Burns' Pediatric Primary Care 7th Edition Test Bank Chapter 1: Health Status of Children G, Exams of Nursing

Download Burns' Pediatric Primary Care 7th Edition Test Bank Chapter 1: Health Status of Children G and more Exams Nursing in PDF only on Docsity! Burns' Pediatric Primary Care 7th Edition Test Bank Chapter 1: Health Status of Children Global and National Perspectives Latest updated 2022 examination Study Guide. Burns' Pediatric Primary Care 7th Edition Test Bank Chapter 1: Health Status of Children: Global and National Perspectives 1. Which region globally has the highest infant mortality rate? A. Indonesia B. Southern Asia C. SubSaharan Africa Correct D. Syria 2. The primary care pediatric nurse practitioner understands that, to achieve the greatest worldwide reduction in child mortality from pneumonia and diarrhea, which intervention is most effective? A. Antibiotics B. Optimal nutrition C. Vaccinations Correct D. Water purification 3. Which is true about the health status of children in the United States? . 13348413856 A. Globalism has relatively little impact on child health measures in the U.S. B. Obesity rates among 2to5yearolds have shown a recent significant decrease. Correct . C. The rate of household poverty is lower than in other economically developed nations. D. Young children who attend preschool or day care have higher food insecurity. 4. The primary care pediatric nurse practitioner understands that a major child health outcome associated with worldwide climate change is A. cost of living. B. education. C. nutrition. Correct D. pollution. 5. When providing well child care for an infant in the first year of life, the primary care pediatric nurse practitioner is adhering to the most recent American Academy of PediatricsRecommendations for Preventive Pediatric Health Care guidelines by A. focusing less on development and more on illness prevention and nutrition. B. following guidelines established by theBright Futures publication. C. scheduling wellbaby visits to coincide with key developmental milestones. Correct D. seeing the infant at ages 2, 4, 6, and 12 months when immunizations are due. Chapter 2. Unique Issues in Pediatrics 1. A nurse is explaining the therapeutic milieu to a new nurse. The best Burns' Pediatric Primary Care 7th Edition Test Bank Chapter 1: Health Status of Children Global and National Perspectives Latest updated 2022 examination Study Guide. explanation of this term would be: 1. The place where the child is receiving care. Burns' Pediatric Primary Care 7th Edition Test Bank Chapter 1: Health Status of Children Global and National Perspectives Latest updated 2022 examination Study Guide. 2. He states, I will be a good boy now. . 3. He starts headbutting the window. 4. He complains that his parents will file a lawsuit. ANS: 3 8. A child has been exhibiting the MacDonald Triad. These behaviors include: 1. Enuresis, pushing others, and pyromania. 2. Swinging a cat by the tail, bed-wetting, and lighting paper on fire in the trash can. 3. Playing with other children, laughing, and conversing with adults. 4. Playing with a campfire, watching television, and seeking adult attention. ANS: 2 9. A teenager diagnosed with borderline personality disorder should have discharge planning instructions of: 1. A consistent caregiver. 2. Monitoring of media, such as the Internet, television, and video games. 3. Obtaining support from family and friends. 4. Seeking medical attention when the teenager feels good. ANS: 3 10. A mental health nurse is teaching the mother of a child with executive functioning issues ways to help her child. Interventions the mother should use include: 1. Placing visual aids on the bathroom mirror so that the child will follow the morning routine. 2. Give the child a choice in foods to eat. 3. Allowing the child to ask for help when needed. 4. Reminding the child to be nice to others. ANS: 1 . 11. Ellie, a 9-year-old girl, was adopted by a family at the age of 4 after several years of severe neglect by her birth family. The adoptive family has been reporting that Ellie is angry a lot, manipulative with her teachers, and does not seek positive attention. The nurse working with Ellie will need to: 1. Provide education on decreasing stimuli in the home environment that triggers the anger. 2. Realize Ellie may have attachment issues related to her previous history and will need to encourage the family to be active in her care. 3. Support the family in the decision-making process of continuing to let Ellie live in the home. 4. Discuss inpatient therapy to decrease Ellies manipulative behavior patterns. ANS: 2 12. An infant displays depression by: 1. Smiling at strangers. 2. Bonding to someone other than the immediate family. 3. Crying more than an average infant. Burns' Pediatric Primary Care 7th Edition Test Bank Chapter 1: Health Status of Children Global and National Perspectives Latest updated 2022 examination Study Guide. 4. Looks away when an adult attempts to play with the infant. ANS: 4 Burns' Pediatric Primary Care 7th Edition Test Bank Chapter 1: Health Status of Children Global and National Perspectives Latest updated 2022 examination Study Guide. 13. A father reports that his adolescent daughter has gotten good grades up until the last quarter of school. She has been hanging out by herself and does not want to talk to him anymore. The mental health nurse should: 1. Realize that this is a natural part of growing up. 2. Perform a mental health screening to check for depression. 3. Attempt to get the adolescent to discuss why she does not like her father anymore. 4. Let the adolescent talk when she is ready. ANS: 2 14. A teen should be checked for depression at physician visit(s). 1. Every . 2. One 3. Monthly 4. Bi-yearly ANS: 1 15. When using the SAD FACES depression screen, it is important to assess: 1. Anhedonia. 2. Suicidal ideations. 3. Sleep patterns. 4. All of the above ANS: 4 16. A school nurse is giving an in-service to teachers on bullycide. The main reason for the teaching is so that: 1. Teachers are aware bullying occurs. 2. Teachers are able to identify students who are risk. 3. Teachers can be aware of the fact that suicides can happen due to bullying by others. 4. Teachers are aware of their role in causing bullycide. ANS: 3 17. An adolescent with a known history of bipolar disorder is in the school nurses office because a teacher reported that she was talking fast and acting like she was God. The school nurse assesses the girl and notes that: 1. She is probably in a manic phase and needs to be treated professionally. 2. She has had too much sleep and is now hyperactive. 3. She forgot to take her medications today. 4. She requires some food and rest before going back to class. ANS: 1 Chapter 3. Genetics and Child Health Questions 1. What is true about haploid cells? . 13348407644 C. Each contains 23 paired chromosomes. Burns' Pediatric Primary Care 7th Edition Test Bank Chapter 1: Health Status of Children Global and National Perspectives Latest updated 2022 examination Study Guide. girl reveals that hemophilia A, an Xlinked Burns' Pediatric Primary Care 7th Edition Test Bank Chapter 1: Health Status of Children Global and National Perspectives Latest updated 2022 examination Study Guide. recessive disorder, is present in males in three previous generations in the mother’s family, whose father had the disease. What will the primary care pediatric nurse practitioner tell the parents about the risk of this disease in their children? E. All of their sons will be affected by the disease. F. Any sons they have will not be affected by the disease. G. Daughters have a 50% chance of being carriers of the disease. Correct H. Their daughter has a 25% chance of having the disease. 8. What is an important responsibility of the primary care pediatric nurse practitioner . to help determine genetic risk factors in families? E. Assessing physical characteristics of genetic disorders F. Knowing which genetic screening tests to perform G. Making appropriate referrals to pediatric geneticists D. Obtaining a threegeneration pedigree for each family Correct 9. Which diagnostic study may be ordered when the provider wishes to detect the . presence of additional genetic material on a chromosome? A. Chromosomal microarray B. FISH Correct D. Karyotype E. Molecular testing 10. Which type of testing will the primary care pediatric nurse practitioner recommend . for a couple concerned about the potential for having children with cystic fibrosis? A. Biochemical testing B. Carrier testing Correct C. FISH testing D. Karyotype testing Chapter 4. Environmental Issues Questions 1. What has been the result of passage of the Toxic Substances Control Act. (TSCA) of 1976? G. A mandate for corporations to disclose known toxic chemicals H. A requirement that all manufactured chemicals undergo toxicity testing I. Authorization of the EPA to require testing and reporting of some chemicals Correct J. Development of a mechanism to report reactions to toxic chemicals 2. Many European nations use the “precautionary principle” to help regulate potentially toxic chemicals. What does this mean? Burns' Pediatric Primary Care 7th Edition Test Bank Chapter 1: Health Status of Children Global and National Perspectives Latest updated 2022 examination Study Guide. G. Chemicals must be proven to be safe before being introduced into the Burns' Pediatric Primary Care 7th Edition Test Bank Chapter 1: Health Status of Children Global and National Perspectives Latest updated 2022 examination Study Guide. Besides avoiding using plastic containers when possible, what else will the primary care pediatric nurse practitioner recommend? A. Avoid heating foods and liquids in plastic containers. Correct B. Clean plastic containers well using the dishwasher. C. Use only plastics stamped with “#7” on the bottom. D. Used canned food products whenever possible. 