PrepU Chapter 2: Factors Influencing Child Health

The nurse is taking a health history and examining a 3-year-old boy. Which action is most important for the parents to take?

protect from tobacco exposure.

The nurse educator has completed a presentation on caring for babies born to mothers with a substance use disorder. Which statement by a participant would indicate the need for further education?

"Babies born to a mother with a substance use disorder don't have any difficulty eating."

A child is seen in the pediatric clinic for update of immunizations prior to starting middle school. During the intake process the nurse asks the parents if the family is involved in any neighborhood or community activities. The parents ask the nurse, "What does that have to do with immunizations?" What is an accurate response by the nurse?

"Based on research, our physician feels that better connection to community leads to better health in many ways."

The student nurse is shadowing a registered nurse on the pediatric inpatient care unit. They are caring for a teen who has openly shared that she was adopted at birth. Which statement by the student nurse indicates the need for intervention by the nurse?

"Are you in contact with your real mother?"

A 4-year-old boy is residing permanently with his grandparents. Which situation is unique to this type of family or living arrangement?

physical and financial stress on the caregivers

The nurse is collecting information from the mother of 3-year-old twins. The records show the mother is single. When planning care, what topic is of the highest priority for the nurse to investigate?

support network

The student nurse is reviewing information about parenting styles. Which statements about parenting styles are incorrect? Select all that apply.

"Permissive parenting is associated with responsible, productive adults." "Authoritarian parenting styles are linked to the development of socially responsible adult behaviors." "No one parenting style has been shown to promote more responsibility in children and adults."

Parents have a 3-year-old boy with a difficult temperament. Which guidance will be most helpful for the nurse to provide?

"Provide a place for him to roughhouse."

The nurse is assessing the risk potential for infection for children on a pediatric unit, based on their developmental level. Which group does the nurse determine is at the highest risk for respiratory infections?

"Being a single parent must be really difficult. Can I offer you some information about a support group, Parents Without Partners?"

The nurse is caring for a child from a different culture. Which statement(s) by the nurse demonstrates an understanding of how culture impacts a client? Select all that apply.

"Culture can impact the diet a client follows." "Culture can impact who a client chooses to see for health care needs." "A client's cultural beliefs should be incorporated into the care a client receives. "A client's cultural beliefs can impact spirituality and/or religion."

A 14-year-old child shares with the nurse that she is adopted. She reports she was born in another country and now wishes she had more information about her ethnic and cultural background. She states her parents are not comfortable with this. What response by the nurse is most appropriate?

"Finding out about your culture may be enlightening for you."

The father of a child mentions to the nurse that he is very worried about his 14-year-old son because he is associating with a group of kids that get into trouble frequently. What responses by the nurse would be appropriate? Select all that apply.

"Have you thought about encouraging your son to become involved in a sport? This could occupy his time in a constructive way." "Are there any activities that your son likes? There are often clubs offered at schools for a variety of interests."

The nurse is assessing for violence in the home. Which statement by a parent would warrant further investigation?

"I don't think my children have seen my husband hit me."

A nurse is educating a group of parents during a community parenting class. One parent asks about spanking as a form of discipline. Which response(s) by the nurse is appropriate? Select all that apply.

"Over time, spanking becomes less effective as a tool to manage behaviors." "Children who are spanked often become passive and unable to confront personal issues." "The intensity of spanking must be increased to continue to obtain the desired behavior changes." "Spanking may result in unintentional physical injury to the child." "The child is taught that hitting or similar physical violence is acceptable."

The nurse is caring for a toddler in the clinic setting. The parent reports the child has begun having development and behavioral problems and "never slows down." What is the best response by the nurse?

"Is the child exposed to lead sources, such as paint, contaminated soil, or dust?"

A nursing instructor is discussing ways to promote safe internet use in children with a group of nursing students. Which statement by a student would indicate a need for further education?

"It is okay for a parent to place a computer in a child's room if it is used for homework."

The nurse is providing a class to a group of parents about child rearing. One of the participants reports that she regularly uses spanking as a form of discipline for her 5-year-old son. What is the best response by the nurse?

"Many studies show that spanking can lead to aggression in children."

The nurse is assessing for violence in the home. Which response by the mother represents the greatest risk to the child?

"My partner calls my child names."

The parents of a 16-year-old child are meeting with the pediatrician to discuss the behavior problems of their adolescent. Which statements by the parents about their parenting style are consistent with an authoritarian style? Select all that apply.

"She will thank us one day for outlining clear expectations for her behavior." "It is important that our daughter follow the rules of the household." "We tell our teen the rules of the household and the importance of her complying."

The nurse is doing an intake history on a 15-year-old client being admitted to a facility. Which statement(s) by the parents demonstrate effective means of discipline according to the American Academy of Pediatrics? Select all that apply.

