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."
The nurse will expect that which hearing test will be performed before the newborn is discharged home?
auditory brainstem response
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 nursing instructor has just completed a discussion about immunization. Which statement by a student would indicate a need for further instruction?
"An example of active immunity would be when immunoglobulins are passed from a mother to her infant by colostrum."
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 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 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 student nurse asks the nursing instructor why nurses must be adept at understanding normal growth and development in children when providing care. How should the nursing instructor respond?
"By knowing normal growth and development, the nurse is able to identify problems in growth and development."
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."
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 recommend you talk with your adolescent child and discuss their preference for which dentist to visit."
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?
"It is important I use sunscreen on my 4-month-old child."
The nurse is discussing healthy eating with the parents of a school-age client. Which statement by the parents indicates additional teaching is needed?
"It is more important for our child to get sleep than eat breakfast."
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."
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."
Which statements by a parent would indicate to the nurse that the family has a future-based orientation? Select all that apply.
"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."
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.
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 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?
"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."
The nurse is promoting the benefits of achieving a healthy weight to an overweight 12-year-old child and her parents. Which approach is best?
Ask what activities she enjoys such as dance or sports.
The community health nurse is planning an immunization clinic. Which action(s) will the nurse use to overcome the barriers to children being fully immunized? Select all that apply.
Check the immunization status of siblings who accompany the child to the clinic appointment. Use every health contact with the child (hospital, clinic, etc.) to check status/administer vaccines. Use combination vaccines to reduce the number of injections children receive in each visit. Schedule walk-in times and evening hours for immunization clinics.
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 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
Using the recommended immunization schedule for infants, the nurse administers vaccines in what order from first to last?
Hepatitis B (HepB) Rotavirus (RV) Influenza Measles, mumps, rubella (MMR)
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 preparing to administer an intramuscular immunization to a 1-month-old infant. What action will the nurse take?
Request the parent to remove the infant's pants so the vastus lateralis muscle is accessible.
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.
Before administering an immunization to their child, the nurse asks parents to take which priority action?
Sign a consent form.
The community nurse is preparing an educational session on how to provide anticipatory guidance to clients for other nurses. Which example will the nurse include in the teaching?
Teaching handwashing at an elementary school.
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.
During the health history of a 2-month-old infant, the nurse identified a risk factor for developmental delay and is preparing to screen the child's development. Which risk might the nurse have found?
The child has small eyes and chin.
The nurse is preparing to administer the measles, mumps and rubella (MMR) vaccine to a child. Which would be a contraindication to administering the vaccine at that time?
The child received the intranasal flu vaccine 2 weeks ago.
A nursing student is asked to provide reasons it is important for the physician or nurse practitioner to have knowledge of the community in which the families and children seen in the practice live. Select all that apply.
The community can be a contributor to child-family health or a cause of illness. Knowing the community is necessary in developing appropriate health surveillance programs. Awareness of agencies serving children results from knowing the community. Understanding the community promotes improved working relationships between families and physicians or nurse practitioners.
The nurse is educating the parent of a 6-month-old infant during a well-baby clinic visit. What does the nurse recommend regarding dental health?
The family should establish a regular dentist for the infant by the time the infant has the first birthday.
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.
During the health history of a 3-month-old, the nurse identified risk factors for developmental delay and is preparing to assess the child's development. Which risk factors did the nurse find? Select all that apply.
The infant's mother is a single parent. The mother did not complete high school.
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.
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 student nurse is preparing to administer an immunization to an 18-month-old child under the direction of a registered nurse. Which actions by the student nurse indicate the need for the registered nurse to intervene? Select all that apply.
The student nurse prepares the triceps muscle for the IM injection. The student nurse reports that IM injections are to be avoided for children under the age of 2 years. The student nurse reports plans to use a 20G needle for an IM deltoid injection.
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 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)
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
Curious parents ask what type of immunity is provided to their child through immunization with various vaccines. What will be the nurse's answer?
artificially acquired active immunity
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 doing a health history for a 14-year-old pregnant girl during a health supervision visit. For which condition should she be screened?
iron-deficiency anemia
The nurse is working with an adolescent to promote a healthy weight. Which goal would be appropriate for the nurse and adolescent to work toward?
limiting computer/TV time
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
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 is interacting with several families with children during their health visits. Which child would the nurse prioritize to receive a hearing screening?
the 3-week-old infant who was discharged without a hearing screening
