Primary Family I Pediatric Test 1

The primary care pediatric nurse practitioner cares for children from a Native American family and learns that they used many herbs to treat and prevent illness. Which approach will the pediatric nurse practitioner use to promote optimum health in the children? 1. Ask about the types of practices used and when they are applied. 2. Provide a list of harmful herbs and ask the family to avoid those. 3. Suggest that the family avoid using these remedies in their children. 4. Tell the parents to use the herbs in conjunction with modern medications

1. Ask about the types of practices used and when they are applied.

The primary care pediatric nurse practitioner is evaluating health literacy in the mother of a new preschool age child. How will the nurse practitioner assess 1. Ask the child how many books he has at home. 2. Ask the mother about her highest grade in school. 3. Ask the mother to determine the correct dose of a drug from a label. 4. Ask the mother to read a health information handout aloud.

1. Ask the child how many books he has at home.

When formulating developmental diagnoses for pediatric patients, the primary care pediatric nurse practitioner may use which resource? 1. DC: 0-3 R 2. ICD-10-CM 3. ICSD-3 4. NANDA International

1. DC: 0-3 R

A teen should be checked for depression at __________ physician visit(s). 1. Every 2. One 3. Monthly 4. Biyearly

1. Every

A mental health nurse is teaching the mother of a child with executive functioning issues ways to help her child. Interventions the mother should use include: 1. Placing visual aids on the bathroom mirror so that the child will follow the morning routine. 2. Give the child a choice in foods to eat. 3. Allowing the child to ask for help when needed. 4. Reminding the child to be nice to others.

1. Placing visual aids on the bathroom mirror so that the child will follow the morning routine.

The mother of a newborn tells the primary care pediatric nurse practitioner that she is worried that her child will develop allergies and asthma. Which tool will the nurse practitioner use to evaluate this risk? 1. Three generation pedigree 2. Review of systems 3. Genogram 4. Ecomap

1. Three generation pedigree

What has been the result of passage of the Toxic Substances Control Act (TSCA) of 1976? 1. A mandate for corporations to disclose known toxic chemicals 2. A requirement that all manufactured chemicals undergo toxicity testing 3. Authorization of the EPA to require testing and reporting of some chemicals 4. Development of a mechanism to report reactions to toxic

3. Authorization of the EPA to require testing and reporting of some chemicals

The primary care pediatric nurse practitioner sees a 3 year old child who chronically withholds stools, in spite of the parents' attempts to stop the behavior, requiring frequent treatments with laxative medications. Which diagnosis will the nurse practitioner use to facilitate third party reimbursement? 1. Altered elimination pattern 2. Elimination disorder 3. Encopresis 4. Parenting alteration

3. Encopresis

A child has a lead level of 25 mcg/dL. Once lead abatement measures are instituted, what is an important intervention to help prevent permanent damage 1. Chelation therapy 2. Dietary changes 3. Followup testing 4. Testing family members

3. Followup testing

Learning disabilities in children have scientifically been linked to: 1. Poor nutrition. 2. The environment in which the child lives. 3. Genetics. 4. Watching more than four hours of television a day.

3. Genetics.

When meeting with a new family, the primary care pediatric nurse practitioner ID: develops a database that identifies family members and others living in the household, relationships with others outside the household, and significant behavioral and emotional problems. Which tool will the nurse practitioner use to record this information? 1. CRAFFT 2, Ecomap 3. Genogram 4.Pedigree

3. Genogram

An 8 year old boy with a history of hallucinations and violent behavior has been place in a seclusion room at the hospital because he has been hurting others. The nurse checks on the patient and realizes she must take him out of the seclusion room when: 1. He is crying to be released. 2. He states, I will be a good boy now. 3. He starts head butting the window. 4. He complains that his parents will file a lawsuit.

3. He starts head butting the window.

The primary care pediatric nurse practitioner evaluates a school age child whose body mass index (BMI) is greater than the 97th percentile. The nurse practitioner is concerned about possible metabolic syndrome and orders laboratory tests to evaluate this. Which diagnosis will the nurse practitioner document for this visit? 1. Metabolic syndrome 2. Nutritional alteration: more than required 3. Obesity 4. Rule out type 2 diabetes mellitus

3. Obesity

A teenager diagnosed with borderline personality disorder should have discharge planning instructions of: 1. A consistent caregiver. 2. Monitoring of media, such as the Internet, television, and video games. 3. Obtaining support from family and friends. 4. Seeking medical attention when the teenager feels good

3. Obtaining support from family and friends.

During a clinic visit, a child's rapid capillary screening test for lead reveals a level of 11 mcg/dL. What will the primary care pediatric nurse practitioner do next? 1. Institute lead abatement measures in the child's home. 2. Monitor lead levels monthly until decreased. 3. Order a venous sample to test for lead levels. 4. Test the child's siblings and parents for lead.

