Chapter 28: Child and Adolescent Health

A nurse is caring for a preschool-aged child who has been exposed to environmental tobacco smoke (ETS) on a regular basis. Which of the following is the child at greater risk for because of this exposure? a. Middle ear infections b. SIDS c. Living in poverty d. Behavioral disturbances

A Children exposed to ETS experience increased episodes of middle ear infections, asthma, upper respiratory tract infections, and more missed school days. SIDS incidence increases with ETS exposure, but this is not a concern with a preschool-aged child.

A nurse is providing anticipatory guidance to parents who have a child under 1 year of age. Which of the following would be the most important topic to discuss? a. Occluded airway b. Burns c. Poisoning d. Falls

A Children under 1 year of age are most frequently injured by occluded airways. Burns, poisoning, and falls are risks for all age groups and are more likely to happen with children over age 1.

A nurse is using motivational interviewing when communicating with a family about improving their eating habits. Which of the following questions would the nurse most likely ask when using this technique? a. "Do you feel comfortable restricting foods your child eats?" b. "Why do you choose unhealthy snacks?" c. "What changes would you like to make to improve your diet?" d. "Where do you do your grocery shopping?"

A Motivational interviewing is a focused communication strategy in which the parents are encouraged to set goals, identify personal barriers, and identify potential mechanisms to overcome the barriers to make safety and health promotion changes for their child. Nurses use open-ended questioning and reflection to encourage sharing from the child and parents. The other questions may be viewed as being judgmental from the perspective of the client and the client may not answer the question truthfully.

A nurse is actively participating in efforts to reduce gun violence among young people. Which of the following actions is most likely being taken by the nurse? a. Identifying populations at risk for violence b. Passing legislation to support gun control c. Searching lockers at school looking for weapons and contraband d. Caring for clients who have sustained gunshot wounds

A Nurses can identify populations at risk and target this population for aggression or anger management. The other responses are not activities community health nurses would engage in.

Which statement is true about the role of nurses in community health? a. The nurse provides direct services to children and their families. b. A major role of community health nurse is the provision of immunizations. c. Children are not the primary focus of community health, since they are often acutely ill. d. Complementary therapies and environmental toxins are often the focus of the health care of children.

A The nurse provides direct services to children and their families: assessing and managing care, education, and counseling. Provision of immunizations is not a major role of community health nurses. Children are not often acutely ill nor are complementary therapies and environmental toxins the focus of health care.

A nurse is providing a health education program for the community about prevention of lead poisoning. Which of the following information would the nurse most likely include in the program? a. Universal screening for all children ages 1 and 2 years is recommended. b. Lead poisoning can lead to serious respiratory system complication. c. The most common exposure to lead occurs when children play with imported toys. d. Lead-based paints are found in all homes built before 1987.

A Universal screening is recommended for 1 and 2 year olds. Lead poisoning can cause significant neurological, cardiovascular, and renal disease. The most common exposure is through lead-based paints and lead-contaminated soil and dust in houses built before 1987. Lead-based paints may be found in some homes built before 1987, but not all.

A community health nurse is working with adolescents. Which of the following characteristics would most likely be displayed by an adolescent who is at increased risk to engage in risk-taking behavior? a. Poor academic performance b. High self-esteem c. Middle-class income d. Involvement in extracurricular activities

A Increased adolescent risk-taking behaviors include: poor academic performance, poor parental role models, low self-esteem, lack of a supportive social environment, and poverty.

A nurse is counseling a family about the management of childhood obesity. Which of the following recommendations should be made by the nurse? (Select all that apply.) a. Set goals related to having a healthier lifestyle, not dieting b. Have low-calorie, nutritious snacks available and ready c. Allow snacking in front of the TV for short periods of time d. Decrease computer time and replace it with activities and chores e. Invest in a gym membership at a local facility

A, B, D Setting goals for a healthier lifestyle; having low-calorie, nutritious snacks available; and decreasing computer time will assist in managing childhood obesity. Allowing snacking in front of the TV will not decrease childhood obesity. Purchasing a gym membership may be expensive and if not used on a regular basis will have limited effect on obesity.

A nurse is educating parents about sports safety. Which of the following information would be included in the education? (Select all that apply.) a. Grouping children according to weight, size, and skill level b. Providing adequate supervision by competent teenagers if adults are not available c. Using appropriate-size equipment d. Encouraging attendance at events by medical personnel e. Having an automated external defibrillator (AED) onsite

A, C Grouping children by size and skill level and using appropriate-size equipment are the best actions to promote sports safety. Teenagers cannot adequately supervise children in sports activities, and medical personnel do not need to be present at all sports events. Having an AED onsite is ideal, but may not be realistic.

A family with children has income too high to qualify for state health insurance, but does not have enough money to purchase private health insurance. Which program would a nurse refer this family to for the children to receive health care coverage? a. Medicare b. Children's Health Insurance Plan (CHIP) c. Medicaid d. Social Security

B CHIP is a federal and state partnership that is directed toward uninsured children and pregnant women in families with incomes too high to qualify for state Medicaid programs but too low to afford private coverage. Medicare is a government insurance program primarily offered to the elderly population. Social Security is not a health care insurance program.

Which statement about sudden infant death syndrome (SIDS) is true? a. SIDS occurs most often in female infants. b. Maternal cigarette smoking increases risk. c. Most deaths occur between 2 and 8 months of age. d. Most victims had a previous episode of cyanosis or apnea.

