CH. 31 Prep U - Health Supervision

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? A. 6 B. 4 C. 5 D. 7

B. 4

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? A. "It is important I use sunscreen on my 4-month-old child." B. "I should apply sunscreen to my child even if we are outside for only 15 minutes." C. "Hourly application of sunscreen is needed if my child is perspiring." D. "Sunscreen should be applied about 30 minutes prior to sun exposure."

A. "It is important I use sunscreen on my 4-month-old child."

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? A. "The testing may have been unreliable due to outdated testing supplies, poor storage of testing supplies, and unreliable documentation." B. "The testing needs to be repeated so your child can have an up-to-date record at our primary physician's office." C. "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." D. "Your child needs to be tested again because most newborns are immunocompromised and test negative at birth."

A. "The testing may have been unreliable due to outdated testing supplies, poor storage of testing supplies, and unreliable documentation."

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

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

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

A. 2 1/2 to 7 years

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? A. The teenager's blood pressure was 122/83. B. The teenager was born at 33 weeks' gestation. C. The teen gets no regular exercise. D. The teenager eats a high-fat diet.

A. The teenager's blood pressure was 122/83.

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? A. auditory brain stem response test B. Weber test C. Rinne test D. tympanometry

A. auditory brain stem response test

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

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

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

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

The nurse is preparing to administer an intramuscular immunization to a 1-month-old infant. What action will the nurse take? A. Locate and clean the deltoid muscle with alcohol prior to administering the injection. B. Request the parent to remove the infant's pants so the vastus lateralis muscle is accessible. C. Swab the fatty tissue on the infant's upper leg with alcohol prior to administering the injection. D. Ask the parent to remove the infant's diaper to allow access to the dorsogluteal muscle.

B. Request the parent to remove the infant's pants so the vastus lateralis muscle is accessible.

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

B. The home is in a high-crime neighborhood.

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. A. lead levels B. phenylketonuria C. auditory brain stem response D. hyperlipidemia E. Denver II

B. phenylketonuria C. auditory brain stem response

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? A. "If you continue to notice these changes, we should follow up within the next 3 months." B. "Every child develops at different rates. Don't be alarmed. Just enjoy your child!" C. "This is a concern. Let's be sure the physician is aware of this change." "Children often regress in their developmental stages...no need to worry."

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

The nurse is preparing to administer a diphtheria, tetanus and pertussis vaccine to a 3-year-old child. Which version of the formulation of the vaccine should be administered? A. DPT B. DT C. DTaP D. TdaP

C. DTaP

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? A. Allow the children to choose whether to get the screening completed that day or another day. B. Encourage the children to play with the dressings, syringes, and medication before using them. C. Purchase stickers or make coloring pages to be given to the children after the screening is completed. D. Make a coloring page and allow the child to color it completely before beginning the screening.

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

A mother of three brings her children in for their vaccinations, and tells the nurse that her mom recently died and her husband just lost his job due to his company downsizing. Which parenting behaviors is the nurse likely to observe? Select all that apply. A. The mother asks if the nurse has suggestions on ways to "potty train" her toddler. B. The mother voices pride in the academic accomplishments of her 7-year-old child. C. The mother rarely looks at her infant when the nurse is assessing the child. D. The mother utilizes the correct size of infant car seat for her 3-month-old child. E. The mother becomes very frustrated and tells the nurse she can't handle her toddler's temper tantrum.

C. The mother rarely looks at her infant when the nurse is assessing the child. E. The mother becomes very frustrated and tells the nurse she can't handle her toddler's temper tantrum.

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. a 2-month-old infant who breastfeeds B. a 7-year-old active in competitive sports and activities C. a 16-year-old, pregnant for the first time and lives with her parents D. a 7-month-old with supplemental breast feeding

C. a 16-year-old, pregnant for the first time and lives with her parents

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? A. "Eating a diet that is healthy will greatly reduce risk factors for several chronic diseases that occur later in life. B. "Eating a well-balanced diet that includes fresh fruits and vegetables, your child will not be at risk for becoming obese in the future." C. "Eating a diet low in fat will help to reduce the risk of colon cancer in your child when they get older." D. "Eating a healthy breakfast will give your child the energy to stay awake and focused during school each day."

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

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? A. "My baby should be seen monthly for the first year of life." B. "Unless there is a problem I do not need to bring my baby back to be seen until he is 6 months old." C. "I will need to schedule an appointment for my baby to be seen when he is 3 months old." D. "My baby will need to again be seen when he is 2 months old."

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

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

D. Sign a consent form.

The nurse will expect that which hearing test will be performed before the newborn is discharged home? A. whisper test B. pure-tone audiometry C. tympanometry D. auditory brainstem response

D. auditory brainstem response

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? A. articulation difficulties B. difficulty with fine motor skills C. visual disorder D. hearing impairment

D. hearing impairment