"Taking away phone privileges from our child seems to work better than any other form of discipline." "We always try to sit down and talk to our child when in trouble instead of scolding the child."

The nurse is caring for a teen who has been hospitalized after a motor vehicle accident. The accident is believed to have been caused by alcohol and drug use. The teen states, "I fit in when I use marijuana and, besides, it is legal in some states." Which response by the nurse is most therapeutic?

"Tell me how you feel when you use marijuana."

The nurse is working with a group of parents at a community center. The nurse hears the parents talking about media use with their children. Which comment(s) by the parents indicate an understanding of media use among children? Select all that apply.

"Violence is so prevalent on TV that we are careful to monitor what our children watch." "We try to limit the amount of TV and movies our children watch and encourage playing outside." "Public television channels have a lot of great programs for children."

The nurse in a community clinic is speaking with the parents of a child. The parents are planning to get a divorce and discuss with the nurse how they plan on handling talking with their child. Which statements by the parents demonstrate an effective approach to speaking with their child? Select all that apply.

"We plan on reminding our child that the divorce is not their fault in any way." "We plan on seeking the advice of a counselor during this difficult transition." "We both plan on communicating with our child every day, no matter whose house our child is staying at the time."

A 13-year-old child tells the school nurse, "A lot of classmates talk bad about me and my parents because I have two moms and no dad. I am just so tired of dealing with this day after day." Which response by the nurse is most appropriate?

"You seem upset. I will write you a pass for class so we can talk."

The public health nurse is assessing the risk potential for suicide among a group of adolescents. Which adolescent would the nurse determine is at highest risk of dying from suicide?

17-year-old Native American/First Nations male adolescent who has poor school attendance

The nurse is providing an educational program for the staff working at a homeless shelter. The program is focused on the impact of homelessness on children. What information should be included in the presentation? Select all that apply.

Acute health conditions are increased in homeless children. Homeless children are at an increased risk for sexual abuse. Homeless children are at risk for developing chronic health problems.

To assess the sociocultural aspects of the family of an adolescent being seen in an ambulatory clinic, the nurse would try to find out more about:

Adolescent's family structure.

Personal space and distance is a cultural perspective that can impact nurse-client interactions. What is the best way for the nurse to interact with a client who has a different cultural perspective on space and distance?

Allow the client to adopt a position that is comfortable for him or her.

You see a 3-year-old girl in an ambulatory clinic because she has a bad cold. Her mother tells you the girl's problem was caused by her being affected by "mal ojo." What would be the best action?

Ask her mother what symptoms her daughter is experiencing.

The nurse notes that a 5-year-old boy is approaching obesity. Which is the priority intervention?

Assessing the diet of the child and family

The nurse is caring for a 7-year-old child who is being treated for multiple fractures after being involved in an automobile accident. The nurse observes that the father frequently takes on the role of nurturer in the family. When planning care, which nursing intervention would most involve the father?

Bathing the child

A homeless single mother and her 6-year-old child present to the emergency room with vomiting and diarrhea. Nurses provide illness care. Shelter is found. An additional priority goal is:

Enroll child into school

The school nurse notes that a 10-year-old child has not had the required immunizations to attend classes. During discussion, the child states that his father lost his job and health insurance. What is the best action by the nurse?

Contact the parents to inform them of the situation and community resources that can be utilized to obtain immunizations.

The nurse is preparing to teach a class on cultural differences to a group of clients from the community. Which principle of culture will the nurse consider while planning the class information?

Each generation learns about culture from family and the community.

A 12-year-old child has low resiliency. The parent has asked for tips in working with the child to promote the improvement of this trait. What would be the most effective advice the nurse can provide to the parent?

Encourage the child's parent to assist the child to set short-term goals for identified projects.

The nurse is caring for a family with a terminally ill child who is actively dying. The family practices the Buddhist faith. What would the nurse further assess for this family?

How the room can be arranged to accommodate the last right chanting after death

The nurse is talking with an adopted child and the family. Which statement represents "positive" adoption language?

The birth mother was how old when your child was born? EXPLAINED: Birth mother, not natural or real mother, is a positive term for the biological parent, as is simply parent for the adoptive mother or father. The adopted child is just a child and not someone given up or given away. Saying an adoption plan was followed makes a positive statement.

A woman has presented to the clinic with her sick school-aged child. The child's mother reports she rarely has enough money to meet the health care needs of her chronically ill child. What information should be provided to the woman?

Medicaid may be available to low-income parents and their children.

The mother of a 12-year-old boy is concerned about the dangers of the Internet. Which suggestion by the nurse best targets safety related to this?

Never share personal information online.

The charge nurse overhears another nurse state, "I do not like caring for clients from a culture different from my own." Which action by the charge nurse is appropriate?