9. A parent desires to buy only organic produce to avoid exposing a child to pesticides but complains that these foods are expensive. The primary care pediatric nurse practitioner provides a list of foods that are relatively safe whether they are organic or not. Which foods are on this list? A. Apples, celery, and peaches B. Potatoes, cherry tomatoes, and peaches C. Strawberries, grapes, and cucumbers D. Sweet corn, cantaloupe, and kiwi Correct Chapter 5. Child and Family Health Assessment Questions 1. The primary care pediatric nurse practitioner is obtaining a medical history about a child. To integrate both nursing and medical aspects of primary care, which will be included in the medical history? K. Complementary medications, alternative health practices, and chief complaint L. Developmental delays, nutritional status, and linear growth patterns M. Medication currently taking, allergy information, and family medical history N. Speech and language development, beliefs about health, and previous illnesses Correct 2. When formulating developmental diagnoses for pediatric patients, the primary care pediatric nurse practitioner may use which resource? A. DC: 03R Correct K. ICD10CM L. ICSD3 M. NANDA International 3. The primary care pediatric nurse practitioner sees a 3yearold child who chronically withholds stools, in spite of the parents’ attempts to stop the behavior, requiring frequent treatments with laxative medications. Which diagnosis will the nurse practitioner use to facilitate thirdparty reimbursement? M. Altered elimination pattern N. Elimination disorder C. Encopresis Correct D. Parenting alteration 4. The primary care pediatric nurse practitioner is assessing a toddler whose weight and body mass index (BMI) are below the 3rd percentile for age. The nurse practitioner learns that the child does not have regular mealtimes and is allowed to carry a bottle of juice around at all times. The nurse practitioner plans to work with this family to Burns' Pediatric Primary Care 7th Edition Test Bank Chapter 1: Health Status of Children Global and National Perspectives Latest updated 2022 examination Study Guide. develop improved meal patterns. Which diagnosis will the nurse practitioner use for this problem? Burns' Pediatric Primary Care 7th Edition Test Bank Chapter 1: Health Status of Children Global and National Perspectives Latest updated 2022 examination Study Guide. J. Failure to thrive K. Home care resources inadequate L. Nutrition alteration – less than required D. Parenting alteration Correct . 5. The primary care pediatric nurse practitioner is p erforming a well child checkup on a 20monthold child. The child was 4 weeks premature and, according to a parentcompleted developmental questionnaire, has achieved milestones for a 15monthold infant. Which action is correct? J. Perform an indepth developmental assessment screen at this visit to evaluate this child. Correct K. Reassure the parent that the child will catch up to normal development by age 2 years. L. Reevaluate this child’s development and milestone achievements at the 2year visit. M. Refer the child to a specialty clinic for evaluation and treatment of developmental delay. 6. The primary care pediatric nurse practitioner performs a developmental assessment on a 3yearold child and notes normal cognitive, finemotor, and grossmotor abilities. The child responds appropriately to verbal commands during the assessment but refuses to speak when asked questions. The parent tells the nurse practitioner that the child talks at home and that most other adults can understand what the child says. The nurse practitioner will D. ask the parent to consider a possible speech delay and report any concerns. E. continue to evaluate the child’s speech at subsequent visits. Correct F. refer the child for a speech and hearing evaluation. G. tell the parent to spend more time in interactive conversations with the child. 7. The parent of a toddler is concerned that the child may have autism. The primary care pediatric nurse practitioner completes a Modified Checklist for Autism in Toddlers (MCHAT) tool, which indicates several areas of concern. What will the nurse practitioner do? E. Administer a Childhood Autism Rating Scale (CARS) in the clinic. F. Consult a specialist to determine appropriate early intervention strategies. G. Refer the child to a behavioral specialist for further evaluation. Correct H. Tell the parent that this result indicates that the child has autism. 8. The primary care pediatric nurse practitioner learns that the mother of a 3yearold child has been treated for depression for over 5 years. Which aspect of this Burns' Pediatric Primary Care 7th Edition Test Bank Chapter 1: Health Status of Children Global and National Perspectives Latest updated 2022 examination Study Guide. B. PHQ2 C. RAAPS Burns' Pediatric Primary Care 7th Edition Test Bank Chapter 1: Health Status of Children Global and National Perspectives Latest updated 2022 examination Study Guide. 14. The primary care pediatric nurse practitioner evaluates a schoolage child whose body mass index (BMI) is greater than the 97th percentile. The nurse practitioner is concerned about possible metabolic syndrome and orders laboratory tests to evaluate this. Which diagnosis will the nurse practitioner document for this visit? A. Metabolic syndrome B. Nutritional alteration: more than required C. Obesity Correct A. Rule out type 2 diabetes mellitus Chapter 6. Cultural Considerations for Pediatric Primary Care Questions 1. The primary care pediatric nurse practitioner provides well child care for a community of immigrant children from Central America. The pediatric nurse practitioner is surprised to learn that some of the families are Jewish and not Catholic. This response is an example of cultural O. collectivism. P. constructivism. Q. essentialism. Correct R. individualism. 2. The primary care pediatric nurse practitioner learns that an AfricanAmerican family lives in a neighborhood with a high crime rate and suggests that they try moving to another neighborhood for the safety of their children. This is an example of N. cultural sensitivity. O. group bias. P. individual privilege. Correct Q. racial awareness. 3. The primary care pediatric nurse practitioner cares f or children from a Native American family and learns that they used many herbs to treat and prevent illness. Which approach will the pediatric nurse practitioner use to promote optimum health in the children? O. Ask about the types of practices used and when they are applied. Correct P. Provide a list of harmful herbs and ask the family to avoid those. Q. Suggest that the family avoid using these remedies in their children. R. Tell the parents to use the herbs in conjunction with modern medications. 4. The primary care pediatric nurse practitioner works with families from a variety of cultures and socioeconomic classes. Which is an example of cultural humility in practice? M. Giving health care advice that takes cultural differences into account N. Identification of other cultures that may be superior to one’s own culture C. Receptivity to learning about the perspectives of other cultures Correct D. Respecting other cultures while maintaining the views of one’s own 5. A Somalian immigrant mother is concerned that her 8yearold Burns' Pediatric Primary Care 7th Edition Test Bank Chapter 1: Health Status of Children Global and National Perspectives Latest updated 2022 examination Study Guide. child is underweight. The primary care pediatric nurse practitioner notes that the child’s weight is at the 25th percentile. After realizing that the mother is comparing her child to a group of Americanborn children who are overweight, the pediatric nurse practitioner is able to convince the mother that this is a normal weight. Which domain of cultural competence does this represent? A. Global B. Interpersonal Correct N. Intrapersonal O. Organizational 6. The primary care pediatric nurse practitioner in a community health center meets a family who has recently immigrated to the United States who speak only Karon. They arrive in the clinic with a church sponsor, who translates for them. The pediatric nurse practitioner notices that the sponsor answers for the family without giving them time to speak. The pediatric nurse practitioner will H. ask the sponsor to allow the family to respond. I. develop the plan of care and ask the sponsor to make sure it is followed. J. request that the sponsor translate written instructions for the family. K. use the telephone interpreter service to communicate with the family. Correct 7. The primary care pediatric nurse practitioner prescribes a twice daily inhaled corticosteroid for a 12yearold child. At a well child visit, the child reports not using the medication on a regular basis. Which response by the pediatric nurse practitioner demonstrates an understanding of clientcentered care? A. Asking the child to describe usual daily routines and schedules Correct I. Referring the family to a social worker to help with medication compliance J. Reviewing the asthma action plan with the parent and the child K. Teaching the child how the medication will help to control asthma Symptoms 8. A primary care pediatric nurse practitioner working in a community health center wishes to develop a program to assist impoverished children and families to have access to healthy foods. Which strategy will the pediatric nurse practitioner employ to ensure the success of such a program? G. Asking community members to assist in researching and implementing a program Correct H. Designing a community garden approach that involves children and their parents I. Gaining support from the corporate community to provide needed resources J. Providing evidencebased information about the importance of a healthy diet Burns' Pediatric Primary Care 7th Edition Test Bank Chapter 1: Health Status of Children Global and National Perspectives Latest updated 2022 examination Study Guide. 3. The child will have immediate developmental delays because of the lack of space for the brain to grow. Burns' Pediatric Primary Care 7th Edition Test Bank Chapter 1: Health Status of Children Global and National Perspectives Latest updated 2022 examination Study Guide. 4. The child will not require surgery. ANS: 1 5. A child that had a shunt placed four years ago for hydrocephalus is in the emergency room complaining of a rapid onset of vomiting and increased lethargy. The nurse knows that the child will need: 1. Nothing, as this is a normal complication and not an emergency. 2. To be placed on IV fluids to help maintain an electrolyte balance. 3. Small amounts of fluids until the vomiting has subsided. 4. To consider this a neurological medical emergency and check the childs head circumference. ANS: 4 6. Night terrors can occur in adolescents because of: 1. Emotional stress. 2. Alcohol use. 3. Bullying. 4. All of the above can trigger night terrors in adolescents. ANS: 4 7. When speaking with a family about their 9-year-old daughters nightmares, it is important to ask: 1. If the child has a history of daytime napping. 2. What medications the child takes during the day. 3. How often the child consumes caffeine. 4. All of the above should be part of the assessment. ANS: 4 8. A quality of a partial seizure is: 1. Status epilepticus. 2. Tonic movements. 3. Fluttering eyelids. 4. Clonic movements. ANS: 4 9. A mother is asking the nurse why her daughter continues to have temporal lobe seizures even though she is on medication. The nurse knows this is occurring because: 1. The medication may not be in the therapeutic range. 2. Temporal lobe seizures do not respond well to medications. 3. The daughter may be missing doses of her medication. 4. The food her daughter eats may have a negative reaction with the medication, causing more seizures. ANS: 2 10. Which of the following types of epilepsy are photosensitive? 