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Burns Pediatric Final Exam Study Guide 2024 2025. Q & A Grade A+, Study notes of Nursing

Johns Hopkins University (JHU)Nursing

Burns Pediatric Final Exam Study Guide 2024 2025. Q & A Grade A+

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Burns Pediatric Final Exam Study Guide

2024 2025. Q & A Grade A+

1. 1. A child has a 1-cm laceration on the forehead proximal to the hairline after

running into a pole while playing sports. To minimize the risk of infection, the primary

care

pediatric nurse practitioner will irrigate the wound and

a. a. allow the wound to heal by secondary intention.

b. b. delay closure of the wound for several days.

c. c. refer the child to a plastic surgeon for wound closure.

d. d. suture the wound within 6 hours. - ANSANS: D

Children are less likely than adults to get wound infections, with an infection rate from

sutured

lacerations at 2%. The PNP should clean and suture the wound. Wounds from animal

bites are

often left to heal by secondary intention to prevent infection. Referral to a plastic

surgeon is

necessary for cosmetic reasons. Delaying closure for several days is recommended for

heavily

contaminated wounds and those caused by high-velocity missile injuries, crush injuries,

and

explosion injuries.

1. 1. According to the 2007 NHIS analysis of the use of CAM therapy, use was higher

among :

a. a. families whose parent or parents had a college education.

b. b. Hispanic and African-American populations.

c. c. persons who had not recently taken prescription medications.

d. d. those living in households earning less than $65,000. - ANSANS: A

The NHIS review showed that CAM use was higher in households with at least one

college-

educated parent. CAM use was also higher in non-Hispanic Caucasians, persons who

had

taken prescription drugs within the past 3 months, and those living in households with

incomes

higher than $65,000.

1. 1. The mother of a 15-year-old female expresses concerns that her daughter may be

sexually active because she's had a steady boyfriend for over a year. The primary care

pediatric nurse practitioner learns that the family is Catholic and that the mother had an

abortion when she was 16 years old. What will the nurse practitioner do initially?

Discover Study notes of Nursing Johns Hopkins University (JHU)

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Burns Pediatric Final Exam Study Guide

2024 2025. Q & A Grade A+

1. A child has a 1-cm laceration on the forehead proximal to the hairline after running into a pole while playing sports. To minimize the risk of infection, the primary care pediatric nurse practitioner will irrigate the wound and a. a. allow the wound to heal by secondary intention. b. b. delay closure of the wound for several days. c. c. refer the child to a plastic surgeon for wound closure. d. d. suture the wound within 6 hours. - ANSANS: D Children are less likely than adults to get wound infections, with an infection rate from sutured lacerations at 2%. The PNP should clean and suture the wound. Wounds from animal bites are often left to heal by secondary intention to prevent infection. Referral to a plastic surgeon is necessary for cosmetic reasons. Delaying closure for several days is recommended for heavily contaminated wounds and those caused by high-velocity missile injuries, crush injuries, and explosion injuries.
1. According to the 2007 NHIS analysis of the use of CAM therapy, use was higher among : a. a. families whose parent or parents had a college education. b. b. Hispanic and African-American populations. c. c. persons who had not recently taken prescription medications. d. d. those living in households earning less than $65,000. - ANSANS: A The NHIS review showed that CAM use was higher in households with at least one college- educated parent. CAM use was also higher in non-Hispanic Caucasians, persons who had taken prescription drugs within the past 3 months, and those living in households with incomes higher than $65,000.
1. The mother of a 15-year-old female expresses concerns that her daughter may be sexually active because she's had a steady boyfriend for over a year. The primary care pediatric nurse practitioner learns that the family is Catholic and that the mother had an abortion when she was 16 years old. What will the nurse practitioner do initially?

a. a. Explore the mother's feelings about her own past experience. b. b. Offer to prescribe contraception to prevent pregnancy. c. c. Recommend that the mother discuss this with her daughter. d. d. Suggest that the mother talk to a priest about her daughter. - ANSANS: A An initial step when assisting families to manage ethical and behavioral issues is to assist parents and children in values clarification. Before offering other suggestions, the PNP should help the mother to clarify her own feelings. The other options may be necessary after values are clarified.

