Exam (elaborations)
NR602 Pediatric Midterm Study SetQuestions and Answers
- Course
- Institution
NR602 Pediatric Midterm Study SetQuestions and Answers
[Show more]
Content preview
NR602 Pediatric Midterm Study Set-Questions and Answers
The primary care pediatric nurse practitioner learns that the mother of a 3-year-old child has
been treated for depression for over 5 years. Which aspect of this child's development will be of
the most concern to the nurse practitioner?
Fine motor
Gross motor
Social/emotional
Speech and language Correct Ans-ANS: D
Maternal depression in the first year of life has been associated with poorer language
development at 3 years of age.
The primary care pediatric nurse practitioner sees a 3-year-old 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 third-party
reimbursement?
Altered elimination pattern
Elimination disorder
Encopresis
Parenting alteration Correct Ans-ANS: C
Encopresis is a medical diagnosis, classified in the ICD-10-CM, and is recognized for
reimbursement purposes. "Altered elimination pattern" and "Parenting alteration" are NANDA
International diagnoses and are not recognized for reimbursement. "Elimination disorder" is a
developmental diagnosis.
,A child is in the clinic for evaluation of an asthma action plan. The primary care pediatric nurse
practitioner notes that the child's last visit was for a pre-kindergarten physical and observes that
the child is extremely anxious. What will the nurse practitioner do initially?
Ask the child's parent why the child is so anxious.
Perform a physical assessment to rule out shortness of breath.
Reassure the child that there is nothing to be afraid of.
Review the purpose of this visit and any anticipated procedures. Correct Ans-ANS: D
The PNP should remember that young children are learning "scripts" for health care visits and
may be stressed when recalling previous visits, especially if those involved immunizations. The
PNP should explain the purpose and any anticipated procedures for this visit to help put the
child at ease.
When meeting with a new family, the primary care pediatric nurse practitioner develops a
database that identifies family members and others living in the household, relationships with
others outside the household, and significant behavioral and emotional problems. Which tool
will the nurse practitioner use to record this information?
CRAFFT
Ecomap
Genogram
Pedigree Correct Ans-ANS: C
The genogram is an approach to developing a family database to provide a graphic
representation of family structure, roles, and problems of recurring significance in a family. The
CRAFFT tool is used to assess substance abuse in adolescents. The ecomap is used to identify
relationships in the family and community that are supportive or harmful. The pedigree is used
to identify potential genetic disorders.
The primary care pediatric nurse practitioner evaluates a school-age 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?
Metabolic syndrome
,Nutritional alteration: more than required
Obesity
Rule out type 2 diabetes mellitus Correct Ans-ANS: C
A problem should never be included on the problem list that is not supported by subjective and
objective data found and recorded in the database. This child has a BMI that suggests obesity,
so this may be used as a diagnosis. Metabolic syndrome is a diagnosis that is determined by
laboratory data, which has not been evaluated yet. Nutritional alteration is a NANDA diagnosis
and not acceptable for reimbursement. "Rule out" should not be used as a diagnosis, but may
be considered part of a plan.
The primary care pediatric nurse practitioner performs a developmental assessment on a 3-
year-old child and notes normal cognitive, fine-motor, and gross-motor 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 :
ask the parent to consider a possible speech delay and report any concerns.
continue to evaluate the child's speech at subsequent visits.
refer the child for a speech and hearing evaluation.
tell the parent to spend more time in interactive conversations with the child. Correct Ans-
ANS: B
Development should be monitored over time and within the context of the child's overall well-
being, rather than at an isolated testing session. The child has normal development in observed
measures and appears to hear and understand well. By parental report, the child is able to
speak. The PNP should continue to evaluate speech over time, since this refusal to speak may
be associated with shyness or intimidation in the clinic. It is not necessary to tell the parent that
the child has a possible speech delay. Unless an actual speech delay is observed, a referral is not
indicated, nor is it necessary to implement a home therapy.
The primary care pediatric nurse practitioner is performing a well child assessment on an
adolescent and is concerned about possible alcohol and tobacco use. Which assessment tool
will the nurse practitioner use?
CRAFFT
, HEEADSSS
PHQ-2
RAAPS Correct Ans-ANS: A
The CRAFFT tool is a six-question tool used to screen for adolescent substance abuse. The
HEEADSSS is used as a psychosocial screening tool. The PHQ-2 is a rapid screen for depression.
The RAAPS is used to assess risk behaviors that contribute to most morbidity, mortality, and
social problems in teens.
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 develop improved meal patterns.
Which diagnosis will the nurse practitioner use for this problem?
Failure to thrive
Home care resources inadequate
Nutrition alteration - less than required
Parenting alteration Correct Ans-ANS: D
Because the PNP is planning to intervene by helping the parents to provide appropriate food
habits, the correct diagnosis should be "Parenting alteration." "Failure to thrive" is a medical
diagnosis and requires a medical and social evaluation to rule out organic causes or detect
neglect. "Home care resources inadequate" would be used if the PNP suspects that the family
lacks adequate funds to purchase food. "Nutrition alteration" is a NANDA diagnosis and would
be used if the PNP planned to consult with a dietician or give nutritional information.
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?
Complementary medications, alternative health practices, and chief complaint
Developmental delays, nutritional status, and linear growth patterns
Medication currently taking, allergy information, and family medical history
The benefits of buying summaries with Stuvia:
Guaranteed quality through customer reviews
Stuvia customers have reviewed more than 700,000 summaries. This how you know that you are buying the best documents.
Quick and easy check-out
You can quickly pay through credit card or Stuvia-credit for the summaries. There is no membership needed.
Focus on what matters
Your fellow students write the study notes themselves, which is why the documents are always reliable and up-to-date. This ensures you quickly get to the core!
Frequently asked questions
What do I get when I buy this document?
You get a PDF, available immediately after your purchase. The purchased document is accessible anytime, anywhere and indefinitely through your profile.
Satisfaction guarantee: how does it work?
Our satisfaction guarantee ensures that you always find a study document that suits you well. You fill out a form, and our customer service team takes care of the rest.
Who am I buying these notes from?
Stuvia is a marketplace, so you are not buying this document from us, but from seller TheeGrades. Stuvia facilitates payment to the seller.
Will I be stuck with a subscription?
No, you only buy these notes for $24.49. You're not tied to anything after your purchase.
Can Stuvia be trusted?
4.6 stars on Google & Trustpilot (+1000 reviews)
84146 documents were sold in the last 30 days
Founded in 2010, the go-to place to buy study notes for 14 years now