1. Juvenile myoclonic epilepsy 2. Temporal lobe epilepsy 3. Febrile seizures 4. Childhood absence epilepsy ANS: 1 1. A child who had a seizure one hour ago is exhibiting signs of paralysis on the left side of the body. The nurse understands the child is exhibiting signs of: 1. Lethargy due to previous seizure activity. 2. Postictal paralysis. Burns' Pediatric Primary Care 7th Edition Test Bank Chapter 1: Health Status of Children Global and National Perspectives Latest updated 2022 examination Study Guide. 3. Permanent paralysis of the left side of the body. 4. Major brain damage that is going to have long-term effects. Burns' Pediatric Primary Care 7th Edition Test Bank Chapter 1: Health Status of Children Global and National Perspectives Latest updated 2022 examination Study Guide. 3. Because of concussions. 4. Because of migraines. ANS: 3 18. Cyclic vomiting may: 1. Last for days. 2. Require SSRIs to stop hurting. 3. Not be associated with a headache. 4. Requires pain medication and Zofran. ANS: 3 19. A child that has rhythmic, repetitive, involuntary movements is exhibiting: 1. Tremors. 2. Dystonia. 3. Contractures. 4. Tics. ANS: 2 20. Identify a therapeutic management technique for a child with a tic disorder. 1. Behavioral modification to suppress the tics 2. Administer anti-psychotic medications to reduce the tics 3. Education and support for the child and the family 4. Genetic counseling for the family ANS: 3 21. Identify a true statement about Tourettes Syndrome (TS) is that: 1. Manifestations rarely change once developed. 2. Children with TS do not have obsessive compulsive disorders. 3. The tics of TS can lead to mental deterioration. 4. The tics are involuntary, and the person cannot control the behavior. ANS: 4 22. The assessment a nurse performed on a 12-year-old boy demonstrated a positive Kernigs sign and a Brudzinskis sign. Identify the priority for the nurses next action. 1. Document the findings and note as normal. 2. Further assess the neurological function of the child and call the doctor with a report. 3. Explain to the patient that the assessment was abnormal and there is no a cause for concern. 4. Prepare the child for a lumbar puncture. ANS: 2 23. Results from cerebrospinal fluid that was tested for meningitis have been received by the nurse. The results indicate bacterial meningitis. The nurse knows this because the results show: 1. A low protein count and a low glucose count. 2. A low red blood cell count. 3. An elevated protein count and a low glucose level. 4. A normal protein count and a high glucose count. ANS: 3 . Chapter 8. Developmental Management in Pediatric Primary Burns' Pediatric Primary Care 7th Edition Test Bank Chapter 1: Health Status of Children Global and National Perspectives Latest updated 2022 examination Study Guide. Care Questions Burns' Pediatric Primary Care 7th Edition Test Bank Chapter 1: Health Status of Children Global and National Perspectives Latest updated 2022 examination Study Guide. 1. A single mother of an infant worries that living in a household with only one parent will cause her child to be maladjusted. To help address the mother’s concerns, the primary care pediatric nurse practitioner will suggest S. developing consistent daily routines for the child. Correct T. exposing her child to extended family members when possible. U. not working outside the home during the first few years. V. taking her child to regular play date activities with other children. 2. During a well child exam, the primary care pediatric nurse practitioner learns that the parents of a young child fight frequently about finances. The parents state that they do not fight in front of the child and feel that the situation is temporary and related to the father’s job layoff. What will the nurse practitioner do? R. Reassure them that the child is too young to understand. S. Recommend that they continue to not argue in front of the child. T. Suggest counseling to learn ways to handle stress. Correct U. Tell them that the conflict will resolve when the situation changes. 3. During a well child assessment of an 18monthold child, the primary care pediatric nurse practitioner observes the child becoming irritable and uncooperative. The parent tells the child to stop fussing. What will the nurse practitioner do? S. Allow the parent to put the child in a “timeout.” T. Ask the parent about usual discipline practices. U. Offer the child a book or a toy to look at. Correct V. Stop the exam since the child has reached a “meltdown.” 4. Which recommendation will a primary care pediatric nurse practitioner make when parents ask about ways to discipline their 3yearold child who draws on the walls with crayons? O. Give the child washable markers so the drawings can be removed easily. P. Provide a roll of paper for drawing and teach the child to use this. Correct Q. Put the child in “timeout” each time the child draws on the walls. R. Take the crayons away from the child to prevent the behavior. 5. The primary care pediatric nurse practitioner conducts a well baby exam on . an infant and notes mild gross motor delays but no delays in other areas. Which initial course of action will the nurse practitioner recommend? P. Consult a developmental specialist for a more complete evaluation. Q. Prepare the parents for a potentially serious developmental disorder. R. Refer the infant to an early intervention program for physical therapy. S. Teach the parents to provide exercises to encourage motor development. Correct 6. The primary care pediatric nurse practitioner is examining a newborn infant recently discharged from the neonatal intensive care unit after a premature birth. The parent is upset and expresses worry about whether the infant will be normal. What will the nurse Burns' Pediatric Primary Care 7th Edition Test Bank Chapter 1: Health Status of Children Global and National Perspectives Latest updated 2022 examination Study Guide. 1. 1. A mother brings her 9 month infant in for a routine visit. What milestone would be appropriate for the doctor to ask if the infant is meeting? 1. Walking 2. Speaking in two word phrases 3. Rolls back to stomach and stomach to back 4. All of the above ANS: 3 2. A 5 day old infant comes in for a newborn checkup. On assessment of the newborn, you note that the skin is jaundice in color. The anterior fontanel is slightly sunken. Per mom, the infant has only had 2 diapers today. The infant is strictly breastfed and this is moms first child. She states baby is having trouble latching on. A bilirubin level is sent and comes back at 18. You identify this newborn to be dehydrated and is most likely to have breast milk jaundice. Which nursing intervention(s) will be required for this baby? 1. Phototherapy 2. Providing support and education for the lactating mother 3. Strict monitoring of intake and output 4. All of the above ANS 4 3. Apgar scores measure heart rate, respiratory rate, reflex irritability, color and : 1. 1. Rigidity 2. 2. Muscle tone 3. 3. Birth weight 4. 4. Capillary refill ANS: 2 4. A mother on the postpartum unit asked to have her infant back from the nursery so that she can breastfeed. The nurse brings the newborn to the room and hands the baby to the mother. She asks the mother to let her know how long the baby feeds. What vital step did the nurse forget to take before giving the baby to the mother? 1. 1. The nurse should have made sure that the baby was latching correctly 2. 2. The nurse should have identified the babys ID band with the mothers 3. 3. The nurse should have the mother speak with a lactation consultant 4. 4. The nurse should have asked the mother how long she planned to feed ANS: 2 5. Excessive heat loss results in which of these? 1. RDS 2. Depletion of glucose levels 3. Jaundice 4. Increase in surfactant levels ANS: 2 6. A mother has just delivered her new baby a few hours ago. She asks the nurse if she can bathe the baby because he has blood on him. The best response from the nurse would be. 1. Sure, let me get you some soap and washcloths 2. Why dont you get some rest, there will be lots of time for bathing 3. Its important that we not bathe the baby too soon after birth. Lets wait till later in the day. 4. Sure, but why dont you feed the baby ANS: 3 7. A 4 week old infant is brought to the ED. Mom states that the baby hasnt Burns' Pediatric Primary Care 7th Edition Test Bank Chapter 1: Health Status of Children Global and National Perspectives Latest updated 2022 examination Study Guide. been eating well and has had Burns' Pediatric Primary Care 7th Edition Test Bank Chapter 1: Health Status of Children Global and National Perspectives Latest updated 2022 examination Study Guide. decreased diapers for 2 days. The baby has been sleeping more and has been hard to wake up. On assessment, you find that the baby is difficult to arouse, is hypotonic and temperature is 35.4 rectally. What is an important lab value to check? Choose the best answer. 1. Complete metabolic panel 2. Liver panel 3. Blood glucose 4. PTT ANS: 3 8. A pregnant woman with a history of a clotting disorder is required to self- administer heparin during her pregnancy. After delivery, the infant will be at greater risk for: 1. Low blood sugar 2. Decrease Vitamin K 3. Increased Vitamin K 4. High blood sugar ANS: 2 . 9. A part of injury prevention is making and keeping infant appointments. The required checkups and vaccinations are at: 1. 3 months, 6 months, 9 months 2. 2 months, 4 months, 6 months and 1 year 3. 2 months, 4 months, 6 month, 9 months and 1 year 4. 2 months, 4 months, 9 months and 1 year ANS: 3 10. You are taking care of an infant who was admitted with dehydration. His weight is 6kg. You have been watching his I & Os. What would you expect the infants urinary output to be in order to maintain adequate hydration? 1. 0.52 ml/kg/hr 2. 0.52.5 ml/kg/hr 3. 13 ml/kg/hr 4. As long as he is having wet diapers it doesnt matter ANS: 3 11. A mother brings her newborn daughter to the ER with concerns that she is having vaginal bleeding. You know this is normal and called what? 1. Pseudomenstruation 2. Milia 3. Vernix caseosa 4. Toxicum ANS: 1 12. While interviewing the mother of an infant, you note that the mother gets frustrated as she explains that her baby has been up all night crying at least 3 times a week for the last 2 weeks. She states that she has tried everything and feels hopeless. What would be the BEST response from you as the nurse? 1. Believe me, I know. I have a newborn too. Burns' Pediatric Primary Care 7th Edition Test Bank Chapter 1: Health Status of Children Global and National Perspectives Latest updated 2022 examination Study Guide. V. The infant should stay on the previously established nursing schedule. . 