1. The parent of a 4-year-old points to a picture and says, "That's your sister." The child responds by saying, "No! It's my baby!" This is an example of which type of thinking in preschool-age children? a. a. Animism b. b. Artificialism c. c. Egocentrism d. d. Realism - ANSANS: D Children at this age are developing their ability to establish causality. Nominal realism occurs when children think that one type of thing can only be called by one name. All dogs are dogs and not various breeds. Animism refers to the belief that objects possess person-like qualities. Artificialism occurs when children think things are caused by a controlling force. Egocentrism is when children see things only as they relate to themselves.
1. The parent of a school-age child reports that the child usually has allergic rhinitis symptoms beginning each fall and that non-sedating antihistamines are only marginally effective, especially for nasal obstruction symptoms. What will the primary care pediatric nurse practitioner do? a. a. Order an intranasal corticosteroid to begin 1 to 2 weeks prior to pollen season. b. b. Prescribe a decongestant medication as adjunct therapy during pollen season. c. c. Recommend adding diphenhydramine to the child's regimen for additional relief. d. d. Suggest using an over-the-counter intranasal decongestant. - ANSANS: A Intranasal corticosteroids are a key component in long-term therapy to manage symptoms associated with AR. These should be begun 1 to 2 weeks prior to the beginning of pollen season. Decongestants are not recommended for long-term use because of side effects. Diphenhydramine causes daytime drowsiness.

symbolic language increases interactive play. Children need both structured and free play, but structured play will not increase interaction during this normally parallel period.

1. The primary care pediatric nurse practitioner is counseling the mother of a newborn about breastfeeding her infant. Which supplements will the nurse practitioner recommend? a. a. Fat-soluble vitamins b. b. Iron c. c. Multivitamins with iron d. d. Vitamin D - ANSANS: D The level of vitamin D in breast milk may not be adequate for breastfed infants, so it should be given as a supplement. Human milk has more than adequate amounts of other vitamins. Iron is not present, but this is generally added at 6 months of age, when solid foods are added to the diet.
1. The primary care pediatric nurse practitioner is examining a school-age child who has had several hospitalizations for bronchitis and wheezing. The parent reports that the child has several coughing episodes associated with chest tightness each week and gets relief with an albuterol metered-dose inhaler. What will the nurse practitioner order? a. a. Allergy testing b. b. Chest radiography c. c. Spirometry testing d. d. Sweat chloride test - ANSANS: C Spirometry testing is the gold standard for diagnosing asthma and is then used on a regular basis to monitor, evaluate, and manage asthma. Allergy testing should be considered but is not diagnostic of asthma. Chest radiography should not be routine. A sweat chloride test is used based on history.
1. The primary care pediatric nurse practitioner is examining a toddler who is below the 3rd percentile for weight even though the parents claim that the child eats "constantly." What will the nurse practitioner do initially? a. a. Evaluate the child's feeding and elimination behaviors and ask the family to describe mealtime routines. b. b. Recommend giving a multivitamin and offering high-calorie foods, such as ice cream.

c. c. Refer the child to a feeding evaluation clinic for a swallow study and evaluation of possible GERD. d. d. Suggest that the parents supplement the child's food intake with a high-calorie formula. - ANSANS: A When a child doesn't thrive, it is first necessary to evaluate feeding and elimination behaviors and mealtime routines to determine what the child's actual intake is along with the types of foods that are eaten. Only after the underlying causes are discovered will the PNP prescribe treatment options.

