chap 6 health promotion

Question 11 Type: MCSA The nurse is assessing an adolescent client whose weight is in the 5th percentile. Based on this information, which question is most appropriate for the nurse to ask the adolescent client? 1. Do you eat the school lunches? 2. Do you have any concerns about your weight? 3. Do you eat fruits, vegetables, and drink milk? 4. How many meals do you eat each day?v

Correct Answer: 2 Rationale 1: The only question that addresses the adolescents weight, which is below the expected norm, is Do you have any concerns about your weight? Asking about school lunches, eating fruits and vegetables, and how many meals eaten each day should be used to obtain a nutritional history; however, those questions do not address the underweight status of the adolescent. Rationale 2: The only question tha

Question 7 Type: MCSA A nurse says to the mother of a 6-month-old infant, Does the baby sit without assistance, and is the baby crawling? Which process is the nurse using in this interaction? 1. Health promotion 2. Health maintenance 3. Disease surveillance 4. Developmental surveillance

Correct Answer: 4 Rationale 1: The question asked by the nurse is seeking information about developmental milestones; therefore, the nurse is involved in developmental surveillance. While health-promotion and health-maintenance activities are related to developmental surveillance, this question is looking specifically at the milestones; therefore, the answers health promotion and health maintenance are incorrect. The questions asked in the stem are not classified as disease-surveillance questions. Rationale 2: The question asked by the nurse is seeking information about developmental milestones; therefore, the nurse is involved in developmental surveillance. While health-promotion and health-maintenance activities are related to developmental surveillance, this question is looking specifically at the milestones; therefore, the answers health promotion and health maintenance are incorrect. The questions asked in the stem are not classified as disease-surveillance questions. Rationale 3: The question asked by the nurse is seeking information about developmental milestones; therefore, the nurse is involved in developmental surveillance. While health-promotion and health-maintenance activities are related to developmental surveillance, this question is looking specifically at the milestones; therefore, the answers health promotion and health maintenance are incorrect. The questions asked in the stem are not classified as disease-surveillance questions. Rationale 4: The question asked by the nurse is seeking information about developmental milestones; therefore, the nurse is involved in developmental surveillance. While health-promotion and health-maintenance activities are related to developmental surveillance, this question is looking specifically at the milestones; therefore, the answers health promotion and health maintenance are incorrect. The questions asked in the stem are not classified as disease-surveillance questions.

Question 6 Type: MCSA A mother of a 2-year-old child becomes very anxious when the child has a temper tantrum in the medical office. Which response by the nurse is the most appropriate? 1. What do you usually do or say during a temper tantrum? 2. Lets ignore this behavior; it will stop sooner or later. 3. Pick up and cuddle your child now, please. 4. This is definitely a temper tantrum; I know exactly what you are feeling right now.

Correct Answer: 1 Rationale 1: Asking the mother to describe her usual behavior via an open-ended question will encourage the mother to talk about home management and will lead the nurse to assist the mother in making a plan of care for temper tantrums. Ignoring the behavior, instructing the mother to cuddle the child, or sympathizing with the mother (I know exactly what you are feeling) are not effective ways to problem solve for temper tantrums. Rationale 2: Asking the mother to describe her usual behavior via an open-ended question will encourage the mother to talk about home management and will lead the nurse to assist the mother in making a plan of care for temper tantrums. Ignoring the behavior, instructing the mother to cuddle the child, or sympathizing with the mother (I know exactly what you are feeling) are not effective ways to problem solve for temper tantrums. Rationale 3: Asking the mother to describe her usual behavior via an open-ended question will encourage the mother to talk about home management and will lead the nurse to assist the mother in making a plan of care for temper tantrums. Ignoring the behavior, instructing the mother to cuddle the child, or sympathizing with the mother (I know exactly what you are feeling) are not effective ways to problem solve for temper tantrums. Rationale 4: Asking the mother to describe her usual behavior via an open-ended question will encourage the mother to talk about home management and will lead the nurse to assist the mother in making a plan of care for temper tantrums. Ignoring the behavior, instructing the mother to cuddle the child, or sympathizing with the mother (I know exactly what you are feeling) are not effective ways to problem solve for temper tantrums.

