(Test Bank) Midterm Exam 602

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MidtermExam602 1.Theprimarycarepediatricnursepractitionerisobtainingamedicalhistory aboutachild.Tointegratebothnursingandmedicalaspectsofprimarycare,whichwillbe includedinthemedicalhistory? A. Complementarymedications,alternativehealthpractices,andchiefcomplaint B. Developmentaldelays,nutritionalstatus,andlineargrowthpatterns C. Medicationcurrentlytaking,allergyinformation,andfamilymedicalhistory D. Speechandlanguagedevelopment,beliefsabouthealth,and previousillnessesCorrect 2.Whenformulatingdevelopmentaldiagnosesforpediatricpatients,theprimary carepediatricnursepractitionermayusewhichresource? A. DC:03R Correct B. ICD10CM C. ICSD3 D. NANDAInternationa 3.Theprimarycarepediatricnursepractitionerseesa3yearoldchildwho chronicallywithholdsstools,inspiteoftheparents’attemptstostopthebehavior,requiring frequenttreatmentswithlaxativemedications.Whichdiagnosiswillthenursepractitioneruseto facilitatethirdpartyreimbursement? A. Alteredeliminationpattern B. Eliminationdisorder C. Encopresis Correct D. Parentingalterat 4.Theprimarycarepediatricnursepractitionerisassessingatoddlerwhose weightandbodymassindex(BMI)arebelowthe3rdpercentileforage.Thenursepractitioner learnsthatthechilddoesnothaveregularmealtimesandisallowedtocarryabottleofjuice aroundatalltimes.Thenursepractitionerplanstoworkwiththisfamilytodevelopimprovedmeal patterns.Whichdiagnosiswillthenursepractitioneruseforthisproblem? A. Failuretothrive B. Homecareresourcesinadequate C. Nutritionalteration–lessthanrequired D. Parentingalteration CorrectMidtermExam602 5.Theprimarycarepediatricnursepractitionerisperformingawellchildcheck 11176 upona20montholdchild.Thechildwas4weeksprematureand,accordingtoaparentcompleted developmentalquestionnaire,hasachievedmilestonesfora15montholdinfant.Whichactionis correct? A. Perform anindepthdevelopmentalassessmentscreenatthisvisittoevaluatethis child.Correct B. Reassuretheparentthatthechildwillcatchuptonormaldevelopmentbyage2 years. C. Reevaluatethischild’sdevelopmentandmilestoneachievementsatthe2yearvisit. D. Referthechildtoaspecialtyclinicforevaluationandtreatmentofdevelopmental delay.MidtermExam602 6.Theprimarycarepediatricnursepractitionerperformsadevelopmental assessmentona3yearoldchildandnotesnormalcognitive,finemotor,andgrossmotor abilities.Thechildrespondsappropriatelytoverbalcommandsduringtheassessmentbut refusestospeakwhenaskedquestions.Theparenttellsthenursepractitionerthatthechild talksathomeandthatmostotheradultscanunderstandwhatthechildsays.Thenurse practitionerwill A. asktheparenttoconsiderapossiblespeechdelayandreportanyconcerns. B. continuetoevaluatethechild’sspeechatsubsequentvisits.Correct C. referthechildforaspeechandhearingevaluation. D. telltheparenttospendmoretimeininteractiveconversationswiththechild. 7.Theparentofatoddlerisconcernedthatthechildmayhaveautism.The primarycarepediatricnursepractitionercompletesaModifiedChecklistforAutisminToddlers (MCHAT)tool,whichindicatesseveralareasofconcern.Whatwillthenursepractitionerdo? A. AdministeraChildhoodAutismRatingScale(CARS)intheclinic. B. Consultaspecialisttodetermineappropriateearlyinterventionstrategies. C. Referthechildtoabehavioralspecialistforfurtherevaluation.Correct D. Telltheparentthatthisresultindicatesthatthechildhasautism. 