Ricci Chapter 31: Health Supervision PrepU

A dental home (like a medical home) establishes a continuing comprehensive relationship of care with the child and family. The American Academy of Pediatric Dentistry (AAPD) recommends this dental home be established by the time the child is age: 1 year. 1½ years. 3 years. 2 years. 2½ years.

1 year.

The school nurse has just finished an educational program for the children at a local elementary school. Which statement by a student would indicate a need for further education? "I always pick chocolate milk instead of juice boxes for lunch." "I love to eat dry cereal for breakfast." "I always drink a big glass of milk before school." "My mom put's frozen grapes in my lunch box."

"I love to eat dry cereal for breakfast."

The mother of a 1-month-old baby is scheduling the next well-child visit for her baby. Which statement by the mother indicates an understanding of the recommended appointment schedule? "My baby will need to again be seen when he is 2 months old." "I will need to schedule an appointment for my baby to be seen when he is 3 months old." "My baby should be seen monthly for the first year of life." "Unless there is a problem I do not need to bring my baby back to be seen until he is 6 months old."

"My baby will need to again be seen when he is 2 months old."

A mother tells the nurse that she is newly pregnant and asks about her 15-month-old's need for the chicken pox immunization because her two older children did "fine" when they had the disease. What is the nurse's best response? "When your child avoids chicken pox, it protects other children from being exposed to the disease. Some cannot be immunized because of their health conditions." "Your toddler should not receive this live-virus immunization today. It may present a risk to your pregnancy." "When chicken pox can be avoided, why not do so?" "I realize that the vaccine is somewhat costly, but it is likely to be more economical than dealing with chicken pox."

"When your child avoids chicken pox, it protects other children from being exposed to the disease. Some cannot be immunized because of their health conditions."

The nurse is performing an Apgar test on a newborn. The newborn is at high risk for a hearing deficit because the infant's 1-minute Apgar score fell below what number? 6 4 5 7

4

The mother of a 5-year-old with eczema is getting a check-up for her child before school starts. Which action should the nurse take during the visit? Change the bandage on a cut on the child's hand Assess how the family is coping with the chronic illness Discuss systemic corticosteroid therapy Assess the child's fluid volume

Assess how the family is coping with the chronic illness

During the health history of a 2-week-old neonate, the nurse discovers the child has not yet had a hearing screening. What test should the nurse schedule? Rinne test Weber test Auditory brain stem response test Tympanometry

Auditory brain stem response test

A nurse is working to provide health promotion services throughout the community. What institutions or organizations best serve as important avenues for disseminating health promotion information? Select all that apply. Churches, synagogues, and mosques Day care centers Political organizations Environmental groups Schools (public and private)

Churches, synagogues, and mosques Schools (public and private) Day care centers

The nurse is caring for a family and their internationally adopted child. The parents indicate the child was adopted and brought to the United States 7 days ago. What recommendation would the nurse give the family? Update the child's medical record within the next 8 weeks at their medical home Postpone vaccines if the child has a low grade fever or respiratory illness Complete a comprehensive health screening within the next week Assure the child has completed Hepatitis B, C and A screening in their home country

Complete a comprehensive health screening within the next week

A nursing student is asked to provide reasons it is important for the physician or nurse practitioner to have knowledge of the community in which the families and children seen in the practice live. Select all that apply. Awareness of agencies serving children results from knowing the community. Knowing the community is necessary in developing appropriate health surveillance programs. Understanding the community promotes improved working relationships between families and physicians or nurse practitioners. The community can be a contributor to child-family health or a cause of illness.

Correct response: The community can be a contributor to child-family health or a cause of illness. Knowing the community is necessary in developing appropriate health surveillance programs. Awareness of agencies serving children results from knowing the community. Understanding the community promotes improved working relationships between families and physicians or nurse practitioners.

Parents report that their 4-year-old is difficult to understand. Which screening tool will the nurse use? Bayley Scale Denver II Developmental Screening Test (Denver II) Denver Articulation Screening Goodenough-Harris Drawing Test

Denver Articulation Screening

The 4-year-old due for the DTaP, IVP, MMR, and varicella vaccines has a runny nose, slight cough, and temperature of 99° F (37.2° C). What should be the response of the nurse? Provide the well-child exam and give all the immunizations except the MMR. Reschedule the visit. Do the well-child exam and give the immunizations due. Complete the well-child exam and reschedule the immunizations. Suggest fever and cough control for home care, do the well-child exam, and reschedule the immunizations.

Do the well-child exam and give the immunizations due.

Infants born to mothers who are HbsAg-positive need to receive the hepatitis B immunoglobulin (HBIg) within how many hours? HBIg needs to be given within 4 hours. HBIg needs to be given within 24 hours. HBIg needs to be given within 8 hours. HBIg needs to be given within 12 hours.