3. Order a venous sample to test for lead levels.

An infant displays depression by: 1. Smiling at strangers. 2. Bonding to someone other than the immediate family. 3. Crying more than an average infant. 4. Looks away when an adult attempts to play with the infant

4. Looks away when an adult attempts to play with the infant

A child that has not exhibited enuresis in four years has exhibited this behavior pattern for the last week. The reason a child may revert back to this behavior pattern is because of: 1. Hallucinations. 2. Behavioral challenges. 3. Delusions. 4. Stress.

4. Stress.

A parent desires to buy only organic produce to avoid exposing a child topesticides but complains that these foods are expensive. The primary care pediatric nurse practitioner provides a list of foods that are relatively safe whether they are organic or not. Which foods are on this list? 1. Apples, celery, and peaches 2. Potatoes, cherry tomatoes, and peaches 3. Strawberries, grapes, and cucumbers 4. Sweet corn, cantaloupe, and kiwi

4. Sweet corn, cantaloupe, and kiwi

The primary care pediatric nurse practitioner in a community health center meets a family who has recently immigrated to the United States who speak only Karon. They arrive in the clinic with a church sponsor, who translates for them. The pediatric nurse practitioner notices that the sponsor answers for the family without giving them time to speak. The pediatric nurse practitioner will 1. ask the sponsor to allow the family to respond. 2. develop the plan of care and ask the sponsor to make sure it is followed. 3. request that the sponsor translate written instructions for the family. 4. use the telephone interpreter service to communicate with the family

4. use the telephone interpreter service to communicate with the family

A child whose parent works in a factory presents with swelling of the extremities, pain and weakness in the pelvis, and an erythematous maculopapular rash. Which industrial toxin will the primary care pediatric nurse practitioner suspect in this child? A. Lead B. Mercury C. Organophosphates D. Phthalates

B. Mercury

When providing well child care for an infant in the first year of life, the primary care pediatric nurse practitioner is adhering to the most recent American Academy of PediatricsRecommendations for Preventive Pediatric Health Care guidelines by A. focusing less on development and more on illness prevention and nutrition. B. following guidelines established by theBright Futures publication. C. scheduling well baby visits to coincide with key developmental milestones. D. seeing the infant at ages 2, 4, 6, and 12 months when immunizations are due.

C. scheduling well baby visits to coincide with key developmental milestones.

Many European nations use the "precautionary principle" to help regulate potentially toxic chemicals. What does this mean? G. Chemicals must be proven to be safe before being introduced into the environment. H. Corporations may be exempt from testing if their costs in doing so are too high. I. Regulators must demonstrate risk to the public before banning a chemical. J. Without a strong risk, corporations need not release data about their products.

G. Chemicals must be proven to be safe before being introduced into the environment.

A Somalian immigrant mother is concerned that her 8 year old child is underweight. The primary care pediatric nurse practitioner notes that the child's weight is at the 25th percentile. After realizing that the mother is comparing her child to a group of American born children who are overweight, the pediatric nurse practitioner is able to convince the mother that this is a normal weight. Which domain of cultural competence does this represent? 1. Global 2. Interpersonal 3. Intrapersonal 4. Organizational

Interpersonal

The primary care pediatric nurse practitioner is performing a well child check up on a 20 month old child. The child was 4 weeks premature and, according to a parent completed developmental questionnaire, has achieved milestones for a 15 month old infant. Which action is correct? J. Perform an in depth developmental assessment screen at this visit to evaluate this child. K. Reassure the parent that the child will catch up to normal development by age 2 years. L. Reevaluate this child's development and milestone achievements at the 2year visit. M. Refer the child to a specialty clinic for evaluation and treatment of developmental delay.

J. Perform an in depth developmental assessment screen at this visit to evaluate this child.

. The primary care pediatric nurse practitioner provides well child care for a community of immigrant children from Central America. The pediatric nurse practitioner is surprised to learn that some of the families are Jewish and not Catholic. This response is an example of cultural O. collectivism. P. constructivism. Q. essentialism. R. individualism.

Q. essentialism.

Health Status of Children: Global and National Perspectives Which region globally has the highest infant mortality rate? 1. Indonesia 2. Southern Asia 3. SubSaharan Africa 4. Syria

SubSaharan Africa

The primary care pediatric nurse practitioner understands that, to achieve the greatest worldwide reduction in child mortality from pneumonia and diarrhea, which intervention is most effective? 1. Antibiotics 2. Optimal nutrition 3. Vaccinations 4. Water purification