1. The primary care pediatric nurse practitioner examines a child who has had stiffness and warmth in the right knee and left ankle for 7 or 8 months but no back pain. The nurse practitioner will refer the child to a rheumatology specialist to evaluate for a. a. enthesitis-related JIA. b. b. oligoarticular JIA. c. c. polyarticular JIA. d. d. systemic JIA. - ANSANS: B Oligoarticular JIA is characterized by mild, painless asymmetric joint involvement without systemic symptoms. Enthesitis-related JIA involves arthritis of the lower limbs, especially the hips, intertarsal joints, and sacroiliac joints, with swelling, tenderness, and warmth. Polyarticular JIA involves 5 or more joints. Systemic JIA presents with systemic symptoms, such as fever.
1. The primary care pediatric nurse practitioner learns that the mother of a newborn infant is being tested for tuberculosis after a positive TB skin test. What will the nurse practitioner tell the mother who states a desire to breastfeed her baby? a. a. Breast milk is contraindicated if the mother has tuberculosis. b. b. She may continue to nurse her baby since the risk of transmission is low. c. c. That she can express breast milk and feed that to her infant d. d. To give formula until results of tuberculosis testing are known - ANSANS: C A maternal diagnosis of active, untreated TB is a contraindication to nursing, but expressed breast milk may be fed to the infant. The mother may feed expressed breast milk
1. The primary care pediatric nurse practitioner sees a 3-year-old child whose parents report is a picky eater in spite of their continued efforts to provide nutritious meals. The parents ask whether a multivitamin is necessary. How will the nurse practitioner respond? a. a. Ask the parents to provide a 3-day food diary.

days. Once frozen breast milk is thawed it should be used within 24 hours.

1. When counseling an adolescent with a family history of hyperinsulinemia and type 2 diabetes, the primary care pediatric nurse practitioner will recommend avoiding a. a. baked potato chips. b. b. canned vegetables. c. c. high-fiber cereals. d. d. processed breads. - ANSANS: D High-glycemic foods, such as soda, sweetened juices, and processed breads, pastries, and crackers are more quickly converted to serum glucose and stimulate a sharp rise in insulin production and a subsequent rapid shift into hypoglycemia. To help prevent this in a child with a family history of this disorder, the PNP should recommend avoiding processed breads, pastries, and crackers. High levels of fructose and low fiber intake also contributes to this phenomenon. Baked potato chips, canned vegetables, and high-fiber cereals do not contribute to excess insulin production.
1. The primary care pediatric nurse practitioner is evaluating an 11-month-old infant who has had three viral respiratory illnesses causing bronchiolitis. The child's parents both have seasonal allergies and ask whether the infant may have asthma. What will the nurse practitioner tell the parents? a. a. "Although it is likely, based on family history, it is too soon to tell." b. b. "There is little reason to suspect that your infant has asthma." c. c. "With your infant's history of bronchiolitis, asthma is very likely." d. d. "Your infant has definitive symptoms consistent with a diagnosis of asthma." - ANSANS: A A genetic predisposition for the development of an IgE-mediated response to aeroallergens is the strongest identifiable predisposing risk factor for asthma, but asthma is rarely diagnosed before age 12 months due to the high rate of viral-induced bronchiolitis. The PNP should be cautious about diagnosing asthma until wheezing without an association to viral illnesses occurs. This infant has clear risk factors for asthma
1. An 8-year-old boy has a recent history of an upper respiratory infection and comes to the clinic with a maculopapular rash on his lower extremities and swelling and

tenderness in both ankles. The pediatric nurse practitioner performs a UA, which shows proteinuria and hematuria and diagnoses HSP. What ongoing evaluation will the nurse practitioner perform during the course of this disease? a. a. ANA titers b. b. Blood pressure measurement c. c. Chest radiographs d. d. Liver function studies - ANSANS: B Hypertension is a serious risk of HSP, so repeated BP measurement is indicated. ANA titers are not measured with HSP. Chest radiographs are performed only if indicated. LFTs are not indicated

1. A 12-year-old child is brought to the clinic with joint pain, a 3-week history of low- grade fever, and a facial rash. The primary care pediatric nurse practitioner palpates an enlarged liver 2 cm below the subcostal margin along with diffuse lymphadenopathy. An ANA test is positive. Which test may be ordered to confirm a diagnosis of SLE? a. a. Anti-double-strand DNA antibodies b. b. Anti-La antibodies c. c. Anti-Ro antibodies d. d. Anti-Sm antibodies - ANSANS: A Anti-double-strand DNA antibodies are present in most people with SLE and are generally exclusively seen in cases of SLE and not other diseases. Anti-SM antibodies are diagnostic of SLE but are only seen in 30% of patients with SLE.
1. A 10-year-old child has a 1-week history of fever of 104°C that is unresponsive to antipyretics. The primary care pediatric nurse practitioner examines the child and notes bilateral conjunctival injection and a polymorphous exanthema, with no other symptoms. Lab tests show elevated ESR, CRP, and platelets. Cultures are all negative. What will the nurse practitioner do? a. a. Begin treatment with intravenous methyl prednisone. b. b. Consider IVIG therapy if symptoms persist one more week. c. c. Order a baseline echocardiogram today and another in 2 weeks. d. d. Reassure the child's parents that this is a self-limiting disorder. - ANSANS: C An echocardiogram should be obtained as soon as the diagnosis of Kawasaki disease (KD) is established, as a baseline study, with subsequent studies in 2 weeks and in 6 to 8 weeks. This child has fever and only two other symptoms, which may be consistent with atypical KD.