Privately discuss the comment with the nurse.

During the data collection in a well-child visit the parent reports divorcing the spouse about 6 months ago. The parent is concerned about the child's well-being and asks for input on the effects of divorce. Which statements by the parent demonstrates the need for further education? Select all that apply.

The largest number of problems noted in the child are most visible 3 to 5 years after the divorce. An estimated 50% of children of divorce may have problems with relationships in the future.

The mother of a child who has been termed to have a "difficult" temperament voices frustration in managing his care. What would be the best initial course of action by the nurse for this parent?

Review strategies that are beneficial in the care of a child with a difficult temperament.

Over coffee following a worship service, parents ask the parish nurse for guidance in disciplining their children ages 4 years, 9 years, and 14 years. What concepts will guide the nurse's response? Select all that apply.

Role model appropriate behavior in word and deed. Use parental attention as positive reinforcement for desired behaviors. Maintain consistency in expectations at all ages.

The hospice nurse observes the family of a child with a terminal illness interacting with the child. According to Friedman's structural functional theory, which action(s) by the family demonstrate affective functioning? Select all that apply.

Siblings frequently play games with the child. The parents read to the child at bedtime every night.

A nursing student asks the instructor why nurses focus on assessing sociocultural aspects of clients. Which response from the nurse is most accurate?

Such assessment can reveal why people take certain preventive or treatment measures related to their health.

An 8-year-old seeks out the school nurse crying because she was recently told her parents would divorce. What is the most important idea the nurse will help the child grasp?

The divorce is not her fault.

The nurse is scheduled to work in a clinic in a neighborhood with many diverse cultures. Which action(s) by the nurse demonstrate cultural competence? Select all that apply

The nurse asks the child or family about the use of folk remedies. The nurse learns about the demographic of the neighborhood. The nurse researches folk healers in the area. The nurse speaks to the father regarding health care decisions.

The hospice nurse observes the family of a child with a terminal illness interacting with the child. The siblings frequently play games with the child and the parents often read to the child. According to Friedman's structural functional theory, the nurse determines that the family is demonstrating which function?

affective function

A 10-year-old girl is living with her grandparents. Which nursing intervention is most important with this family structure?

assessing the child for emotional problems

The nurse is assessing a woman who is pregnant. Her health history reveals she has three young adult children. Which nursing intervention would be most appropriate according to Duvall's developmental theory?

assessing the parent's coping abilities

The nurse is assessing an adolescent. When discussing his parents, the adolescent states that his parents have very strict rules and he is expected to follow them. If he breaks a rule, he is punished. The nurse is aware that this is which parenting style?

authoritarian

While caring for a hospitalized child, the nurse notes the parent does not take into consideration the wishes or opinions of the child. During a period of discussion, the parent states "My child needs clear rules and knows I expect my child to do as I say." This is consistent with which style of parenting?

authoritarian

A client who just learned she is pregnant says, "I can no longer eat strawberries, even though they are my favorite." What best explains this statement?

cultural related

A nurse is reviewing a journal article that describes a view of the world and a set of traditions that a specific social group uses and transmits to the next generation. The nurse is reading an article about which concept?

culture

A client family recently moved to the United States. They live with their relatives, who were already residing in the United States. This is an example of which family form?

extended family

First-time parents are discussing temperament with the nurse. They describe their child as easily frustrated by his toys and withdrawing from anything new. Overall, he is quite physically active and can become irritated easily. The nurse believes this child could be categorized as:

difficult

During a well-child care visit, the mother of a 4-year-old child reports her son is extremely active at home and cries easily if frustrated. This is consistent with which level of the classic temperament theory?

difficult temperament

When caring for a woman in her sixth month of pregnancy, the client reports her plans to nurse her baby for at least 2 to 3 years like the rest of the women in her family. Based upon the nurse's knowledge, the nurse should:

document her report but do nothing as this is a cultural belief that should be respected.

Native Americans who are wearing their tribal dress are demonstrating their native dance to a community group. This is an example of:

ethnicity

A Native American who has just delivered her first child asks the nurse if she might have the placenta to take home. The nurse tells a co-worker that she thought it was the most bizarre request she has ever heard. This is an example of which type of behavior by the nurse?

ethnocentrism

A boy tells you that his family celebrates the Fourth of July by eating out at a local restaurant. He tells you this is a better way to celebrate the holiday than having a picnic like his neighbors. This statement is an example of:

ethnocentrism

During a parenting class, the nurse gives examples of extinction as a form of discipline. What would be an example of this technique?

ignoring a temper tantrum

A girl comes from a large family that you analyze as being extended. In planning hospital care for her, which factor would be most important for you consider?

organizing nursing care at times other than visiting hours