HBIg needs to be given within 12 hours.

A nurse asking questions during an infant's health surveillance visit has the mother tell her: "My baby was premature and weighed 3 pounds at birth." The medical record provides an Apgar score of 5 at 5 minutes and indicates the child received gentamicin in the neonatal intensive care unit (NICU). What should the nurse consider as the greatest risk for this child? Hypertension Eating disorder Hearing deficit Visual deficit Gross motor problems

Hearing deficit

Parents report that their neonate received intravenous antibiotics while in the newborn nursery. The nurse recognizes this as a potential risk factor for which health problem? Hearing impairment Difficulty with fine motor skills Visual disorder Articulation difficulties

Hearing impairment

The nurse is preparing to administer the diphtheria, tetanus, and pertussis (DTaP) vaccine to an infant. Which route will the nurse utilize? Subcutaneous Intramuscular Oral Intrathecal

Intramuscular All diphtheria, tetanus, and pertussis vaccines (TDaP, TD, Tdap) are administered intramuscularly to children of all ages. A needle of appropriate length must be used to reach the muscle and avoid depositing the vaccine in subcutaneous tissue.

The nurse is doing a health history for a 14-year-old pregnant girl during a health supervision visit. For which condition should she be screened? Hyperlipidemia Iron-deficiency anemia Lead level Congenital problems

Iron-deficiency anemia

The nurse is performing a vision screening for a 2-month-old. Which technique should the nurse use? Move a small stuffed panda to midline. Hold a photo of a clown 10 to 12 inches in front of the child. Move a card with a black-and-white checkerboard pattern in a 180-degree arc past the infant. Move a colorful toy through the field of vision.

Move a card with a black-and-white checkerboard pattern in a 180-degree arc past the infant.

The nurse working with children and families knows there are certain universal screening tests all children should receive. Which tests are included in this group? Select all that apply. Denver II Auditory brain stem response Hyperlipidemia Phenylketonuria Lead levels

Phenylketonuria Auditory brain stem response

Which children will the nurse avoid immunizing with a live-virus vaccine? Select all that apply. Two-month-old infant Toddler with constipation Pregnant teen Preschooler receiving radiation therapy School-age patient with fractured arm

Preschooler receiving radiation therapy Pregnant teen

During the health history, the parent of a 10-year-old child mentions the child seems to have trouble hearing. Which test is the nurse most likely to use? Rinne test Auditory brain stem response test Evoked otoacoustic emissions test Whisper test

Rinne test

The mother of a 4-month-old refuses for her baby to be "stuck" when immunized. What immunization will the nurse administer under these restrictions? Polio Haemophilus influenzae Hepatitis A Rotavirus

Rotavirus

A nurse is conducting visual acuity screening for a 6-year-old child. Assessment reveals that the child knows the alphabet. Which tool would be most appropriate for the nurse to use to screen this child's vision? Allen object recognition tool Tumbling E Ishihara tool Snellen eye chart

Snellen eye chart

The community nurse is preparing an educational session on how to provide anticipatory guidance to clients for other nurses. Which example will the nurse include in the teaching? Ordering the prescribed diet for a child who had surgery Providing vaccinations to the children in a community Taking a child's vital signs Teaching handwashing at an elementary school

Teaching handwashing at an elementary school

The nurse will administer which recommended immunizations to an 11- or 12-year-old patient during a wellness visit? Select all that apply. Varicella Hepatitis A (HepA) Human papillomavirus (HPV) Meningococcal vaccine (MCV) Tetanus, diphtheria, pertussis (Tdap)

Tetanus, diphtheria, pertussis (Tdap) Human papillomavirus (HPV) Meningococcal vaccine (MCV)

During the health history of a 2-month-old infant, the nurse identified a risk factor for developmental delay and is preparing to screen the child's development. Which risk might the nurse have found? The child was born at 36 weeks. The parents are both in college. The child has small eyes and chin. The child had neonatal conjunctivitis.

The child has small eyes and chin.

The nurse is conducting education with a group of community partners regarding mandatory metabolic screenings for newborns. The nurse would identify the recommended screening tests be conducted for specific diseases for what reason? These screenings permit multiple levels of assistance to be available to the parents These screenings alert the parents to the diseases their child has which are curable These screenings allow parents to understand their child's conditions These screenings are for diseases that have treatments available for the child

These screenings are for diseases that have treatments available for the child

The nursing instructor has just completed a discussion about immunization. Which statement by a student would indicate a need for further instruction? "Passive immunity only lasts a few weeks or months." "Immunologic memory develops after a person receives a vaccine." "Active immunity develops when a person receives a vaccine." "An example of active immunity would be when immunoglobulins are passed from a mother to her infant by colostrum."