Question 4 Type: MCSA Which of these strategies would be most effective for a teachable moment during a routine office visit for the parents of a 6-year-old child? 1. Select one topic and present a brief amount of information on the topic. 2. Review all 6-year-old anticipatory guidelines with the parents. 3. Review 7-year-old anticipatory guidelines with the parents. 4. Discuss signs of malnutrition with the parents.

Correct Answer: 1 Rationale 1: Children and families often learn best when presented with small bits of information. Do not give too much information to the parents at one time; therefore, selecting one topic and presenting information is appropriate. It is not appropriate to discuss malnutrition with these parents, since nothing in the stem of the question indicates that the child has a problem with nutrition. Rationale 2: Children and families often learn best when presented with small bits of information. Do not give too much information to the parents at one time; therefore, selecting one topic and presenting information is appropriate. It is not appropriate to discuss malnutrition with these parents, since nothing in the stem of the question indicates that the child has a problem with nutrition. Rationale 3: Children and families often learn best when presented with small bits of information. Do not give too much information to the parents at one time; therefore, selecting one topic and presenting information is appropriate. It is not appropriate to discuss malnutrition with these parents, since nothing in the stem of the question indicates that the child has a problem with nutrition. Rationale 4: Children and families often learn best when presented with small bits of information. Do not give too much information to the parents at one time; therefore, selecting one topic and presenting information is appropriate. It is not appropriate to discuss malnutrition with these parents, since nothing in the stem of the question indicates that the child has a problem with nutrition.

Question 15 Type: MCSA A nurse is discussing health promotion activities with parents of a 4-year-old client. What health-promotion activity is most appropriate for this family? 1. Make arrangements to tour the kindergarten in which the child will enroll next year. 2. Plan a movie afternoon with the childs big brother. 3. Maintain appropriate immunizations. 4. Teach the child the proper method for brushing the teeth.

Correct Answer: 4 Rationale 1: Teaching proper oral hygiene through proper teeth brushing is a health-promotion activity. Touring the kindergarten might alleviate anxiety, but is not health promotion. A movie afternoon with the big brother is sedentary, and also not a health-promotion activity. Maintaining immunizations is a health-maintenance, not health-promotion, activity.

Question 1 Type: MCSA A nurse is helping the parents of 2-year-old twins cope with the daily demands of life in an active household. Which strategy is most appropriate for the nurse to use? 1. Health maintenance 2. Health promotion 3. Health protection 4. Health supervision

orrect Answer: 2 Rationale 1: In health promotion, nurses partner with families to promote family strategies in the areas of lifestyle and coping. The definition of health maintenance and health supervision makes the other answers incorrect. Health protection is another term for health maintenance. Rationale 2: In health promotion, nurses partner with families to promote family strategies in the areas of lifestyle and coping. The definition of health maintenance and health supervision makes the other answers incorrect. Health protection is another term for health maintenance. Rationale 3: In health promotion, nurses partner with families to promote family strategies in the areas of lifestyle and coping. The definition of health maintenance and health supervision makes the other answers incorrect. Health protection is another term for health maintenance. Rationale 4: In health promotion, nurses partner with families to promote family strategies in the areas of lifestyle and coping. The definition of health maintenance and health supervision makes the other answers incorrect. Health protection is another term for health maintenance.

Question 8 Type: MCSA A parent says to a nurse, How do you know when my child needs these screening tests the doctor just mentioned? Which response by the nurse is the most appropriate? 1. Screening tests are administered at the ages when a child is most likely to develop a condition. 2. Screening tests are done in the newborn nursery and from these results, additional screening tests are ordered throughout the first two years of life. 3. Screening tests are most often done when the doctor suspects something is wrong with the child. 4. Screening tests are done at each office visit.

