EAQ: health promo and safety

A registered nurse is teaching a student nurse about safety during the feeding of preterm infants. Which statement made by the student nurse indicates effective learning?

"A firm nipple should be chosen to feed preterm infants."

A nurse is teaching student nurses about the mental milestones reached by children at different stages of development. Which statement made by a student nurse indicates effective learning?

"An 11-year-old child can write occasional short letters to friends on their own initiative."

At a community health center, a nurse is explaining age-related behavior and developmental changes to the parents of a 6-year-old child. Which statements made by the nurse are appropriate?

"At the age of 6 the child follows the actions of adults." "At the age of 6 the child feels more independent." "At the age of 6 the child feels jealous of younger brothers or sisters."

The nurse is preparing a teaching plan to improve the quality of health care for children and their families. What instructions should the nurse include in the plan to educate parents about the importance of nutrition in children?

"Human milk is the preferred form of nutrition for all infants." "Breastfeeding provides micronutrients and immunity to infants. "Eating preferences of children are influenced by family and culture."

The parent of an 11-month-old infant tells the nurse that the infant vomits a lot and cries for no obvious reason. On examination, the infant's weight is found to fall below the fifth percentile on a standard growth chart. Which dietary instruction included in the care plan of the infant is most appropriate?

"Include fortified rice cereals in the infant's diet."

What should the nurse ask the parent before giving influenza vaccination to a child?

"Is your child allergic to eggs of any kind?"

The nurse has explained to the parents about hepatitis vaccination for the baby born to the HBsAg-positive mother and weighing 2000 g.The nurse evaluates the understanding of the parent regarding the vaccination. Which statement by the parent needs correction?

"My baby will need only one dose of vaccine after this one."

The parents of a 5-year-old child are worried because the child stutters when speaking. On examination the nurse finds that the child has no problem with hearing. What should the nurse tell the parents?

"Stuttering is common at this age and usually resolves during late childhood."

The nurse is educating a parent about rotavirus vaccine. Which statement pertaining to the rotavirus vaccine RotaTeq is appropriate?

"The first dose is administered between 6 to 12 weeks of age."

A mother is worried that her preterm infant sleeps only 3 hours and awakens frequently during the nighttime. The mother asks the nurse if her infant has any health problems. Which statement made by the nurse is appropriate in response to the question?

"The infant is normal and has no health issues."

A parent of an 18-month-old child informs the nurse that the child does not eat properly and is very fussy. Sometimes the child does not eat anything; on other days the child eats a lot. What is the most appropriate response of the nurse?

"This is a normal phenomenon at this age. Your child is fine."

The nurse is teaching health promotion activities to a group of adolescents. What is included in the teaching?

"Use safety apparel while driving." "Use adequate sunscreen." "Avoid alcohol during water sports." "Refuse to ride with reckless drivers."

During the home visit, the parents of a 10-year-old child ask the nurse about safety guidelines because the child wants to get a bicycle. Which statement by the parents indicates the nurse's teaching has been effective?

"Wear light-colored clothes while riding the bicycle at night."

The nurse is assessing a child with delayed growth. Which questions does the nurse include in the assessment while interviewing the parents?

"What kind of developmental issues did the child have?" "Have there been changes in the child's appetite?" "What kind of medications does the child take?" "Tell me about diseases in your family."

The parents of a 4-month-old infant bring the infant to the clinic for a well-baby check-up. Which instruction about injury prevention should the nurse include at this time?

"When she learns to roll over, you'll need to continue to supervise whenever she's on a surface that she could fall from."

The nurse is assessing a 4-year-old child. What age-appropriate language skills should the nurse expect in this child?

1500 3-4

The nurse works in a vaccination clinic. Which clients may receive the MMR vaccine?

A 12-month-old baby with flu. A 14-month-old baby allergic to eggs. A breastfeeding mother.

The nurse is assessing a 6-month-old infant who smiles, coos, and exhibits a strong head lag. The nurse should recognize which finding?

A developmental and neurologic evaluation is needed.

A child with cancer is scheduled to receive chemotherapy. Some of the regular childhood vaccinations of the child are due over the next few months. What is the best step for immunizing the child?

Administer inactivated hepatitis A virus vaccine seven months after the chemotherapy.

In which age group will it be especially important to ensure privacy and to explain how the procedure will affect their appearance?

Adolescent

An adolescent is accompanied by his mother for an annual physical examination. On which topic does the nurse, drawing on knowledge of this age group, avoid questioning the adolescent?