"An example of active immunity would be when immunoglobulins are passed from a mother to her infant by colostrum."

The nurse manager is orienting a new nurse. Which statement by the new nurse would indicate that the nurse manager should intervene? "I do not need to document the vaccine manufacturer's name in the child's permanent record." "I will document the date and time the vaccine was given in the child's permanent record." "If a child receives a vaccine at another facility, we will need to document it in the child's permanent record." "If a child has a fever after a vaccine, I do not have to report it to the Vaccine Adverse Event Reporting System."

"I do not need to document the vaccine manufacturer's name in the child's permanent record."

The mother of a 6-month-old child reports she has been hearing so much about autism. She questions if this is something that can be tested for. What response by the nurse is appropriate? "Autism is on the rise and I understand your concern but screening is only done for those children considered to be at an increased risk." "Screening is recommended between 18 and 24 months or when concerns are identified." "Unfortunately there are no reliable screening tools for autism available." "Your child is too young for screening at this time."

"Screening is recommended between 18 and 24 months or when concerns are identified."

The nurse is performing an Apgar test on a newborn. The newborn is at high risk for a hearing deficit because the infant's 1-minute Apgar score fell below what number? 6 5 7 4

4

Choose the options that will assist nurses in overcoming some of the barriers to having children fully immunized. Select all that apply. Checking the immunization status of siblings who accompany the child who has the healthcare appointment Using every health contact with the child (hospital, urgent care, emergency, and well-child visits) to check status/administer vaccines Using separate vaccines (except the well-known DTaP) so parents can more readily track/understand immunizations received Using combination vaccines to reduce the number of injections children receive Having parents postpone all immunizations when they are concerned about certain vaccines

Checking the immunization status of siblings who accompany the child who has the healthcare appointment Using every health contact with the child (hospital, urgent care, emergency, and well-child visits) to check status/administer vaccines Using combination vaccines to reduce the number of injections children receive

Before administering an immunization to their child, the nurse asks parents to take which priority action? Assist in restraining the child Sign a consent form Provide the child's immunization record Reassure the child

Sign a consent form

The nurse is discussing healthy eating with the parents of a school-age client. Which statement by the parents indicates additional teaching is needed? "It is more important for our child to get sleep than eat breakfast." "Since our child does not like broccoli, we will not put it on our child's plate." "We will limit our child's snacks to after school and bedtime." "We will freeze fruits before putting them in our child's lunchbox."

"It is more important for our child to get sleep than eat breakfast."

The student nurse is working on a program to address barriers to immunizations. Which would be an example of an intervention that the student nurse should include? Providing combination vaccines to reduce the number of shots the child is to receive. Schedule separate appointments for families with multiple children so the focus will be on one child at a time during the visit. Providing education that free vaccines are only given by the local public health agencies. Providing a modified vaccine schedule to allow for more time between vaccines.

Providing combination vaccines to reduce the number of shots the child is to receive.

Which question by the nurse is the best one to elicit complete information about a young boy's immunization status? "Are your son's immunizations up-to-date?" "When and where did your child receive his last immunization?" "Do you have any questions about the immunizations children need at various ages?" "Tell me which immunizations your child needs today."

"When and where did your child receive his last immunization?"

The nurse is mentoring a newly licensed nurse in the health clinic, talking with the single mother of an infant. The mother was 10 minutes late to the appointment and is concerned the clinic will not allow the health visit to be conducted today. Which statement by the newly licensed nurse would alert the nurse to provide additional teaching to the newly licensed nurse? "It is important to be current with your baby's progress, so we will see her today." "Why don't you plan to have your retired neighbor bring the baby next time since having the parent with the baby isn't necessary?" "Follow me into the private exam room so we can discuss any concerns you have about your baby." "I know work schedules can make getting to appointment on time difficult and I am glad you are here now."

"Why don't you plan to have your retired neighbor bring the baby next time since having the parent with the baby isn't necessary?"

The nurse will use the Denver Articulation Screening for children in what age range? 0 to 2 years 6 months to one year 2 1/2 to 7 years 6 to 10 years

2 1/2 to 7 years

The nurse is providing education to a group of parents concerning safety and sun exposure. Which statement by a participant indicates the need for further instruction? "It is important I use sun screen on my 4-month-old child." "I should apply sunscreen to my child even if we are outside for only 15 minutes." "Hourly application of sunscreen is needed if my child is perspiring." "Sunscreen should be applied about 30 minutes prior to sun exposure."

"It is important I use sun screen on my 4-month-old child."