5. The mother of a 6weekold breastfeeding infant tells the primary care pediatric Burns' Pediatric Primary Care 7th Edition Test Bank Chapter 1: Health Status of Children Global and National Perspectives Latest updated 2022 examination Study Guide. nurse practitioner that her baby, who previously had bowel movements with each feeding, now has a bowel movement once every third day. What will the nurse practitioner tell her? T. Her baby is probably constipated. U. It may be related to her dietary intake. V. She should consume more water. W. This may be normal for breastfed babies. Correct 6 . The mother of a 3monthold child tells the primary care pediatric nurse practitioner that it is “so much fun” now that her infant coos and smiles and wants to play. What is important for the nurse practitioner to teach this mother? A. Appropriate ways to stimulate and entertain the infant B. How to read the infant’s cues for overstimulation Correct O. The importance of scheduling “play dates” with other infants P. To provide musical toys to engage the infant 7. The parent of a 5monthold is worried because the infant becomes fussy but doesn’t always seem interested in nursing. What will the nurse practitioner tell this parent? P. The infant may be expressing a desire to play or to rest. Correct Q. The parent should give ibuprofen for teething pain before nursing. R. This is an indication that the infant is ready for solid foods. S. This may indicate gastrointestinal discomfort such as constipation. 8. The mother of a 6monthold infant is distressed because the infant can Say “dada” but not “mama” and asks the primary care pediatric nurse practitioner why this is when she is the one who spends more time with the infant. How will the nurse practitioner respond? R. “At this age, your baby does not understand the meaning of sounds.” Correct S. “Babies at this age cannot make the ‘ma’ sound.” T. “Most sounds made by babies at this age are accidental.” U. “This may mean that your baby doesn’t hear well.” 9. The primary care pediatric nurse practitioner is performing a well child examination on a 9monthold infant whose hearing is normal but who responds to verbal cues with only single syllable vocalizations. What will the nurse practitioner recommend to the parents to improve speech and language skills in this infant? L. Provide educational videos that focus on language. M. Read simple board books to the infant at bedtime. Correct L. Sing to the child and play lullabies in the baby’s room. M. Turn the television to Sesame Streetduring the day. 10. The primary care pediatric nurse practitioner is examining a 12monthold Infant who was 6 weeks premature and observes that the infant uses a raking motion to pick up small objects. The PEDS questionnaire completed by the parent did not show significant developmental delays. What will the nurse practitioner do first? G. Perform an indepth developmental assessment. Correct Burns' Pediatric Primary Care 7th Edition Test Bank Chapter 1: Health Status of Children Global and National Perspectives Latest updated 2022 examination Study Guide. H. Reassure the parent that this is normal for a premature infant. I. Refer the infant to a developmental specialist. Burns' Pediatric Primary Care 7th Edition Test Bank Chapter 1: Health Status of Children Global and National Perspectives Latest updated 2022 examination Study Guide. X. Most bilingual children are able to shift from one language to another when appropriate. Correct 5. The primary care pediatric nurse practitioner is counseling the parents of a toddler about appropriate discipline. The parents report that the child is very active and curious, and they are worried about the potential for injury. What will the pediatric nurse practitioner recommend? • Allow the child to explore and experiment while providing appropriate limits. • Correct • Be present while the child plays to continually teach the child what is appropriate. • Let the child experiment at will and to make mistakes in order to learn. • Say “no” whenever the child does something that is not acceptable. • T. The mother of a 3yearold child takes the child to a play group once a week. . 13348437961 6. She expresses concern that the child plays with toys but does not interact with the other toddlers.What will the primary care pediatric nurse practitioner counsel the mother? The child probably is very shy but will outgrow this tendency with repeated exposure to other children. V. The toddler may have a language delay that interferes with socialization with other children. W. Toddlers may be interested in other children but usually do not engage in interactive play. Correct X. Toddlers need more structured play to encourage interaction and socialization with others. 7. The parent of a 4yearold 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 preschoolage children? P. Animism Q. Artificialism R. Egocentrism D. Realism Correct 8. The parent of a 24monthold child asks the primary care pediatric nurse practitioner when toilet training should begin. How will the pediatric nurse practitioner respond? N. “Begin by reading to your child about toileting.” O. “Most children are capable by age 2 years.” K. “Tell me about your child’s daily habits.” Correct L. “We should assess your child’s motor skills.” 9. The primary care pediatric nurse practitioner performs a physical examination on a 9monthold infant and notes two central incisors on the lower gums. The parent states that the infant nurses, takes solid foods three times daily, and Burns' Pediatric Primary Care 7th Edition Test Bank Chapter 1: Health Status of Children Global and National Perspectives Latest updated 2022 examination Study Guide. occasionally takes water from a cup. What will the pediatric nurse practitioner counsel the parent to promote optimum dental health? D. To begin brushing the infant’s teeth with toothpaste E. To consider weaning the infant from breastfeeding F. To discontinue giving fluoride supplements D. To make an appointment for an initial dental examination Correct 10. The parents of a 3yearold 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? D. Allow the child to choose foods for meals to improve caloric intake. E. Place a variety of nutritious foods on the child’s plate at each meal. Correct F. Prepare mashed potatoes and chicken strips for the child at mealtimes. G. Suggest cutting out snacks to improve the child’s appetite at mealtimes. Chapter 12. Developmental Management of Middle Childhood Questions 1. The primary care pediatric nurse practitioner is examining a 6yearold Child who attends first grade. The child reports “hating” school. The parent states that the child pretends to be sick frequently in order to stay home from school. To further assess this situation, the nurse practitioner will first ask the child EE. about school performance and grades. FF. why school is so distressing. GG. to name one or two friends. Correct HH. whether bullying is taking place. 2. The parent of a 10yearold boy tells the primary care pediatric nurse practitioner that the child doesn’t appear to have any interest in girls and spends most of his time with a couple of other boys. The parent is worried about the child’s sexual identity. The nurse practitioner will tell the parent DD. children at this age who prefer interactions with samegender peers usually have a homosexual orientation. EE. children experiment with sexuality at this age as a means of deciding later sexual orientation. FF. this attachment to other samegender children is how the child learns to interact with others. Correct GG. to encourage mixed gender interactions in order to promote development of sexual values. 3. The parents of a 12yearold child are concerned that some of the child’s older classmates may be a bad influence on their child, who, they say, has been raised to believe in right and wrong. What will the primary care pediatric nurse practitioner tell the parent? DD. Allowing the child to make poor choices and accept consequences is Burns' Pediatric Primary Care 7th Edition Test Bank Chapter 1: Health Status of Children Global and National Perspectives Latest updated 2022 examination Study Guide. important for learning values Burns' Pediatric Primary Care 7th Edition Test Bank Chapter 1: Health Status of Children Global and National Perspectives Latest updated 2022 examination Study Guide. day Correct AA. Prepare vegetables separately for the child to encourage adequate intake BB. Teach the child how important it is to eat h ealthy fruits and vegetables 9. The primary care pediatric nurse practitioner performs a physical examination on a 12yearold child and notes poor hygiene and inappropriate clothes for the weather. The child’s mother appears clean and well dressed. The child reports getting 6 to 7 hours of sleep each night because of texting with friends late each evening. What action by the nurse practitioner will help promote healthy practices? A. Discuss setting clear expectations about selfcare with the mother Correct B. Give the child information about sleep and selfcare S. Reassure the mother that this “noncompliance” is temporary T. Tell the mother that experimenting with selfcare behaviors is normal 10. During a well child exam on a 5yearold child, the primary care pediatric nurse practitioner assesses the child for school readiness. Which finding may be a factor in limiting school readiness for this child? T. Adherence to daily family routines and regular activities U. Having two older siblings who attend the same school C. Parental concerns about bullying in the school Correct D. The child’s ability to recognize four different colors 11. The primary care pediatric nurse practitioner is examining a schoolage child who complains of frequent stomach pain and headaches. The parent reports that the child misses several days of school each month. The child has a normal exam. Before proceeding with further diagnostic tests, what will the nurse practitioner initially ask the parent? A. About the timing of the symptoms each day and during the week Correct M. How well the child performs in school and in extracurricular activities N. If the parent feels a strong need to protect the child from problems O. Whether there are any unusual stressors or circumstances at home 12. The primary care pediatric nurse practitioner is evaluating recurrent stomach pain in a schoolage child. The child’s exam is normal. The nurse practitioner learns that the child reports pain most evenings after school and refuses to participate in sports but does not have nausea or vomiting. The child’s grandmother recently had gallbladder surgery. Which action is correct? A. Encourage the child to keep a log of pain, stool patterns, and dietary intake Correct G. Order radiologic studies and laboratory tests to rule out systemic causes H. Reassure the child and encourage resuming sports when symptoms Burns' Pediatric Primary Care 7th Edition Test Bank Chapter 1: Health Status of Children Global and National Perspectives Latest updated 2022 examination Study Guide. subside I. Refer the child to a counselor to discuss anxiety about health problems Burns' Pediatric Primary Care 7th Edition Test Bank Chapter 1: Health Status of Children Global and National Perspectives Latest updated 2022 examination Study Guide. Chapter 13. Developmental Management of Adolescents/Young Adults Questions 1. The primary care pediatric nurse practitioner is performing a well child assessment on a 13yearold female whose mother asks when her daughter’s periods may start. Which information will the nurse practitioner use to help estimate the onset of periods? A. The age of the mother’s menarche B. The patient’s age at thelarche Correct II. When adrenarche occurred JJ. Whether linear growth has stopped 2. The primary care pediatric nurse practitioner is examining a 15yearold female who reports having her first period at age 13. She states that she has had five periods in the last year, with the last one 2 months prior. She participates in basketball at school. Which action is correct? HH. Perform biometric screening to determine lean body mass. Correct II. Prescribe oral contraceptives pills to regulate her periods. JJ. Reassure her that this is perfectly normal at her age. KK. Refer her to an endocrinologist for hormonal evaluation. 