Correct Answer: 1 Rationale 1: Screening tests administered at ages when a child is most likely to develop a condition provide a good basis for health promotion. The remaining answers all provide incorrect information to the parent. Abnormal newborn screening tests require immediate follow-up. Screening tests are done to detect the possibility of problems, not when a problem is suspected; at that point, a child needs diagnostic testing. Screening tests are not done at each office visit. Rationale 2: Screening tests administered at ages when a child is most likely to develop a condition provide a good basis for health promotion. The remaining answers all provide incorrect information to the parent. Abnormal newborn screening tests require immediate follow-up. Screening tests are done to detect the possibility of problems, not when a problem is suspected; at that point, a child needs diagnostic testing. Screening tests are not done at each office visit. Rationale 3: Screening tests administered at ages when a child is most likely to develop a condition provide a good basis for health promotion. The remaining answers all provide incorrect information to the parent. Abnormal newborn screening tests require immediate follow-up. Screening tests are done to detect the possibility of problems, not when a problem is suspected; at that point, a child needs diagnostic testing. Screening tests are not done at each office visit. Rationale 4: Screening tests administered at ages when a child is most likely to develop a condition provide a good basis for health promotion. The remaining answers all provide incorrect information to the parent. Abnormal newborn screening tests require immediate follow-up. Screening tests are done to detect the possibility of problems, not when a problem is suspected; at that point, a child needs diagnostic testing. Screening tests are not done at each office visit.

Question 5 Type: MCMA The clinic administrator has asked each nurse to classify the nursing activities as a beginning step of clinic reorganization. Which of these strategies can be identified as health promotion and health maintenance? Standard Text: Select all that apply. 1. Administration of the flu vaccine for infants from 6 months to 23 months old. 2. Daily feeding schedules for infants. 3. Instruction to adolescents on how to use dental floss. 4. Treatment for a child with a diagnosis of acute otitis media.

Correct Answer: 1,2,3 Rationale 1: Administering flu vaccines, discussion of feeding schedules, and instructions to adolescents are all health-promotion and/or health-maintenance topics. Treatment of an acute ear infection (otitis media) would not be a topic for health promotion and health maintenance since it is an acute illness. Rationale 2: Administering flu vaccines, discussion of feeding schedules, and instructions to adolescents are all health-promotion and/or health-maintenance topics. Treatment of an acute ear infection (otitis media) would not be a topic for health promotion and health maintenance since it is an acute illness. Rationale 3: Administering flu vaccines, discussion of feeding schedules, and instructions to adolescents are all health-promotion and/or health-maintenance topics. Treatment of an acute ear infection (otitis media) would not be a topic for health promotion and health maintenance since it is an acute illness. Rationale 4: Administering flu vaccines, discussion of feeding schedules, and instructions to adolescents are all health-promotion and/or health-maintenance topics. Treatment of an acute ear infection (otitis media) would not be a topic for health promotion and health maintenance since it is an acute illness.

Question 16 Type: MCMA The nurse educator is teaching a group of students about the key concepts of a medical home during the developmental years of the pediatric client. Which items should the educator include in the teaching session? Standard Text: Select all that apply. 1. Financial accessibility 2. Consistent, ongoing care 3. Coordination of care 4. No individualization of care 5. A paternalistic view of care

Correct Answer: 1,2,3 Rationale 1: All children need a medical home, where accessible, continuous, and coordinated health supervision is provided during the developmental years. Accessibility refers to both financial and geographic access; continuous indicates that the care is ongoing with consistent care providers; coordination refers to the need for communication among health professionals to provide for the needs of the child. Care is individualized and is not paternalistic.

Question 9 Type: MCMA Which nursing assessment activities should be included for the child and family at each health-supervision visit? Standard Text: Select all that apply. 1. Interview to obtain an updated health history. 2. Performing an age-appropriate development assessment. 3. Monitoring parents ability to pay for services. 4. Performing age-appropriate screening examinations. 5. Physical assessment for genetic abnormalities.