The nurse is talking with the grandparent of an infant born at 32 weeks' gestation to an adolescent mother who states, "I am concerned my grandbaby will have developmental problems." Which response by the nurse is most appropriate? "We cannot know the outcomes for your grandchild at this point in time." "The risks of developmental concerns are heightened for your grandchild." "Children born to adolescent mothers will likely have developmental delays." "Premature children often have problems."

"The risks of developmental concerns are heightened for your grandchild."

The parents of a 12-month-old child tell the nurse the child has stopped walking and is now only crawling or sitting with support. How should the nurse respond? "Every child develops at different rates. Don't be alarmed. Just enjoy your child!" "Children often regress in their developmental stages...no need to worry." "If you continue to notice these changes, we should follow up within the next 3 months." "This is a concern. Let's be sure the physician is aware of this change."

"This is a concern. Let's be sure the physician is aware of this change."

The nurse is discussing healthy eating habits with a school-age child and her parents. Which recommendation would the nurse make for the family? Light snacks should be offered so the child doesn't overeat at meals Carbohydrates at breakfast will give a child energy to start the day When serving a food the child doesn't like, insist they take several bites A bedtime snack should be part of the child's bedtime ritual/pattern

Light snacks should be offered so the child doesn't overeat at meals

The nurse will record what information about each vaccine after immunizing a child? Select all that apply. Whether bacterial or viral Lot number and expiration date of vaccine Manufacturer of vaccine How vaccine was stored Site and route of vaccine administration

Lot number and expiration date of vaccine Site and route of vaccine administration Manufacturer of vaccine

The nursing staff at the clinic are discussing the best way to encourage cooperation from young pediatric clients during screenings. Which suggestion would be appropriate? Purchase stickers or make coloring pages to be given to the children after the screening is completed. Encourage the children to play with the dressings, syringes and medication before using them. Make a coloring page and allow the child to color it completely before beginning the screening. Allow the children to chose whether to get the screening completed that day or another day.

Purchase stickers or make coloring pages to be given to the children after the screening is completed.

The 4-year-old due for the DTaP, IVP, MMR, and varicella vaccines has a runny nose, slight cough, and temperature of 99° F (37.2° C). What should be the response of the nurse? Provide the well-child exam and give all the immunizations except the MMR. Complete the well-child exam and reschedule the immunizations. Suggest fever and cough control for home care, do the well-child exam, and reschedule the immunizations. Do the well-child exam and give the immunizations due. Reschedule the visit.

Do the well-child exam and give the immunizations due.

Which nurse response to the parent indicates the nurse recognizes the importance of the child's increasing responsibility for their personal heath choice? "I suggest you offer your toddler healthy snacks after school and at bedtime rather than after dinner." "If your school-aged child isn't current on immunizations, we can work to get them caught up." "I am so glad you are reading to your baby, especially during feeding time." "I recommend you talk with your adolescent child and discuss their preference for which dentist to visit."

"I recommend you talk with your adolescent child and discuss their preference for which dentist to visit."

The school nurse has completed an educational program about vaccines to a group of parents. Which statement by a parent would indicate the need for further education? "I only need to worry about the Hib vaccine if my kids are under 5 years old." "My 14-month-old will need a Hib vaccine booster." "The Hib vaccine helps to prevent infections such as meningitis, epiglottitis and septic arthritis." "My 7-year-old will need to get a Hib booster at his next checkup."

"My 7-year-old will need to get a Hib booster at his next checkup."

The nurse prepares to administer the measles, mumps and rubella (MMR) vaccine to a child. What statement by the child's parent would alert the nurse to avoid giving the vaccine? "My child breaks out in a rash sometimes just after eating eggs." "My child had gelatin at day care and broke out in hives afterwards." "I am so glad you are able to give the varicella vaccine today." "I am so excited. I just found out I am 10 weeks' pregnant."

"My child had gelatin at day care and broke out in hives afterwards."

When working in a very busy pediatric office or clinic, nurses could substitute which screening test for the Denver II Developmental Screening Test to detect delays that otherwise could be missed? Denver Articulation Screening Goodenough-Harris Drawing Test Denver Prescreening Developmental Questionnaire (R-PDQ) Bayley Scale

Denver Prescreening Developmental Questionnaire (R-PDQ)

The nurse is working with an adolescent to promote a healthy weight. Which goal would be appropriate for the nurse and adolescent to work towards? Weight loss of 1 to 2 pounds per week on average Limiting computer/TV time Weekly physical activity of 60 minutes Weighing on the scales weekly and recording

Limiting computer/TV time

The nurse works at a health clinic located in a suburb of a large city. Which action by the health clinic will further enhance the bond between child, family and community? Discontinuing the practice of two evenings a week being set aside for walk-in visits Setting up screenings in a public library downtown Telling a family to take a taxi to the clinic if transportation is a concern Scheduling the last appointment each weekday at 3:30pm

Setting up screenings in a public library downtown

During the health history of a 3-month-old, the nurse identified risk factors for developmental delay and is preparing to assess the child's development. Which risk factors did the nurse find? Select all that apply. The mother did not complete high school. The infant's mother is a single parent. A sibling was born prematurely. The infant was delivered via a scheduled cesarean section.

