l. The primary care pediatric nurse ANS: C
practitioner understands that a major There is growing evidence that climate change is having a dramatic effect on food
child health outcome associated ith crops that leads to food distribution issues and food insecurity among families.
worldwide climate change is .
cost of living.
b. education.
nutrition.
. pollution.
The primary care pediatric nurse ANS: C
practitioner understands that, to Rotavirus is the most common cause of diarrhea globally and Strep pneumonia is the
achieve he greatest world-wide leading Cat.JSe of pneumonia, and together these are the leading infectious causes
reduction in child mortality from of childhood morbidity and mortality globally. Both are vaccine-preventable
pneumonia and diarrhea, which diseases. Antibiotics to treat pneumonia, optimal nutrition, and clean water all help
intervention is most effective? to reduce morbidity and mortality, but vaccination prevents the diseases from
occurring.
Antibiotics
b. Optimal nutrition
Vaccinations
Water purification
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BIJrnS Pediatric Final Exam Study Guide
care peatatrtc nurse practitioner is tnere IS a greater emphasis on behavioral and developmental issues and a
adhering to the most recent recommendation that well child care be based on child and family development
American Academy of Pediatrics rather than the periodicity of immunization schedules.
Recommendations for This will require a revision of the current
Preventive Pediatric Health Care guidelines recommendations in Bright Futures.
by .
focusing less on development and more
n illness prevention and nutrition.
b. following guidelines established by the
Bright Futures publication.
scheduling well-baby visits to coincide
ith key developmental milestones.
seeing the infant at ages 2, 4, 6, and 12
months when immunizations are due.
4. Which is true about the health status of ANS: B
hildren in the United States? Obesity rates are a major concern for child health in the U.S. but recently have
Globalism has relatively little impact on stabilized in the rate of increase and have declined among 2- to 5-year-olds
hild health measures in the U.S. between 2004 and 2013.
b. Obesity rates among 2- to 5-year-olds Globalism has an increasing effect on child health in the U.S. The rate of household
have shown a recent significant decrease. poverty in the U.S. is higher than in other economically developed nations. Young
. The rate of household poverty is lower children who attend preschool or day care have lower food insecurity.
han in other economically developed
nations.
Young children who attend preschool or
ay care have higher food insecurity.
5. Which region globally has the highest ANS: C
infant mortality rate? Although Sub-Saharan Africa and Southern Asia together account for 81% of the
Indonesia infant mortality rate globally, Sub-Saharan Africa has the highest infant
b. Southern Asia mortality rate in the world.
Sub-Saharan Africa
Syria
l. The parent of a toddler is concerned that ANS: C
he child may have autism. The primary care The M-CHAT is a screening tool and is useful for detecting behaviors that may
pediatric nurse practitioner completes a indicate autism. This instrument has been found to have acceptable sensitivity,
Modified specificity, and significant positive predictive value. If these behaviors are detected,
Checklist for Autism in Toddlers (M-CHAT) the PNP should refer the child to a specialist for further assessment, using more
001, which indicates everal areas of diagnostic tools. The CARS may be used but requires specialty training and proper
credentials. Until the diagnosis is determined, strategies for intervention are not
concern. What will the nurse
discussed. The M-CHAT is a screening tool and is not diagnostic.
practitioner do?
Administer a Childhood Autism Rating
Scale (CARS) in the clinic.
b. Consult a specialist to determine
ppropriate early intervention strategies.
Refer the child to a behavioral specialist
or further evaluation.
. Tell the parent that this result indicates
hat the child has autism.
