NUR 236 PrepU Chapter 31: Health Supervision
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 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 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 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 school nurse has completed an educational program about vaccines to a group of parents. Which statement by a parent would indicate the need for further education?
"My 7-year-old will need to get a Hib booster at his next checkup."
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 the health history, the mother of a 4-month-old child tells the nurse she is concerned that her baby is not doing what he should be at this age. What is the nurse's best response?
"Tell me what concerns you."
During a well-check for a 2-year-old client, the nurse notes the client's vaccinations are not up to date. The caregiver states, "It is hard to make it to all the appointments, but my child will get caught up before going to school." Which response by the nurse is most appropriate?
"To prevent serious illnesses, it is vital your child receive all vaccines as scheduled."
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."
Which question by the nurse is the best one to elicit complete information about a young boy's immunization status?
"When and where did your child receive his last immunization?"
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.
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.
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
Before administering an immunization to their child, the nurse asks parents to take which priority action?
Sign a consent form.
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.
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 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.
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 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 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
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.
A family of five seeks care for their preschool-age child with an upper respiratory infection. The facility has no medical record for the family. Why does the nurse encourage this family to establish a medical home?
To establish a continuing relationship with a physician or nurse practitioner.
Which nursing intervention is likely to be most effective in keeping the childhood immunization status for all ages at its highest possible level?
Use every contact to potentially immunize.
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
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 nurse will expect that which hearing test will be performed before the newborn is discharged home?
auditory brainstem response
While assessing a 14-year-old female client, the nurse notes the following: blood pressure 108/48 mm Hg, glucose 95 mg/dL (5.27 mmol/L), intermittent dieting, and lacto-ovo-vegetarian. The client also states she is an avid gymnast. The nurse will anticipate which prescription from the primary health care provider?
complete blood count (CBC)
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
Shelley, a mother, is new to the community, and the family is in a low-income bracket with limited transportation options. How could the pediatric nurse help Shelley get her new baby to her well-child visits to promote healthy growth and development? The nurse could:
link Shelley with the community's child health clinic.
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 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?
setting up screenings in a public library downtown