The infant's mother is a single parent. The mother did not complete high school.

Which situation would indicate the nurse is facilitating trust in the family members decisions about their child's health? The nurse discourages the parents from following the advice of a grandparent regarding parenting approaches. The nurse teaches the family about side effects of a prescribed medication without first assessing their knowledge about the medication. The nurse recommends the parents review the list of available specialists before they select one for referral. The nurse ask the parent why the used a home remedy cream on the child's rash before being seen at the clinic.

The nurse recommends the parents review the list of available specialists before they select one for referral.

During a health visit, the parents of a 6-month-old ask the nurse when to take the infant for the first dental visit. What would the nurse recommend? The dental home should be established by the time the child has their first birthday. The child should be seen by a dentist by 6 years of age, if the child has good oral health habits. The child should be seen by a dentist only if there is concern of caries, decay or infection. The first dental visit should be completed within a month of the first tooth erupting.

The dental home should be established by the time the child has their first birthday.

The nurse is anticipating that health supervision for a 5-year-old child will be challenging. Which indicator supports this concern? Grandparents play a significant role in the family. The child has a number of chores and responsibilities. The mother dotes on the child. The home is in a high-crime neighborhood.

The home is in a high-crime neighborhood.

Place in proper order the vision screening procedures used by the nurse to assess children from neonate to school age. Click an option, hold and drag it to the desired position, or click an option to highlight it and move it up or down in the order using the arrows to the left. 1Follow object to the midline 2Follow object past midline 3Fixate on an object at 10 to 12 inches 4Respond to E chart 5Use Snellen test for visual acuity

Fixate on an object at 10 to 12 inches Follow object to midline Follow object past midline Respond to E chart Use Snellen test for visual acuity

Using the recommended immunization schedule for infants, the nurse administers vaccines in what order from first to last? Click an option, hold and drag it to the desired position, or click an option to highlight it and move it up or down in the order using the arrows to the left. 1Measles, mumps, rubella (MMR) 2Hepatitis B (HepB) 3Influenza 4Rotavirus (RV)

Hepatitis B (HepB) Rotavirus (RV) Influenza Measles, mumps, rubella (MMR)

Curious parents ask what type of immunity is provided to their child through immunization with various vaccines. What will be the nurse's answer? Naturally acquired active immunity Artificially acquired active immunity Artificially acquired passive immunity Naturally acquired passive immunity

Artificially acquired active immunity

The parents of a child asks the nurse why it is recommended that their child be screened for intestinal parasites. What would be the response by the nurse? "The treatment for intestinal parasites is expensive so screening will indicate if treatment is necessary." "Very few children have intestinal parasites, but we still have to test children for them." "The child will be treated at the public school, so a screening is recommended now." "Children with intestinal parasites often exhibit no signs or symptoms, so a screening is recommended."

"Children with intestinal parasites often exhibit no signs or symptoms, so a screening is recommended."

The nurse is counseling a pregnant adolescent about the health benefits associated with breastfeeding. Which statement by the client indicates understanding? "Breastfeeding my baby will pass on a type of active immunity." "Breastfeeding my baby will help to stimulate my baby's immune system to activate." "Breastfeeding my baby will provide lifelong immunity against certain diseases." "Breastfeeding my baby will pass on passive immunity."

"Breastfeeding my baby will pass on passive immunity." Passive immunity results when immunoglobulins are passed from one person to another. This immunity is temporary. This is the type of immunity that takes place when a mother breastfeeds her child. Active immunity results when an individual's own immunity generates an immune response.

The nurse has just finished administering the DTaP vaccine to a 2-month-old and is educating the parent about immunization. Which statement is accurate? "There are no side effects from this vaccine." "You need to renew this immunization every 10 years." "The 'T' stands for tuberculosis." "Bring her back for the second dose when she is 4 months old."

"Bring her back for the second dose when she is 4 months old."

The student nurse asks the nursing instructor why nurses must be adept at understanding normal growth and development in children when providing care. What should the nursing instructor respond? "Understanding normal growth and development is vital because it allows the nurse to administer the correct doses of medication to children." "By knowing normal growth and development, the nurse is able to identify problems in growth and development." "The nurse must understand normal development in order to measure the child's height and weight accurately." "If the nurse understands normal growth and development, the nurse will be able to identify normal milestones in children."

"By knowing normal growth and development, the nurse is able to identify problems in growth and development."