3. During a well child assessment of a 13yearold male, the primary care pediatric nurse practitioner notes small testicles and pubic and axillary hair. To further evaluate these findings, the nurse practitioner will ask the patient about HH. alcohol and tobacco use. II. changes in voice. JJ. increase in height and weight. KK. participation in sports. Correct 4. The mother of a 16yearold male was recently divorced after several years of an abusive relationship and tells the primary care pediatric nurse practitioner that the adolescent has begun skipping school and hanging out with friends at the local shopping mall. When she confronts her child, he responds by saying that he hates her. What will the nurse practitioner tell this mother? XX. Adolescence is marked by an inability to comprehend complex situations. YY. Adolescence is typically marked by tempestuous and transient episodes. ZZ. Adolescents normally have extreme, disruptive conflicts with parents. AAA. Adolescents often need counseling to help them cope with life events. Correct . 5. The primary care pediatric nurse practitioner is performing a well child exam on a 12yearold female who has achieved early sexual maturation. The mother reports that Burns' Pediatric Primary Care 7th Edition Test Bank Chapter 1: Health Status of Children Global and National Perspectives Latest updated 2022 examination Study Guide. parent? Burns' Pediatric Primary Care 7th Edition Test Bank Chapter 1: Health Status of Children Global and National Perspectives Latest updated 2022 examination Study Guide. U. Do not allow a vegetarian diet in order to maintain appropriate limits for the adolescent. V. Provide vegetarian options for the adolescent that preserve adequate nutrition and protein intake. W. Suggest that the adolescent prepare appropriate vegetarian dishes to complement family meals. Correct X. Tell the adolescent that a vegetarian diet may be considered in adulthood but not while living at home. 1 0. The primary care pediatric nurse practitioner is performing a well child exam on a 17yearold female whose mother is present during the history. The mother expresses concern that her daughter wishes to have an eyebrow piercing and states that she is opposed to the idea. What will the nurse practitioner do? V. Provide information about piercings and encourage continued discussion. Correct W. Remind the adolescent that her mother is responsible for her health. X. State that piercings are relatively harmless and are an expression of individuality. Y. Suggest that she wait until she is 18 years old and can make her own decisions. 11. The parent of a 16yearold tells the primary care pediatric nurse practitioner that the teen was recently caught smoking an electronic cigarette (ecigarette). What will the nurse practitioner tell this parent? P. Ecigarette use may be a risk factor for later substance abuse. Correct Q. Experimentation with ecigarettes does not lead to future tobacco use. R. Most teens who experiment with tobacco usually do not become addicted. S. This form of nicotine ingestion is safer than regular cigarettes. 12. The parent of an adolescent reports noting cutting marks on the teen’s arms and asks the primary care pediatric nurse practitioner what it means. What will the nurse practitioner tell this parent? J. Cutting is a way of dealing with emotional distress. Correct K. It is a method of fitting in with other adolescents. L. The behavior is common and will usually stop. H. This type of behavior is a type of suicide attempt. Chapter 14. Introduction to Health Promotion Health Protection for Children & Families Questions 1. The primary care pediatric nurse practitioner is performing a focused problem assessment on a child who has asthma and learns that one of the child’s parents smokes around the child in spite of being advised against this. The nurse Burns' Pediatric Primary Care 7th Edition Test Bank Chapter 1: Health Status of Children Global and National Perspectives Latest updated 2022 examination Study Guide. practitioner recognizes this as a possible Burns' Pediatric Primary Care 7th Edition Test Bank Chapter 1: Health Status of Children Global and National Perspectives Latest updated 2022 examination Study Guide. this represent? A. Action B. Contemplation Correct V. Precontemplation W. Preparation 7. The primary care pediatric nurse practitioner sees a 17yearold client who quit smoking almost a year prior but who reports having renewed cravings when around friends who smoke. Using knowledge of the maintenance stage of change, the primary care pediatric nurse practitioner will AA. go over with the adolescent about the health risks associated with smoking. BB. recommend avoiding friends who smoke and making new friends. CC. remind the adolescent about the struggles associated with quitting smoking. DD. suggest that the teen consider taking up a sport or other physical activity.Correct 8. The primary care pediatric nurse practitioner is working with a 12yearold Female who has poor diabetes control. The child tells the nurse practitioner that the parent forgets to remind her to check her blood sugars. Which action is correct? EE. Assess the parent’s knowledge about diabetes management. FF. Help the child develop a strategy to remember without parental prompts. Correct GG. Refer to a social worker to help the family overcome obstacles to care. HH. Remind the child’s parent about the importance of good diabetes control. 9. The primary care pediatric nurse practitioner is counseling an obese 16yearold client about weight management. The adolescent says, “I know I need to lose weight, but I don’t want to give up all my favorite foods.” When using motivational interviewing techniques, how will the nurse practitioner respond? Y. “Do you think there are any foods you could limit or do without for a while?” Correct Z. “I hear you telling me that you really don’t have a desire to lose weight.” AA. “If you can’t give up these foods, you won’t see the benefits of weight loss.” BB. “In the long run, the sacrifices you make today will improve your health.” 10. The parent of a newborn has quit smoking cigarettes within the past month and reports feeling fidgety. Using a “reframing” technique, how will the primary care pediatric nurse practitioner respond? Z. Explore ways that the parent can use this extra energy to do things for the baby. Correct AA. Remind the parent that this is a normal, temporary part of nicotine withdrawal. BB. Suggest that the parent take up exercise to enjoy the benefits of not smoking. CC. Tell the parent that, over time, these symptoms of withdrawal will subside. Burns' Pediatric Primary Care 7th Edition Test Bank Chapter 1: Health Status of Children Global and National Perspectives Latest updated 2022 examination Study Guide. 11. The primary care pediatric nurse practitioner is assessing the health literacy of the parent of a toddler. Which tool will the nurse practitioner use to estimate reading level? T. FleschKincaid Readability Test U. Gunning Fog Index V. Number of children’s books in the home D. SMOG Correct 1 2. The pediatric nurse practitioner provides primary care for a special needs infant whose parent takes an active role in the infant’s care. The parent has a high school diploma and asks many questions about her infant’s treatments. Which approach will the nurse practitioner take to ensure health literacy for this parent? M. Ask the parent to read back all information given. Correct N. Encourage the parent to ask questions when confused. O. Provide written materials presented at an 8th grade level. P. Reinforce written information with verbal instructions. . Chapter 15. Behavioral and Mental Health Promotion Questions 1. A child who has attentiondeficit/ hyperactivity disorder (ADHD) has difficulty stopping activities to begin other activities at school. The primary care pediatric nurse practitioner understands that this is due to difficulty with the selfregulation component of MM. emotional control. NN. flexibility. Correct OO. inhibition. PP. problemsolving. 2. The primary care pediatric nurse practitioner cares for a preschoolage child who was exposed to drugs prenatally. The child bites other children and has tantrums when asked to stop but is able to state later why this behavior is wrong. This child most likely has a disorder of PP. executive function. Correct QQ. information processing. RR. sensory processing. SS. social cognition. 3. The primary care pediatric nurse practitioner uses the Neurodevelopmental Learning Framework to assess cognition and learning in an adolescent. When evaluating social cognition, the nurse practitioner will ask the adolescent NN. about friends and activities at school. Correct OO. if balancing sports and homework is difficult. PP. to interpret material from a pie chart. QQ. to restate the content of something just read. 4. The primary care pediatric nurse practitioner is evaluating a schoolage child who has been diagnosed with ADHD. Which plan will the nurse practitioner recommend asking Burns' Pediatric Primary Care 7th Edition Test Bank Chapter 1: Health Status of Children Global and National Perspectives Latest updated 2022 examination Study Guide. the child’s school about to help with academic performance? A. 504 Correct Burns' Pediatric Primary Care 7th Edition Test Bank Chapter 1: Health Status of Children Global and National Perspectives Latest updated 2022 examination Study Guide. limited speech. The parent reports having had concerns more than 2 years ago about autism, but was told that it was too early to diagnose. What will the nurse practitioner do first? A. Administer an MCHAT screen to screen the child for communication and socialization delays. CC. Ask the parent to describe the child’s earlier behaviors from infancy through preschool. Correct DD. Reassure the parent that if symptoms weren’t present earlier, the likelihood of autism is low. EE. Refer the child to a pediatric behavioral specialist to develop a plan of treatment and management. 