Nursing Concepts Week 9
Which foods should be avoided when a child with autism spectrum disorder (ASD) is being treated with a gluten- and casein-free diet? Select all that apply.
Milk Cheese Correct! Grain
The school nurse is arranging an appointment for a physical examination of an 11-year-old client recently diagnosed with attention-deficit/hyperactivity disorder (ADHD). The client's parent states, "Our child was evaluated at home and here at school, and now we have to make another appointment for a physical? Why?" Which is the best response by the nurse?
"We need to rule out neurological diseases and other health problems in your child that may affect treatment of ADHD."
The nurse is teaching the parents of a child with cerebral palsy about appropriate therapies that can be helpful for the child 's mobility status. Which statement made by a parent indicates that this teaching has been effective?
c "Braces will help maintain our child's skeletal alignment." Learning Objective Identify independent and collaborative therapies used by interdisciplinary teams. Rationale Medications used to control seizures and spasms include skeletal muscle relaxants, baclofen, benzodiazepines, and botulinum toxin. Antidepressants are not used to manage the symptoms of cerebral palsy.
Mr. Justice is concerned that Kara will have to wear a brace. You educate him that scoliosis does not require bracing until the curve reaches:
25 to 30 degrees Bracing is required to slow the progression of scoliosis when the curvature reaches 25 to 30 degrees.
Stacy Capers is a term female newborn diagnosed with an infection contracted in utero. The healthcare provider advises the parents that the newborn may have spastic cerebral palsy (CP) because of a brain insult related to the infection. When talking with the parents, which area of the brain will the nurse indicate is affected by the insult?
Cerebral cortex Spastic cerebral palsy (CP) is generally attributable to a brain insult in the cerebral cortex. Ataxic CP is generally attributable to a brain insult in the cerebellum. Mixed CP is generally attributable to multiple injury sites. Dyskinetic CP is generally attributable to a brain insult in the basal ganglia.
The nurse is assessing a 3-year-old child for symptoms of autism spectrum disorder (ASD). Which assessment finding does not support the diagnosis of ASD?
Comprehends language well beyond the complexity of age
The family of a client diagnosed with autism spectrum disorder (ASD) has opted to begin a gluten-free and casein-free diet. Which food choices indicate appropriate understanding of this diet? Select all that apply.
Cornmeal Soy milk Grilled salmon
The nurse is conducting a health history for a client diagnosed with failure to thrive (FTT). Which questions should the nurse include in the family assessment for a client diagnosed with FTT? (Select all that apply.)
Do any of your other children have a history of feeding disorders? Correct Answer Which developmental milestones has your child accomplished? Correct! Did you have any problems during the pregnancy? Are there any stressors in your life that affect your interaction with your child? History of the pregnancy and birth, history of other children with feeding disorders, developmental milestones, and stressors are all important data to gather during the history-taking process. The number of soiled diapers is not essential to the family assessment.
The nurse is discussing a 13-year-old female client's recent diagnosis of attention-deficit/hyperactivity disorder (ADHD) with her parents. The client's mother states, "Our daughter has a male cousin who also has ADHD, but he doesn't act anything like her." How would the nurse best explain this difference to the client's parents?
Girls with ADHD tend to show less impulsiveness than boys with ADHD." Learning Objective Differentiate the pathophysiology, etiology, risk factors, prevention, and clinical manifestations. Rationale Girls with ADHD tend to show less aggression and impulsiveness than boys with ADHD. However, girls show more anxiety, mood swings, social withdrawal, rejection, and cognitive and language problems. Girls are usually older, not younger, than boys at the time of diagnosis.
Which assessment findings are specific to the infant stage of growth and development?
Growth is associated with body type and quality of feeding. Correct! Height increases by about 1 foot.
A team approach is being used to help a middle-age client with autism spectrum disorder (ASD) achieve his full potential. A community center has been engaged to help find a position for him. Which strategy will allow this client to have the best opportunity for success?
Help the client find a position that will allow him to use his strongest talents. Individuals with ASD have the greatest chance of success with training and finding opportunities that use their strengths. Many are active members of the community while others need more support.
The nurse is conducting an assessment for a child diagnosed with failure to thrive (FTT). Which parent-child interaction is not included in the nursing assessment?
History of the pregnancy and birth The nurse would observe for eye contact, touching, and cuddling in the physical examination for parent-child interaction. The history of the pregnancy and birth is an appropriate assessment completed during the health history portion of the nursing assessment.
A 9-month-old child has been diagnosed with ataxic cerebral palsy (CP). Which clinical manifestation would the nurse expect to assess in this client?
Hypotonia and muscle instability
As compared with boys, girls with attention-deficit/hyperactivity disorder (ADHD) typically show less of which characteristic?
Impulsiveness
A parents group asks the nurse what they would look for if they suspected their child has attention-deficit/hyperactivity disorder (ADHD). Which observations would the nurse have the parents report for further assessment? Select all that apply.
Inability to stay on an assigned task to completion Correct! Limited attention span when speaking with parent Correct! Having difficulty with learning at school Excessive motor activity
The nurse is providing care to a hospitalized child who is diagnosed with autism spectrum disorder. Which intervention is appropriate for this child?
Incorporating rituals used at home in the hospital environment
Which factor cause cerebral palsy before or during birth?
Injury to periventricular white matter Fetal viral infection Correct Answer Premature birth
Which is a side effect of stimulants used as medication for children with ADHD?
Insomnia
What is geriatric failure to thrive (GFTT)?
It is a disorder of undernutrition in an older adult.
Kara's father asks you why there is a need for follow-up when the curvature does not need treatment. What is your best response to Mr. Justice's question?
Kara requires follow up because curves generally worsen during growth spurts. urves generally worsen during growth spurts. Kara is not done growing, so follow up visits will be required. A phone interview will not allow the health care provider to determine if the condition has gotten worse. Asking Mr. Justice if he would like to see another provider in 6 months does not address his question.
Mr. Justice asks you if Kara will have any activity restrictions after surgery. What is your best response to Mr. Justice's question?
Kara should not bend or twist at the waist. You should educate Mr. Justice that Kara should not bend or twist at the waist after spinal surgery. Climbing steps and swimming are activities that are encouraged after surgery. Bicycle riding is an activity that is not recommended.
Which is a characteristic of attention-deficit/hyperactivity disorder (ADHD)? Select all that apply.