The nurse is employed at a clinic that provides services to a large population of clients from a culture with a present-based orientation. When providing education about proper nutrition to a family from this culture, which would be the best response by the nurse? "Eating a healthy breakfast will give your child the energy to stay awake and focused during school each day." "Eating a well-balanced diet that includes fresh fruits and vegetables, your child will not be at risk for becoming obese in the future." "Eating a diet low in fat will help to reduce the risk of colon cancer in your child when they get older." "Eating a diet that is healthy will greatly reduce risk factors for several chronic diseases that occur later in life.

"Eating a healthy breakfast will give your child the energy to stay awake and focused during school each day."

The nurse is providing education to a group of parents concerning safety and sun exposure. Which statement by a participant indicates the need for further instruction? "It is important I use sun screen on my 4-month-old child." "Sunscreen should be applied about 30 minutes prior to sun exposure." "Hourly application of sunscreen is needed if my child is perspiring." "I should apply sunscreen to my child even if we are outside for only 15 minutes."

"It is important I use sun screen on my 4-month-old child."

The nurse is discussing healthy eating with the parents of a school-age client. Which statement by the parents indicates additional teaching is needed? "We will limit our child's snacks to after school and bedtime." "We will freeze fruits before putting them in our child's lunchbox." "Since our child does not like broccoli, we will not put it on our child's plate." "It is more important for our child to get sleep than eat breakfast."

"It is more important for our child to get sleep than eat breakfast."

The mother of a 1-month-old baby is scheduling the next well-child visit for her baby. Which statement by the mother indicates an understanding of the recommended appointment schedule? "I will need to schedule an appointment for my baby to be seen when he is 3 months old." "Unless there is a problem I do not need to bring my baby back to be seen until he is 6 months old." "My baby will need to again be seen when he is 2 months old." "My baby should be seen monthly for the first year of life."

"My baby will need to again be seen when he is 2 months old."

The nurse is caring for families at a health clinic. Which statement by a client would indicate to the nurse the health clinic could be more effective at providing health supervision to this community? "My husband takes off work to go to the clinic with our child so he can relay the visit details to me in our language." "When I arrived, I found an area in the waiting room playing my toddler's favorite movie." "The clinic offered me a list of resources that I can access via the citywide transportation system." "I ride the bus from my apartment that drops us off at the corner where the clinic is located."

"My husband takes off work to go to the clinic with our child so he can relay the visit details to me in our language."

During a physical assessment of a 6-year-old child, the nurse observes the child has lost a tooth. The nurse uses the opportunity to promote oral health care with the child and parents. Which comment should the nurse include in this discussion? "Try to keep the child's hands out of the mouth." "Oral health can affect general health." "Limit the amount of soft drinks in the child's diet." "Fluoridated water has significantly reduced cavities."

"Oral health can affect general health."

What would the nurse respond when the parent asks the nurse why the nurse is using pictures with high contrast patterns to assess their 4-month-old's vision? "Children respond emotionally better to black and white patterns and pictures." "The child's eyes are more attune to high contrast patterns than to specific colors." "A child's color vision isn't well developed until 12 to 18 months of age or later." "This allows us to assess for color blindness in infants younger than 6 months."

"The child's eyes are more attune to high contrast patterns than to specific colors."

The parents of a toddler adopted from an area outside the United States ask the nurse why their child would need testing for infectious diseases since the child was tested as a newborn in the child's home country. Which response by the nurse would be appropriate? "The testing may have been unreliable due to outdated testing supplies, poor storage of testing supplies and unreliable documentation." "The testing needs repeated so your child can have an up-to-date record at our primary physician's office." "Your child needs tested again because most newborns are immunocompromised and test negative at birth." "Your child is likely to have received excellent treatment for infectious diseases as a newborn in their home country but we need to repeat the testing again."

"The testing may have been unreliable due to outdated testing supplies, poor storage of testing supplies and unreliable documentation."

The nurse is discussing measles, mumps, and rubella vaccination with a mother who is concerned about using the combined vaccine for her 12-month-old. Which statements by the nurse will be most helpful to the mother in accepting the vaccine? "This vaccine is approved by the American Academy of Pediatrics." "This vaccine is recommended by the Centers for Disease Control and Prevention." "The vaccine is shown to be effective and safe and will reduce the number of injections your child will need." "It is one of the most commonly used childhood vaccines."

"The vaccine is shown to be effective and safe and will reduce the number of injections your child will need."

During a well-child visit for a 2-month-old infant, the nurse explains the need to perform a hearing screening on the child within the next few months. The child's mother reports she has not noticed any deficits and does not see the need for this being done. Which response by the nurse is indicated? "Hearing deficits related to neurological problems are often not noticeable by parental observations." "Unfortunately hearing losses in infants are common and it is best to check hearing before your child is 6 months old to rule out problems." "Hearing loss related to sensory concerns are often not noticeable by parental observations." "Since you do not see any issues we can wait to test at a later time."

