BURNS PEDIATRIC PRIMARY CARE 7TH EDITION TEST BANK
2024 LATEST GRADED A+ ANSWERS WITH
FEEDBACK/RATIONALES
14. 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?
a. Complementary medications, alternative health practices, and chief complaint
b. Developmental delays, nutritional status, and linear growth patterns
c. Medication currently taking, allergy information, and family medical history
d. Speech and language development, beliefs about health, and previous illnesses -
ANS: D
An assessment model that integrates the nursing and medical aspects of primary care
uses three domains:
developmental problems (speech and language development), functional health
problems (beliefs about
health), and diseases (chief complaint). The other examples all use domains associated
with the traditional
medical model and do not contain nursing aspects associated with functional health
problems.
1. The primary care pediatric nurse practitioner learns that an African-American 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
a. cultural sensitivity.
b. group bias.
c. individual privilege.
d. racial awareness. - ANS: C
Privilege can be individual- or group-based and refers to the often unconscious lack of
understanding of
what other groups must deal with. The PNP is not aware that the family may lack the
resources to move,
may be fearful of moving to a "white" neighborhood, or may even feel safe around
people that they know.
Cultural sensitivity is an awareness of and respect for other cultures. Group bias is a
prejudice, based on
cultural, racial, or ethnic differences, toward a group of people. Racial awareness would
describe an
,awareness of cultural differences based on race.
2. The primary care pediatric nurse practitioner is examining a child whose parents
recently emigrated
from a war-torn country in the Middle East. Which is a priority assessment when
performing the
patient history?
a. Asking about physical, psychological, and emotional trauma
b. Determining the parents' English language competency and literacy level
c. Learning about cultural preferences and complementary medicine practices
d. Reviewing the child's previous health and illness records - ANS: A
Recent history that includes trauma, loss, and refugee camp experience may
exacerbate difficulties
adjusting to life in the U.S. and can lead to acute and chronic physical and mental
health concerns. All of
the other parts of the history will be necessary, but this should be a priority, since the
family has escaped a
war-torn country.
3. 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 :
a. ask the sponsor to allow the family to respond.
b. develop the plan of care and ask the sponsor to make sure it is followed.
c. request that the sponsor translate written instructions for the family.
d. use the telephone interpreter service to communicate with the family. - ANS: D
Federally funded managed care networks and community health centers are required to
have interpreters
accessible for clients with limited English proficiency. A commercial telephone
interpreter service has
been shown to be as effective as an "in-person" interpreter. Relying on family members
or community
members may not be reliable and may jeopardize patient confidentiality. This interpreter
is answering for
the clients without hearing what they have to say, which can compromise care.
4. 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 :
,a. collectivism.
b. constructivism.
c. essentialism.
d. individualism. - ANS: C
An essentialist view of culture, which dominates the health care literature, portrays an
ethnic minority
group as having a static set of traits and oversimplifies cultural information, applying
traits to all members
of the group. Assuming that all people from Central America are Catholic is an example
of this
oversimplification. Collectivism refers to a member of an ethnic group who perceives
himself or herself
to be intrinsically part of that group. A constructive view recognizes culture as complex
and dynamic and
sees people as individuals who may belong to multiple cultures simultaneously.
Individualism recognizes
the individual, and not the group, as the basic unit of survival.
5. The primary care pediatric nurse practitioner cares for 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?
a. Ask about the types of practices used and when they are applied.
b. Provide a list of harmful herbs and ask the family to avoid those.
c. Suggest that the family avoid using these remedies in their children.
d. Tell the parents to use the herbs in conjunction with modern medications. - ANS: A
The challenge, when working with families from different cultural backgrounds, who use
alternative or
complementary medicines, is to find ways to achieve a mutual understanding of the
differences and to
negotiate an acceptable plan of care. The first step is to begin a discussion about these
practices.
Providing a list of harmful herbs, suggesting that the family avoid certain herbs, and
suggesting that the
herbs are only an adjunct to "modern medicine" will sound disparaging and will convey
a sense of
mistrust.
1. 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.
d. pollution. - ANS: C
, There is growing evidence that climate change is having a dramatic effect on food crops
that leads to food
distribution issues and food insecurity among families.
2. The primary care pediatric nurse practitioner understands that, to achieve the
greatest world-wide
reduction in child mortality from pneumonia and diarrhea, which intervention is most
effective?
a. Antibiotics
b. Optimal nutrition
c. Vaccinations
d. Water purification - ANS: C
Rotavirus is the most common cause of diarrhea globally and Strep pneumonia is the
leading cause of
pneumonia, and together these are the leading infectious causes of childhood morbidity
and mortality
globally. Both are vaccine-preventable diseases. Antibiotics to treat pneumonia, optimal
nutrition, and
clean water all help to reduce morbidity and mortality, but vaccination prevents the
diseases from
occurring.
3. 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 Pediatrics
Recommendations for
Preventive Pediatric Health Care guidelines by :
a. focusing less on development and more on illness prevention and nutrition.
b. following guidelines established by the Bright Futures publication.
c. scheduling well-baby visits to coincide with key developmental milestones.
d. seeing the infant at ages 2, 4, 6, and 12 months when immunizations are due. - ANS:
C
In the most recent AAP Recommendations for Preventive Pediatric Health Care, there is
a greater
emphasis on behavioral and developmental issues and a recommendation that well
child care be based on
child and family development rather than the periodicity of immunization schedules. This
will require a
revision of the current recommendations in Bright Futures.
4. Which is true about the health status of children in the United States?
a. Globalism has relatively little impact on child health measures in the U.S.
b. Obesity rates among 2- to 5-year-olds have shown a recent significant decrease.
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. - ANS:
B
