Ch 31: Health Supervision
What will the nurse ask the school-age client when a vibrating tuning fork is placed at the middle of the top of the child's head? A) "Do you hear the sound in one or both ears?" B) "Please describe the taste in your mouth." C) "Describe what you feel." D) "Do you feel like swallowing?"
A) "Do you hear the sound in one or both ears?" This procedure, known as the Weber test, assesses hearing and evaluates bone conduction of sound. The sound should be heard in both ears. Another hearing test using a tuning fork is the Rinne test, which compares bone conduction of sound versus air conduction. The other questions if asked by the nurse do nothing to evaluate the hearing of the school-age client.
Which statements by a parent would indicate to the nurse that the family has a future-based orientation? Select all that apply. A) "We will fill our son's prescription for asthma prevention medication today in case he has another asthma attack." B) "Heart problems run in our family, I don't think it matters how healthy our son eats." C) "We limit the amount of TV our children watch and are sure they get enough physical activity." D) "We will wait until our daughter's high glucose level causes her problems before we treat it." E) "We will get our son vaccinated for varicella. We don't want him to get chickenpox."
A) "We will fill our son's prescription for asthma prevention medication today in case he has another asthma attack." C) "We limit the amount of TV our children watch and are sure they get enough physical activity." E) "We will get our son vaccinated for varicella. We don't want him to get chickenpox." Obtaining prescriptions to have on hand for an asthma attack demonstrates planning ahead for an event. Having the child vaccinated now in order to avoid the disease in the future demonstrates a future-based orientation in which the child/family believe they have control in their own health. Ensuring physical activity helps in preventing obesity in children. The other choices indicate a present-based orientation in which there is little control over health concerns and the family/child feel their own input or prevention strategies are not going to make a difference.
The nurse is promoting the benefits of achieving a healthy weight to an overweight 12-year-old child and her parents. Which approach is best? A) Ask what activities she enjoys such as dance or sports B) Point out fattening foods and excesses in their diet C) Suggest that the child join a little league softball team D) Show the family the appropriate weight for the child
A) Ask what activities she enjoys such as dance or sports Asking what activities the child enjoys in order to promote exercise is best for several reasons. It provides assessment of the child's activity preferences and whether the child is health-centered (positive) or weight-centered (negative). It also offers variety. If one sport doesn't work, others might. Emphasizing appropriate weight or dietary shortcomings can lead to eating disorders or body hatred. Suggesting only softball limits the success of the healthy weight promotion.
Which situation would indicate the nurse is facilitating trust in the family members decisions about their child's health? A) The nurse recommends the parents review the list of available specialists before they select one for referral. B) The nurse discourages the parents from following the advice of a grandparent regarding parenting approaches. C) The nurse teaches the family about side effects of a prescribed medication without first assessing their knowledge about the medication. D) The nurse ask the parent why they used a home remedy cream on the child's rash before being seen at the clinic.
A) The nurse recommends the parents review the list of available specialists before they select one for referral. One sign of potential hearing impairment is turning the television up too loudly. Listening to music with headphones, talking on the telephone, and learning sign language are not signs of potential hearing impairment.
What is an example of anticipatory guidance of health care by the community nurse? A) The nurse orders food for a post-op surgery client. B) The nurse teaches hand washing at an elementary school. C) The nurse gives medicine to a 2-year-old. D) The nurse takes an 8-year-old child's vital signs.
B) The nurse teaches hand washing at an elementary school. The nurse should take a proactive role in discussing anticipatory guidance issues with children and families. The nurse should be an educator to promote a healthy lifestyle, and any encounters with children and families should be an opportunity to educate. The other choices are basic nursing care tasks.
Curious parents ask what type of immunity is provided to their child through immunization with various vaccines. What will be the nurse's answer? A) Naturally acquired passive immunity B) Artificially acquired passive immunity C) Artificially acquired active immunity D) Naturally acquired active immunity
C) Artificially acquired active immunity Artificially acquired active immunity develops through vaccine administration of an antigen that stimulates the child's body to produce antibodies against that antigen (pathogen) and to remember the antigen should it reappear. Natural immunity is produced through natural invasion of an antigen (pathogen). Natural and artificial passive immunity involves providing antibodies to fight a pathogen rather than expecting the child's body to produce them. This type of immunity has a short life.
The nurse is counseling a pregnant adolescent about the health benefits associated with breastfeeding. Which statement by the client indicates understanding? A) "Breastfeeding my baby will provide lifelong immunity against certain diseases." B) "Breastfeeding my baby will pass on a type of active immunity." C) "Breastfeeding my baby will help to stimulate my baby's immune system to activate." D) "Breastfeeding my baby will pass on passive immunity."
D) "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.
A pregnant woman reports she is interested in breastfeeding to promote improved health for her child. Which statement by the nurse is most appropriate? A) "Breastfeeding provides what is called active immunity." B) "Lifelong immunity is provided against some bacterial illnesses from breasting." C) "Breastfeeding will improve your child's health." D) "Passive immunity can be transmitted to your child providing him with some temporary immunity against illness."
D) "Passive immunity can be transmitted to your child providing him with some temporary immunity against illness." Children may obtain some temporary immunity from breastfeeding. This is referred to as passive immunity. Active immunity is achieved when the immune system is exposed to pathogens and antigens are developed.
The nurse is speaking to a parent of a 5-year-old child. Which statement by the parent would indicate a potential hearing impairment in the child? A) "My daughter loves to talk on the phone to her grandparents." B) "My son is always listening to music with headphones on." C) "My daughter is learning sign language in school." D) "When my son is watching TV, I can't stand to be in the room. The sound is always turned up so loud."
D) "When my son is watching TV, I can't stand to be in the room. The sound is always turned up so loud." One sign of potential hearing impairment is turning the television up too loudly. Listening to music with headphones, talking on the telephone, and learning sign language are not signs of potential hearing impairment.
The nurse is conducting a community screening program for hyperlipidemia in children. Which children would the nurse identify as being a candidate for screening? Select all that apply. A) Child reporting 3 of their older siblings are obese and lead sedentary lifestyles B) Child who reports grandfather has angioplasty at 72 years of age C) Child who reports his uncle has type I diabetes diagnosed at age 19 D) Child with one sibling diagnosed with peripheral vascular disease E) Child whose mother has a cholesterol level of 250 mg/dL
D) Child with one sibling diagnosed with peripheral vascular disease E) Child whose mother has a cholesterol level of 250 mg/dL