Correct Answer: 1,2,4 Rationale 1: The interview, the developmental assessment, and age-appropriate screenings are all included in the nursing assessment of a child and family during each health-supervision visit. A nurse would not assess the parents financial status at each health-supervision visit. Physical assessments for genetic abnormalities would be done based on history and/or physical findings, not at each routine visit. Rationale 2: The interview, the developmental assessment, and age-appropriate screenings are all included in the nursing assessment of a child and family during each health-supervision visit. A nurse would not assess the parents financial status at each health-supervision visit. Physical assessments for genetic abnormalities would be done based on history and/or physical findings, not at each routine visit. Rationale 3: The interview, the developmental assessment, and age-appropriate screenings are all included in the nursing assessment of a child and family during each health-supervision visit. A nurse would not assess the parents financial status at each health-supervision visit. Physical assessments for genetic abnormalities would be done based on history and/or physical findings, not at each routine visit. Rationale 4: The interview, the developmental assessment, and age-appropriate screenings are all included in the nursing assessment of a child and family during each health-supervision visit. A nurse would not assess the parents financial status at each health-supervision visit. Physical assessments for genetic abnormalities would be done based on history and/or physical findings, not at each routine visit. Rationale 5: The interview, the developmental assessment, and age-appropriate screenings are all included in the nursing assessment of a child and family during each health-supervision visit. A nurse would not assess the parents financial status at each health-supervision visit. Physical assessments for genetic abnormalities would be done based on history and/or physical findings, not at each routine visit.

Question 3 Type: MCSA A mother brings a child to the pediatric office for a sick visit. Which action by the nurse is the most appropriate? 1. Focus exclusively on the reported illness. 2. Review health-promotion and health-maintenance activities. 3. Ask the mother to leave the room after obtaining the history. 4. Obtain a comprehensive history, including sociodemographic data.

Correct Answer: 2 Rationale 1: A nurse should use every opportunity during an office visit to review health-promotion and health-maintenance activities. Focusing exclusively on the reported illnesses ignores the opportunity to use health-promotion strategies. There is not enough data in this scenario to determine whether the mother should be asked to leave the room. There is not enough information to indicate that a comprehensive history should be taken at this visit. Rationale 2: A nurse should use every opportunity during an office visit to review health-promotion and health-maintenance activities. Focusing exclusively on the reported illnesses ignores the opportunity to use health-promotion strategies. There is not enough data in this scenario to determine whether the mother should be asked to leave the room. There is not enough information to indicate that a comprehensive history should be taken at this visit. Rationale 3: A nurse should use every opportunity during an office visit to review health-promotion and health-maintenance activities. Focusing exclusively on the reported illnesses ignores the opportunity to use health-promotion strategies. There is not enough data in this scenario to determine whether the mother should be asked to leave the room. There is not enough information to indicate that a comprehensive history should be taken at this visit. Rationale 4: A nurse should use every opportunity during an office visit to review health-promotion and health-maintenance activities. Focusing exclusively on the reported illnesses ignores the opportunity to use health-promotion strategies. There is not enough data in this scenario to determine whether the mother should be asked to leave the room. There is not enough information to indicate that a comprehensive history should be taken at this visit. Global Rationale: A nurse should use every opportunity during an office visit to review health-promotion and health-maintenance activities. Focusing exclusively on the reported illnesses ignores the opportunity to use health-promotion strategies. There is not enough data in this scenario to determine whether the mother should be asked to leave the room. There is not enough information to indicate that a comprehensive history should be taken at this visit.

Question 14 Type: MCSA Which assessment would not be included with a 17-year-olds screening during a routine health supervision visit? 1. STI evaluation 2. Autism screening 3. Hemoglobin test 4. Vision screening

Correct Answer: 2 Rationale 1: Autism screening would not be appropriate at this age. If autism were present, it would have presented before this age. STI evaluation, hemoglobin test, and vision screening are all appropriate for a 17-year-old.

Question 12 Type: MCSA In the pediatric well-child clinic, the nurse explains the reason for an immunization series to the childs mother. This action represents which item? 1. Health assessment 2. Health promotion 3. Health maintenance 4. Health screening

Correct Answer: 2 Rationale 1: The explanation to the mother by the nurse provides an understanding of the immunization series to the mother and enables the mother to make an intelligent choice. While administering immunizations is considered health maintenance, the activity described in the question is clearly health promotion. A health assessment would be completed to determine what immunizations are needed. Health maintenance is the actual administration of the immunization and health screening involves looking at the immunization record to determine which immunizations are needed.