8.Theprimarycarepediatricnursepractitionerlearnsthatthemotherofa3 yearoldchildhasbeentreatedfordepressionforover5years.Whichaspectofthischild’s developmentwillbeofthemostconcerntothenursepractitioner? A. Finemotor B. Grossmotor C. Social/emotional D. Speechandlanguage CorrectMidtermExam602 9.Whenmeetingwithanewfamily,theprimarycarepediatricnursepractitioner develops a database thatidentifies family members and others living in the household, relationships with others outside the household,and significantbehavioraland emotional problems.Whichtoolwillthenursepractitionerusetorecordthisinformation?MidtermExam602 A. CRAFFT B. Ecomap C. Genogram Correct D. Pedigree 10.Achildisintheclinicforevaluationofanasthmaactionplan.Theprimary carepediatricnursepractitionernotesthatthechild’slastvisitwasforaprekindergarten physicalandobservesthatthechildisextremelyanxious.Whatwillthenursepractitionerdo initially? A. Askthechild’sparentwhythechildissoanxious. B. Performaphysicalassessmenttoruleoutshortnessofbreath. C. Reassurethechildthatthereisnothingtobeafraidof. D. Reviewthepurposeofthisvisitandanyanticipatedprocedures.Correct 11.Theprimarycarepediatricnursepractitionerisevaluatinghealthliteracyinthe motherofanewpreschoolagechild.Howwillthenursepractitionerassess A. Askthechildhowmanybookshehasathome.Correct B. Askthemotheraboutherhighestgradeinschool. C. Askthemothertodeterminethecorrectdoseofadrugfromalabel. D. Askthemothertoreadahealthinformationhandoutaloud. 12.Themotherofanewborntellstheprimarycarepediatricnursepractitioner thatsheisworriedthatherchildwilldevelopallergiesandasthma.Whichtoolwillthenurse practitionerusetoevaluatethisrisk? A. Threegenerationpedigree Correct B. Reviewofsystems C. Genogram D. Ecomap 13.Theprimarycarepediatricnursepractitionerisperformingawellchild assessmentonanadolescentandisconcernedaboutpossiblealcoholandtobaccouse. Whichassessmenttoolwillthenursepractitioneruse?MidtermExam602 A. CRAFFT Correc B. HEEADSSS C. PHQ2 D. RAAPS 14.Theprimarycarepediatricnursepractitionerevaluatesaschoolagechild whosebodymassindex(BMI)isgreaterthanthe97thpercentile.Thenursepractitioneris concernedaboutpossiblemetabolicsyndromeandorderslaboratoryteststoevaluatethis. Whichdiagnosiswillthenursepractitionerdocumentforthisvisit? A. Metabolicsyndrome B. Nutritionalalteration:morethanrequired C. Obesity Correct D. Ruleouttype2diabetesmellitusMidtermExam602 Questions 1.Asinglemotherofaninfantworriesthatlivinginahouseholdwithonlyone parentwillcauseherchildtobemaladjusted.Tohelpaddressthemother’sconcerns,the primarycarepediatricnursepractitionerwillsuggest E. developingconsistentdailyroutinesforthechild.Correct F. exposingherchildtoextendedfamilymemberswhenpossible. G. notworkingoutsidethehomeduringthefirstfewyears.MidtermExam602 H. takingherchildtoregularplaydateactivitieswithotherchildren. 2.Duringawellchildexam,theprimarycarepediatricnursepractitionerlearns thattheparentsofayoungchildfightfrequentlyaboutfinances.Theparentsstatethatthey donotfightinfrontofthechildandfeelthatthesituationistemporaryandrelatedtothe father’sjoblayoff.Whatwillthenursepractitionerdo? E. Reassurethemthatthechildistooyoungtounderstand. F. Recommendthattheycontinuetonotargueinfrontofthechild. G. Suggestcounselingtolearnwaystohandlestress.Correct H. Tellthemthattheconflictwillresolvewhenthesituationchanges. 3.Duringawellchildassessmentofan18montholdchild,theprimarycare pediatricnursepractitionerobservesthechildbecomingirritableanduncooperative.The parenttellsthechildtostopfussing.Whatwillthenursepractitionerdo? C. Allowtheparenttoputthechildina“timeout.” D. Asktheparentaboutusualdisciplinepractices. E. Offerthechildabookoratoytolookat.Correct F. Stoptheexamsincethechildhasreacheda“meltdown.” 