Linked to exposure to excess lead Correct! Linked to heredity Correct! Often persists into adulthood
The nurse is educating the parents of a child recently diagnosed with autism spectrum disorder (ASD). The parents ask the nurse how this could have happened. Which etiologies will the nurse include in the response to the client's parents? Select all that apply.
Neurotransmitters - dopamine, serotonin Genetics Environmental factors Immunologic factors
Which are ways in which culture and/or ethnicity can influence growth and development? (Select all that apply.)
Nutritional practices Correct Answer Social interaction patterns Genetic variations
During an exam, the nurse begins to suspect that a client has cerebral palsy. Upon what does the nurse make this assessment?
Observation of uncontrolled movements
Which nonpharmacologic therapies are used in the care of a client with cerebral palsy (CP)? (Select all that apply.)
Occupational therapy Correct Answer Speech therapy Physical therapy Correct Answer Special education
During a check-up, the nurse notes that the client has reached physical growth milestones but has not achieved cognitive developmental milestones. Other than developmental disorders, what else should the nurse consider?
Parental interaction Learning Objective Examine common alterations in growth and development across the life span. Rationale Family is an important environmental factor that plays an essential role in child development. Parenting influences risk and protective factors, personality characteristics, and developmental outcomes. Cerebral palsy is a physical disability. Genetic abnormalities would typically impact both growth and development. Child temperament is not a known factor that would impact the ability to achieve cognitive developmental milestones.
The nurse is caring for an older adult client who has been diagnosed with failure to thrive and has a caregiver present at the bedside. What role will the nurse assume in this process?
Provide nutritional education to the caregiver Learning Objective Compare common independent and collaborative interventions for individuals and families. Rationale The nurse may provide dietary and nutritional education to the caregiver. The nurse may not prescribe medications or provide behavioral therapy. The referral to genetic counseling is not indicated for an older adult with FTT.
Which is the best intervention for the nurse to implement when caring for a 16-year-old client with attention-deficit/hyperactivity disorder (ADHD
Provide opportunities to increase self-esteem.
The nurse is caring for a client who has cerebral palsy. Which independent intervention is appropriate for the nurse to provide?
Range-of-motion (ROM) exercises should be used to promote flexibility and prevent contracture formation. Learning Objective Compare common independent and collaborative interventions for individuals and families. Rationale The nurse should assist the client in range-of-motion (ROM) exercises to promote flexibility and prevent contracture formation. Additionally, the nurse can provide the family and/or caregiver information about injury prevention and the creation of a safe home environment, as well as information on support and financial aid services. Nurses cannot provide speech therapy or prescribe muscle relaxants or mood stabilizers.
Which medication is not used to control seizures and muscle spasms in CP?
Ranitidine
Tina White, a 7-year-old African American girl with dyskinetic cerebralpalsy, has used a stroller or wheelchair for mobility since birth. During every healthcare provider appointment, on which finding should the nurse focus when assessing this client?
Skin integrity and body alignment Skin integrity and good body alignment are essential for a child with CP who is in a wheelchair. Pillows, towels, and bolsters may be needed for positioning or to take pressure off reddened areas of skin. Height and weight must be assessed for every child, as should nutrition status and bowel habits. Assessment of persistent newborn reflexes and for swallowing difficulty is used to detect clinical manifestations that may indicate a child has CP.
While taking an assessment of Arthur Kim, a 12-year-old boy, Arthur tells the nurse that he is getting bad grades at school, and he repeatedly interrupts to talk about his favorite character from a new movie. The nurse suspects that Arthur might have attention-deficit/hyperactivity disorder (ADHD). Which other finding would the nurse expect when questioning the father about Arthur's behavior?
Sleep disturbances Sleep disturbances are common in children with ADHD. Arthur is likely to have difficulty completing tasks and maintaining friendships with other children. His social isolation and poor performance in school are likely to lead to poor, not high, self-esteem.
The nurse is interviewing the mother of a child who is being evaluated for attention-deficit/hyperactivity disorder (ADHD). Which factor within the child's health history should the nurse recognize could be associated with the development of ADHD?
Smoking during pregnancy Research shows that a mother's use of cigarettes during pregnancy can increase the risk for ADHD. Immune response can be associated with autism spectrum disorders but not ADHD. Young parental age has not been associated with ADHD. The measles, mumps, and rubella vaccine has been thought to be associated with autism spectrum disorder, although a relationship has never been established through research.
Impairments in which areas are evident by the age of 3 in the child with autism spectrum disorder (ASD)? (Select all that apply.)
Social interactions Correct! Social adaptability Correct! Ability to organize responses to situations Communication
Diabetes Mellitus is when blood glucose (sugar in the blood) is unable to move into the cells and help in the making of ATP...AKA energy. The body makes insulin to assist with this process. Insulin is a hormone that allows the sugar in the blood to move across the cell wall so the body can use to to produce ATP. There are two types of diabetes. Type I and Type II.
Stimulants
he nurse is preparing educational material for the parents of children with cerebral palsy. Which treatment would the nurse include in this teaching session? (Select all that apply.)
Surgery Correct! Positioning devices Correct! Muscle relaxants Correct! Serial casting
Which resource will the healthcare provider use to diagnose autism spectrum disorder (ASD)?
The American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders
The nurse is evaluating an adult client with attention-deficit/hyperactivity disorder (ADHD). Which observation indicates to the nurse that treatment has been successful?
The client reports fewer sleep disturbances. Sleep disturbances are common in clients with ADHD, and a decrease in their frequency indicates successful treatment of the condition. Stating that ADHD is a "childish disease" displays a lack of understanding about the condition, which often persists into adulthood. Finishing the nurse's sentences indicates remaining problems with impulse control. Asking for a higher dosage of medication indicates ineffective pharmacologic treatment or medication abuse.
Which goal is appropriate to include in the plan of care for a client with autism spectrum disorder (ASD) who is hospitalized for a tonsillectomy?
The client will demonstrate behavior that is not self-destructive.
The nurse is preparing an educational seminar about early intervention programs to promote growth and development of the child with cerebral palsy (CP). Which information would the nurse include to assist the parents of these children?