10. The primary care pediatric nurse practitioner is examining a 3yearold child who speaks loudly, in a monotone, does not make eye contact, and prefers to sit on the exam room floor moving a toy truck back and forth in a repetitive manner. Which disorder does the nurse practitioner suspect? A. Attentiondeficit/hyperactivity disorder B. Autism spectrum disorder Correct DD. Executive function disorder EE. Sensory processing disorder 11. The primary care pediatric nurse practitioner is selecting a medication for a 12yearold child who is newly diagnosed with ADHD. The child is overweight, has a history of an atrial septal defect at birth, and reports mild shortness of breath during exercise. What will the nurse practitioner prescribe? W. A lowdose stimulant medication X. A nonstimulant medication Y. Behavioral therapy only D. Cardiovascular prescreening Correct 12. The primary care pediatric nurse practitioner is conducting a followup examination on a child who has recently begun taking a lowdose stimulant medication to treat ADHD. The child’s school performance and home behaviors have improved. The child’s parent reports noticing a few tics, such a twitching of the eyelids, but the child is unaware of them and isn’t bothered by them. What will the nurse practitioner recommend? Q. Adding an alphaagonist medication R. Changing to a nonstimulant medication C. Continuing the medication as prescribed Correct I. Stopping the medication immediately . . . . Burns' Pediatric Primary Care 7th Edition Test Bank Chapter 1: Health Status of Children Global and National Perspectives Latest updated 2022 examination Study Guide. Continue Burns' Pediatric Primary Care 7th Edition Test Bank Chapter 1: Health Status of Children Global and National Perspectives Latest updated 2022 examination Study Guide. . Chapter 16. Breastfeeding Questions 1. The primary care pediatric nurse practitioner provides anticipatory guidance for a 6monthold infant who is breastfed who takes 400 IU of vitamin D daily. The parent reports that the infant has begun taking cereals, fruits, and vegetables in addition to nursing. What will the nurse practitioner recommend to promote healthy nutrition? QQ. Begin supplementing with iron. RR. Continue to nurse as long as desired. Correct SS. Discontinue the vitamin D supplement. TT. Stop breastfeeding at 1 year of age. 2. The parent of a toddler tells the primary care pediatric nurse practitioner that The family has adopted a plantbased diet and the child is receiving rice and almond milk instead of cow’s milk. The nurse practitioner will counsel the parents about TT. calcium deficiency. UU. excess caloric intake. VV. excess fat intake. WW. protein deficiency. Correct 3. The parent of a 12monthold infant asks the primary care pediatric nurse practitioner why 2% cow’s milk is recommended instead of whole milk. What will the nurse practitioner tell this parent? RR. Whole milk is usually not fortified with vitamin D. SS. 2% milk is higher in essential proteins and minerals. TT. Young children don’t need the extra calories found in whole milk. UU. Younger children need a limited amount of fats. Correct 4. The primary care pediatric nurse practitioner sees a 3yearold 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? WWW. Ask the parents to provide a 3day food diary. Correct XXX. Prescribe a daily multivitamin with iron. YYY. Reinforce the need to meet DRIs each day. ZZZ. Tell them that supplements are unnecessary 5. 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? KK. Evaluate the child’s feeding and elimination behaviors and ask the family to describe mealtime routines. Correct LL. Recommend giving a multivitamin and offering highcalorie Burns' Pediatric Primary Care 7th Edition Test Bank Chapter 1: Health Status of Children Global and National Perspectives Latest updated 2022 examination Study Guide. obesity. What will the nurse practitioner recommend? Burns' Pediatric Primary Care 7th Edition Test Bank Chapter 1: Health Status of Children Global and National Perspectives Latest updated 2022 examination Study Guide. A. Developing a system to reward compliance with a dietary regimen B. Restricting all access to food in the house and at school Correct FF. Suggesting an afterschool exercise program to help with weight loss GG. Using a food diary to track all calories and food intake 11. When counseling an adolescent with a family history of hyperinsulinemia and type 2 diabetes, the primary care pediatric nurse practitioner will recommend avoiding Z. baked potato chips. AA. canned vegetables. BB. highfiber cereals. CC. processed breads. Correct 12. The parent of a schoolage child reports that the child is on a glutenfree 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 glutenfree grain products for all family members. The nurse practitioner will tell this parent that glutenfree diets S. are generally low in sugar and fat. T. are healthy and help prevent obesity. U. may be deficient in essential nutrients. Correct V. provide adequate protein to meet daily needs. Chapter 17. Nutrition Questions 1. The primary care pediatric nurse practitioner performs a well child assessment on a 6monthold infant whose mother reports having less breast milk because of stressors associated with pumping and returning to work. The nurse practitioner will provide resources to promote pumping and UU. discuss adding other foods to the baby’s diet. Correct VV. encourage the mother to increase her fluid intake. WW. prescribe a multivitamin containing iron. XX. suggest offering only breast milk to the infant. 2. The mother of a newborn asks the primary care pediatric nurse practitioner about . benefits of breastfeeding. What will the nurse practitioner tell her? XX. Breastfeeding for 9 months or longer will reduce the incidence of food allergies. YY. Breast milk is an excellent source of vitamin D, iron, and other essential nutrients for the baby. ZZ. Nursing her baby exclusively for at least 4 months will help her infant to resist infections. Correct AAA. There is a decreased risk of atopic dermatitis in babies who nurse for 12 months or longer. 3. The primary care pediatric nurse practitioner learns that the mother of a newborn Burns' Pediatric Primary Care 7th Edition Test Bank Chapter 1: Health Status of Children Global and National Perspectives Latest updated 2022 examination Study Guide. 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? VV. Breast milk is contraindicated if the mother has tuberculosis. WW. She may continue to nurse her baby since the risk of transmission is low. C. That she can express breast milk and feed that to her infant Correct D. To give formula until results of tuberculosis testing are known 4. The primary care pediatric nurse practitioner sees a 3dayold nursing infant whose newborn metabolic screen is positive for galactosemia. The nurse practitioner refers the newborn to a specialist for immediate evaluation and will tell the mother AAAA. to continue to breastfeed her infant. BBBB. to give the infant a cow’s milk formula. CCCC. to supplement breast milk with formula. DDDD. to stop breastfeeding immediately. Correct 5. The mother of a nursing infant expresses concern about whether high cholesterol foods will increase her infant’s risk of hyperlipidemia. What will the primary care pediatric nurse practitioner tell her? OO. Breastfed infants have lower serum cholesterol levels than those who are not breastfed. PP. Maternal cholesterol levels affect the cardiovascular risk of breastfed babies. QQ. Maternal dietary cholesterol intake does not affect the infant’s serum cholesterol values. Correct RR. She should limit her dietary cholesterol to prevent hyperlipidemia in her infant. 6. The primary care pediatric nurse practitioner is counseling the mother of a newborn about breastfeeding her infant. Which supplements will the nurse practitioner recommend? BB. Fatsoluble vitamins CC. Iron DD. Multivitamins with iron D. Vitamin D Correct 7. The primary care pediatric nurse practitioner is examining a newborn who is breastfeeding and notes the presence of an ankyloglossia. What will the nurse practitioner do next? KK. Ask the mother if the infant has any feeding difficulties. Correct LL. Refer the infant for a possible frenulectomy. MM. Schedule an appointment with a lactation consultant. NN. Suggest that the mother feed breast milk by bottle. 8. The primary care pediatric nurse practitioner performs an initial well baby exam on a 1weekold infant who is breastfeeding and who is at birth weight. The mother tells the nurse practitioner that her baby is already sleeping 5 or 6 hours at Burns' Pediatric Primary Care 7th Edition Test Bank Chapter 1: Health Status of Children Global and National Perspectives Latest updated 2022 examination Study Guide. day to only one stool every other day. How will the nurse practitioner respond? Burns' Pediatric Primary Care 7th Edition Test Bank Chapter 1: Health Status of Children Global and National Perspectives Latest updated 2022 examination Study Guide. YY. Ask the mother to describe the color and consistency of the stools. Correct ZZ. Explain to the mother that breastfed infants should have daily stools. AAA. Recommend using a glycerin suppository as needed. BBB. Suggest to the mother that she increase her intake of fluids. 2. The primary care pediatric nurse practitioner is performing a well child exam on a 12monthold infant. The parent tells the nurse practitioner that the infant has predictable bowel and bladder habits and asks about toilet training. What will the nurse practitioner tell this parent? BBB. It is too early to begin introducing the child to the toilet, and the parent should wait until the child is at least 2 years old. CCC. Placing the child on a “potty” chair helps the child associate elimination cues with the toilet. Correct DDD. Predictability of elimination patterns indicates readiness for toilet training, and the parent can begin this process. EEE. The parent should wait until other signs of toilet training readiness occur before introducing the child to the toilet. 3. The primary care pediatric nurse practitioner is performing a well child exam on a 24monthold child. The parent tells the nurse practitioner that the child is being toilet trained and expresses frustration that on some days the child uses the toilet every time and on other days not at all. What will the nurse practitioner do? XX. Advise the parent to make the child get clean clothes after an accident. YY. Ask the parent about the child’s toilet habits and understanding of toilet training. Correct ZZ. Recommend using an awards system to encourage toilet use. AAA. Suggest that the parent place the child on the toilet at predictable intervals. 