Peds Ch. 31 Prep-U You're Welcome
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 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.
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.
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 passive immunity."
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?
"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?
"By knowing normal growth and development, the nurse is able to identify problems in growth and development."
The nurse is discussing Varicella immunization with a mother of a 13-month-old. The mother is reluctant to vaccinate because she feels it is "not necessary." Which comment by the nurse will be most persuasive for immunization?
"Children not immunized are at risk if exposed to the disease."
The parents of a child, recently adopted internationally, asks the nurse why it is recommended that their child be screened for intestinal parasites. What would be the best response by the nurse?
"Children with intestinal parasites often exhibit no signs or symptoms, so a screening is
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."
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?
"My 7-year-old will need to get a Hib booster at his next checkup."
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."
The nurse prepares to administer the measles, mumps and rubella (MMR) vaccine to a child. What statement by the child's mother would alert the nurse to avoid giving the vaccine?
"My child had gelatin at day care and broke out in hives afterwards."
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 communiuty?
"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?
"Oral health can affect general health."
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?
"Screening is recommended between 18 and 24 months or when concerns are identified."
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?
"The child's eyes are more attune to high contrast patterns than to specific colors."
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."
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?
"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?
"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."
Which question by the nurse is the best one to elicit complete information about a young boy's immunization status?
"When and where did your child receive his last immunization?"
The nurse will use the Denver Articulation Screening for children in what age range?
2 1/2 to 7 years
Which child poses the greatest risk for elevated lead levels?
2-year-old child living with parents from international adoption
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 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 16-year-old, pregnant for the first time and lives with her parents
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.
A ball to throw and catch Blocks to stack Raisins to place in a bottle
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?
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?
Auditory brain stem response test
The nurse is reviewing the health history of an infant who is demonstrating developmental delays. Which finding would be considered a possible risk factor?
Being raised by a single teenaged mom
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?
Complete a comprehensive health screening within the next week
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
Parents report that their 4-year-old is difficult to understand. Which screening tool will the nurse use?
Denver Articulation Screening
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 Prescreening Developmental Questionnaire (R-PDQ)
During a developmental screening, the nurse notes the toddler is not meeting expected developmental milestones. What is the best action by the nurse?
Discuss the delay in milestones with the primary care provider and family.
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 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?
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
The nurse is performing a vision screening for 6-year-old child. Which screening chart is best for the nurse use to determine the child's ability to discriminate color?
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?
Light snacks should be offered so the child doesn't overeat at meals
The nurse is performing a vision screening for a 2-month-old. Which technique should the nurse use?
Move a card with a black-and-white checkerboard pattern in a 180-degree arc past the infant.
The nurse will expect that which hearing test will be performed before the newborn is discharged home?
The nurse will expect that which hearing test will be performed before the newborn is discharged home?
The nurse is providing discharge teaching to parents preparing to take their 1-day-old infant home from the hospital. The parents question the nurse about the timing of the newborn screen. What information can be provided by the nurse?
Newborn screening needs to be performed at or after 48 hours of age.
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.
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.
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?
Rotavirus
Before administering an immunization to their child, the nurse asks parents to take which priority action?
Sign a consent form
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.
The nurse is anticipating that health supervision for a 5-year-old child will be challenging. Which indicator supports this concern?
The home is in a high-crime neighborhood.
Which situation would indicate the nurse is facilitating trust in the family members decisions about their child's health?
The nurse recommends the parents review the list of available specialists before they select one for referral.
Shelley, a mother, is new to the community, and the family is in a low-income bracket with limited transportation options. How could the pediatric nurse help Shelley get her new baby to her well-child visits to promote healthy growth and development? The nurse could:
link Shelley with the community'a child health clinic.
Which nurse response to the parent indicates the nurse recognizes the importance of the child's increasing responsibility for their personal heath choice?
"I recommend you talk with your adolescent child and discuss their preference for which dentist to visit."
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."
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."
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?
"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?"
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, he can still have his shots."
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 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
The nurse will record what information about each vaccine after immunizing a child? Select all that apply.
-Lot number and expiration date of vaccine -Site and route of vaccine administration -Manufacturer of vaccine
The nurse will administer which recommended immunizations to an 11- or 12-year-old patient during a wellness visit? Select all that apply.
-Tetanus, diphtheria, pertussis (Tdap) -Human papillomavirus (HPV) -Meningococcal vaccine (MCV)
The nurse will expect that which hearing test will be performed before the newborn is discharged home?
Auditory brainstem response
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?
Do the well-child exam and give the immunizations due.
The nurse is doing a health history for a 14-year-old boy during a health supervision visit. The boy says he has outgrown his clothes recently. For which condition should the nurse check, based on this information?
Iron deficiency anemia
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?
Rotavirus (RV)
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?
Setting up screenings in a public library downtown
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?
Snellen eye chart