The use of adaptive devices to help the child communicate more independently
When would an infant diagnosed with failure to thrive (FTT) not require hospitalizations
To protect the child from the caregivers
Kara asks you how many hours she will need to wear the brace each day. You respond by telling her:
You will need to wear the brace 23 hours a day." To achieve maximum effectiveness, Kara needs to wear the brace 23 hours a day. Wearing the brace for shorter periods of time may result in poorer outcomes for Kara
The nurse is assessing a 4-month-old client because the mother is concerned that the client may be developmentally delayed. Which finding would lead the nurse to suspect cerebral palsy (CP) in the infant?
b Hypotonia Learning Objective Summarize assessment findings in clients across the lifespan. Rationale Head lag, tonic neck reflex, and following objects 180 degrees are all normal for a 4-month-old infant. If head lag and tonic neck reflex persist beyond 6 months, then they would be a concern and suggest CP. Hypotonia is not normal and could be a sign of CP.
The nurse is planning care for an adult client diagnosed with attention-deficit/hyperactivity disorder (ADHD). The client has a strong social network and does not display much impulsivity but has problems with inattentiveness. Which goal is the priority for the nurse to include in the plan of care? Select all that apply.
he client will be able to complete tasks. The client will achieve work performance to maximum potential.
The nurse is providing care to the family of a child diagnosed with failure to thrive (FTT). Which intervention is aimed at the family 's psychosocial needs?
referring the family to community resources
The nurse educator of a pediatric medical-surgical unit is conducting an educational session for the nursing staff related to failure to thrive (FTT). The educator wants the staff to identify families who may be at risk of having children with FTT. Which populations will the educator include in the session? (Select all that apply.)
substance abusers mental retardation depression
The nurse is providing care for an older adult client who is diagnosed with failure to thrive (FTT). Which treatment is appropriate for the nurse to include in the discharge instructions for this client?
teaching about the use fo selective serotonin reuptake inhibitors (SSRIs) for depression per order
The mother of 8-month-old Hannah Morgan is concerned that her daughter, who weighed 8 pounds at birth, is now overweight at 18 pounds. How should the nurse respond to the mother?
"Hannah's growth is on target as a baby's birth weight triples in the first year." Hannah's growth is on target. An infant's birth weight doubles by about 5 months and triples in the first year. Hannah is not underweight, she is not at risk for obesity, and she does not require limited food intake.
The parents of a toddler are concerned that their daughter sits quietly to play, but does not actively interact with her playmates who are sitting nearby. What should the nurse explain to the parents?
"It is typical for toddlers to engage in parallel play." Learning Objective Describe the elements of growth and development across the life span. Rationale Toddlers engage in both parallel play and imitative play. Responding that it is typical for a toddler to engage in solitary play, cooperative play, or dramatic play is not correct.
Kara arrives for her follow-up visit, and you call her back to the examination room. You begin the client history and interview. What information provided by Kara's father might indicate that Kara's condition has worsened?
"When Kara wears a t-shirt, one side hangs lower than the other side." The fact that Kara's t-shirts hang lower on one side versus the other is an indication that the curvature of her spine has worsened. The fact that Kara tucks in all her shirts, rolls her jeans, or needs to have all the hems in her dresses adjusted does not indicate that her scoliosis has worsened.
The nurse suspects that a client may have attention deficit hyperactivity disorder (ADHD). Upon which assessment technique might the nurse have made this diagnosis?
Questionnaire about study and behavior habits at school and home Learning Objective Differentiate components of assessment related to alterations in development. Rationale ADHD is diagnosed via questionnaires, observations, and screenings related to client functioning in more than one setting (e.g., home, school, and work). Screenings about eye contact and facial expression, temper tantrums and aggression, and balance and coordination techniques do not diagnose ADHD
Jason is a 5-year-old boy with autism spectrum disorder (ASD). He is at the office for his annual physical. Upon entering the room the nurse notices that he is sitting on his mother's lap playing with his teddy bear. He does not respond to the nurse's greeting. Which approach is most appropriate for the nurse to use with Jason?
Allow Jason to stay on his mother's lap, keep his teddy bear, and speak to him calmly and concisely. It is best to allow Jason to stay on his mother's lap and keep his teddy bear, which will help him accept the new environment and activities that will be taking place. Using Jason's name before saying hello to him will help him recognize that you are speaking to him. The other answers would not be helpful to Jason.
Which interaction pattern will the nurse include in the physical assessment of a client diagnosed with failure to thrive (FTT)?
Identifying hunger cues
The nurse educator is teaching a group of students about the risk factors associated with the diagnosis of failure to thrive (FTT). Which risk factor stated by the students indicates appropriate understanding of the lecture material? (Select all that apply.)
Neurological disease Excessive caloric expenditure Correct! Esophageal reflux Correct! Inadequate calorie intake Esophageal reflux, neurological disease, inadequate calorie intake, and excessive calorie expenditure can all contribute to FTT and indicate understanding of the lecture material. Lactose intolerance is not a cause of failure to thrive and would indicate that the student needs remediation.
During a routine exam, the nurse notices that Emma Adams, a 2-year-old girl, shows signs of inadequate coordination and muscle stiffness. This may indicate that Emma may be suffering from which developmental disorder?
Cerebral palsy Emma may have the developmental disorder of cerebral palsy, which is characterized by Inadequate balance and coordination (ataxia), uncontrolled movements (dyskinesia), and muscle stiffness (spasticity). Failure to thrive, autism spectrum disorder, and attention-deficit/hyperactivity disorder are not correct answers.
During an assessment, the nurse suspects that an 11-month-old infant is demonstrating manifestations of cerebral palsy. Which assessment finding would bring the nurse to this conclusion? (Select all that apply.)
Asymmetric crawling Correct! Head lag Correct! Arched back Correct! Poor trunk control
The nurse is visiting Gerry James, a 17-year-old adolescent with cerebral palsy (CP). Which would the nurse recommend to assist this client with physical mobility in his planning to begin college in a few months?
Obtain a customized wheelchair Adaptive and assistive technology to promote mobility includes the use of a customized wheelchair. American sign language would help with communication. Adaptive utensils ensure adequate nutritional intake. Receiving therapeutic massages would reduce spasticity and encourage muscle relaxation.
A nurse is assessing an adult client with autism spectrum disorder (ASD). Which characteristic of autism spectrum disorder (ASD) is not likely to be problematic for thisclient?
Language skills and sentence formation
Which are characteristics of cerebral palsy?
Muscle stiffness Correct! Uncontrolled movements Inadequate balance
Kara was sent for x-rays prior to her follow-up appointment. Kara's x-ray results indicate a curvature of 30 degrees. Based on this diagnostic finding, you teach Kara and her family that she will require which treatment option?