4. The primary care pediatric nurse practitioner is discussing toileting issues with the parent of a 3yearold toddler who reports that the child has been toilet trained for several months but has recently been refusing to have bowel movements and is becoming constipated. What will the nurse practitioner do? OOOO. Ask the parent about bathroom facilities in the child’s day care. Correct PPPP. Refer the child to a gastroenterologist for evaluation of pathology. QQQQ. Suggest putting the child in diapers and resuming toilet training in a few weeks. RRRR. Tell the parent that this represents a developmental delay. 5 . The primary care pediatric nurse practitioner is evaluating a 5yearold child who has frequent soiling of stool associated with stomach aches and decreased appetite for the past Burns' Pediatric Primary Care 7th Edition Test Bank Chapter 1: Health Status of Children Global and National Perspectives Latest updated 2022 examination Study Guide. 2 months. The parent states that the child has two or fewer formed bowel movements each week Burns' Pediatric Primary Care 7th Edition Test Bank Chapter 1: Health Status of Children Global and National Perspectives Latest updated 2022 examination Study Guide. have vesicoureteral reflux based on a history of dysfunctional voiding patterns and a series of urinary tract infections. Which intervention is appropriate? KK. Initiating a bladder retraining program LL. Ordering a voiding cystourethrogram C. Referral to a urologist for evaluation Correct D. Treatment with prophylactic antibiotics 10. The primary care pediatric nurse practitioner is evaluating a 4yearold female child for enuresis. The parents reports that the child has never been dry at night and has recently begun having daytime incontinence, usually when at preschool. The nurse practitioner learns that the child does not appear to have an abnormal urine stream. What will the nurse practitioner do next? LL. Examine the urethral meatus and labia and obtain a dipstick clean catch urinalysis. Correct MM. Reassure the parent that the child probably gets distracted and puts off voiding until it is urgent. NN. Refer the child to a pediatric urologist for evaluation of possible vesicoureteral reflux. OO. Suggest a bladder retraining program and use of a nighttime bedwetting alarm. 11. The primary care pediatric nurse practitioner is counseling the parent of an 8yearold child who has primary nocturnal enuresis. The nurse practitioner recommends an enuresis alarm, but the parent wishes to use medication. What will the nurse practitioner tell the parent? HH. Anticholinergic medications are most commonly used for enuresis. II. Drug therapy is an effective way to achieve longterm control. JJ. Drug therapy is safest when the nasal spray form is used. KK. The combination of alarm therapy and intermittent drug therapy is best. Correct . Chapter 19. Physical Activity and Sports Questions 1. The primary care pediatric nurse practitioner counseling the parent of an overweight schoolage child about improving overall fitness. What will the nurse practitioner include? CCC. Encourage the child to begin by engaging in swimming or cycling. Correct DDD. Exercise will help lower total cholesterol and lowdensity lipoproteins. EEE. Schoolage children need 60 minutes of moderate exercise daily. FFF. Strength training exercises are not safe for schoolage children. Burns' Pediatric Primary Care 7th Edition Test Bank Chapter 1: Health Status of Children Global and National Perspectives Latest updated 2022 examination Study Guide. 2. The parent of a child who has asthma asks the primary care pediatric nurse Burns' Pediatric Primary Care 7th Edition Test Bank Chapter 1: Health Status of Children Global and National Perspectives Latest updated 2022 examination Study Guide. practitioner about whether the child may engage in strenuous exercise. What will the nurse practitioner tell the parent? FFF. Children with asthma should be excluded from vigorous exercise and most strenuous sports. GGG. Children with asthma show improved aerobic and anaerobic fitness with moderate to vigorous/physical activity. Correct HHH. Physical activity has been shown to improve overall pulmonary function in children with asthma. III. Vigorous exercise helps improve symptoms in children with poorly controlled asthma. 3. The primary care pediatric nurse practitioner is discussing lifestyle changes with an adolescent who has hypertension. What will the nurse practitioner recommend about exercise for this client? A.Regular to vigorous activity initially with a combination of resistance and aerobic exercise to maintain lower blood pressure Correct BBB. Moderate daily exercise such as walking for 20 minutes daily with increasing intensity as blood pressure drops CCC. Vigorous aerobic exercise combined with maximal strength training to lower blood pressure DDD. Vigorous aerobic exercise only to reduce blood pressure and then to maintain lowered blood pressure . 4. The primary care pediatric nurse practitioner is offering anticipatory guidance to the parents of a 6yearold child who has Down syndrome. What will the nurse practitioner tell the parents about physical activity and sports in school? A. Children with Down syndrome get frustrated easily when engaging in sports. SSSS. Children with Down syndrome should not participate in strenuous aerobic activity. TTTT. Their child should have a cervical spine evaluation before participation in sports. Correct D. Their child should only participate in sports sanctioned by the Special Olympics. 5. The primary care pediatric nurse practitioner is discussing fitness and exercise with the parents of a 5yearold child who ask what kinds of activities are developmentally appropriate for their child. What will the nurse practitioner recommend? A. Bike riding Correct UU. Interactive play VV. Martial arts WW. Organized sports 6. The parents of a prepubertal female who is on the local swim team tell the primary care pediatric nurse practitioner that their daughter wants to begin a strength training program to help improve her swimming ability. What will the nurse Burns' Pediatric Primary Care 7th Edition Test Bank Chapter 1: Health Status of Children Global and National Perspectives Latest updated 2022 examination Study Guide. CC. A murmur with narrow and variable splitting of S2 DD. A systolic murmur that is grade 1 or 2 Burns' Pediatric Primary Care 7th Edition Test Bank Chapter 1: Health Status of Children Global and National Perspectives Latest updated 2022 examination Study Guide. 12. The parent of a 12yearold child who has sickle cell trait (SCT) asks the primary care pediatric nurse practitioner whether the child may play football. What will the nurse practitioner tell this parent? J. Children with SCT should not play any contact sports. K. Children with SCT may not play for NCAA schools in college. L. Children with SCT should follow heat acclimatization guidelines. Correct M. Children with SCT should not participate in organized sports. 13. The parent of a child newly diagnosed with epilepsy asks the primary care pediatric nurse practitioner if the child will ever be able to participate in gym or sports. What will the nurse practitioner recommend? C. Bicycle riding is not safe for children with seizures. D. Contact sports should be avoided. E. Direct supervision of some activities is necessary. Correct F. Underwater sports are not recommended. 14. The primary care pediatric nurse practitioner diagnoses a high school basketball player with mononucleosis. The adolescent asks when she may resume play. What will the nurse practitioner tell her? B. After 3 weeks, she may begin lifting weights but not full sports. C. After 4 weeks, she may return to full play and practice. D. At 4 weeks, she must have an exam to determine fitness for play. Correct E. She may engage in moderate exertion and practice after 3 weeks. 15. A 12yearold child who plays soccer is diagnosed with vocal cord dysfunction. What will the primary care nurse practitioner say when the child’s parents ask about continued sports participation? A. The child may continue to participate in soccer. Correct B. The child should limit activity to nonaerobic sports. C. This condition is a contraindication for all sports. D . This condition predisposes the child to sudden cardiac death. 16. The parent of a high school basketball player tells the primary care pediatric nurse practitioner that the adolescent becomes short of breath only when exercising. What will the nurse practitioner recommend? A. Permanent discontinuation of all strenuous and aerobic activities B. Enrollment in a conditioning program to improve performance C. Evaluation for underlying cardiac causes of this symptom Correct D. Treatment for exerciseinduced asthma with a bronchodilator 17. A 10yearold is hit in the head with a baseball during practice and is diagnosed with concussion, even though no loss of consciousness occurred. The primary care pediatric nurse practitioner is evaluating the child 2 weeks after the injury and learns that the child is still experiencing some sleepiness every day. The neurological exam is normal. The child and the parent are adamant that the child be allowed to return to play baseball. What will the nurse practitioner recommend? A. Continuation of cognitive rest only B. Continuation of physical and cognitive rest Correct A. Continuation of physical rest only Burns' Pediatric Primary Care 7th Edition Test Bank Chapter 1: Health Status of Children Global and National Perspectives Latest updated 2022 examination Study Guide. B. Returning to play Burns' Pediatric Primary Care 7th Edition Test Bank Chapter 1: Health Status of Children Global and National Perspectives Latest updated 2022 examination Study Guide. 4. The primary care pediatric nurse practitioner is counseling a new parent about ways to reduce the risk of sudden infant death syndrome (SIDS). What will the nurse practitioner include when discussing SIDS? UUUU. Bedsharing with infants greatly increases the risk of SIDS. Correct VVVV. Breastfeeding does not appear to have any influence on SIDS risk. WWWW. Infants who attend day care have a higher than usual incidence of SIDS. XXXX. There is no difference in SIDS rates in immunized versus nonimmunized infants. . 