1. An adolescent who has exercise-induced asthma (EIA) is on the high school track team and has recently begun to practice daily during the school week. The adolescent uses 2 puffs of albuterol via a metered-dose inhaler 20 minutes before exercise but reports decreased effectiveness since beginning daily practice. What will the primary care pediatric nurse practitioner do? a. a. Counsel the adolescent to decrease the number of practices each week. b. b. Increase the albuterol to 4 puffs 20 minutes prior to exercise. c. c. Order a daily inhaled corticosteroid medication. d. d. Prescribe cromolyn sodium in addition to the albuterol. - ANSANS: C Children with EIA should use 2 puffs of a B2-agonist and/or cromolyn MDI 15 to 30 minutes prior to exercise, but, since tolerance may develop if a B2-agonist is used more than a few times a week, it should not be used as a controller monotherapy. Those who exercise regularly should use an ICS as a controller medication. Patients with asthma should be encouraged to exercise to improve overall health. Increasing the albuterol dose will not overcome the tolerance. And ICS is a preferred controller medication.
1. A school-age child steps on a nail while wearing tennis shoes and develops cellulitis in that foot. The child's immunizations are up-to-date. What antibiotic will the pediatric nurse practitioner empirically prescribe? a. a. Amoxicillin-clavulanate b. b. Ciprofloxacin c. c. Clindamycin d. d. Trimethoprim-sulfamethoxazole - ANSANS: B Plantar puncture wounds, particularly those wounds that occur following puncture of sneakers/shoes, require ciprofloxacin to cover potential Pseudomonas infection and to protect against an osteomyelitis. Amoxicillin-clavulanate is used in other puncture wounds with signs of infection. Clindamycin is used for similarly wounded children allergic to penicillins. TMP- SMX is used if MRSA is cultured.
1. The mother of a 2-month-old infant tells the primary care pediatric nurse practitioner that she is afraid her breast milk is "drying up" because her baby never seems satisfied and wants to nurse all the time. Which action is correct? a. a. Recommend pumping her breasts after feedings.

b. b. Refer the mother to a lactation consultant. c. c. Suggest supplementation with formula. d. d. Weigh the infant to assess for a growth spurt. - ANSANS: D Infants have growth spurts about every 3 to 4 weeks that increase their breast milk needs. Until the mother's milk supply catches up, the infant will act hungry and want to nurse more frequently. The PNP should evaluate for this growth spurt and then instruct the mother to feed her baby more often to increase her milk supply. Since the infant is hungry, the infant should nurse. It is not necessary to refer for a lactation consultation or to supplement with formula.

1. The parent of a newborn reports using echinacea for family members to help treat viral illnesses and feels that it is usually effective. What will the primary care pediatric nurse practitioner tell this parent? a. a. That echinacea has no known therapeutic effects and should not be given b. b. That the supplement should not be given to children under 2 years of age c. c. To give half the recommended adult dose until the child is 5 years old d. d. To wait until the infant is at least 1 month old before giving this product - ANSANS: B Echinacea use should be restricted to children older than 2 years. Telling a parent who is convinced that a product works that it is not effective will prevent open communication between the parent and practitioner. Children under 2 years should not receive the supplement.
1. The primary care pediatric nurse practitioner is providing anticipatory guidance to the mother of a breastfed 6-month-old infant who asks about "baby-led weaning." What will the nurse practitioner tell her about this practice? a. a. "Foods given for this purpose do not meet all the child's nutritional needs." b. b. "Giving infants control of the feeding process will help prevent obesity." c. c. "Infants are given soft, mashable table foods when able to self-feed." d. d. "Infants must be able to grasp and feed themselves from a spoon to do this." - ANSANS: C Baby-led weaning is a concept where infants feed themselves, soft, mashable table foods that they grasp rather than being spoon-fed, allowing the infant more control. Foods given either by spoon or finger-fed will meet the child's nutritional needs. More research is needed to determine if this method affords protection from obesity by improving self-regulation. Infants must be able to sit without support and to reach and grasp for objects.