Boston brace A Boston brace is the normal course of treatment for a curvature that reaches 30 degrees. Surgery is not considered until the curvature reaches 40 degrees. A halo brace is used only after corrective surgery. Occupational therapy is not a treatment option for scoliosis.
During a routine examination, Paola Chiappe, a 41-year-old woman, mentions that she has always had difficulty concentrating at work and asks whether there are any strategies to help her focus. While taking Ms. Chiappe's health history, the nurse suspects that the client has previously undiagnosed attention-deficit/hyperactivity disorder (ADHD). Which finding would the nurse most likely assess in Ms. Chiappe?
Participation in high-risk activities Ms. Chiappe is likely to participate in high-risk activities because of the impulsivity associated with ADHD. She is also likely to have a limited attention span, engage in excessive talking, and be an underachiever at work.
The nurse is providing care to a client diagnosed with failure to thrive (FTT). Which nursing intervention item will the nurse include at each visit for this client?
Plotting weight on the growth chart An appropriate nursing intervention at each visit for a client diagnosed with FTT is to plot the current weight on the growth chart. It is inappropriate for the nurse to suggest herbal supplements for this client. While family counseling may be needed, this is not an intervention that is completed during each visit. Assessing entries in the food journal should occur only if the child is not gaining weight.
Which interventions should the nurse teach to the parents of a school-age child with attention-deficit/hyperactivity disorder (ADHD)? Select all that apply.
Praising all positive behaviors Turning off the television when client is doing homework Maintaining a consistent bedtime routine and time turning off the television
Kara returns for another follow-up appointment. X-rays indicate the curve of her spine is now 45 degrees. The health care provider tells Kara and her father that surgery is recommended. Kara's surgery is scheduled, and you begin education regarding postoperative care. Which information is appropriate to include? Select all that apply.
Proper positioning Correct Answer Donating own blood prior to surgery Correct! Pain management techniques Correct Answer The importance of deep breathing following surgery Kara should be taught the importance of deep breathing following surgery, pain management techniques to use, and proper positioning. Kara and her family can also be taught to donate blood that can be used for any transfusions that may be needed during surgery. Exercises to decrease the severity of spinal curvature are not taught at this stage in the disease process.
A home care nurse is providing care to a client diagnosed with failure to thrive (FTT). Which interventions are appropriate for this client and family? (Select all that apply.)
Providing community resources Correct! Observing the parent-child relationship in the home Encouraging the use of a food diary Correct! Frequent growth and weight measurements Interventions that are appropriate for a client diagnosed with FTT include frequent growth and weight measurements, observing the parent-child relationship, providing community resources, and encouraging the use of a food diary. Recommending breastfeeding is not an appropriate intervention to treat FTT.
The nurse is preparing to care for a child with cerebral palsy. Knowing the different classifications, for which type of cerebral palsy would the nurse most likely plan care?
a Spastic cerebral palsy Learning Objective Differentiate the pathophysiology, etiology, risk factors, prevention, and clinical manifestations. Rationale 75% of all cases of cerebral palsy are classified as spastic. 10% to 15% of all cases of cerebral palsy are classified as dyskinetic. 5% to 10% of all cases of cerebral palsy are classified as ataxic. A small percentage of cerebral palsy cases are classified as mixed.
A pediatric home health nurse cares for several infant clients who are diagnosed with failure to thrive (FTT). The nurse wants to initiate community interventions to decrease the number of pediatric diagnoses of FTT. What can the nurse do to help prevent FTT within the community?
educate infant caregivers
The nurse is assessing an adult client with suspected attention-deficit/hyperactivity disorder (ADHD). Which finding would the nurse most likely observe?
excessive talking Learning Objective Summarize assessment findings in clients across the lifespan. Rationale As clients with ADHD age, physical hyperactivity tends to turn into verbal hyperactivity, which can manifest as excessive talking or constant interruptions. Physical hyperactivity such as constant fidgeting and squirming, and standing up in the middle of the health history interview is more commonly seen in children.
The nurse is caring for Charlie Jost, an 8-month-old infant diagnosed with failure to thrive (FTT). Charlie's father, Mr. Jost, is visibly concerned about his son's condition and diagnosis. He is pacing the room and approaches with a question when the nurse enters the room. "Are you here to do tests on my son? How do we know what is wrong with him if you haven't taken any x-rays or blood work?" Which response to Mr. Jost is most appropriate?
"There are no diagnostic tests for FTT. We diagnose the condition based on assessment and comparing your son's height and weight to the standard growth chart for his age." Assessment is the primary diagnostic tool for FTT. There is no specific laboratory test for diagnosis of this condition.
A nurse is conducting a consultation with a client who has a developmental alteration. What should the nurse take into consideration when interacting with the client? (Select all that apply.)
The client's literacy skills The client's reliance on social services Correct! The client's family history
Mrs. Barth is a new parent with a 6-month-old daughter, Madison. Madison is being seen for a 6-month well-child checkup. Mrs. Barth tells the nurse that she is concerned that Madison's height and weight are less than those of her neighbor's 6-month-old baby. Madison is in the top half of the fifth percentile for weight and height on the standard growth chart. Mrs. Barth is describing the baby's eating patterns and behavior. Which characteristic would the nurse recognize as a symptom of the feeding disorder called failure to thrive (FTT)?
"She often refuses a bottle and is difficult to comfort." Symptoms of a feeding disorder include refusing food, an erratic sleeping pattern, irritability, being difficult to comfort, and not meeting expected growth pattern. Gas and liquid stool are not attributed to failure to thrive.
The community health nurse is working with a group of women from another country who smoke. The nurse is encouraging them to stop smoking before and during pregnancy. The nurse knows that her teaching has been effective when the women state that the reason to stop smoking is to lessen the chance that their children could develop which health problem?
Attention-deficit/hyperactivity disorder (ADHD) Recent studies suggest that nicotinic dysregulation may play a role in child and adolescent disorders. Maternal smoking during pregnancy increases the risk for ADHD in children. Smoking during pregnancy is not related to personality disorder, unhappy memories, or benzodiazepine withdrawal.
The nurse is caring for a client recently diagnosed with autism spectrum disorder (ASD). The client's mother asks the nurse about medications that may be prescribed for ASD. Which medication will not be included in the teaching session?
Antipyretic agents
In collaboration with a medical team, the nurse is caring for Jason Cox, a 3-month-old infant being treated for failure to thrive. Which type of care should the nurse provide for Jason and his caregivers?
