Question 1

A mother says to a nurse, "I am so concerned about my 14-year-old daughter because she has been caught stealing small articles of clothing and jewelry from stores on several occasions." The nurse begins a discussion on strategies for improving ethical behavior. This plan of care is part of:

Accepted Answer

Discussing strategies for improving ethical behavior aligns with health promotion, as it involves educating and guiding individuals towards healthier behavioral choices, which includes ethical decision-making and actions.

Question 2

A four-year-old child is seen in the pediatric clinic for a well-child visit. During this visit, the nurse recognizes that appropriate assessments that should be completed at this time include: Standard Text: Select all that apply.

Accepted Answer

At four years old, height and weight (A) are routinely measured to monitor growth. Immunizations (C) are checked to ensure the child is up-to-date. A developmental assessment (D) is important to evaluate the child's progress in various developmental domains. Safety counseling (E) is crucial to educate parents on preventing injuries. Head circumference (B) is typically measured in younger children, usually up to age two.

Question 3

A nurse in the outpatient pediatric clinic is reviewing the records of a preschool-age child and notes that the parents have missed the last two health care visits. The nurse also notes that the child has not received the second measles, mumps, and rubella (MMR) vaccine. The nurse should:

Accepted Answer

The nurse should call the parents and encourage them to bring the child for recommended care. It is important to communicate with the parents and remind them about the importance of preventive health care and keeping up with the child's immunizations. Calling them directly allows for immediate action and intervention. Planning to discuss the principles of health supervision at the next scheduled visit may be too late if the child is already overdue for vaccinations. Notifying the physician may also be necessary but should not be the first step as it may not address the immediate problem of the missed appointments and vaccinations. Speaking firmly with the parents may come across as confrontational and may not be an effective approach.

Question 4

The nurse wants to perform developmental screenings on a five-year-old child. Which screening tools would be appropriate for this purpose? Standard Text: Select all that apply.

Accepted Answer

The answer of The nurse wants to perform developmental screenings...

Question 5

Which of these strategies would be most effective for a "teachable moment" for the parents of a four-year-old child during a routine office visit?

Accepted Answer

Selecting one topic that is a common problem or concern for parents of four-year-olds and presenting a brief amount of information on the topic would be the most effective teachable moment during a routine office visit. This approach is more focused and practical than discussing preparation for school or reviewing anticipatory guidelines. It can help the parents address a specific issue relevant to their child's development and behavior.

Question 6

During a well-child visit, the nurse asks the mother of a six-month-old infant, "Does your baby sit without assistance?" and "Is the baby crawling?" Which process is the nurse using in this interaction?

Accepted Answer

The nurse is using developmental surveillance, which involves observing and assessing a child's developmental milestones during healthcare visits. By asking if the baby can sit without assistance and if they are crawling, the nurse is assessing the child's gross motor skills, which are important indicators of development at six months old.

Question 7

The mother of a two-year-old child becomes very anxious when the child has a temper tantrum in the medical office. The appropriate nursing response to the mother would be to say:

Accepted Answer

Asking the mother what she usually does or says during a temper tantrum can help the nurse understand the mother's coping strategies and provide guidance or support if necessary. This approach also validates the mother's experience and shows empathy towards her.

Question 8

A new patient is admitted to the pediatric clinic. The nurse wants to partner with the parents in creating a health care home. The first step for the nurse in becoming an effective partner with the parents would be to:

Accepted Answer

The first step in becoming an effective partner with the parents is to develop a relationship with them through open, supportive communication and show an interest and concern for the family's goals. This will help the nurse establish trust and build rapport with the family. It is important to create a partnership between the nurse and the family to provide the best possible care for the child.

Question 9

The nurse is evaluating the developmental skills of an eight-month-old child recently adopted from a foreign country. The nurse attempts to get the child to wave "bye-bye" and to play "patty-cake." When the child is unable to perform either skill, the nurse should:

Accepted Answer

Adopted children may have different developmental experiences and language skills, and it may take some time for them to catch up with the developmental milestones of their new culture. The nurse should not jump to conclusions about developmental delay or suggest medical attention without further evaluation. Instead, the nurse should recognize that the child may need extra time and support to develop these skills and provide age-appropriate toys and activities to encourage development.

Question 10

The nurse working in the pediatric clinic performs many activities. Which of these nursing activities can be classified promoting health promotion and maintenance? Standard Text: Select all that apply.

Accepted Answer

Administering vaccines, teaching proper dental hygiene, and discussing feeding schedules are all activities that promote health and maintenance. Administering antibiotics and teaching pulmonary drainage and cupping are treatments for acute illnesses, not preventative measures for promoting health maintenance.

Question 11

A parent asks a nurse, "How do you know when my child needs these screening tests the doctor just mentioned?" How should the nurse respond to the parent?

Accepted Answer

Screening tests are scheduled at specific ages because those are the times when children are most at risk for developing certain conditions or when the tests are most likely to detect potential health issues.

Question 12

Which nursing assessment activities should be included for the child and family at each health supervision visit? Standard Text: Select all that apply.

Accepted Answer

The nursing assessment activities that should be included for the child and family at each health supervision visit are performing an age-appropriate developmental assessment, performing age-appropriate screening examinations, and obtaining an updated health history. Monitoring parents' ability to pay for services and assessing for genetic abnormalities are not standard nursing assessment activities at health supervision visits.

Question 13

The nurse at an outpatient clinic is sitting with the parents while their adolescent goes for a test. The parents are complaining about their child's behavior. Which response by the nurse would promote family-centered communication?

Accepted Answer

This response encourages the parents to share their thoughts and feelings, promoting open communication and allowing the nurse to gain a better understanding of their perspective.

Question 14

A mother brings her two-year-old child to the pediatric office for a sick visit. The child is seen regularly at the office and was last seen at her well-child visit two months ago. Based on this information, which is the most appropriate action by the nurse?

Accepted Answer

Given the child's regular visits and recent well-child check, focusing on health promotion and maintenance activities is appropriate to ensure ongoing health and development, alongside addressing the current illness.

Question 15

Student nurses are observing in the pediatric well-child clinic. The students observe that prior to administering an immunization to a child, a nurse explains the reason for the immunization series to the mother. While discussing the incident in post-conference, the students report that this activity was:

Accepted Answer

This activity is an example of health promotion as the nurse is educating the mother about the importance of immunization, which is a preventive measure to maintain the child's health. Health screening is the process of identifying the presence of a health condition, while health assessment involves a comprehensive evaluation of a patient's overall health status. Health maintenance refers to activities that promote ongoing health and prevent illness or disease.

Question 16

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 manage the clinic more efficiently. 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?

Accepted Answer

Focusing anticipatory guidance on topics of interest to the parent or child can help prioritize important information, make the most of the limited time available, and ensure that key pieces of information are covered during the visit. This can be more effective than relying only on pamphlets or a limited assessment, and is a more proactive approach than asking parents to complain to the manager. Planning to do anticipatory guidance first may not be feasible, as the order of activities may vary based on the child's needs and the availability of providers.

Quiz 8: Concepts of Health Promotion and Health Maintenance