1. The primary care pediatric nurse practitioner sees a child for follow-up care after hospitalization for ARF. The child has polyarthritis but no cardiac involvement. What will the nurse practitioner teach the family about ongoing care for this child? a. a. Aspirin is given for 2 weeks and then tapered to discontinue the medication. b. b. Prophylactic amoxicillin will need to be given for 5 years. c. c. Steroids will be necessary to prevent development of heart disease. d. d. The child will need complete bedrest until all symptoms subside. - ANSANS: A ASA is given for arthritis for 2 weeks and then will be tapered. Children with ARF will need penicillin prophylaxis, not amoxicillin. Steroids are sometimes used for symptomatic relief but do not prevent chronic heart disease. Bed rest is indicated only when cardiac symptoms occur.
1. An adolescent female reports poor sleep, fatigue, muscle and joint paint, and anxiety lasting for several months. The primary care pediatric nurse practitioner notes point tenderness at several sites. What will the nurse practitioner do next? a. a. Evaluate the adolescent's pain using a numeric pain scale. b. b. Obtain ANA, CBC, liver function, and muscle enzymes tests. c. c. Reassure the adolescent that this condition is not life-threatening. d. d. Refer the adolescent to a rheumatologist for further evaluation. - ANSANS: D Children with widespread musculoskeletal pain and painful point tenderness may have fibromyalgia and should be referred. The Widespread Pain Index is used to define the degree of pain. Laboratory studies are of little benefit when diagnosing fibromyalgia. Even though children need reassurance that this disease is not life-threatening, this is not the next action.
1. The primary care pediatric nurse practitioner is managing care for a child who has JIA who has a positive ANA. Which specialty referral is critical for this child? a. a. Cardiology b. b. Ophthalmology c. c. Orthopedics d. d. Pain management - ANSANS: B An ophthalmology consultation is critical for children with JIA who have a positive ANA. Uveitis occurs in up to 35% of children with JIA who have a positive ANA. Other specialists may be consulted for specific symptoms.
1. The parent of a school-age child who is diagnosed with oligoarticular JIA asks the primary care pediatric nurse practitioner what exercises the child may do to help reduce

symptoms. What will the nurse practitioner recommend? a. a. Running b. b. Swimming c. c. Weights d. d. Yoga - ANSANS: B Swimming is an excellent exercise for children with JIA because water therapy and the use of heat or cold reduce pain and stiffness, unless they have severe anemia or cardiac involvement.

1. A school-age child with asthma is seen for a well child checkup and, in spite of "feeling fine," has pronounced expiratory wheezes, decreased breath sounds, and an FEV less than 70% of personal best. The primary care pediatric nurse practitioner learns that the child's parent administers the daily medium-dose ICS but that the child is responsible for using the SABA. A treatment of 4 puffs of a SABA in clinic results in marked improvement in the child's status. What will the nurse practitioner do? a. a. Have the parent administer all of the child's medications. b. b. Increase the ICS medication to a high-dose preparation. c. c. Reinforce teaching about the importance of using the SABA. d. d. Teach the child and parent how to use home PEF monitoring. - ANSANS: D Home PEF monitoring is useful for children to identify when symptoms are worsening. This child does not appear to notice the presence of airway tightness or wheezing and so might benefit from PEF monitoring to know when to use the SABA. School-age children should be learning how to manage their chronic disease, so having the parent administer all medications is not the best choice, especially since use of the SABA is still dependent on the child's report of symptoms. Since the child responded well to administration of the SABA, increasing the dose of ICS should not be done unless better management is not effective. Reinforcing the teaching is part of the plan but, unless the child is aware of symptoms, may not occur.
1. A toddler is brought to the clinic after grabbing the hot end of his mother's curling iron. An examination reveals a pale, yellow burned area to the palm of one hand. What is true about this burn? a. a. It may take up to 3 weeks to heal with scarring likely. b. b. Scarring is unlikely, with healing expected in 3 to 7 days. c. c. Surgical intervention and skin grafting are usually required.