4.Whichrecommendationwillaprimarycarepediatricnursepractitionermake whenparentsaskaboutwaystodisciplinetheir3yearoldchildwhodrawsonthewallswith crayons? D. Givethechildwashablemarkerssothedrawingscanberemovedeasily. E. Providearollofpaperfordrawingandteachthechildtousethis. Correct F. Putthechildin“timeout”eachtimethechilddrawsonthewalls. G. Takethecrayonsawayfromthechildtopreventthebehavior.MidtermExam602 5.Theprimarycarepediatricnursepractitionerconductsawellbabyexam oMidtermExam602 aninfantandnotesmildgrossmotordelaysbutnodelaysinotherareas.Whichinitialcourseof actionwillthenursepractitionerrecommend? E. Consultadevelopmentalspecialistforamorecompleteevaluation. F. Preparetheparentsforapotentiallyseriousdevelopmentaldisorder. G. Refertheinfanttoanearlyinterventionprogramforphysicaltherapy. H. Teachtheparentstoprovideexercisestoencouragemotordevelopment.Correct 11122 6.Theprimarycarepediatricnursepractitionerisexamininganewborninfant recentlydischargedfromtheneonatalintensivecareunitafteraprematurebirth.Theparentis upsetandexpressesworryaboutwhethertheinfantwillbenormal.Whatwillthenurse practitionerdointhissituation? E. Explaintotheparentthatdevelopmentaldelaysoftendonotmanifestatfirst. F. Performadevelopmentalassessmentandtelltheparentwhichdelaysareevident. 11120 G. Pointoutthetasksthattheinfantcanperformwhileconductingthe assessment. Correct D. Refertheinfanttoadevelopmentalspecialistforacompleteevaluation. 7.Theprimarycarepediatricnursepractitionerseesadevelopmentallydelayed toddlerforaninitialvisit.Thefamilyhasjustmovedtotheareaandasksthenursepractitione aboutcommunityservicesandresourcesfortheirchild.Whatshouldthenursepractitionerd initially? E. Asktheparentsiftheyhaveanindividualizedfamilyserviceplan(IFSP).Correct F. Consultwithaphysiciantoensurethechildgetsappropriatecare.MidtermExam602 G. Informthefamilythatservicesareprovidedwhenthechildbeginsschool. H. Referthefamilytoasocialworkerforassistancewithreferralsandservices. 8.Theprimarycarepediatricnursepractitionerhasacohortofpatientswho havespecialhealthcareneeds.Whichisanimportantroleofthenursepractitionerwhen caringforthesechildren? A. Carecoordinationandcollaboration Correct D. Developingprotocolsforparentstofollow E. Monitoringindividualeducationplans(IEPs) F. Providinglistsofresourcesforfamilies 9.Theprimarycarepediatricnursepractitionerperformsaphysicalexamination ona9montholdinfantandnotestwocentralincisorsonthelowergums.Theparentstatesthat theinfantnurses,takessolidfoodsthreetimesdaily,andoccasionallytakeswaterfrom acup. WhatwillthepediatricnursepractitionercounseltheparenttopromoteoptimumdentalMidtermExam602 Continuehealth?C. Tobeginbrushingtheinfant’steethwithtoothpaste D. Toconsiderweaningtheinfantfrombreastfeeding E. Todiscontinuegivingfluoridesupplements D. Tomakeanappointmentforaninitialdentalexamination 10.Theprimarycarepediatricnursepractitionerentersanexam roomandfinds a2montholdinfantinacarseatontheexamtable.Theinfant’smotherisplayingagameon hersmartphone.Thenursepractitionerinterpretsthisbehavioras E. asignthatthemotherhaspostpartumdepression. F. extremelyconcerningforpotentialparentalneglect. G. ofmoderateconcernforparentingproblems.Correct H. withinthenormalrangeofbehaviorinearlyparenthood. CorrectMidtermExam602 Questions 1.Theparentofanewborninfantaskstheprimarycarepediatricnursepractitioner whentointervenetohelptheinfant’sfutureintellectualgrowth.Whatwillthenursepractitioner tell theparent? I. Cognitivelearningbeginsduringthetoddleryears. J. Intellectualgrowthbeginwhenspeechdevelops.MidtermExam602 K. Languageandliteracyskillsbeginatbirth.Correct L. Preschoolisanoptimaltimetobegingenerallearning. 