Education on home safety Nurses can educate Jason's caregivers on injury prevention and the creation of a safe home environment. Nurses cannot provide physical therapy, behavioral therapy or psychological testing.
A 6-year-old child with cerebral palsy who is new to the school district is experiencing severe rigidity and spasticity. Which recommendation would the school nurse make to the child's parents?
"Make an appointment with a physical therapist."
The nurse is providing care to a group of pediatric clients seen for well-child check-ups. Which client may require a more in-depth developmental assessment from the nurse?
A preschooler who was recently adopted from China
A community health nurse is educating pregnant clients about the prenatal causes and risk factors associated with the development of attention-deficit/hyperactivity disorder (ADHD). Which statement will the nurse include?
ADHD has been linked to prenatal exposure to cigarette smoke." Although ADHD has not been linked to a specific gene, the disorder has been linked to prenatal exposure or disease. Prenatal exposure to cigarette smoke increases the risk for the child to develop ADHD. ADHD has been linked to childhood exposure to lead, not folate.
Which surgical intervention is not used to treat cerebral palsy (CP)?
Achilles tendon shortening
An 8-year-old boy with attention-deficit/hyperactivity disorder (ADHD) arrives at the clinic for a well visit with his parents. The client's parents appear fatigued and argue with each other when answering questions about the client's home and school routine. The client talks happily about school and new friends he has made this year. The client has been taking methylphenidate (Ritalin) for the past year, and his parents verbalize proper administration and management of the medication. Which is the priority nursing diagnosis for this client?
Alterations in family processes
The nurse is educating a 27-year-old client with attention-deficit/hyperactivity disorder (ADHD) who is taking ADHD medications. About which medication would the nurse most likely educate the client?
Atomoxetine (Strattera) The nonstimulant medication atomoxetine (Strattera) is used in children over age 6, adolescents, and adults to control the symptoms of ADHD. Stimulants like dextroamphetamine and methylphenidate are approved for use in adults; however, there is a higher risk of adverse effects on the cardiovascular system. Guanfacine does not appear to be beneficial for adults with ADHD.
The nurse is providing care for a client diagnosed with failure to thrive (FTT). Which assessment finding supports the diagnosis for this client?
Being below the fifth percentile for weight on the standardized growth chart Diagnosis of failure to thrive (FTT) is made when an infant falls or is falling below the fifth percentile for weight on a standard growth chart. A lack of sleep, frequent diarrhea, and being above the fifth percentile for height on a standard growth chart do not support the diagnosis of FTT.
A nurse is caring for a toddler client whose parent suspects the child may have attention-deficit/hyperactivity disorder (ADHD). Which statements should the nurse recognize as true regarding the diagnostic criteria for ADHD?
Children must have 6 or more symptoms that have persisted for 6 or more months with negative impacts. Correct! Children must have a physical examination prior to the diagnosis of ADHD to rule out other diseases. Children with learning disabilities are often misdiagnosed as having ADHD. In order to be diagnosed with ADHD, the child age 17 and younger must have 6 or more symptoms that have persisted for 6 or more months with negative impacts. Children with learning disabilities are often misdiagnosed as having ADHD. The diagnostic criteria for ADHD are specific and standard with every child. Children must have a physical examination prior to the diagnosis of ADHD to rule out other diseases.
The nurse is teaching the family of a child who has been prescribed amphetamine mixed salts (Adderall) for attention-deficit/hyperactivity disorder (ADHD). At which time should the nurse instruct the family to provide the medication?
Early in the morning Administering the medication early in the day can help alleviate the effect of insomnia. Before lunch might be difficult and cause embarrassment to the child if the child is in school. Evening and bedtime are incorrect as this medicine can cause insomnia.
The school nurse is talking to a child with attention-deficit/hyperactivity disorder (ADHD) who wants to play soccer. Which action is the most appropriate for the school nurse to take?
Encourage the child to play soccer. The child should be encouraged to play soccer. Participation in a team sport will assist the child with ADHD to expend some energy while cooperating with others and following game rules. Participating in a team sport can help promote self-esteem in the child with ADHD and encourage connectedness with other children. There is no reason for a child with ADHD not to play sports. The mother would not need physician approval for her son to play soccer. Vigorous physical activity is encouraged for all children with ADHD. Some of the benefits of participating in a team sport would not be available with individual sports.
The nurse assessing a 25-month-old toddler client notices that she is not communicating with words. Which comment by the mother supports the diagnosis of autism spectrum disorder (ASD)?
Engages in mostly solitary activity The fact that the toddler prefers solitary activity would support a diagnosis of ASD. Many, but not all, children with ASD would not like to play with siblings, enjoy cuddling, or respond to conversation in the room.
The nurse is addressing a group of high-risk teen mothers. Which risk factors that can lead to attention-deficit/hyperactivity disorder (ADHD) in children would the nurse describe to the teen mothers? Select all that apply.
Exposure to high levels of lead in childhood Correct! Poor nutrition Correct! Drinking alcohol during pregnancy Lack of proper parenting Risk factors for ADHD in children include improper parenting, exposure to high levels of lead, prenatal exposure to alcohol, and poor nutrition. Daily television exposure at ages 1-3years, not limited exposure, is another risk factor of ADHD.
The nurse is providing care to a client who is admitted for diagnostic testing for failure to thrive (FTT). Which diagnostic test does the nurse not anticipate for this client?
Extensive blood studies There are no definitive laboratory tests done to diagnose failure to thrive. Diagnosis is made on the basis of the history, physical exam, height, weight, and the client's behavior. The nurse would not anticipate extensive blood studies for this client.
A nurse is caring for a 10-year-old client who is scheduled to have a tonsillectomy the next day. The nurse has planned a preoperative teaching session for the child, who has a history of attention-deficit/hyperactivity disorder (ADHD). Which teaching technique should the nurse use for this client?
Give instructions verbally and use a picture pamphlet, repeating points more than once. A teaching session for a child with ADHD should foster attention. Giving instructions verbally and in written form, repeating the main points, will improve learning for a child with ADHD. Talking to other children who have had this procedure may not foster understanding, because this child has ADHD. A child who has difficulty concentrating should not lead the session even though the child needs to feel in control. The environment should be quiet, with minimal distractions. Distractions such as noise from a television should be minimized.
Which nonpharmacologic therapies would be appropriate for a client with failure to thrive (FTT)? (Select all that apply.)