Alcohol use Sexual activity Cigarette smoking

A parent tells the nurse that her preschool child refuses to sleep in his bed alone. Which instruction given by the nurse to the parent is most appropriate?

Allow the child to hold his favorite toy when he sleeps."

A child who has growth failure is suspected to be in the initial stages of failure to thrive. What should be primary goals in nutrition management of this child?

Allowing for catch-up growth in the infant Correcting nutritional deficiency in the infant Restoring correct body composition in the infant Educating caretakers about nutritional requirements

What dimensions should be included in any consideration of an adolescent's sexual orientation?

Attraction Fantasy Actual sexual behavior Self-labeling or group affiliation

A newborn had a breech intrauterine presentation and has a family history of hip dysplasia. What is the most reliable procedure to diagnose developmental dysplasia of the hip in a newborn?

Barlow and Ortolani maneuvers

A nurse is teaching a mother of a 2-month-old infant about nutrition of the baby. Which food is best for the child at this age?

Breast milk

The nurse is educating the mother who recently delivered a baby about nutritional support measures in the initial 6 months of life. What information does the nurse include in the teachings?

Breastfed infants do not require supplemental water in the initial 4 months. Take daily supplementation of vitamin D (400 IU) during the initial few days. Add daily supplementation of vitamin D and vitamin B 12 if maternal intake is inadequate.

Dental caries is the most common chronic disease of childhood. What facts regarding dental disease in childhood should the nurse remember?

Childhood caries is the most common form of early dental disease. Nearly one in five children between the ages of 2 and 4 years has visible cavities. Preschoolers in low-income families are twice as likely to have tooth decay as other children. Dental caries in children may start before the first birthday and result in pain and infection within the first 2 years of life.

What are the primary goals in the nutritional management of infants with failure to thrive?

Correct nutritional deficiencies. Restore optimal body composition. Educate the parents or primary caregivers on the child's nutritional requirements.

During a home visit, the nurse assesses the growth and development of a 7-year-old child. After the assessment, the nurse documents that the child's physical development is inadequate. Which physical characteristic did the nurse find in the child?

Decreased leg length in relation to height

Nurses play an important role in identifying children with cognitive impairment. What should the nurse recognize as a major clue to cognitive impairment?

Delayed developmental milestones

A nurse is delivering a lecture on oral health for children. Which is the most common dental condition in children that the nurse should specifically address?

Dental caries

The nurse is guiding an infant's parents in selecting a daycare facility for their child. What are the most important areas that the nurse should encourage the parents to evaluate before they choose a facility?

Discipline policy Safety measures Caregiver-to-student ratio Infection-control procedures

A new adoptive parent asks the nurse about typical play activities to provide for the 4-year-old child they are adopting. Which answers by the nurse expresses understanding of usual play activities of preschool children?

Dramatic play Winter sledding Associative play Number flash cards

The nurse observes that parents pressure the child to speak words that produce sounds beyond the child's developmental level. Which consequences of this parental action does the nurse warn the parents about?

Dyslalia Infantile speech

Nursing interventions to promote health during middle childhood should include what action?

Educating the child and parents about the need for effective dental hygiene because these are the years in which permanent teeth erupt

What should be the nurse's instruction to the parent of a child who is overweight?

Emphasize the importance of physical activity for the child.

A nurse is caring for a preterm infant. In a developmental approach to feeding, the infant's readiness to feed is considered. What factors should the nurse consider to determine whether an infant is ready to nipple feed?

Energy level Medical status Presence of a gag reflex Ability to sustain a brief quiet alert state

The parents of an infant are very concerned about the child's inability to pull to a standing position by 12 months of age. How does the nurse manage this situation?

Evaluate for dysplasia of the hip joint in the child.

What is the most commonly used method in completed suicides of adolescents?

Firearms

A nurse works in a pediatric clinic. Which routine vaccines does the nurse recommend for reducing the incidence of bacterial meningitis during infancy?

H. influenza vaccine Pneumococcal vaccine

What question does a nurse ask a 14-year-old patient to determine whether a varicella vaccination is needed?

Have you ever had chickenpox?"

A nurse is teaching a parent about the safety measures to be taken at home. Which statement made by the parent requires further teaching?

I would provide attractive small toys for my child to play with."

What does the nurse recognize as having the greatest impact on the significant decline in incidence of communicable diseases of childhood?

Immunizations

Which statement is correct regarding immunization?