5. The primary care pediatric nurse practitioner is counseling the parents of a toddler about sleep. The parents report that the toddler has recently begun resisting sleep and is often more irritable during the day. What will the nurse practitioner recommend? XX. Cosleeping with the child to help alleviate possible nighttime fears YY. Referral to a sleep disorders clinic for evaluation of sleepdisordered breathing ZZ. Reintroducing a second, morning nap time to compensate for lost sleep D. Understanding that sleep resistance is a common developmental problem Correct 6. The parent of a 3yearold child tells the primary care pediatric nurse practitioner that the child has never been able to fall asleep without a parent in the room. The child has a new sibling and the parent is concerned that the toddler’s cries will awaken the infant. What will the nurse practitioner counsel the parent? A.Leaving the room as the child is falling asleep and returning at intervals to check on the child Correct LL. Offering a reward for each night the child falls asleep without the parent in the room MM. Putting the child to bed at the same time every night and ignoring all sleep interfering behaviors NN. Taking away a favorite activity or video for each night the child fusses about the parent not being in the room 7. The parent of a 4yearold who has difficulty initiating and maintaining sleep has tried several nonpharmacological methods with variable success and asks about medications. What will the primary care pediatric nurse practitioner recommend? VV. Diphenhydramine WW. Lorazepam C. Melatonin Correct D. Zolpidem 8. The parent of a 3yearold child tells the primary care pediatric nurse Burns' Pediatric Primary Care 7th Edition Test Bank Chapter 1: Health Status of Children Global and National Perspectives Latest updated 2022 examination Study Guide. practitioner that after falling asleep in the living room and being awakened to go to bed one evening, the child appeared confused and disoriented for a period of time. What will the nurse practitioner counsel this parent? EEE. That if this occurs again, to question the child about nightmares FFF. That this is a sign of sleep walking and could be dangerous GGG. That this is a type of sleep terror which will resolve over time D. That this is probably a benign, temporary type of a sleep disorder Correct . 9. During a well child examination, the primary care pediatric nurse practitioner learns that a 5yearold child has had several episodes of walking out of the bedroom after falling asleep, looking dazed, with open eyes, and saying things that don’t make sense. What will the nurse practitioner recommend? A. Establishing a graduated extinction program and good sleep hygiene B. Making sure that stairs are blocked and doors are locked Correct OO. Referral to a sleep disorder clinic for evaluation of a parasomnia PP. To awaken the child when these occur and asking about nightmares 10. The parent of a schoolage child tells the primary care pediatric nurse practitioner that the child is restless most nights and complains often that bugs are in the bed. After consultation with a sleep disorder specialist and subsequent evaluation of a ferritin level of 30, the nurse practitioner may expect to treat this child with SS. clonazepam. TT. ferrous sulfate. Correct UU. gabapentin. VV. sertraline. 11. An adolescent exhibits mild depressive symptoms and tells the primary care pediatric nurse practitioner that he is most concerned about difficulty falling and staying asleep. The adolescent does not want to take medication to treat the depressive symptoms. What will the nurse practitioner recommend? A. A program of sleep hygiene and gradual sleep extension Correct OO. A sedativenarcotic will help both sleep and depression PP. Cognitive therapy can help the adolescent to sleep better QQ. Using an antidepressant will improve sleep patterns 12. A child with Down syndrome who has sleepdisordered breathing with obstructive sleep apnea continues to have symptoms in spite of tonsillectomy and adenoidectomy and treatment with a leukotriene receptor antagonist medication and a nasal steroid spray. The primary care pediatric nurse practitioner will refer the child Burns' Pediatric Primary Care 7th Edition Test Bank Chapter 1: Health Status of Children Global and National Perspectives Latest updated 2022 examination Study Guide. to a sleep disorder clinic to discuss which therapy? Burns' Pediatric Primary Care 7th Edition Test Bank Chapter 1: Health Status of Children Global and National Perspectives Latest updated 2022 examination Study Guide. . 5. The primary care pediatric nurse practitioner is co unseling the parents of a 13yearold female who has Down syndrome about sexual maturation. What will the nurse practitioner tell these parents? OO. It is important to discuss and support healthy sexuality. Correct PP. Providing too much information about sexuality may be confusing given the child’s cognitive level of understanding. QQ. Suppressing periods with contraceptives will lessen their daughter’s distress. RR. They should give her information about periods but not about sexuality. 6 . During a well child exam on a 13yearold female, the primary care pediatric nurse practitioner notes that the child is at Tanner Stage 3. During the exam, when the nurse practitioner initiates a conversation about healthy sexuality education, the parent states that this topic is “off limits.” What will the nurse practitioner do? XX. Ask the adolescent whether she wishes to discuss these matters since she is becoming an adult. YY. Separate the parent from the adolescent to discuss the adolescent’s concerns in private. ZZ. Spend private time with the parent to discuss how sexuality education reduces the risk of early sexual intercourse and risky sexual behaviors. Correct AAA. Tell the parent that this information is a routine part of adolescent well child examinations and must be included. 7. During a well child examination, a 15yearold female tells the primary care pediatric nurse practitioner that some of her friends have begun having sex. She has a boyfriend but denies engaging in sex with him. What will the nurse practitioner do initially? HHH. Ask her for her definitions of “sex.” Correct III. Discuss the risks of sexually transmitted diseases. JJJ. Find out if she is considering sexual relations. KKK. Give her information about contraception. 8. During a well child examination of a 6yearold girl, the primary care pediatric nurse practitioner notes that the child becomes embarrassed and resists taking off her underwear for the exam. What should the nurse practitioner infer from this observation? QQ. The child has been sexually molested. RR. The child is feeling violated by the examiner. SS. The parent is exhibiting regressive behavior. TT. This is a normal reaction in a child of this age. Correct Burns' Pediatric Primary Care 7th Edition Test Bank Chapter 1: Health Status of Children Global and National Perspectives Latest updated 2022 examination Study Guide. . 9. The primary care pediatric nurse practitioner is providing anticipatory guidance to the parent of a schoolage boy. The parent expresses concerns that the child prefers to play with dolls, is worried that the child will be a homosexual, and asks what can be done to prevent this from happening. What will the nurse practitioner tell this parent? WW. Homosexual identity formation cannot be predicted by early childhood behavior. XX. Masculinizing boys from an early age helps to determine heterosexual orientation. YY. Sexual orientation identification begins late in adolescence and not in childhood. ZZ. The development of sexual orientation is generally a multifaceted process. Correct Chapter 22. Immunizations Questions 1. A 2monthold infant has a staccato cough and fever. Which aspect of the history is most important in determining the diagnosis? A. Day care attendance B. Immunization history Correct OOO. Medication history PPP. Past medical history 2. When reviewing a white blood cell (WBC) count, the primary care pediatric nurse practitioner suspects a viral infection when which WBC element is elevated? OOO. Bands PPP. Leukocytes C. Lymphocytes Correct D. Neutrophils 3. Which lab value is most concerning in an infant with fever and a suspected bacterial infection? A. Creactive protein of 11.5 mg/L Correct JJJ. Lymphocyte count of 8.7 KKK. Platelet count of 475 LLL. White blood cell count of 14 4. A toddler is receiving longterm antibiotics to treat osteomyelitis. Which laboratory test will the primary care pediatric nurse practitioner order to monitor response to therapy in this child? A. Blood cultures B. Erythrocyte sedimentation rate (ESR) Correct c. Serum procalcitonin (ProCT) d. White blood count (WBC) Burns' Pediatric Primary Care 7th Edition Test Bank Chapter 1: Health Status of Children Global and National Perspectives Latest updated 2022 examination Study Guide. 5. According to recent research, which populations may have higher rates of under immunization than others? A. Those with higher rates of Asians B. Those with higher rates of graduate degrees Correct C. Those with lower rates of poverty D. Those with lower rates of primary providers 6. The parent of a 2monthold infant is reluctant to have the baby vaccinated. What is an initial step in responding to these concerns? KKK. Inform the parent that all vaccines may be given without thimerosol. LLL. Providing Vaccine Information Statements for the parent to review. MMM. Question the parent’s reasons for concern about immunizations. Correct NNN. Remind the parent that the infant is exposed to thousands of germs each day. 7. A parent is concerned about vaccine adverse reactions. Based on an Institute of Medicine report, what will the primary care pediatric nurse practitioner tell the parent? SS. Administering multiple vaccines may trigger the development of type 1 diabetes. TT. The MMR may be linked to febrile seizures in immunocompromised children. Correct UU. There is some risk of CNS disorders associated with the hepatitis B vaccine. VV. Vaccines containing thimerosol are linked to pervasive developmental disorders. 8. A 2monthold infant will receive initial immunizations, and the parent asks about giving medications to increase the infant’s comfort and minimize fever. What will the pediatric nurse practitioner recommend? A. Administering ibuprofen or acetaminophen as needed Correct BBB. Avoiding antipyretics if possible to attain better immunity CCC. Giving ibuprofen and acetaminophen only after the vaccines DDD. Pretreating the infant with both ibuprofen and acetaminophen 9. The parent of an infant asks why some vaccines, such as MMR, are not given along with the other series of immunizations at 2, 4, and 6 months of age. What will the primary care pediatric nurse practitioner tell this parent? LLL. Febrile seizures are more likely in younger infants with some vaccines. MMM. Maternal antibodies neutralize some vaccines and are delayed until 12 months. Correct NNN. The risk of adverse effects is lower for some vaccines after the first year. OOO. Too many vaccines at once can overwhelm the infant’s immune system. 10. The primary care pediatric nurse practitioner is performing an initial well child exam on a 3yearold child recently adopted from Africa. The adoptive parent has a record of