Hospitalization Correct! Assessing and educating a breastfeeding mother Correct! Detailed history and physical exam Correct! Nutritional supplements
Baby Jane and her parents are seen for a follow-up visit after being discharged from the hospital 3 days ago. Baby Jane was admitted to the hospital for failure to thrive (FTT). Which nursing diagnosis would not be appropriate for Baby Jane and her parents?
Increased activity Increased activity is not an appropriate nursing diagnosis for an infant diagnosed with FTT. Imbalanced nutrition, potential for enhanced knowledge, impaired growth and development, and altered parenting are all appropriate nursing diagnoses considering the recent hospital discharge.
A 1-year-old child is being evaluated for cerebral palsy. When assessing the child, which finding is the nurse least likely to observe?
Normal muscle tone in all extremities
The nurse is preparing to complete a physical examination for a pediatric client diagnosed with autism spectrum disorder (ASD). Which assessment is appropriate for thisclient?
Performing a developmental screening
Kara begins to cry when she learns that she will have to wear a brace to treat her scoliosis. She states, "All my friends are going to make fun of me!" What type of emotional support can you provide to Kara? Select all that apply.
Provide Kara with a phone number for a support group of other teenagers with scoliosis. Teach Kara how long treatment will be necessary. Correct! Educate Kara about why she needs to wear the brace. Correct Answer Teach Kara how to wear the brace. Providing Kara with a phone number for a support group of other teenagers with scoliosis will allow her to connect with others her age who are experiencing the same problem that she has. Educating Kara about why she needs the brace, how to wear the brace, and how long treatment will be necessary will provide Kara with accurate information that she can use to explain the brace to her friends. These interventions will help Kara maintain her self-image. Educating Kara to ignore her friends will not help the situation.
The home care nurse is performing a visit to a child diagnosed with autism spectrum disorder (ASD). Which intervention is appropriate for the nurse to include in the treatment plan for this family?
Providing appropriate education regarding what to expect for the child
Which behavioral therapy can help improve quality of life for the client with ADHD? You Answered
Setting consistent limits
Which theory of growth and development proposes that children learn attitudes, beliefs, customs, and values by modeling the behaviors of others?
Social learning theory
The nurse is providing care to Deanna, a 9-month-old infant diagnosed with failure to thrive (FTT). Deanna's parents are teenagers who lack knowledge regarding infant nutrition. A nursing diagnosis of potential for enhanced knowledge is the priority diagnosis for this family. Which nursing intervention is appropriate for the nurse to include in Deanna's plan of care for this priority nursing diagnosis?
Teaching about the child's nutritional requirements The nursing diagnosis of potential for enhanced knowledge indicates that the parents will require education to provide appropriate nutrition to their child. Teaching the parents about Deanna's nutritional needs is an appropriate intervention for this plan of care. Weight would be assessed daily for a child with FTT. There is no indication of a need to refer the client to a speech pathologist or to demonstrate tube feedings.
The school nurse is administering methylphenidate (Ritalin) to an adolescent male who has been diagnosed with attention-deficit/hyperactivity disorder (ADHD). Even though the drug helps the adolescent with focus and grades, he will not go to the nurse's office at noon for his medication. What should the school nurse suspect is the reason for this adolescent's behavior?
The adolescent may be embarrassed about having to take medicine at school and fear a social stigma. ome adolescent clients believe that having to take drugs in school will cause them to be viewed as weak, unhealthy, or dependent. Clients can also perceive this as a social stigma. Methylphenidate (Ritalin) is a short-acting drug and doses must be administered about 4 hours apart, so the client must receive a dose during school hours. ADHD is a brain-based disorder, and the primary treatment is medication; alternative coping mechanisms will not usually help to increase focus during classes. Appropriate treatment of ADHD will result in lessening the likelihood for addiction to mood-altering substances, not an increase in the likelihood.
The nurse is providing education to the family of a client diagnosed with failure to thrive (FTT). Which statements by the family indicate appropriate understanding of the teaching session regarding treatment options and goals for FTT? (Select all that apply.)
There is no medication for her condition. Nutritional supplements will help restore the missing nutrients and calories. The goal of hospitalization and treatment of FTT is to establish feeding patterns, restore sleep patterns, provide adequate caloric and nutritional intake, and promote growth and development. There are no definitive lab tests for FTT.
Which speech pattern anomalies are likely to appear in the young child with autism spectrum disorder (ASD)? Select all that apply.
Use of the word you to represent I Correct Answer Reiteration of questions as opposed to answering them Correct! Enchantment with rhythmic, repetition of verse or song Correct Answer Echolalia
The nurse is providing care to a client diagnosed with failure to thrive (FTT). Which option does the nurse anticipate will be prescribed to treat FTT in this client?
nutritional supplements
The nurse is caring for a family with four children whose third child has been diagnosed with ADHD. After completing an assessment, which statement made by the mother leads the nurse to a diagnosis of compromised family coping?
"I don't know how to tell the rest of the family or how we will manage the other children." The mother does not have a positive outlook on this situation and appears indecisive and ashamed. This family will need assistance with coping with the child and continuing on with life. Alerting the teachers at school is a positive action and a way to protect the child. The school play will be a decision made with the teachers, but the mother's statement does not suggest poor coping. Asking if the child will need to be placed in an institution is reasonable at this time.
You are providing care to Trevor, a 6-year-old client who is diagnosed with autism spectrum disorder (ASD). As you review the medicalrecord, which item in the health history may have caused Trevor to develop ASD?
Fetal Alcohol Syndrome History of maternal alcohol use during pregnancy is an item in the health history that may have contributed to the development of ASD. Childhood vaccinations and cystic fibrosis are not linked to ASD. The ability to adapt to new environments is an appropriate goal for a client diagnosed with ASD.
During a routine examination, the mother of a young teen client mentions that her son is constantly eating and is rapidly growing out of many of his clothes. What should the nurse explain to the mother? (Select all that apply.)
You can expect height and weight increases to last over the next few years. Correct! Nutritional needs increase with growth spurts. You can expect height and weight increases to last over the next few years. Correct! Nutritional needs increase with growth spurts.
A nurse is caring for a child who has been diagnosed with attention-deficit/hyperactivity disorder (ADHD). The client's healthcare provider has prescribed amphetamine-dextroamphetamine (Adderall) to treat the child's disorder. What statement will the nurse make to the child's parent regarding this medication?