2.Theprimarycarepediatricnursepractitionerperformsawellbabyexamination ona7dayoldinfantwhoisnursingwell,accordingtothemother.Thenursepractitionernotes thattheinfantweighed3250gramsatbirthand2990gramswhendischargedonthesecond dayoflife.Theinfantweighs3080gramsatthisvisit.Whichactioniscorrect? I. Followupatthe2monthcheckup. J. Refertoalactationconsultant. K. Scheduleaweightcheckin1week.Correct L. Suggestsupplementingwithformula. 3.Duringanassessmentofa4weekoldinfant,theprimarycarepediatricnurse practitionerlearnsthatabreastfedinfantnursesevery2hoursduringthedaybutisableto sleepfora4hourperiodduringthenight.Theinfanthasgained20gramsperdayinthe intervalsincelastseenintheclinic.Whatwillthenursepractitionerrecommend? A. Continuingtonursetheinfantusingthecurrentpattern Correct G. Nursingtheinfantforlongerperiodsevery4hours H. Supplementingwithformulaatthelastnighttimefeeding I. Wakingtheinfantevery2hourstonurseduringthenight 4.Theprimarycarepediatricnursepractitionerisperformingawellbaby examinationona2montholdinfantwhohasgained25gramsperdayinthelastinterval. Themotherisnursingandtellsthenursepractitionerthatherinfantseemsfussyandwants tonursemoreoften.Whatwillthenursepractitionertellher? H. Shemaynotbemakingasmuchbreastmilkasbefore. I. Sheshouldkeepalogofthefrequencyanddurationofeachfeeding. J. Theinfantmaybegoingthroughanexpectedgrowthspurt.Correct K. Theinfantshouldstayonthepreviouslyestablishednursingschedule.MidtermExam602 Themotherofa6weekoldbreastfeedinginfanttellstheprimarycarepediatric I. nursepractitionerthatherbaby,whopreviouslyhadbowelmovementswitheachfeeding,nowhasa bowelmovementonceeverythirdday.Whatwillthenursepractitionertellher? I. Herbabyisprobablyconstipated. J. Itmayberelatedtoherdietaryintake. K. Sheshouldconsumemorewater.MidtermExam602 L. Thismaybenormalforbreastfedbabies.Correct 5.Themotherofa3montholdchildtellstheprimarycarepediatricnurse practitionerthatitis“somuchfun”nowthatherinfantcoosandsmilesandwantstoplay.Whatis importantforthenursepractitionertoteachthismother? A. Appropriatewaystostimulateandentertaintheinfant B. Howtoreadtheinfant’scuesforoverstimulation H. Theimportanceofscheduling“playdates”withotherinfants I. Toprovidemusicaltoystoengagetheinfant 6.Theparentofa5montholdisworriedbecausetheinfantbecomesfussybut doesn’talwaysseeminterestedinnursing.Whatwillthenursepractitionertellthisparent? I. Theinfantmaybeexpressingadesiretoplayortorest.Correct J. Theparentshouldgiveibuprofenforteethingpainbeforenursing. K. Thisisanindicationthattheinfantisreadyforsolidfoods. L. Thismayindicategastrointestinaldiscomfortsuchasconstipation. 7.Themotherofa6montholdinfantisdistressedbecausetheinfantcansay “dada”butnot“mama”andaskstheprimarycarepediatricnursepractitionerwhythisiswhensheis theonewhospendsmoretimewiththeinfant.Howwillthenursepractitionerrespond? G. “Atthisage,yourbabydoesnotunderstandthemeaningofsounds.”Correct H. “Babiesatthisagecannotmakethe‘ma’sound.” I. “Mostsoundsmadebybabiesatthisageareaccidental.” J. “Thismaymeanthatyourbabydoesn’thearwell.” 8.Theprimarycarepediatricnursepractitionerisperformingawellchild examinationona9montholdinfantwhosehearingisnormalbutwhorespondstoverbalcueswithonly singlesyllablevocalizations.Whatwillthenursepractitionerrecommendtotheparentstoimprove speechandlanguageskillsinthisinfant? F. Provideeducationalvideosthatfocusonlanguage. G. Readsimpleboardbookstotheinfantatbedtime.Correct CorrectMidtermExam602 I. Singtothechildandplaylullabiesinthebaby’sroom. A. B. J. TurnthetelevisiontoSesameStreetduringtheday. 