurse teaches parents the importance of health promotion and maintenance for children. Which major factor should the nurse include as contributing to diminished incidence of childhood disease?

Recommended immunizations

The nurse is developing teen health initiatives for the community. Which intervention would be consistent with the initiatives of Healthy People 2020?

Reduce the obesity rate among adolescents.

The nurse identifies that Healthy People 2020 focuses on which health initiatives for adolescents?

Reduction of obesity Wellness checkups in the last 12 months Reduce the number of adolescents who start smoking

Which adverse effects of tobacco use during pregnancy will the community health nurse teach to pregnant women to prevent morbidity and mortality? Select all that apply.

Stillbirth Low birth weight Intrauterine growth restriction Premature rupture of membranes

Which non-nutritional factors contribute most to childhood and adolescent obesity? Select all that apply.

Television Electronic games Lack of outdoor exercise Readily accessible transportation

A nurse is preparing a workshop for middle-school adolescents that includes a segment on healthy cooking. What is the rationale for including this information? Select all that apply.

The rate of teen obesity and associated health conditions is increasing. It is important to start learning about healthy food options at a young age. The workshop will enable and encourage teens to help with food preparation.

Which risk-taking behaviors are most common for the nurse to assess for when providing care for adolescents? Select all that apply.

Tobacco use Unsafe driving Alcohol & drug use Early & unprotected sexual activity

The nurse is caring for an adolescent with obesity. Which is the primary additional health concern?

Type 2 diabetes

Which maternal behaviors during pregnancy can contribute to infant morbidity or mortality?

Using illicit drugs Smoking tobacco Consuming one alcoholic drink per week