Vaccinations

The primary care pediatric nurse practitioner understands that a major child health outcome associated with worldwide climate change is 1. cost of living 2. education 3. nutrition 4. pollution

nutrition

The primary care pediatric nurse practitioner prescribes a twice daily inhaled corticosteroid for a 12 year old child. At a well child visit, the child reports not using the medication on a regular basis. Which response by the pediatric nurse practitioner demonstrates an understanding of client centered care? 1. Asking the child to describe usual daily routines and schedules 2. Referring the family to a social worker to help with medication compliance 3. Reviewing the asthma action plan with the parent and the child 4. Teaching the child how the medication will help to control asthma symptoms

1. Asking the child to describe usual daily routines and schedules

A parent asks about ways to limit exposure to risks associated with plastics. Besides avoiding using plastic containers when possible, what else will the primary care pediatric nurse practitioner recommend? 1. Avoid heating foods and liquids in plastic containers. 2. Clean plastic containers well using the dishwasher. 3. Use only plastics stamped with "#7" on the bottom. 4. Used canned food products whenever possible.

1. Avoid heating foods and liquids in plastic containers.

An 18 year old male has called the crisis line for help. The crisis nurse recognizes the intervention needs may consist of all of the following except: 1. Discussing the individuals everyday activities. 2. Recognizing that the patient may be in a catharsis state. 3. Expressing empathy toward the caller 4. Avoiding entropy

1. Discussing the individuals everyday activities.

An adolescent with a known history of bipolar disorder is in the school nurses office because a teacher reported that she was talking fast and acting like she was God. The school nurse assesses the girl and notes that: 1. She is probably in a manic phase and needs to be treated professionally. 2. She has had too much sleep and is now hyperactive. 3. She forgot to take her medications today. 4. She requires some food and rest before going back to class.

1. She is probably in a manic phase and needs to be treated professionally.

A 16 year old male has received a pink slip from the police for inpatient psychiatric treatment. The teen has been expressing thoughts of hanging himself because Life sucks. The nursing staff should consider placing the child: 1. With peers. 2. In an area where he can be watched one on one .3. With a roommate that is expressing the same concerns. 4. In an area close to an external door

2. In an area where he can be watched one on one

A father reports that his adolescent daughter has gotten good grades up until the last quarter of school. She has been hanging out by herself and does not want to talk to him anymore. The mental health nurse should: 1. Realize that this is a natural part of growing up. 2. Perform a mental health screening to check for depression. 3. Attempt to get the adolescent to discuss why she does not like her father anymore. 4. Let the adolescent talk when she is ready.

2. Perform a mental health screening to check for depression.

Ellie, a 9 year old girl, was adopted by a family at the age of 4 after several years of severe neglect by her birth family. The adoptive family has been reporting that Ellie is angry a lot, manipulative with her teachers, and does not seek positive attention. The nurse working with Ellie will need to: 1. Provide education on decreasing stimuli in the home environment that triggers the anger. 2. Realize Ellie may have attachment issues related to her previous history and will need to encourage the family to be active in her care. 3. Support the family in the decisionmaking process of continuing to let Ellie live in the home. 4. Discuss inpatient therapy to decrease Ellies manipulative behavior patterns.

2. Realize Ellie may have attachment issues related to her previous history and will need to encourage the family to be active in her care.

A child has been exhibiting the MacDonald Triad. These behaviors include: 1. Enuresis, pushing others, and pyromania. 2. Swinging a cat by the tail, bedwetting, and lighting paper on fire in the trash can. 3. Playing with other children, laughing, and conversing with adults. 4. Playing with a campfire, watching television, and seeking adult attention

2. Swinging a cat by the tail, bedwetting, and lighting paper on fire in the trash can.

A child who has been playing in a public park is brought to the clinic with ID: wheezing, vomiting, diarrhea, and drooling. A physical exam reveals a low heart rate and diaphoresis. What will the primary care pediatric nurse practitioner suspect as a cause for these symptoms? 1. Arsenic consumption 2. Lead poisoning 3. Organophosphate exposure 4. Phthalate ingestion

3. Organophosphate exposure

The primary care pediatric nurse practitioner works with families from a variety of cultures and socioeconomic classes. Which is an example of cultural humility in practice? 1. Giving health care advice that takes cultural differences into account 2. Identification of other cultures that may be superior to one's own culture 3. Receptivity to learning about the perspectives of other cultures 4. Respecting other cultures while maintaining the views of one's own

3. Receptivity to learning about the perspectives of other cultures

The parent of a toddler is concerned that the child may have autism. The primary care pediatric nurse practitioner completes a Modified Checklist for Autism in Toddlers (MCHAT) tool, which indicates several areas of concern. What will the nurse practitioner do? 1. Administer a Childhood Autism Rating Scale (CARS) in the clinic. 2. Consult a specialist to determine appropriate early intervention strategies. 3. Refer the child to a behavioral specialist for further evaluation. 4. Tell the parent that this result indicates that the child has autism.