"Unfortunately hearing losses in infants are common and it is best to check hearing before your child is 6 months old to rule out problems."

Which statements by a parent would indicate to the nurse that the family has a future-based orientation? Select all that apply. "We will fill our son's prescription for asthma prevention medication today in case he has another asthma attack." "Heart problems run in our family, I don't think it matters how healthy our son eats." "We will get our son vaccinated for varicella. We don't want him to get chickenpox." "We limit the amount of TV our children watch and are sure they get enough physical activity." "We will wait until our daughter's high glucose level causes her problems before we treat it."

"We will fill our son's prescription for asthma prevention medication today in case he has another asthma attack." "We will get our son vaccinated for varicella. We don't want him to get chickenpox." "We limit the amount of TV our children watch and are sure they get enough physical activity."

A mother calls the doctor's office to let them know that her son has had a fever and a runny nose. The mother wants to know if she should still bring him for his 15-month immunizations. What is the appropriate response from the nurse? "Yes, bring him in, but we will not do his shots today." "No, do not bring him until his symptoms subside." "Yes, bring him in, he can still have his shots." "No, do not bring Jacob in today."

"Yes, bring him in, he can still have his shots."

The nurse is reviewing a group of medical records for compliance with recommended well-child care visits. Which finding would warrant further investigation? A 13-year-old child who was last seen 2 years ago. The 5-year-old child who has been seen annually since age 3. A child who is 5 months old who was seen at one, two, and three months of age. A child who is 26 months whose last 2 visits were at 18 and 24 months.

A 13-year-old child who was last seen 2 years ago.

The nurse will expect that which hearing test will be performed before the newborn is discharged home? Tympanometry Auditory brainstem response Pure-tone audiometry Whisper test

Auditory brainstem response

The nurse is caring for a variety of pediatric clients in the community health clinic. Which client is the nurse most concerned with being at risk for iron-deficiency anemia? A 2-month-old infant who breastfeeds A 7-year-old active in competitive sports and activities A 7-month-old with supplemental breast feeding A 16-year-old, pregnant for the first time and lives with her parents

A 16-year-old, pregnant for the first time and lives with her parents

A nurse is working at a busy pediatric clinic and is scheduled to see several children this morning to conduct health supervision. Which child would the nurse expect to screen for hypertension? An 18-month-old with a history of ear infections A 1-year-old child who was born at term A 2-year-old child with a fever A 3-year-old child in for a well-child visit

A 3-year-old child in for a well-child visit

Nurses use standardized materials to administer the Denver II Developmental Screening Test. What are some of the materials included in the test kit? Select all that apply. Shapes to fit into corresponding openings Cards with letters of the alphabet Blocks to stack Raisins to place in a bottle A ball to throw and catch

A ball to throw and catch Blocks to stack Raisins to place in a bottle

Choose the options that will assist nurses in overcoming some of the barriers to having children fully immunized. Select all that apply. Checking the immunization status of siblings who accompany the child who has the healthcare appointment Having parents postpone all immunizations when they are concerned about certain vaccines Using every health contact with the child (hospital, urgent care, emergency, and well-child visits) to check status/administer vaccines Using combination vaccines to reduce the number of injections children receive Using separate vaccines (except the well-known DTaP) so parents can more readily track/understand immunizations received

Checking the immunization status of siblings who accompany the child who has the healthcare appointment Using every health contact with the child (hospital, urgent care, emergency, and well-child visits) to check status/administer vaccines Using combination vaccines to reduce the number of injections children receive

A nurse is working to provide health promotion services throughout the community. What institutions or organizations best serve as important avenues for disseminating health promotion information? Select all that apply. Churches, synagogues, and mosques Schools (public and private) Day care centers Environmental groups Political organizations

Churches, synagogues, and mosques Schools (public and private) Day care centers

The nurse is preparing to administer a routine vaccine to a pediatric client. When obtaining the vaccine, the nurse discovers the refrigerator containing the facility's vaccines has been unplugged for an unknown amount of time and is warmer than the proper storage temperature. Which action by the nurse is appropriate? Plug the refrigerator back in but wait to use the vaccines until it is cool Discard all of the vaccines and reschedule the child for another appointment Contact another local facility to borrow a vaccine to administer to the child Use only the vaccines that feel cold to the touch and discard all others

Discard all of the vaccines and reschedule the child for another appointment

The nurse is performing a vision screening for 6-year-old child. Which screening chart is bestfor the nurse use to determine the child's ability to discriminate color? Allen figures Snellen Ishihara CVTME