9. Theprimarycarepediatricnursepractitionerisexamininga12montholdinfant whowas6weeksprematureandobservesthattheinfantusesarakingmotiontopickup smallobjects.ThePEDSquestionnairecompletedbytheparentdidnotshowsignificant developmentaldelays.Whatwillthenursepractitionerdofirst? E. Performanindepthdevelopmentalassessment.Correct F. Reassuretheparentthatthisisnormalforaprematureinfant. G. Refertheinfanttoadevelopmentalspecialist. H. Suggestactivitiestoimprovefinemotorskills.MidtermExam602 Questions 37959 37947 37957 37949 1.Theprimarycarepediatricnursepractitionerisevaluatinga2yearoldwitha documentedspeechdelay.Screeningstoassessmotorskillsandcognitionarenormal,and thechildpassedarecenthearingtest.Whatwillthepediatricnursepractitionerdonext? M. Askthechild’sparentswhethertheyreadtothechild. N. Giveparentseducationalmaterialstoencouragespeech. O. Referthechildtoanearlyinterventionprogram.MidtermExam602 P. Suggestthattheypurchaseageappropriatemusicvideos. 2.Theprimarycarepediatricnursepractitionerperformsadevelopmental assessmentona32montholdchild.Thechild’sparentreportsthatabout70% ofthechild’s speechisintelligible.Thepediatricnursepractitionerobservesthatthechildhasdifficulty pronouncing“t,”“d,”“k,”and“g”sounds.Whichactioniscorrect? M. Evaluatethechild’scognitiveabilities. N. Obtainahearingevaluation. O. Reassuretheparentthatthisisnormal.Correct P. Referthechildtoaspeechtherapist. 3.Duringawellchildassessmentofan18montholdchild,theprimarycare pediatricnursepractitionerobservesthechildpointtoapictureofadogandsay,“Want puppy!”Thenursepractitionerrecognizesthisasanexampleof J. holophrasticspeech. K. receptivespeech. L. semanticspeech. M. telegraphicspeech.Correct 4.Theprimarycarepediatricnursepractitionerisofferinganticipatoryguidance totheparentsofa12montholdchild.TheparentsarebilingualinSpanishandEnglishand havemanySpanishspeakingrelativesnearby.Theyareresistingexposingthechildto SpanishoutofconcernthatthechildwillnotlearnEnglishwell.Whatwillthepediatricnurse practitionertelltheparents? L. Childrenwholearntwolanguagessimultaneouslyoftenconfusethemin conversation. M. Childrenwithmultilanguageproficiencydonotunderstandthatotherscannotdo this. N. Learningtwolanguagesatanearlyagepreventschildrenfromdevelopinga dominantlanguage. M. Mostbilingualchildrenareabletoshiftfromonelanguagetoanotherwhen appropriate.CorrecMidtermExam602 5.TheprimarycarepediatricnursepractitioneriscounselingtheparentsofaMidtermExam602 toddleraboutappropriatediscipline.Theparentsreportthatthechildisveryactiveand curious,andtheyareworriedaboutthepotentialforinjury.Whatwillthepediatricnurse practitionerrecommend? ← Allowthechildtoexploreandexperimentwhileprovidingappropriate limits.Correct ← Bepresentwhilethechildplaystocontinuallyteachthechildwhatisappropriate. ← Letthechildexperimentatwillandtomakemistakesinordertolearn. ← Say“no”wheneverthechilddoessomethingthatisnotacceptable. M.Themotherofa3yearoldchildtakesthechildtoaplaygrouponceaweek.37961Sheexpresses concernthatthechildplayswithtoysbutdoesnotinteractwiththeothertoddlers.Whatwillthe primarycarepediatricnursepractitionercounselthemother? ← Thechildprobablyisveryshybutwilloutgrowthistendencywithrepeated exposuretootherchildren. K. Thetoddlermayhavealanguagedelaythatinterfereswithsocializationwithother children. L. Toddlersmaybeinterestedinotherchildrenbutusuallydonotengagein interactiveplay.Correct M. Toddlersneedmorestructuredplaytoencourageinteractionandsocializationwith others. 