Deck 2: Child and Family Health Assessment

Question 1

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
D. Rule out type 2 diabetes mellitus

Answer 1

Obesity

Question 2

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?
A. CRAFFT
B. HEEADSSS
C. PHQ­2
D. RAAPS

Answer 2

CRAFFT

Question 3

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?
A. Failure to thrive
B. Home care resources inadequate
C. Nutrition alteration - less than required
D. Parenting alteration

Answer 3

Parenting alteration

Question 4

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
A. ask the parent to consider a possible speech delay and report any concerns.
B. continue to evaluate the child's speech at subsequent visits.
C. refer the child for a speech and hearing evaluation.
D. tell the parent to spend more time in interactive conversations with the child.

Question 5

The primary care pediatric nurse practitioner is evaluating health literacy in
the mother of a new preschool­age child. How will the nurse practitioner assess this?
A. Ask the child how many books he has at home.
B. Ask the mother about her highest grade in school.
C. Ask the mother to determine the correct dose of a drug from a label.
D. Ask the mother to read a health information handout aloud.

Question 6

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?
A. CRAFFT
B. Ecomap
C. Genogram
D. Pedigree

Question 7

When formulating developmental diagnoses for pediatric patients, the primary care pediatric nurse practitioner may use which resource?
A. DC: 0­3R
B. ICD­10­CM
C. ICSD­3
D. NANDA International

Question 8

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 pre­kindergarten physical and observes that the child is extremely anxious. What will the nurse practitioner do initially?
A. Ask the child's parent why the child is so anxious.
B. Perform a physical assessment to rule out shortness of breath.
C. Reassure the child that there is nothing to be afraid of.
D. Review the purpose of this visit and any anticipated procedures.

Question 9

The primary care pediatric nurse practitioner learns that the mother of a 3­
year­old 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?
A. Fine motor
B. Gross motor
C. Social/emotional
D. Speech and language

Question 10

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

Question 11

The mother of a newborn tells the primary care pediatric nurse practitioner
that she is worried that her child will develop allergies and asthma. Which tool will the nurse practitioner use to evaluate this risk?
A. Three­generation pedigree
B. Review of systems
C. Genogram
D. Ecomap

Question 12

The primary care pediatric nurse practitioner is performing a well child check­
up on a 20­month­old child. The child was 4 weeks premature and, according to a parent­ completed developmental questionnaire, has achieved milestones for a 15­month­old infant. Which action is correct?
A. Perform an in­depth developmental assessment screen at this visit to evaluate this child.
B. Reassure the parent that the child will catch up to normal development by age 2 years.
C. Re­evaluate this child's development and milestone achievements at the 2­year visit.
D. Refer the child to a specialty clinic for evaluation and treatment of developmental delay.

Question 13

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?
A. Administer a Childhood Autism Rating Scale (CARS) in the clinic.
B. Consult a specialist to determine appropriate early intervention strategies.
C. Refer the child to a behavioral specialist for further evaluation.
D. Tell the parent that this result indicates that the child has autism.

Question 14

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?
A. Altered elimination pattern
B. Elimination disorder
C. Encopresis
D. Parenting alteration