NUR109- Mod 1 Chapter 31
The nurse will expect that which hearing test will be performed before the newborn is discharged home?
auditory brainstem response
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 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.
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
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 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 nurse is discussing varicella immunization with a parent of a 13-month-old infant. The parent is reluctant to vaccinate because "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 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 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."
The school nurse has just finished an educational program for the children at a local elementary school. Which statement by a student would indicate a need for further education?
"I love to eat dry cereal for breakfast."
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."
The nurse is caring for families at a health clinic. Which statement by a client would indicate to the nurse that the health clinic should take steps to be more effective at providing health supervision to this community?
"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."
How would the nurse respond when the parent asks the nurse why she is using pictures with high-contrast patterns to assess a 4-month-old's vision?
"The child's eyes are more attune to high-contrast patterns than to specific colors."
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."
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."
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?"
Which statements by a parent would indicate to the nurse that the family has a future-based orientation? Select all that apply.
- "We limit the amount of TV our children watch and are sure they get enough physical activity." - "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."
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.
- Schools (public and private) - Day care centers - Churches, synagogues, and mosques
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 mother did not complete high school. - The infant's mother is a single parent.
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 becomes very frustrated and tells the nurse she can't handle her toddler's temper tantrum.
The nurse will record what information about each vaccine after immunizing a child? Select all that apply.
- manufacturer of vaccine - site and route of vaccine administration - lot number and expiration date of vaccine
Which child(ren) will the nurse avoid immunizing with a live-virus vaccine? Select all that apply.
- preschool-age child receiving radiation therapy - toddler with a severe acute illness
Using the recommended immunization schedule for infants, the nurse administers vaccines in what order from first to last?
1. Hepatitis B (HepB) 2. Rotavirus (RV) 3. Influenza 4. Measles, mumps, rubella (MMR)
The nurse will use the Denver Articulation Screening for children in what age range?
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?
Assess how the family is coping with the chronic illness.
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
The nurse is preparing to administer a routine vaccine to a pediatric client. When obtaining the vaccine, the nurse discovers the refrigerator containing the facility's vaccines has been unplugged for an unknown amount of time and is warmer than the proper storage temperature. Which action by the nurse is appropriate?
Discard all of the vaccines and reschedule the child for another appointment.
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.
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 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 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.
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)
Before administering an immunization to their child, the nurse asks parents to take which priority action?
Sign a consent form.
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
The nurse manager is mentoring a newly licensed nurse as they screen the vision of a 5-year-old child. Which action by the newly licensed nurse would alert the nurse manager to provide additional teaching?
The child is asked to place her toes on the pre-measured mark on the floor.
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.
The nurse is observing the parents and child during a health supervision visit. Which observation would alert the nurse to inquire and observe further?
The mother says, "Wait until we are finished with this doctor's visit and then I will take you to the bathroom."
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.
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 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
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 pediatric nurse will state that the priority reason to have a thorough grasp of the growth and development of children is to:
identify developmental risks or delays promptly.
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?
scheduling the last appointment each weekday at 3:30pm setting up screenings in a public library downtown
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