7.Theparentofa4yearoldpointstoapictureandsays,“That’syoursister.” Thechildrespondsbysaying,“No!It’smybaby!”Thisisanexampleofwhichtypeofthinking inpreschoolagechildren? H. Animism I. Artificialism J. Egocentrism D. Realism Correct 8.Theparentofa24montholdchildaskstheprimarycarepediatricnurse practitionerwhentoilettrainingshouldbegin.Howwillthepediatricnursepractitioner respond? K. “Beginbyreadingtoyourchildabouttoileting.” L. “Mostchildrenarecapablebyage2years.”MidtermExam602 I. “Tellmeaboutyourchild’sdailyhabits.”C. D. A. B. J. “Weshouldassessyourchild’smotorskills.” 9.Theprimarycarepediatricnursepractitionerperformsaphysicalexamination ona9montholdinfantandnotestwocentralincisorsonthelowergums.Theparentstates thattheinfantnurses,takessolidfoodsthreetimesdaily,andoccasionallytakeswaterfrom a cup.Whatwillthepediatricnursepractitionercounseltheparenttopromoteoptimumdental health? E. Tobeginbrushingtheinfant’steethwithtoothpaste F. Toconsiderweaningtheinfantfrombreastfeeding G. Todiscontinuegivingfluoridesupplements D. Tomakeanappointmentforaninitialdentalexamination 10.Theparentsofa3yearoldchildareconcernedthatthechildhasbegun refusingusualfoodsandwantstoeatmashedpotatoesandchickenstripsateverymealand snack.Thechild’srateofweighthasslowed,butthechildremainsatthesamepercentilefor weightonagrowthchart.Whatwilltheprimarycarepediatricnursepractitionertellthe parentstodo? E. Allowthechildtochoosefoodsformealstoimprovecaloricintake. F. Placeavarietyofnutritiousfoodsonthechild’splateateachmeal.Correct G. Preparemashedpotatoesandchickenstripsforthechildatmealtimes. H. Suggestcuttingoutsnackstoimprovethechild’sappetiteatmealtimes. CorrectMidtermExam602 MidtermExam602 37967 37977 Questions 37975 37983 1.Theprimarycarepediatricnursepractitionerisexamininga6yearoldchildwho MidtermExam602 attendsfirstgrade.Thechildreports“hating”school.Theparentstatesthatthechildpretendsto besickfrequentlyinordertostayhomefrom school.Tofurtherassessthissituation,thenurse practitionerwillfirstaskthechild Q. aboutschoolperformanceandgrades. R. whyschoolissodistressing. S. tonameoneortwofriends.Correct T. whetherbullyingistakingplace. 2.Theparentofa10yearoldboytellstheprimarycarepediatricnursepractitioner thatthechilddoesn’tappeartohaveanyinterestingirlsandspendsmostofhistimewithacouple ofotherboys.Theparentisworriedaboutthechild’ssexualidentity.Thenursepractitionerwilltell theparent Q. childrenatthisagewhopreferinteractionswithsamegenderpeersusuallyhave ahomosexualorientation. R. childrenexperimentwithsexualityatthisageasameansofdecidinglater sexualorientation. S. thisattachmenttoothersamegenderchildrenishowthechildlearnstointeract withothers.Correct T. toencouragemixedgenderinteractionsinordertopromotedevelopmentofsexual values. 3.Theparentsofa12yearoldchildareconcernedthatsomeofthechild’solder classmatesmaybeabadinfluenceontheirchild,who,theysay,hasbeenraisedtobelievein rightandwrong.Whatwilltheprimarycarepediatricnursepractitionertelltheparent? N. Allowingthechildtomakepoorchoicesandacceptconsequencesisimportantfor learningvalues O. Childrenatthisagehaveahighregardforauthorityandsocialnorms,sothisisnot likelytohappen P. Moralvaluesinstilledintheearlyschoolageperiodwillpersistthroughoutchildhood Q. Thepressuresfromoutsideinfluencesmaysupersedeparentalteachingsandshould beconfrontedCorrect 4.Duringawellchildexam ofaschoolagechild,theprimarycarepediatricnurse practitionerlearnsthatthechildhasbeenhavingangryepisodesatschool.Thenurse practitionerobservesthechildtoappearwithdrawnandsad.Whichactionisappropriate? A. Askthechildandtheparentaboutstressorsathome O. Makeareferraltoachildbehavioralspecialist P. Provideinformationaboutangermanagement Correct