Your child's growth may be delayed with this medication." Amphetamine-dextroamphetamine (Adderall), a psychostimulant, may delay the child's growth and height should be monitored frequently. Liver function should be monitored with nonstimulant medications, not stimulants. Nonstimulants, not stimulants, may increase the risk of psychosis.
The parents of a child with cerebral palsy ask if there are any medications available to help control the child's symptoms. Which type of medication would the nurse explain is used for symptom management for cerebral palsy?
a Botulinum toxin b Baclofen d Muscle relaxants e Benzodiazepines Learning Objective Identify independent and collaborative therapies used by interdisciplinary teams. Rationale Medications used to control seizures and spasms include skeletal muscle relaxants, baclofen, benzodiazepines, and botulinum toxin. Antidepressants are not used to manage the symptoms of cerebral palsy.
The mother of a 4-year-old child with cerebral palsy asks how this health problem occurred. Which pre-birth insults would the nurse explain to the mother are possible causes? (Select all that apply.)
b Prematurity d Fetal viral infection e Genetic factors Prematurity is an etiology of CP that occurs before birth. Fetal viral infection is an etiology of CP that occurs before birth. Genetic factors are an etiology of CP that occurs before birth. Hyperbilirubinemia is an etiology of CP that occurs after birth. Brain injury is an etiology of CP that occurs after birth.
The parents of Tyler Thomas, a 5-year-old client with mixed cerebral palsy, ask why a baclofen pump is scheduled to be surgically implanted in the child. Which explanation would the nurse give about the purpose of this medication pump?
Controls muscle spasms Implantation of a baclofen pump allows continuous delivery of the drug baclofen, which improves muscle spasms. The surgical treatment of Achilles tendon lengthening is used to increase ankle range of motion and to allow the child to walkflat-footed. Intrathecal pump implantation actually increases the risk of infection and must be carefully monitored. Baclofen is not being provided to the client to prevent infections.
The parents of a 6-year-old client with attention-deficit/hyperactivity disorder (ADHD) are receiving education about the disorder from the nurse. Which statement made by the parents indicates a need for further teaching?
Our child will grow out of the ADHD, so we only have to deal with it a few more years." Learning Objective Differentiate the pathophysiology, etiology, risk factors, prevention, and clinical manifestations. Rationale ADHD continues into adulthood in 30%- 70% of cases, so thinking that their child will grow out of it requires further teaching from the nurse. Areas in the brain that control self-regulation are slow to mature in children with ADHD. The brains of children with ADHD are also more sensitive to stimuli, which cause hyperactivity. Children with ADHD are at risk for antisocial behavior and substance abuse as adults.
You prepare Kara for a thorough assessment during her visit. You know that the health care provider will focus the assessment on which systems? Select all that apply.
The neurologic system Correct! The respiratory system Correct! The cardiac system Rib cage deformity can influence the functioning of the neurologic system, the cardiac system, and the respiratory system; therefore, the health care provider will conduct a thorough examination of these systems. The GI system and the GU system are not affected by rib cage deformity.
A 34-year-old client recently diagnosed with attention-deficit/hyperactivity disorder (ADHD) asks the nurse about treatment options. Which treatment options should the nurse describe? Select all that apply.
The nonstimulant medication Strattera is approved for use in adults. Stimulant medications such as Focalin are not approved for use in adults. Environmental modifications that decrease stimulation, such as maintaining a quiet environment and having an orderly work area, are beneficial to clients with ADHD. Having a structured routine is more helpful to clients with ADHD than a loose, flexible schedule. Learning Objective Identify independent and collaborative therapies used by interdisciplinary teams. Rationale The nonstimulant medication Strattera is approved for use in adults. Stimulant medications such as Focalin are not approved for use in adults. Environmental modifications that decrease stimulation, such as maintaining a quiet environment and having an orderly work area, are beneficial to clients with ADHD. Having a structured routine is more helpful to clients with ADHD than a loose, flexible schedule.
A 22-year-old client with attention-deficit/hyperactivity disorder (ADHD) is currently taking atomoxetine (Strattera). The client states, "I don't want to be dependent on medication my entire life. I've heard that cutting out sugar from my diet and taking ginkgo biloba might help my ADHD symptoms." Which is the best response by the nurse about complementary and alternative therapies for ADHD?
These are popular alternative treatments, but scientific evidence does not consistently support their effectiveness Learning Objective Identify independent and collaborative therapies used by interdisciplinary teams. Rationale To date, there is no consistent evidence that elimination diets, dietary supplements, or herbs are effective in treating ADHD. Telling the client this in a factual, nonjudgmental manner is the best response. The nurse does not have the authority to change the client's treatment regimen without approval from the healthcare provider, even if the nurse tells the client to tell the provider about the change. Neither suggesting a new medication nor minimizing the client's concerns addresses the client's interest in alternative therapies and does not acknowledge the client's concerns.
The nurse suspects that a 6-month-old client may be suffering from failure to thrive (FTT). What aspects of culture should the nurse take into account when performing an assessment of the client?
Variances in nutritional practices in ethnic groups Learning Objective Differentiate components of assessment related to alterations in development. Rationale The aspects of culture the nurse should take into account when performing an assessment for FTT include nutritional practices. Educational motivation, variance in childrearing, and social interactions do not apply specifically to the assessment of the client with FTT.
The nurse is preparing discharge instructions for the parents of a child with cerebral palsy. Which instruction would the nurse include to promote safety for this child? (Select all that apply.)
a The use of a helmet to protect against head injuries c The use of seat belts in strollers and wheelchairs e The use of adaptive seating for automobile transportation The nurse should teach the use of a helmet to protect against head injuries for children with CP who experience seizures. The nurse should teach the use of seat belts for children in strollers and wheelchairs to decrease the likelihood of falling out of the seat. The use of adaptive seating in automobiles is an important area of teaching related to safety. Range-of-motion exercises are important to enhance physical mobility, not for child safety. The use of splints and braces is important to prevent contractures and promote mobility but not for child safety.
The nurse is observing a 17-year-old client with attention-deficit/hyperactivity disorder (ADHD) at home. Which observation indicates to the nurse that client outcomes have been met?
client receives several text messages from friends and does not respond until after asking permission to do so. Learning Objective Examine the nursing interventions and expected outcomes for an individual and the family. Rationale Text messaging is an age-appropriate social interaction for the client. While they can be distracting and cause the client to lose focus, the client did ask permission before responding, which indicates that the client is controlling impulsivity and inattentiveness. An inability to complete tasks and follow directions indicates that client goals have not been met. Excessive talking is another sign that client goals have not been met.