1. The primary care pediatric nurse practitioner is offering anticipatory guidance to the parents of a 12-month-old child. The parents are bilingual in Spanish and English and have many Spanish-speaking relatives nearby. They are resisting exposing the child to Spanish out of concern that the child will not learn English well. What will the pediatric nurse practitioner tell the parents? a. a. Children who learn two languages simultaneously often confuse them in conversation. b. b. Children with multi-language proficiency do not understand that others cannot do this. c. c. Learning two languages at an early age prevents children from developing a dominant language. d. d. Most bilingual children are able to shift from one language to another when appropriate. - ANSANS: D Most children who are bilingual are able to sort out the languages in conversation but may "code switch" at times for clarity as they speak. They seem to understand that not everyone has this ability. Most children who are bilingual develop a dominant language.
1. The primary care pediatric nurse practitioner is performing a medication history on a child and learns that the child's parents use various complementary treatments and remedies for the child. According to the American Academy of Pediatrics standard for providers, what will the nurse practitioner do? a. a. Evaluate the safety and efficacy of each product and monitor use. b. b. Incorporate these therapies into standard care practices. c. c. Recommend not using the products until the child is older. d. d. Suggest that most of these treatments are not safe for children. - ANSANS: A The AAP suggests that providers be nonjudgmental and sensitive to cultural and ethnic practices of patients and that they keep an open mind regarding the use of complementary and alternative therapies as long as safety and efficacy are evaluated and monitored. Products that are not safe should be discouraged and not just incorporated into standard care. Telling parents not to use the products and suggesting that they are not safe may be perceived as judgmental and will likely prevent collaboration with the parent.
1. The primary care pediatric nurse practitioner is performing an assessment on a 1- week-old newborn with a slightly elevated bilirubin who is breastfeeding well and who has gained 30 grams in the past 24 hours. The infant is stooling and voiding well. The nurse practitioner suspects breast milk jaundice. Which action is correct?

a. a. Order home phototherapy and closely monitor bilirubin levels. b. b. Reassure the mother that the bilirubin level will drop in a few days. c. c. Recheck the serum bilirubin and infant's weight in 24 hours. d. d. Recommend that the mother pump her breast milk for a couple of days. - ANSANS: C Infants with breast milk jaundice who are gaining weight and thriving should continue to breastfeed and be monitored for the development of pathologic jaundice. It is not necessary to order phototherapy or discontinue breastfeeding unless pathologic jaundice is present. The bilirubin may remain elevated up to 3 months.

1. A child has a fever and arthralgia. The primary care pediatric nurse practitioner learns that the child had a sore throat 3 weeks prior and auscultates a murmur in the clinic. Which test will the nurse practitioner order? a. a. Anti-DNase B test b. b. ASO titer c. c. Rapid strep test d. d. Throat culture - ANSANS: B This child has symptoms and a history consistent with ARF. The ASO titer peaks in 3 to 6 weeks and will confirm a recent strep infection. The anti-DNase B test will also confirm a recent strep infection, but this doesn't peak until 6 to 8 weeks after the initial infection. A rapid strep test and throat culture do not differentiate the carrier state from a true infection.
1. A child is brought to the clinic immediately after being stung by a wasp while playing in the yard. The physical examination reveals localized redness and edema at the site, along with abdominal tenderness, watery eyes, and generalized hives. What is the initial treatment? a. a. Administer intramuscular epinephrine. b. b. Apply a topical glucocorticoid cream. c. c. Give oral diphenhydramine. d. d. Order a bronchodilator treatment. - ANSANS: A This child has signs of a severe reaction to the sting and should receive epinephrine first, followed by oral diphenhydramine and bronchodilators if wheezing. Topical glucocorticoids are used for mild, localized reactions.
1. An adolescent will begin taking the combination oral contraceptive pill (OCP).

infection than infants breastfed for less time. However, infants who breastfeed exclusively for 9 months or for longer than 12 months may have increased risks for food hypersensitivities and atopic dermatitis. Breast milk is a poor source of vitamin D and iron.