Question 10 Type: MCSA The nurse of an outpatient clinic is sitting with the parents while their adolescent goes for a test. The parents are complaining about their childs behavior. Which statement by the nurse fosters family-centered communication? 1. I agree with you, discipline is an important part of parenting. 2. I know just how you feel. I had the same experience with my children. 3. You are so right. Adolescents function in the me-first mode all the time. 4. Tell me what concerns you about your childs behavior.

Correct Answer: 4 Rationale 1: Using an open-ended question allows the parents to discuss a family concern. All the other questions or statements are blocking statements and would not foster family-centered communication. Rationale 2: Using an open-ended question allows the parents to discuss a family concern. All the other questions or statements are blocking statements and would not foster family-centered communication.

Question 13 Type: MCSA A pediatric nurse who is employed in a busy ambulatory clinic setting is informed by the nurse manager that average nursing time allocated for each child and family is being reduced to 10 minutes to more efficiently manage the clinic. The nursing activities must include a nursing assessment and discussion on anticipatory guidance. Which of these strategies should the nurse utilize in the plan of care delivery? 1. Attempt to complete the assessment and education in 10 minutes, but extend the time whenever the nurse deems necessary. 2. Plan to do the anticipatory guidance first since either the nurse practitioner or the physician can perform the assessment of the child. 3. Encourage the parent to ask for specific time to talk with the nurse privately at each office visit. 4. Focus anticipatory guidance strategies on topics that the parent or child have expressed as an area of interest.

Correct Answer: 4 Rationale 1: With limited time for each visit, the nurse should focus on anticipatory guidance strategies that will most benefit the parent and child during that office visit.

Question 2 Type: MCSA A nurse in the outpatient pediatric clinic is reviewing the records of a preschool-age child and notes that because the parents often miss routine healthcare visits the child has not received the second measles, mumps, and rubella (MMR) vaccine. Which action by the nurse is most appropriate in this situation? 1. Speak firmly with the parents about the importance of being compliant. 2. Notify the physician that the childs immunizations are no longer up to date. 3. Call the parents and encourage them to bring the child for recommended care. 4. Plan to discuss the principles of health supervision at the next scheduled visit.

orrect Answer: 3 Rationale 1: The nurse in the pediatric healthcare setting is responsible for reviewing the health supervision of the child. Partnering with the parents and encouraging the parents to follow health-supervision guidelines are the best strategies to use. Speaking firmly with the parents about compliance will alienate the parents at this time. A discussion of the principles of health supervision without an intervention at this visit would mean a delay in needed health care for the child in this example. Discussing with the physician that the immunizations are not up to date is not necessary in an outpatient clinic. Immunizations are given per schedule. Rationale 2: The nurse in the pediatric healthcare setting is responsible for reviewing the health supervision of the child. Partnering with the parents and encouraging the parents to follow health-supervision guidelines are the best strategies to use. Speaking firmly with the parents about compliance will alienate the parents at this time. A discussion of the principles of health supervision without an intervention at this visit would mean a delay in needed health care for the child in this example. Discussing with the physician that the immunizations are not up to date is not necessary in an outpatient clinic. Immunizations are given per schedule. Rationale 3: The nurse in the pediatric healthcare setting is responsible for reviewing the health supervision of the child. Partnering with the parents and encouraging the parents to follow health-supervision guidelines are the best strategies to use. Speaking firmly with the parents about compliance will alienate the parents at this time. A discussion of the principles of health supervision without an intervention at this visit would mean a delay in needed health care for the child in this example. Discussing with the physician that the immunizations are not up to date is not necessary in an outpatient clinic. Immunizations are given per schedule. Rationale 4: The nurse in the pediatric healthcare setting is responsible for reviewing the health supervision of the child. Partnering with the parents and encouraging the parents to follow health-supervision guidelines are the best strategies to use. Speaking firmly with the parents about compliance will alienate the parents at this time. A discussion of the principles of health supervision without an intervention at this visit would mean a delay in needed health care for the child in this example. Discussing with the physician that the immunizations are not up to date is not necessary in an outpatient clinic. Immunizations are given per schedule.