The school nurse is helping to create an individualized education plan (IEP) for a 12-year-old client with attention-deficit/hyperactivity disorder (ADHD). Which behavioral goal is appropriate to include in the plan of care?
client will respect the boundaries of others. Learning Objective Summarize assessment findings in clients across the lifespan. Rationale An appropriate behavioral goal for the client with ADHD is for the client to respect the boundaries of others. Because the client is a child, it is not appropriate to expect the client to manage medication administration. The client should demonstrate an increase, not decrease, in attentiveness. An appropriate goal is for the client to achieve school performance to maximum potential, not merely minimum competency.
The nurse is caring for a child with cerebral palsy. Which intervention would the nurse use to promote nutrition for this child?
d Providing the child with small amounts of food at a time Learning Objective Examine the nursing interventions and expected outcomes for an individual and the family. Rationale Small amounts of food should be given to a child with cerebral palsy because of problems with chewing and swallowing. Utensils with large, not small, padded, adaptive handles should be utilized for this child. There is no need to restrict this child 's fluid; the nurse would need to perform frequent assessments to determine hydration status, as the child may not be able to communicate thirst. Fiber, not protein, would be given to prevent constipation.
The nurse is teaching a caregiver about treatment for failure to thrive (FTT). Which statements made by the caregiver indicate a need for further education? (Select all that apply.)
most babies do not sleep well anyway; my baby will sleep when she is tired i hope my baby will not need surgery; that idea scares me medications rae given daily to treat this condition
The nurse is preparing to perform a nursing assessment of a client diagnosed with failure to thrive. Which item in the health history will the nurse assess prior to beginning the nursing assessment of this client?
percentials on growth chart for previous visits.
The nurse is writing a plan of care for a client diagnosed with failure to thrive (FTT). Which goal is a priority for this client?
the child will attain adequate growth and normal development
The nurse is caring for a 6-year-old child who was recently diagnosed with attention-deficit/hyperactivity disorder (ADHD). Which statement by the child's mother indicates to the nurse that teaching goals have not been achieved?
"I will let him do his homework while he is watching his favorite television show." This child should do homework in a quiet environment, away from distractions. Giving ADHD medication with meals will help counteract the anorexia associated with this medication. Maintaining the same daily routine helps the child know expectations, and a nighttime routine helps counteract insomnia. Children with ADHD should be screened regularly for height and weight to monitor growth.
Lainey Fuller, a 10-year-old girl with attention-deficit/hyperactivity disorder (ADHD), has been taking atomoxetine (Strattera) for the past 4 months. It has not improved her symptoms, so her healthcare provider is changing her prescription to methylphenidate (Ritalin). Lainey's mother asks, "Isn't Ritalin a stimulant? That doesn't make any sense. How is a stimulant going to help Lainey get better?" What is the nurse's best response?
"It does seem like the opposite of what should happen, but stimulants help improve focus and attention in children with ADHD and do not increase hyperactivity." Explaining that stimulants paradoxically improve focus and attention and do not increase hyperactivity most directly addresses Mrs. Fuller's concerns. Explaining the side effects of Strattera and Ritalin does not answer Mrs. Fuller's question. Inaddition, Lainey is being prescribed Ritalin because Strattera has been ineffective, not because it carries a greater suicide risk.
A nurse is caring for a client who has been diagnosed with autism spectrum disorder. His parents cannot understand how their son developed this disorder since there is no family history of it and the client was not subjected to harmful substances. Which response by the nurse is the most appropriate?
"Sometimes the specific cause of ASD cannot be determined." Learning Objective Examine common alterations in growth and development across the life span. Rationale Although the cause of ASD is unknown, it is believed to be associated with a complex interplay between genetic, immunologic, and environmental factors. The most appropriate answer from the nurse is that sometimes the specific cause of ASD cannot be determined. While low birth weight may be associated with the development of ASD, it is not a direct cause. ASD is not caused by poor nutritional intake. ASD is not a chromosomal disorder; therefore, this response is not appropriate for the parents of this child.
Thirteen-year-old Kara Justice arrives at the health care provider's office after being screened for scoliosis by the school nurse. You call Kara back to the exam room for a complete assessment. Kara is accompanied by her father. You carefully assess Kara's back and extremities. While she stands with her back to you, you notice that her hips and shoulders are uneven. You have her perform the Adams test (forward-bending test), which reveals a curve requiring further evaluation. Upon further question, Kara admits to occasional back pain. You report your findings to the health care provider, who orders radiology testing. Kara and her father are instructed to go to the radiology department for x-rays that will determine the degree of her spinal curvature. The radiologist reads the x-rays, which reveal a curve of 10°. You call Kara's father and inform him that no treatment is required at this time, but that Kara should be seen in the office in 6 months for a follow-up. You review Kara's medical record and note that Kara has both a brother and a sister at home. What information should you provide to Kara's father regarding his other children?
"Your other children should also be screened for scoliosis." Because the etiology of scoliosis is complex, if one child is diagnosed with scoliosis, the other children should be examined and observed closely. There is no need for the other children to undergo genetic testing; an examination and x-rays will confirm diagnosis. Males and females can both develop scoliosis. Physical therapy is a treatment option for mild scoliosis; it is not used to avoid the development of scoliosis.
The mother of 10-year-old Michael Donahue is concerned because her son fidgets and talks a lot, loses things, and doesn't like school work. The nurse should consider that Michael may have which developmental disorder?
Attention-deficit/hyperactivity disorder The nurse should consider that Michael has attention-deficit/hyperactivity disorder, which is characterized by making careless mistakes during completion of homework assignments, routinely losing items needed to complete activities ortasks, avoiding (or disliking) activities that require mental focus, excessive fidgeting or an apparent inability to sit still, excessive talking and/or verbal outbursts, and habitual interruption of others during conversation. Cerebral palsy, failure to thrive, and autism spectrum disorder are not correct choices.
The nurse is obtaining a health history from the parents of a child with cerebral palsy (CP). Which question would be most helpful in determining whether the child's brain insult happened after birth?
c "Were there any accidents before age 3?" Learning Objective Summarize assessment findings in clients across the lifespan. Rationale Asking about maternal age at birth, prematurity, and birth order all assess possible prenatal causes of CP. Asking about accidents before age 3 can help determine whether the child's brain insult happened after birth.