Infants should be immunized at birth or within 2 weeks of birth.

The nurse is caring for an infant who has protein-energy malnutrition. Which nutritional supplement is administered only when the infant is able to tolerate a steady food source?

Iron

The parents of a 12-year-old child complain to the nurse that the child asks them about masturbation after watching a contraceptive advertisement. The parents are anxious about their child. Which response of the nurse helps relieve the parents' anxiety?

It is an age-associated behavior.

What gross motor skill is developmentally appropriate for a toddler who is 18 months of age?

Jumps in place with both feet

A parent of a young child is fearful his or her child will become overweight. What advice should the nurse provide to the parent to prevent obesity?

Limit the consumption of sugar-sweetened beverages. Encourage 1 hour of physical activity per day. Encourage the consumption of adequate quantities of fruits and vegetables.Encourage limitation of television viewing.

Which clinical manifestations should the nurse expect in an infant with failure to thrive?

Malnutrition, developmental delays, feeding disorders

A nurse is administering varicella and measles, mumps, and rubella vaccines to a child. Which statement is correct regarding the administration of the vaccines?

May be administered to children when they have the common cold.

The nurse is educating preschoolers about the importance of personal hygiene. What strategy does the nurse implement for educating these children?

Models and diagrams

While caring for hospitalized adolescents, the nurse observes that sometimes they are skeptical of their parents' religious beliefs and practices. What should the nurse recognize as about this behavior?

Normal in spiritual development

What factors place an infant at risk for reactive attachment disorder?

Parental alcoholism Parental mental illness Being a victim of neglect Having been in foster care

What is the most widely used therapy to treat the 1-week-old infant who has developmental dysplasia of the hip (DDH)?

Pavlik harness

Which factor is instrumental when the nurse is developing a dietary teaching plan for an adolescent?

Peer acceptability

A parent is trying to prevent sleep problems in her newborn. Which advice given by the nurse is correct?

Place your infant awake in the crib."

The nurse assesses a toddler and finds that the child is in a growth spurt. What should the nurse tell the family regarding feeding the child to meet his or her nutritional needs?

Plan a nutritionally balanced week. Serve food in various physical forms.

A nurse is caring for an infant with developmental dysplasia of the hip (DDH). What clinical manifestation should the nurse expect to observe?

Presence of Ortolani and Barlow signs Asymmetries of thigh and gluteal folds Shortening of the limb on the affected side

The mother of a preterm infant asks the nurse about the benefits of breast milk for preterm infants. What information should the nurse include in the response to this mother?

Preterm infants who breastfeed demonstrate fewer incidences of oxygen desaturation than do preterm infants who are bottle fed. Secretory IgA concentration is higher in the milk from the mothers of preterm infants than in milk from the mothers of full-term infants. Preterm infants who breastfeed demonstrate better coordination of breathing, sucking, and swallowing than preterm infants who are bottle fed. Milk from mothers with preterm infants contains higher amounts of protein, sodium, chloride, and immunoglobulin A.

What measure should a school nurse promote to reduce incidents related to injuries among schoolchildren?

Promote wearing helmets while using bicycles.

The nurse is teaching the parents of a preterm infant ways to prevent possible nutritional deficiency anemia. What recommendations should the nurse make?

Provide breast milk as much as possible. Give citrus fruit or juice with iron supplements. Administer iron supplements in two divided doses between meals. Limit quantities of milk and introduce solid food rich in iron, fluoride, zinc, and vitamin C.

Which intervention is appropriate for a school age child who has developed gastrointestinal candidiasis?

Providing oral fluconazole

A parent asks the nurse about the activities that can help her 1-year-old develop language skills. Which activity suggested by the nurse best helps in improving the language skill of the child?

Reading books together

During a well-child visit the father of a 4-year-old child tells the nurse that he is not certain that his child is ready for kindergarten. The child's birthday is close to the cutoff date, and the child has not attended preschool. What is the most appropriate recommendation by the nurse?

Referring the child for developmental screening and making a recommendation based on the results

The nurse is teaching the parents of a crawling infant about childhood injuries and how to prevent them. What is the most important information the nurse should include in the teaching?

See to it that the child does not place objects in mouth.

Injuries are the most common cause of death and disability to children in the United States. The nurse explains to new parents that which factors most increase the risks associated with childhood injury?

Sex Stress Poverty History of previous injury

Which statement is correct with regard to the safety of toddlers in car restraints?