B Maternal smoking increases risk three to four times. SIDS occurs most often in male infants, most deaths occur between 1 and 5 months, and only a small number of victims have had a previous episode of cyanosis or apnea.

The leading cause of death for unintentional injuries among children and teenagers is: a. drowning. b. motor vehicle accidents. c. burns. d. poisonings.

B Motor vehicle crashes remain the leading cause of death for unintentional injuries in children and teens. Drowning, poisonings, and burns account for most of the other deaths.

A nurse assesses the playground safety at a new community center and notices rope swings and a trampoline. Which of the following actions should be taken by the nurse? a. No action is required. b. Explain to the staff that these items are not recommended for playgrounds. c. Supervise the children closely when they are using this equipment. d. Compose a letter to be shared at the next city council meeting.

B Rope swings and trampolines are not recommended for playgrounds. Action should be taken by the nurse because these items are dangerous. Close supervision will not prevent an accidental injury from occurring. Writing a letter to be shared at the next city council meeting is not a timely response by the nurse.

A nurse is assessing a child with chronic health problems and his family. Which of the following factors should be taken into account? a. The ability of the family to pay for expensive equipment b. The degree of impairment to the child's ability to develop c. How often recreational activities will take place d. Special needs "camp" placement for the child in the summer

B The degree of impairment to the child's ability to develop is a concern of the community health nurse. Financial resources need to be assessed and adaptations may need to be made to avoid expensive equipment. The frequency of other treatments and therapies should be considered in addition to recreational activities. A special needs "camp" placement may not be an appropriate suggestion for every child with chronic health problems.

A nurse is planning to administer an immunization to a child. Which of the following factors would be a medical contraindication for the administration of immunizations? a. Religious beliefs b. Sore throat c. Leukemia d. Fear of side effects

C People with the following conditions are not routinely immunized and require medical consultation: pregnancy, generalized malignancy, immunosuppressive therapy or immunodeficiency disease, sensitivity to components of the agent, or recent administration of immune serum globulin, plasma, or blood. Leukemia would be a medical contraindication for receiving an immunization. Religious beliefs, sore throat, and fear of side effects are not medical contradictions.

A nurse is aware that there is a rising incidence of abusive head trauma (AHT). Which of the following would be a focus of the nurse? a. Taking at-risk babies out of violent households b. Placing babies under the care of community health nurses c. Educating and providing support to new parents d. Helping those affected seek proper legal representation

C Prevention strategies are necessary to reduce the incidence of AHT. Parental education and support is necessary to prevent child maltreatment. Taking at-risk babies out of violent households, placing babies under the care of community health nurses, and helping those affected seek proper legal representation are not prevention strategies.

The group with the lowest injury death rate is: a. infants. b. toddlers and preschoolers. c. school-age children. d. adolescents

C School-age children have the lowest death rate among younger age groups. Infants have the second highest injury rate of all groups of children; their small size contributes to some types of injury. Adolescents are at the highest risk of any age group for motor vehicle deaths and fatal poisonings.

A mother tells the nurse she is afraid to have her infant immunized. Which of the following statements would be the most appropriate response by the nurse? a. "It is normal to be concerned, as some immunizations have been linked to autism." b. "Researching the Internet will provide you more information as to the importance of immunizations." c. "Choosing not to vaccinate your child puts your child and others at risk." d. "Your infant received active immunity at birth, so immunizations are not indicated until 4 months of age."

C The child who is not immunized and others around the child are at risk if immunizations do not occur. Scientific studies have not found a relationship between immunizations and autism. Information that is researched on the Internet may not be a reliable source of information as the nurse has no control over the information the client receives. Infants receive natural passive immunity at birth through the placental transfer of maternal antibodies; this protection lasts for about 2 months.

A nurse is caring for a client who has a medical home. Which of the following best describes what is being used by the client? a. A building that houses multiple primary care providers and specialists b. A partnership between a community health nurse, a client, and a family c. A system that meets the needs of the individual, family, and community d. A collaboration of care provided by an inter-professional team

D A medical home emphasizes an integrated health system with collaboration of care from an interprofessional team of primary care physicians, specialists and subspecialists, other health professionals, hospitals and health care facilities, and public health and community working with children and families. The medical home may not necessarily all be housed in the same building. The partnership is bigger than only the nurse, client, and family. The medical home is specific to meeting the needs of the child and family.

A nurse is working with a child who lives in poverty. Which of the following best describes this child? a. A child who has poor academic performance b. A child whose parents have a college education c. A child of Caucasian descent d. A child living in a single-parent household

D Characteristics that put children at risk for living in low-income families are parents without a high school degree, lack of parental employment, and living in a single-parent household.

A nurse is conducting a developmental screening to assess for domain-specific development, including gross and fine motor skills. Which developmental screening tool would the nurse most likely use? a. Pediatric Symptom Checklist b. Ages and Stages Questionnaire c. Parents' Evaluation of Developmental Status d. Denver II

D The Denver II screening tool assesses domain specific development (gross and fine motor, social, and language). The Pediatric Symptom Checklist assesses coping and mental health concerns, the Ages and Stages Questionnaire assesses social and emotional development, and the Parents' Evaluation of Developmental Status assesses general developmental and behavioral screening.