Ishihara

The nurse is discussing healthy eating habits with a school-age child and her parents. Which recommendation would the nurse make for the family? When serving a food the child doesn't like, insist they take several bites A bedtime snack should be part of the child's bedtime ritual/pattern Light snacks should be offered so the child doesn't overeat at meals Carbohydrates at breakfast will give a child energy to start the day

Light snacks should be offered so the child doesn't overeat at meals

The nurse will record what information about each vaccine after immunizing a child? Select all that apply. Lot number and expiration date of vaccine Whether bacterial or viral Site and route of vaccine administration Manufacturer of vaccine How vaccine was stored

Lot number and expiration date of vaccine Site and route of vaccine administration Manufacturer of vaccine

The nurse is providing discharge teaching to parents preparing to take their 1-day-old newborn home from the hospital. The parents question the nurse about the timing of the newborn metabolic screening. What information can be provided by the nurse? Newborn metabolic screening needs to be performed at or after 48 hours of age. These tests will need to be completed between 24 and 48 hours of age. Newborn screening needs to be repeated at 1 week of age. The newborn metabolic screen can be done anytime after the first formula or breastmilk feeding.

Newborn metabolic screening needs to be performed at or after 48 hours of age.

While enrolled in a geography course, a student nurse learns that diarrheal illness is deadly for large numbers of infants in Third World countries. What vaccine will this nursing student identify as part of the solution to this problem? Hepatitis A (HepA) H. influenzae type B (Hib) Diphtheria, tetanus, pertussis (DTap) Rotavirus (RV)

Rotavirus (RV)

A single mother has brought her 9-month-old, recently adopted Chinese daughter for a health supervision visit. Although there are screening documents from China and the child seems healthy, the nurse plans to screen for infectious diseases. What explains the nurse's caution? Testing by the child's home country is unreliable. Many babies adopted from foreign countries have pediculosis. The child may have come from rural China. Infants tend to have insidious symptoms.

Testing by the child's home country is unreliable.

The nurse is interacting with several families with children during their health visits. Which child would the nurse prioritize to receive a hearing screening? The 8-week-old who had an initial hearing screening reported as negative The 3-week-old infant who was discharged without a hearing screening The 6-month-old who attempts to mimic sounds the parents make The 3-month-old whose mother reports the child turns their head to noises

The 3-week-old infant who was discharged without a hearing screening

The student nurse is preparing for a class project about health supervision. The student plans to include which information? Select all that apply. Health supervision of the child is most effective when the child has multiple sources of health care. Education regarding proper immunizations is included in health supervision. The goal of health supervision is to optimize the child's level of functioning. Health supervision promotes education about preventing injury and illness. Health supervision involves providing services after the child has become ill.

The goal of health supervision is to optimize the child's level of functioning. Health supervision promotes education about preventing injury and illness. Education regarding proper immunizations is included in health supervision.

The nurse is observing the parents and child during a health supervision visit. Which observation would alert the nurse to inquire and observe further? The infant, in a car seat, is placed on the exam table so the baby is facing the parents as they talk with the nurse The mother asks the father to hold the toddler when the nurse asks the mother to sign paperwork at the front desk. The mother says, "Wait until we are finished with this doctor's visit and then I will take you to the bathroom." The father of the child states, "He didn't get first at the spelling bee, but he did well in his class."

The mother says, "Wait until we are finished with this doctor's visit and then I will take you to the bathroom."

Which information obtained by the nurse from the parents at the initial health supervision visit would alert the nurse to conduct the newborn metabolic screening during this visit? The screening was completed when the newborn was 24 hours old The screening was completed at the clinic when the newborn was 4 days old The screening was completed and the results noted in the infant's permanent record The screening was completed prior to discharge from the birthing unit

The screening was completed when the newborn was 24 hours old

Which information obtained by the nurse from the parents at the initial health supervision visit would alert the nurse to conduct the newborn metabolic screening during this visit? The screening was completed when the newborn was 24 hours old The screening was completed prior to discharge from the birthing unit The screening was completed at the clinic when the newborn was 4 days old The screening was completed and the results noted in the infant's permanent record

The screening was completed when the newborn was 24 hours old

The nurse has just taken the blood pressure of a 13-year-old, and the percentile rank is 88%. Why would the nurse categorize the child as prehypertensive? The teenager was born at 33 weeks' gestation. The teenager eats a high-fat diet. The teen gets no regular exercise. The teenager's blood pressure was 122/83.

The teenager's blood pressure was 122/83.

Which nursing intervention is likely to be most effective in keeping the childhood immunization status for all ages at its highest possible level? Use every contact to potentially immunize Make immunizations as pain-free as possible Organize community-wide immunization events Promote immunization through mass media campaigns

Use every contact to potentially immunize