3. Refer the child to a behavioral specialist for further evaluation.

A school nurse is giving an inservice to teachers on bullycide. The main reason for the teaching is so that: 1. Teachers are aware bullying occurs. 2. Teachers are able to identify students who are risk. 3. Teachers can be aware of the fact that suicides can happen due to bullying by others. 4. Teachers are aware of their role in causing bullycide

3. Teachers can be aware of the fact that suicides can happen due to bullying by others.

A mental health nurse has assessed a child and determined that the child exhibits behavioral challenges. When the school nurse explains this to a teacher, the best description would be: 1. The child may exhibit physical outbursts. 2. The child may exhibit violence toward others. 3. The child may be defiant or have tantrums. 4. The child will need special interventions for learning.

3. The child may be defiant or have tantrums.

The primary care pediatric nurse practitioner learns that an AfricanAmerican family lives in a neighborhood with a high crime rate and suggests that they try moving to another neighborhood for the safety of their children. This is an example of 1. cultural sensitivity 2. group bias 3. individual privilege. 4. racial awareness.

3. individual privilege.

When using the SAD FACES depression screen, it is important to assess: 1. Anhedonia. 2. Suicidal ideations. 3. Sleep patterns. 4. All of the above

4. All of the above

A nurse is explaining the therapeutic milieu to a new nurse. The best explanation of this term would be: 1. The place where the child is receiving care. 2. Group therapy. 3. Personal interactions between patients and staff. 4. All of the above are correct.

4. All of the above are correct.

The primary care pediatric nurse practitioner is assessing a toddler whose weight and body mass index (BMI) are below the 3rd percentile for age. The nurse practitioner learns that the child does not have regular mealtimes and is allowed to carry a bottle of juice around at all times. The nurse practitioner plans to work with this family to develop improved meal patterns. Which diagnosis will the nurse practitioner use for this problem? 1. Failure to thrive 2. Home care resources inadequate 3. Nutrition alteration - less than required 4. Parenting alteration

4. Parenting alteration

A child is in the clinic for evaluation of an asthma action plan. The primary care pediatric nurse practitioner notes that the child's last visit was for a prekindergarten physical and observes that the child is extremely anxious. What will the nurse practitioner do initially? 1. Ask the child's parent why the child is so anxious. 2. Perform a physical assessment to rule out shortness of breath. 3. Reassure the child that there is nothing to be afraid of. 4. Review the purpose of this visit and any anticipated procedures.

4. Review the purpose of this visit and any anticipated procedures.

The primary care pediatric nurse practitioner is obtaining a medical history about a child. To integrate both nursing and medical aspects of primary care, which will be included in the medical history? 1. Complementary medications, alternative health practices, and chief complaint 2. Developmental delays, nutritional status, and linear growth patterns 3. Medication currently taking, allergy information, and family medical history 4. Speech and language development, beliefs about health, and previous illnesses

4. Speech and language development, beliefs about health, and previous illnesses

The primary care pediatric nurse practitioner is performing a well child assessment on an adolescent and is concerned about possible alcohol and tobacco use. Which assessment tool will the nurse practitioner use? A. CRAFFT 2. HEEADSSS 3. PHQ2 4. RAAPS

A. CRAFFT

3. Which is true about the health status of children in the United States? A. Globalism has relatively little impact on child health measures in the U.S. B. Obesity rates among 2 to 5yearolds have shown a recent significant decrease. C. The rate of household poverty is lower than in other economically developed nations. D. Young children who attend preschool or day care have higher food insecurity.

B. Obesity rates among 2 to 5yearolds have shown a recent significant decrease.

When counseling a mother who smokes about preventing exposure to smoking related risks to her nursing newborn, what will the primary care pediatric nurse practitioner tell her? A. If she quits now, her child will not have longterm effects from exposure. B. Prenatal smoke exposure does not cause respiratory effects after the infant is born. C. Smoking outdoors or near an open window prevents exposure to tobacco smoke. D. Thirdhand smoke exposure risks may last for years even if the mother quits now.

D. Thirdhand smoke exposure risks may last for years even if the mother quits now.

The primary care pediatric nurse practitioner performs a developmental assessment on a 3 year old child and notes normal cognitive, fine motor, and grossmotor abilities. The child responds appropriately to verbal commands during the assessment but refuses to speak when asked questions. The parent tells the nurse practitioner that the child talks at home and that most other adults can understand what the child says. the nurse practitioner will: D. ask the parent to consider a possible speech delay and report any concerns. E. continue to evaluate the child's speech at subsequent visits. F. refer the child for a speech and hearing evaluation. G. tell the parent to spend more time in interactive conversations with the child.

E. continue to evaluate the child's speech at subsequent visits.

The primary care pediatric nurse practitioner learns that the mother of a 3 year old child has been treated for depression for over 5 years. Which aspect of this child's development will be of the most concern to the nurse practitioner? D. Fine motor E. Gross motor F. Social/emotional G. Speech and language

G. Speech and language