1. The parent of a school-age child reports that the child is on a gluten-free diet. When questioned about the reason for this diet, the parent states that the child has fewer stomach aches since beginning the diet but has never been diagnosed with celiac disease. The parent reports using gluten-free grain products for all family members. The nurse practitioner will tell this parent that gluten-free diets a. a. are generally low in sugar and fat. b. b. are healthy and help prevent obesity. c. c. may be deficient in essential nutrients. d. d. provide adequate protein to meet daily needs. - ANSANS: C Gluten-free grain products are often highly processed and not enriched with iron or folate. Many are very low in protein, enough so that they are used for patients with metabolic conditions such as PKU who need severe protein restrictions. They often have sugar and fat added to them to improve taste and do not help prevent obesity.
1. The parents of a 3-year-old child are concerned that the child has begun refusing usual foods and wants to eat mashed potatoes and chicken strips at every meal and snack. The child's rate of weight has slowed, but the child remains at the same percentile for weight on a growth chart. What will the primary care pediatric nurse practitioner tell the parents to do? a. a. Allow the child to choose foods for meals to improve caloric intake. b. b. Place a variety of nutritious foods on the child's plate at each meal. c. c. Prepare mashed potatoes and chicken strips for the child at mealtimes. d. d. Suggest cutting out snacks to improve the child's appetite at mealtimes. - ANSANS: B Young children should have three meals and two nutritious snacks each day. The parents' responsibility is to provide nutritious foods and allow children to choose how much they will eat. Children who are allowed to choose foods will likely make selections that are not healthy. Parents should be discouraged from preparing separate meals for their children. Snacks are

necessary to maintain adequate intake and energy.

1. A school-age child sustained a contusion on the front of one thigh while playing football and reports some difficulty flexing his foot on the affected side. What will the primary care pediatric nurse practitioner do to treat this injury? a. a. Place the child on crutches and limit weight-bearing until symptoms subside. b. b. Prescribe acetaminophen with hydrocodone along with NSAIDs. c. c. Recommend rest, ice packs, compression, and elevation of the extremity. d. d. Refer the child to an orthopedic specialist for immediate evaluation and treatment. - ANSANS: D Children with contusions that restrict movement or sensation and those affecting the quadriceps muscle may include compartment syndrome. These children should be referred to orthopedic specialists immediately so that the compartment pressure does not result in irreplaceable damage. The other options may be performed in consultation with a specialist.
1. The mother of a 6-year-old child tells the primary care pediatric nurse practitioner that the child only wants to eat French fries and hamburgers and refuses most vegetables. What will the nurse practitioner recommend? a. a. Giving the child a multivitamin since this is a phase b. b. Having the child eat vegetables before getting the hamburger c. c. Providing a variety of healthy foods at each meal d. d. Putting extra lettuce and tomatoes on hamburgers - ANSANS: C Parents are responsible for the foods their children eat, and it is their responsibility to provide healthful foods. Children should be exposed to a variety of healthy foods but not forced to eat any of them. However, parents should not bribe children with the reward of getting the unhealthy food that they want. With a well-balanced diet, not eating a vegetable prepared at one meal, for example, will not compromise the child's health, so a multivitamin is not necessary if the overall diet is healthy. Allowing hamburgers and adding desired foods again puts the child in control.
1. The parent of a 24-month-old child asks the primary care pediatric nurse practitioner when toilet training should begin. How will the pediatric nurse practitioner respond? a. a. "Begin by reading to your child about toileting." b. b. "Most children are capable by age 2 years." c. c. "Tell me about your child's daily habits."

Burns Pediatric Final Exam Study Guide 2024 2025. Q & A Grade A+, Study notes of Nursing

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Burns Pediatric Final Exam Study Guide

2024 2025. Q & A Grade A+