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BIJrnS Pediatric Final Exam Study Guide
nat sne IS worrtea tnat ner hild will Tamiltes, as well as conditions with modifiable risk factors. The review of systems
develop allergies and asthma. is used to evaluate the history of the child's body systems. The genogram is an
Which tool will the nurse practitioner use approach to developing a family database to provide a graphic representation of
to valuate this risk? family structure, roles, and problems of recurring significance in a family. The
ecomap is used to identify relationships in the family and community that are
. Three-generation pedigree
supportive or harmful.
b. Review of systems
Genogram
Ecomap
The primary care pediatric nurse This child should be at a 19-month adjusted age for prematurity so, according to
practitioner is performing a well child the parent screen, is 4 months behind. The PNP should perform a more in-depth
heck-up on a 20-month-old hild. The child screen to evaluate this delay. Waiting to see if the child will "catch up" or assuring
was 4 weeks premature nd, according to a the parent that this will happen will CatJSe the delays to become more severe. A
parent-completed evelopmental referral to a specialty clinic should not be made solely on the basis of the parent-
uestionnaire, has achieved milestones for completed questionnaire but only after further evaluation of possible delays.
15-month-old infant. Which action is
orrect?
Perform an in-depth developmental
ssessment screen at this visit to
evaluate his child.
b. Reassure the parent that the child will
atch up to normal development by age 2
ears.
Re-evaluate this child's development and
milestone achievements at the 2-year visit.
Refer the child to a specialty clinic for
valuation and treatment of
developmental elay.
A NS: A
The DC: 0-3R refers to the Diagnostic Classification of Mental Health and
4. When formulating developmental
Developmental Disorders of
iagnoses for pediatric patients, the
Infancy and Early Childhood and is useful for developmental problem diagnosis. The
primary care pediatric nurse
ICD-IO-CM is the
practitioner may use which resource? International Classification of Diseases-Tenth Revision, Clinical Modification and is
DC: 0-3R USefUl for identifying physiologic diseases. The ICSD-3 is the International
b. ICD-IO-CM Classification of
ICSD-3 Sleep Disorders - 3rd edition. NANDA International is used to label problems
NANDA International in the functional health domain.
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BIJrnS Pediatric Final Exam Study Guide
ne motner 0T a new preschool-age parent now many children's books are in the home. Greater than 10 books in
child. How will the nurse practitioner the home is an independent positive predictor of adequate parent health
assess this? literacy. The other questions may determine a specific level of literacy in general
Ask the child how many books he has at but are not as efficient.
home.
b. Ask the mother about her highest grade
in school.
Ask the mother to determine the correct
ose of a drug from a label.
Ask the mother to read a health
information handout aloud.
6. The primary care pediatric nurse ANS: D
practitioner learns that the mother of a Maternal depression in the first year of life has been associated with poorer
3ear-old child has been reated for language development at 3 years of age.
depression for over 5 years. Which
aspect of this child's development ill be
of the most oncern to the nurse
practitioner?
Fine motor
b. Gross motor
Social/emotional
Speech and language
7. The primary care pediatric nurse ANS: C
practitioner sees a 3-year-old child who Encopresis is a medical diagnosis, classified in the ICD-IO-CM, and is recognized for
hronically withholds stools, in spite of the reimbursement purposes. "Altered elimination pattern" and "Parenting alteration"
parents' attempts to stop the behavior, are NAN DA
requiring frequent treatments ith laxative International diagnoses and are not recognized for reimbursement. "Elimination
medications. Which diagnosis will the disorder" is a developmental diagnosis.
nurse practitioner use to facilitate third-
party reimbursement?
Altered elimination pattern
b. Elimination disorder
Encopresis
Parenting alteration
pealatnc nurse practitioner notes that VISItS ana may oe stressed when recalling previous visits, especially if those
the child's last visit as for a pre- involved immunizations.
kindergarten physical and bserves that The PNP should explain the purpose and any anticipated procedures for this visit to
the hild is extremely anxious. What will help put the child at ease.
the nurse practitioner do initially?
Ask the child's parent why the child is so
nxious.
b. Perform a physical assessment to rule
ut shortness of breath.
Reassure the child that there is nothing
to be afraid of.
Review the purpose of this visit and any
nticipated procedures.
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