Shoulder belt is used if it does not cross child's neck or face.

What gross motor skill are infants able to perform at 7 months of age?

Sitting erect momentarily

The nurse assesses a preschooler with a sleeping disorder and finds that the child appears awake but not quite aware of people around him. He cannot be comforted and pushes away anyone who tries to hold or restrain him. Which sleeping disorder should the nurse expect to find in the child's medical record?

Sleep terrors

What are some characteristics of physical development in a 30-month-old child?

Sphincter control has been achieved. Primary dentition is complete.

The parents of a 5-month-old child complain to the nurse that they are exhausted because the infant still wakes up as often as every 1 to 2 hours during the night. When the child awakens, the parents change the diaper and the mother nurses the child back to sleep. Which should the nurse suggest to help the parents deal with this problem?

Start putting the infant to bed while still awake.

The nurse should teach parents of toddlers how to prevent poisoning by instructing them to do what?

Store poisonous substances in a locked cabinet.

What are the roles of a school nurse in educating children about reducing bicycle-associated injuries?

Stress the importance of wearing helmets when riding. Encourage peer leaders to act as role models. Address issues related to noncompliance for helmet use.

Which food item consumed in excess is the most likely cause for the symptoms of dental caries, obesity, and metabolic syndrome in a preschooler?

Sweetened beverages

The nurse is assessing the immunization history of an adolescent. The nurse finds that the child has not received the tetanus booster dose. What is the likely recommendation for the adolescent?

Tdap (tetanus, diphtheria, acellular pertussis) vaccine

A nurse is teaching about the growth and developmental stages in children to their parents. Which statement does the nurse include about tasks that can be performed by a 6-year-old child?

The child can count 13 pennies without effort

The nurse is assessing the gross motor skills of a 5-year-old child. The nurse finds that the child's gross motor development is delayed and is similar to that of a 4-year-old child. Which activities of the child lead the nurse to conclude this?

The child is able to throw a ball overhead. The child stands on one foot for a few seconds

During an assessment of an 18-month-old child, the nurse finds that the child can say four to six words and can build a tower of four cubes. The child also throws temper tantrums occasionally. Which statement describes the child's development?

The child may have delayed language development.

An infant is brought to the health care clinic for measles, mumps, rubella and varicella (MMRV) vaccination. Upon reviewing the medical history, the child is found to be allergic to eggs. Which is the best nursing intervention in this situation?

The nurse should administer the MMRV vaccine.

Which factor or habit of a preschooler does the nurse expect to be responsible for inadequate development of the child's musculoskeletal system?

The preschooler plays travel soccer.

Administer varicella-zoster immune globulin to prevent chickenpox.

The school nurse is concerned about an outbreak of chickenpox because two children at the school have cancer and are immunodeficient as a result of chemotherapy. What is the most appropriate recommendation by the school nurse?

What are some of the ways in which play helps school-age children develop?

They acquire mastery over themselves, their environment, and others.

What is one of the major tasks of toddlerhood?

Toilet training

The nurse is performing a well-child assessment of an infant. The infant's mother tells the nurse that the family follows a strict vegan diet. For what nutritional deficiencies is this child at risk?

Vitamin D, vitamin 12 vitamin B 6 iron, calcium, zinc

The nurse is teaching a community health promotion class to parents and school-age children related to bicycle safety. Which issue is important to cover in this teaching session?

Walking bicycles through busy intersections

A mother tells the nurse that her infant wakes up frequently at night and returns to sleep only with a bottle. Which advice given by the nurse is most appropriate to manage the infant's sleep disorder?

avoid holding

During a home visit to a toddler, the nurse finds that the home has a balcony with rails, and the opening between the rails is 3 inches. There is a carbon monoxide detector in the home. Cough syrup has been placed in a childproof container on a high level shelf. The house has an old refrigerator in a storage room, and its doors have been removed. Which finding in the home should be addressed by the nurse?

cough syrup

A nurse is giving information about different kinds of injuries at different developmental ages. What kinds of injuries are more common in toddlers?

falls, burns

Which statement is accurate about patterns of sleep and wakefulness in the infant?

the first period of reactivity is the best stage for infant stimulation.

The parents of a 13-year-old child often have to work until late at night and cannot take care of the child when the child returns from school. Which actions employed by the parent are appropriate?

the parents instruct the child to heat food in the microwave at low heat.

Which vaccines are contraindicated for children who are immunocompromised?

varicella, MMR