NSG 242 Chapter 31: Health Supervision

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? "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." "If you continue to notice these changes, we should follow up within the next 3 months." "Every child develops at different rates. Don't be alarmed. Just enjoy your child!"

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

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? "I am so glad you are reading to your baby, especially during feeding time." "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 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 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." "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." "I am so glad you are able to give the varicella vaccine today."

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

The mother of a 6-month-old child reports she has been hearing so much about autism spectrum disorder. She questions if this is something that can be tested for. What response by the nurse is appropriate? "Unfortunately there are no reliable screening tools for autism spectrum disorder available." "Autism spectrum disorder 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." "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 discussing measles, mumps, and rubella vaccination with a mother who is concerned about using the combined vaccine for her 12-month-old. Which statement by the nurse will be most helpful to the mother in accepting the vaccine? "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." "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."

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 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." "Your toddler should not receive this live-virus immunization today. It may present a risk to your pregnancy."

"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 manager 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 manager to provide additional teaching? "I know work schedules can make getting to appointment on time difficult; 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?" "It is important to be current with your baby's progress, so we will see her today." "Follow me into the private exam room so we can discuss any concerns you have about your baby."

"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 2 1/2 to 7 years 6 months to one year 6 to 10 years

2 1/2 to 7 years

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.

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? DtaP DPT TdaP DT

DTaP

During a developmental screening, the nurse notes the toddler is not meeting expected developmental milestones. What is the best action by the nurse? Encourage the family to provide specific developmental tasks to correct the delay. Ask the family if they have a preference of hospitals for an overnight stay for further evaluation. Discuss the delay in milestones with the primary care provider and family. Tell the parents they should monitor the child closely for changes over the next year.

Discuss the delay in milestones with the primary care provider and family.

A mother and her 4-week-old infant have arrived for a health maintenance visit. Which activity will the nurse perform? Assess the child for an upper respiratory infection. Take a health history for a minor injury. Administer a varicella injection. Plot the child's head circumference on a growth chart.

Plot the child's head circumference on a growth chart.

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

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. The mother rarely looks at her infant when the nurse is assessing the child. The mother voices pride in the academic accomplishments of her 7-year-old child. The mother becomes very frustrated and tells the nurse she can't handle her toddler's temper tantrum. The mother asks if the nurse has suggestions on ways to "potty train" her toddler. The mother utilizes the correct size of infant car seat for her 3-month-old child.

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

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

The teenager's blood pressure was 122/83.

The mother of a 5 month-old tells the nurse that she thinks her baby has difficulty hearing. The nurse anticipates assisting with which hearing tests to assess this 5 month-old child's hearing? Select all that apply. auditory brain stem response otoacoustic emissions (EOAE) tympanometry conditioned play audiometry (CPA) pure-tone (conventional) audiometry

auditory brain stem response otoacoustic emissions (EOAE)

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

auditory brainstem response

The nurse prepares to administer a vaccine to a 12-month-old child using a 5/8-inch needle. The nurse cleans the fatty tissue over the anterolateral thigh before administering the vaccine. Which vaccine is the nurse preparing to administer? DTaP varicella hepatitis A influenza

varicella